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Hyperglycemia in critical patient

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https://www.readbyqxmd.com/read/28728435/hyperglycemia-as-a-predictor-for-adverse-outcome-in-icu-patients-with-and-without-diabetes
#1
Simon Lebech Cichosz, Clara Schaarup
The aim of this study was to investigate hyperglycemia as a predictor for mortality and length of intensive care unit (ICU) stay in groups of patients with and without known diabetes. The present study examines data from 200 859 patients included in eICU Collaborative Research Database, a large multicenter critical care database. The results show that hyperglycemia among ICU patients without diabetes is strongly associated with adverse event. In comparison, hyperglycemia is not as strong among patients with diabetes...
July 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28725195/vitamin-e-as-a-potential-interventional-treatment-for-metabolic-syndrome-evidence-from-animal-and-human-studies
#2
REVIEW
Sok Kuan Wong, Kok-Yong Chin, Farihah Hj Suhaimi, Fairus Ahmad, Soelaiman Ima-Nirwana
A constellation of medical conditions inclusive of central obesity, hyperglycemia, hypertension, and dyslipidemia is known as metabolic syndrome (MetS). The safest option in curtailing the progression of MetS is through maintaining a healthy lifestyle, which by itself, is a long-term commitment entailing much determination. A combination of pharmacological and non-pharmacological approach, as well as lifestyle modification is a more holistic alternative in the management of MetS. Vitamin E has been revealed to possess anti-oxidative, anti-inflammatory, anti-obesity, anti-hyperglycemic, anti-hypertensive and anti-hypercholesterolemic properties...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28724042/hyperglycemia-in-critical-patients-determinants-of-insulin-dose-choice
#3
Aline Klitzke Paliosa, Cassiano Teixeira, Regis Goulart Rosa, Carine Raquel Blatt
Objective: To identify factors that can determine the choice of intermittent subcutaneous regular insulin dose in critically ill patients with hyperglycemia. Method: Cross-sectional study in a general adult ICU with 26 beds, data collected between September and October 2014. The variables analyzed were: sex, age, previous diagnosis of diabetes mellitus, use of corticosteroids, use of lactulose, sepsis, fasting, enteral nutrition, use of dextrose 5% in water, NPH insulin prescription and blood glucose level...
May 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28710409/machine-learning-algorithms-for-risk-prediction-of-severe-hand-foot-mouth-disease-in-children
#4
Bin Zhang, Xiang Wan, Fu-Sheng Ouyang, Yu-Hao Dong, De-Hui Luo, Jing Liu, Long Liang, Wen-Bo Chen, Xiao-Ning Luo, Xiao-Kai Mo, Lu Zhang, Wen-Hui Huang, Shu-Fang Pei, Bao-Liang Guo, Chang-Hong Liang, Zhou-Yang Lian, Shui-Xing Zhang
The identification of indicators for severe HFMD is critical for early prevention and control of the disease. With this goal in mind, 185 severe and 345 mild HFMD cases were assessed. Patient demographics, clinical features, MRI findings, and laboratory test results were collected. Gradient boosting tree (GBT) was then used to determine the relative importance (RI) and interaction effects of the variables. Results indicated that elevated white blood cell (WBC) count > 15 × 10(9)/L (RI: 4(9).47, p < 0...
July 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28708678/dysglycemia-glycemic-variability-and-outcome-after-cardiac-arrest-and-temperature-management-at-33%C3%A2-c-and-36%C3%A2-c
#5
Ola Borgquist, Matt P Wise, Niklas Nielsen, Nawaf Al-Subaie, Julius Cranshaw, Tobias Cronberg, Guy Glover, Christian Hassager, Jesper Kjaergaard, Michael Kuiper, Ondrej Smid, Andrew Walden, Hans Friberg
OBJECTIVES: Dysglycemia and glycemic variability are associated with poor outcomes in critically ill patients. Targeted temperature management alters blood glucose homeostasis. We investigated the association between blood glucose concentrations and glycemic variability and the neurologic outcomes of patients randomized to targeted temperature management at 33°C or 36°C after cardiac arrest. DESIGN: Post hoc analysis of the multicenter TTM-trial. Primary outcome of this analysis was neurologic outcome after 6 months, referred to as "Cerebral Performance Category...
August 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28698384/palmitic-acid-dysregulates-the-hippo-yap-pathway-and-inhibits-angiogenesis-by-inducing-mitochondrial-damage-and-activating-the-cytosolic-dna-sensor-cgas-sting-irf3-signaling
#6
Liangshuai Yuan, Yun Mao, Wei Luo, Weiwei Wu, Hao Xu, Xing Li Wang, Ying H Shen
Impaired angiogenesis and wound healing carry significant morbidity and mortality in diabetic patients. Metabolic stress from hyperglycemia and elevated free fatty acids have been shown to inhibit endothelial angiogenesis. However, the underlying mechanisms remain poorly understood. In this study, we show that dysregulation of the Hippo-YAP pathway, an important signaling in regulating tissue repair and regeneration, underlies palmitic acid (PA) -induced inhibition of endothelial angiogenesis. PA inhibited endothelial cell proliferation, migration and tube formation, which were associated with increased MST1 expression, YAP phosphorylation/inactivation and nuclear exclusion...
July 11, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28672010/fibroblasts-accelerate-islet-revascularization-and-improve-long-term-graft-survival-in-a-mouse-model-of-subcutaneous-islet-transplantation
#7
Marcos Perez-Basterrechea, Manuel Martinez Esteban, Maria Alvarez-Viejo, Tania Fontanil, Santiago Cal, Marta Sanchez Pitiot, Jesus Otero, Alvaro Jesus Obaya
Pancreatic islet transplantation has been considered for many years a promising therapy for beta-cell replacement in patients with type-1 diabetes despite that long-term clinical results are not as satisfactory. This fact points to the necessity of designing strategies to improve and accelerate islets engraftment, paying special attention to events assuring their revascularization. Fibroblasts constitute a cell population that collaborates on tissue homeostasis, keeping the equilibrium between production and degradation of structural components as well as maintaining the required amount of survival factors...
2017: PloS One
https://www.readbyqxmd.com/read/28637358/comparative-simulation-study-of-glucose-control-methods-designed-for-use-in-the-intensive-care-unit-setting-via-a-novel-controller-scoring-metric
#8
Jeremy DeJournett, Leon DeJournett
BACKGROUND: Effective glucose control in the intensive care unit (ICU) setting has the potential to decrease morbidity and mortality rates and thereby decrease health care expenditures. To evaluate what constitutes effective glucose control, typically several metrics are reported, including time in range, time in mild and severe hypoglycemia, coefficient of variation, and others. To date, there is no one metric that combines all of these individual metrics to give a number indicative of overall performance...
June 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28606340/cardiovascular-protection-in-the-treatment-of-type-2-diabetes-a%C3%A2-review-of-clinical-trial-results-across-drug-classes
#9
Francesco Paneni, Thomas F Lüscher
Patients with type 2 diabetes (T2DM) have a significantly higher risk of developing cardiovascular disease (CVD)-namely myocardial infarction, heart failure, and stroke. Despite clear advances in the prevention and treatment of CVD, the impact of T2DM on CVD outcome remains high and continues to escalate. Available evidence indicates that the risk of macrovascular complications increases with the severity of hyperglycemia, thus suggesting that the relation between metabolic disturbances and vascular damage is approximately linear...
July 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28545981/the-role-of-dyslipidemia-in-diabetic-retinopathy
#10
Sandra S Hammer, Julia V Busik
Diabetic retinopathy (DR) affects over 93million people worldwide and is the number one cause of blindness among working age adults. These indicators coupled with the projected rise of patients diagnosed with diabetes, makes DR a serious and prevalent vision threating disease. Data from recent clinical trials demonstrate that in addition to the well accepted role of hyperglycemia, dyslipidemia is an important, but often overlooked factor in the development of DR. The central aim of this review article is to showcase the critical role of dyslipidemia in DR progression as well as highlight novel therapeutic solutions that take advantage of the vital roles lipid metabolism plays in DR progression...
May 26, 2017: Vision Research
https://www.readbyqxmd.com/read/28528862/crocetin-restores-diabetic-endothelial-progenitor-cell-dysfunction-by-enhancing-no-bioavailability-via-regulation-of-pi3k-akt-enos-and-ros-pathways
#11
Wei Cao, Jinjin Cui, Shufeng Li, Donghui Zhang, Yibo Guo, Qiannan Li, Ying Luan, Xian Liu
AIMS: Endothelial progenitor cell (EPC) dysfunction underlies a critical risk factor in diabetic vascular complications due to function defect in restoring endothelium injury. Crocetin has attracted increasing attention in several vascular-related diseases. In present study, we aimed to explore the role of crocetin in diabetic EPC dysfunction. MAIN METHODS: EPCs were isolated from bone marrow in diabetic mice and identified using the fluorescence staining and flow cytometry...
May 18, 2017: Life Sciences
https://www.readbyqxmd.com/read/28526186/cardiovascular-protection-in-the-treatment-of-type-2-diabetes-a-review-of-clinical-trial-results-across-drug-classes
#12
REVIEW
Francesco Paneni, Thomas F Lüscher
Patients with type 2 diabetes (T2DM) have a significantly higher risk of developing cardiovascular disease (CVD)-namely myocardial infarction, heart failure, and stroke. Despite clear advances in the prevention and treatment of CVD, the impact of T2DM on CVD outcome remains high and continues to escalate. Available evidence indicates that the risk of macrovascular complications increases with the severity of hyperglycemia, thus suggesting that the relation between metabolic disturbances and vascular damage is approximately linear...
June 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28515940/nivolumab-induced-autoimmune-diabetes-mellitus-presenting-as-diabetic-ketoacidosis-in-a-patient-with-metastatic-lung-cancer
#13
James Luke Godwin, Shuchie Jaggi, Imali Sirisena, Pankaj Sharda, Ajay D Rao, Ranee Mehra, Colleen Veloski
BACKGROUND: Advances in cancer immunotherapy have generated encouraging results in multiple malignancies refractory to standard chemotherapies. As the use of immune checkpoint inhibitors (ICI) proliferates, the incidence of autoimmune side effects associated with these agents, termed immune related adverse events (irAE), is expected to increase. The frequency of significant irAE in ICI treated patients is about 10-20% and early recognition is critical to prevent serious morbidity and even mortality...
2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/28511644/relationship-between-glycemic-levels-and-treatment-outcome-among-critically-ill-children-admitted-into-emergency-room-in-enugu
#14
Nwachinemere Davidson Uleanya, Elias Chikee Aniwada, Ikenna Chidiebele Nwokoye, Ikenna Kingsley Ndu, Christopher Bismarck Eke
BACKGROUND: Critically ill children are those in need of immediate attention on arrival to an emergency room. The importance of glycemic level measurement as well as maintaining the patency of the airway, effective breathing and circulation cannot be overemphasied. It has been highlighted that the peak hyperglycemia and hypoglycemia predict poor prognosis, longer lengths of hospital stay and higher mortality. The study aims to assess the relationship between glycemic level and treatment outcomes as well as length of hospital stay...
May 16, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28504650/neutrophil-derived-s100-calcium-binding-proteins-a8-a9-promote-reticulated-thrombocytosis-and-atherogenesis-in-diabetes
#15
Michael J Kraakman, Man Ks Lee, Annas Al-Sharea, Dragana Dragoljevic, Tessa J Barrett, Emilie Montenont, Debapriya Basu, Sarah Heywood, Helene L Kammoun, Michelle Flynn, Alexandra Whillas, Nordin Mj Hanssen, Mark A Febbraio, Erik Westein, Edward A Fisher, Jaye Chin-Dusting, Mark E Cooper, Jeffrey S Berger, Ira J Goldberg, Prabhakara R Nagareddy, Andrew J Murphy
Platelets play a critical role in atherogenesis and thrombosis-mediated myocardial ischemia, processes that are accelerated in diabetes. Whether hyperglycemia promotes platelet production and whether enhanced platelet production contributes to enhanced atherothrombosis remains unknown. Here we found that in response to hyperglycemia, neutrophil-derived S100 calcium-binding proteins A8/A9 (S100A8/A9) interact with the receptor for advanced glycation end products (RAGE) on hepatic Kupffer cells, resulting in increased production of IL-6, a pleiotropic cytokine that is implicated in inflammatory thrombocytosis...
June 1, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28497374/the-effect-of-insulin-administration-on-c-peptide-in-critically-ill-patients-with-type-2-diabetes
#16
Marco Crisman, Luca Lucchetta, Nora Luethi, Luca Cioccari, Que Lam, Glenn M Eastwood, Rinaldo Bellomo, Johan Mårtensson
BACKGROUND: In critically ill patients with permissive hyperglycemia, it is uncertain whether exogenous insulin administration suppresses or enhances c-peptide secretion (a marker of pancreatic beta-cell response). We aimed to explore this effect in patients with type 2 diabetes. METHODS: We prospectively enrolled a cohort of 45 critically ill patients with type 2 diabetes managed according to a liberal glucose protocol (target blood glucose 10-14 mmol/l). We recorded the administration of insulin and oral hypoglycemic agents and measured plasma c-peptide as surrogate marker of endogenous insulin secretion on the first two consecutive days in ICU...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28495827/hyperbaric-oxygen-reduces-infarction-volume-and-hemorrhagic-transformation-through-atp-nad-sirt1-pathway-in-hyperglycemic-middle-cerebral-artery-occlusion-rats
#17
Qin Hu, Anatol Manaenko, Hetao Bian, Zongduo Guo, Jun-Long Huang, Zhen-Ni Guo, Peng Yang, Jiping Tang, John H Zhang
BACKGROUND AND PURPOSE: Energy depletion is a critical factor leading to cell death and brain dysfunction after ischemic stroke. In this study, we investigated whether energy depletion is involved in hyperglycemia-induced hemorrhagic transformation after ischemic stroke and determined the pathway underlying the beneficial effects of hyperbaric oxygen (HBO). METHODS: After 2-hour middle cerebral artery occlusion, hyperglycemia was induced by injecting 50% dextrose (6 mL/kg) intraperitoneally at the onset of reperfusion...
June 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28468528/improving-physical-health-of-patients-with-severe-mental-disorders-a-critical-review-of-lifestyle-psychosocial-interventions
#18
Corrado De Rosa, Gaia Sampogna, Mario Luciano, Valeria Del Vecchio, Benedetta Pocai, Giuseppina Borriello, Vincenzo Giallonardo, Micaela Savorani, Federica Pinna, Maurizio Pompili, Andrea Fiorillo
People with severe mental disorders have a mortality rate that is more than two times higher than the general population, with at least a decade of potential years of life lost. People with mental disorders have a significantly higher risk of obesity, hyperglycemia and metabolic syndrome, which are related to modifiable risk factors, such as heavy smoking, poor physical activities, and inappropriate unhealthy diet, which can be improved through lifestyle changes. Areas covered: Lifestyle behaviours are amenable to change through the adoption of specific psychosocial interventions, and several approaches have been promoted...
May 15, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28444346/resistant-starch-as-a-novel-dietary-strategy-to-maintain-kidney-health-in-diabetes-mellitus
#19
Gar Yee Koh, Matthew J Rowling
The worldwide prevalence of diabetes mellitus is expected to reach 439 million by 2030. Diabetes increases the risk for developing secondary complications such as nephropathy and cardiovascular disease, critical factors that dictate the survival rate of diabetes patients. Compelling evidence has indicated that the positive impact of fermentable carbohydrates in obesity-related diabetes is mediated by the production of short-chain fatty acids and the modulation of colonic microbiota. This review summarizes the potential implications of dietary resistant starch, a class of fermentable fiber, in glucose homeostasis and kidney health in obesity-associated diabetes and examines the mechanisms underlying the protective effect of resistant starch...
May 1, 2017: Nutrition Reviews
https://www.readbyqxmd.com/read/28437809/reactive-rather-than-proactive-diabetes-management-in-the-perioperative-period
#20
Inge Hommel, Petra J van Gurp, Alfons A den Broeder, Hub Wollersheim, Femke Atsma, Marlies E J L Hulscher, Cees J Tack
As perioperative hyperglycemia is associated with poor postoperative patient outcomes, clinical guidelines provide recommendations for optimal perioperative glucose control. It is unclear to what extent recommended glucose levels are met in daily practice, and little is known about factors that influence these levels. We describe blood glucose levels throughout the hospital care pathway in 375 non-critically ill patients with diabetes who underwent major surgery (abdominal, cardiac, or orthopedic) in 6 hospitals, examine determinants of these levels including adherence to 9 quality indicators for optimal perioperative diabetes care, and perform qualitative interviews to identify barriers for optimal care...
July 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
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