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https://www.readbyqxmd.com/read/28202439/variable-reliability-of-surrogate-measures-of-insulin-sensitivity-after-roux-en-y-gastric-bypass
#1
Kirstine N Bojsen-Moller, Carsten Dirksen, Maria S Svane, Nils B Jørgensen, Jens J Holst, Erik A Richter, Sten Madsbad
Roux-en-Y gastric bypass (RYGB) induces weight loss and improves insulin sensitivity when evaluated by the hyperinsulinemic-euglycemic clamp (HEC). Surrogate indices of insulin sensitivity calculated from insulin and glucose concentrations at fasting or after an oral glucose tolerance test (OGTT) are frequently used, but have not been validated after RYGB. Our aim was to evaluate whether surrogate indices reliably estimate changes in insulin sensitivity after RYGB. Four fasting (inverse-HOMA-IR, HOMA2-%S, QUICKI, revised-QUICKI) and three OGTT-derived surrogates (Matsuda, Gutt, OGIS) were compared with HEC-estimated peripheral insulin sensitivity (Rd or Rd/I, depending on how the index was originally validated) and the tracer-determined hepatic insulin sensitivity index (HISI) in patients with preoperative type 2 diabetes (n=10) and normal glucose tolerance (n=10) 1 week, 3 months and 1 year postoperatively...
February 15, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28202005/impact-of-gut-hormone-fgf-19-on-type-2-diabetes-and-mitochondrial-recovery-in-a-prospective-study-of-obese-diabetic-women-undergoing-bariatric-surgery
#2
Lucia Martinez de la Escalera, Ioannis Kyrou, Jana Vrbikova, Voitech Hainer, Petra Sramkova, Martin Fried, Milan K Piya, Sudhesh Kumar, Gyanendra Tripathi, Philip G McTernan
BACKGROUND: The ileal-derived hormone, fibroblast growth factor 19 (FGF-19), may promote weight loss and facilitate type-2 diabetes mellitus remission in bariatric surgical patients. We investigated the effect of different bariatric procedures on circulating FGF-19 levels and the resulting impact on mitochondrial health in white adipose tissue (AT). METHODS: Obese and type-2 diabetic women (n = 39, BMI > 35 kg/m(2)) undergoing either biliopancreatic diversion (BPD), laparoscopic greater curvature plication (LGCP), or laparoscopic adjustable gastric banding (LAGB) participated in this ethics approved study...
February 16, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28199805/bariatric-surgery-versus-intensive-medical-therapy-for-diabetes-5-year-outcomes
#3
Philip R Schauer, Deepak L Bhatt, John P Kirwan, Kathy Wolski, Ali Aminian, Stacy A Brethauer, Sankar D Navaneethan, Rishi P Singh, Claire E Pothier, Steven E Nissen, Sangeeta R Kashyap
Background Long-term results from randomized, controlled trials that compare medical therapy with surgical therapy in patients with type 2 diabetes are limited. Methods We assessed outcomes 5 years after 150 patients who had type 2 diabetes and a body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) of 27 to 43 were randomly assigned to receive intensive medical therapy alone or intensive medical therapy plus Roux-en-Y gastric bypass or sleeve gastrectomy. The primary outcome was a glycated hemoglobin level of 6...
16, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28196240/metabolic-surgery-in-the-treatment-algorithm-for-type-2-diabetes-a-joint-statement-by-international-diabetes-organizations
#4
Juan P Brito, Victor M Montori, Andrew M Davis
No abstract text is available yet for this article.
February 14, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28196056/effect-of-an-intravitreal-dexamethasone-implant-on-diabetic-macular-edema-after-cataract-surgery
#5
Pilar Calvo, Antonio Ferreras, Fadwa Al Adel, Wantanee Dangboon, Michael H Brent
PURPOSE: To analyze the effects of a dexamethasone intravitreal implant (DEX; Ozurdex 700 μg; Allergan) administered immediately after cataract surgery in diabetic patients. METHODS: This prospective, single-arm, open label study (NCT01748487 at ClinicalTrials.gov) involved Type 2 diabetic patients with at least mild diabetic retinopathy (DR) who underwent cataract surgery and DEX insertion after phacoemulsification, and intraocular lens implantation were enrolled...
February 10, 2017: Retina
https://www.readbyqxmd.com/read/28195942/preoperative-hemoglobin-a1c-and-the-occurrence-of-atrial-fibrillation-following-on-pump-coronary-artery-bypass-surgery-in-type-2-diabetic-patients
#6
Shahin Abbaszadeh, Akbar Shafiee, Payvand Bina, Arash Jalali, Saeed Sadeghian, Abbasali Karimi
BACKGROUND: We investigated the association of the preoperative hemoglobin A1c (HbA1c) with occurrence of postoperative atrial fibrillation (POAF) in type-2 diabetic patients who underwent isolated coronary artery bypass grafting. METHODS: We prospectively studied 708 type-2 diabetes patients [433 men ([61.2%)], candidate for isolated coronary artery bypass grafting. Biochemistry profile was measured on the day of operation. All patients were telemonitored for 72 hours after operation for the occurrence of atrial fibrillation...
March 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28193516/metabolic-and-bariatric-surgery-for-obesity
#7
Josep Vidal, Ricard Corcelles, Amanda Jiménez, Lílliam Flores, Antonio M Lacy
Metabolic and bariatric surgery (MBS) leads to weight loss in obese individuals and reduces comorbidities such as type 2 diabetes. MBS is superior to medical therapy in reducing hyperglycemia in persons with type 2 diabetes, and has been associated with reduced mortality and incidences of cardiovascular events and cancer in obese individuals. New guidelines have been proposed for the use of MBS in persons with type 2 diabetes. We review the use of MBS as a treatment for obesity and obesity-related conditions and, based on recent evidence, propose health care systems make the appropriate changes to increase accessibility for eligible patients...
February 10, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28191539/management-of-hospitalized-type-2-diabetes-mellitus-patients
#8
Juan José Marín-Peñalver, Iciar Martín-Timón, Francisco Javier Del Cañizo-Gómez
Both hyperglycemia and hypoglycemia in hospitalized patients are associated with adverse outcomes including increased rates of infection, longer hospital length of stay, and even death. Clinical trials in patients with type 2 diabetes mellitus proved that by improving glycemic control, we can reduce all of them. Insulin is the preferred treatment for glycemic control in most cases, but alternative treatment options that can normalize blood glucose levels without hypoglycemia are being sought. Moreover, hospitalized patients are particularly vulnerable to severe, prolonged hypoglycemia since they may be unable to sense or respond to the early warning signs and symptoms of low blood glucose...
December 1, 2016: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28191525/obesity-diabetes-and-the-role-of-bile-acids-in-metabolism
#9
Gerald H Tomkin, Daphne Owens
Bile acids have many activities over and above their primary function in aiding absorption of fat and fat soluble vitamins. Bile acids are synthesized from cholesterol, and thus are involved in cholesterol homeostasis. Bile acids stimulate glucagon-like peptide 1 (GLP1) production in the distal small bowel and colon, stimulating insulin secretion, and therefore, are involved in carbohydrate and fat metabolism. Bile acids through their insulin sensitising effect play a part in insulin resistance and type 2 diabetes...
June 1, 2016: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28183788/prognostic-factors-in-ectopic-cushing-s-syndrome-due-to-neuroendocrine-tumors-a-multicenter-study
#10
Maria Vittoria Davi', Elisa Cosaro, Serena Piacentini, Giuseppe Reimondo, Nora Albiger, Giorgio Arnaldi, Antongiulio Faggiano, Giovanna Mantovani, Nicola Fazio, Alessandro Piovesan, Emanuela Arvat, Franco Grimaldi, Letizia Canu, Massimo Mannelli, Alberto Giacinto Ambrogio, Francesca Pecori Giraldi, Chiara Martini, Andrea Lania, Manuela Albertelli, Diego Ferone, Maria Chiara Zatelli, Davide Campana, Annamaria Colao, Carla Scaroni, Massimo Terzolo, Laura De Marinis, Sara Cingarlini, Rocco Micciolo, Giuseppe Francia
OBJECTIVE: Evidence is limited regarding outcome of patients with ectopic Cushing's syndrome (ECS) due to neuroendocrine tumors (NETs). DESIGN: We assessed the prognostic factors affecting the survival of patients with NETs and ECS. METHODS: Retrospective analysis of clinicopathological features, severity of hormonal syndrome, treatments from a large cohort of patients with NETs and ECS collected from 17 Italian centers. RESULTS: Our series included 110 patients, 58...
April 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28183563/effect-of-basal-insulin-dosage-on-blood-glucose-concentration-in-ambulatory-surgery-patients-with-type-2-diabetes
#11
Linda J Demma, Karen T Carlson, Elizabeth W Duggan, John Gordon Morrow, Guillermo Umpierrez
STUDY OBJECTIVE: Among patients with type 2 diabetes treated with insulin, perioperative hyperglycemia and hypoglycemia may cause undesirable symptoms, surgery delay or cancellation, or unexpected hospitalization. Our objective was to compare preoperative glargine dosing regimens on perioperative glycemic control in patients undergoing ambulatory surgery. DESIGN: Observational study. SETTING: Pre- and postoperative holding areas. PATIENTS: One hundred fifty patients with type 2 diabetes using a once daily, evening insulin glargine regimen undergoing ambulatory surgery were included...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28181933/severe-intraoperative-hyperglycemia-is-independently-associated-with-postoperative-composite-infection-after-craniotomy-an-observational-study
#12
Shaun E Gruenbaum, Laura Toscani, Kenneth M Fomberstein, Keith J Ruskin, Feng Dai, Ega Qeva, Giovanni Rosa, Lingzhong Meng, Federico Bilotta
BACKGROUND: Postoperative infection after craniotomy carries an increased risk of morbidity and mortality. Identification and correction of the risk factors should be prioritized. The association of intraoperative hyperglycemia with postoperative infections in patients undergoing craniotomy is inadequately studied. METHODS: A total of 224 patients were prospectively enrolled in 2 major medical centers to assess whether severe intraoperative hyperglycemia (SIH, blood glucose ≥180 mg/dL) is associated with an increased risk of postoperative infection in patients undergoing craniotomy...
February 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28176218/evaluation-of-metabolic-syndrome-in-morbidly-obese-patients-submitted-to-laparoscopic-bariatric-surgery-comparison-of-the-results-between-roux-en-y-gastric-bypass-and-sleeve-gastrectomy
#13
Rodrigo Koprovski Menguer, Antônio Carlos Weston, Helena Schmid
BACKGROUND: Morbid obesity is a state of insulin resistance combined with excess of visceral fat, which contributes to the development of metabolic syndrome (MetS). Nonsurgical treatment of obesity usually improves MetS, but there is no ultimate resolution and weight regain is common. Surgical options like Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) result in a significant and sustained weight loss accompanied by improvement of MetS. The aim of this study was to compare the weight loss and improvement of MetS parameters between degree II and III obese patients with MetS undergoing RYGB or SG in a period of 12 months...
February 7, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28168134/ocular-inflammatory-disease-as-a-predictor-for-in-hospital-mortality-in-patients-hospitalized-with-disseminated-tuberculosis
#14
Salil Mehta
AIM: To ascertain whether the presence of ocular inflammatory disease is a predictor for death in patients hospitalized with disseminated tuberculosis. METHODS: This is an IRB-approved retrospective study of patients admitted with a diagnosis of disseminated tuberculosis within a seven-year period (2002-2009). The following data was collected from each record: age, sex, details of previous surgeries or therapy, the findings of anterior segment examination, the findings of dilated indirect ophthalmoscopy, systemic findings, investigations done, treatment rendered, and final status (died or discharged)...
January 5, 2017: Curēus
https://www.readbyqxmd.com/read/28166744/effect-of-large-weight-reductions-on-measured-and-estimated-kidney-function
#15
Bernt Johan von Scholten, Frederik Persson, Maria S Svane, Tine W Hansen, Sten Madsbad, Peter Rossing
BACKGROUND: When patients experience large weight loss, muscle mass may be affected followed by changes in plasma creatinine (pCr). The MDRD and CKD-EPI equations for estimated GFR (eGFR) include pCr. We hypothesised that a large weight loss reduces muscle mass and pCr causing increase in eGFR (creatinine-based equations), whereas measured GFR (mGFR) and cystatin C-based eGFR would be unaffected if adjusted for body surface area. METHODS: Prospective, intervention study including 19 patients...
February 6, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28163299/a-rare-case-of-acute-phlegmonous-esophagogastritis-complicated-with-hypopharyngeal-abscess-and-esophageal-perforation
#16
Yuan-Chun Huang, Ching-Yuan Cheng, Chiung-Ying Liao, Ching Hsueh, Yeu-Sheng Tyan, Shang-Yun Ho
BACKGROUND Acute phlegmonous esophagogastritis is a life-threatening disease that may be combined with serious complications. We present the classical radiological and endoscopic features and treatment strategy of a middle-aged female patient suffering from acute phlegmonous esophagogastritis complicated with hypopharyngeal abscess, esophageal perforation, mediastinitis, and empyema. CASE REPORT A 60-year-old Taiwanese female presented at our hospital due to fever, fatigue, painful swallowing, and vague chest pain for 5 days...
February 6, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28158300/impact-of-diabetes-mellitus-on-clinical-outcomes-of-pancreatic-cancer-after-surgical-resection-a-systematic-review-and-meta-analysis
#17
Xinghua Lv, Wenhui Qiao, Yufang Leng, Lupeng Wu, Yanming Zhou
BACKGROUND AND OBJECTIVE: Diabetes mellitus (DM) is a risk factor for pancreatic cancer but its impact on postoperative outcomes and long-term survival after cancer resection remains controversial. A meta-analysis of published studies was conducted to address this issue. METHODS: An extensive electronic search of four databases was performed for relevant articles. Data were processed for meta-analysis using Review Manager version 5.1. RESULTS: Seventeen observational studies involving 5407 patients were subjected to the analysis...
2017: PloS One
https://www.readbyqxmd.com/read/28157428/incidence-of-biliary-reflux-esophagitis-after-laparoscopic-omega-loop-gastric-bypass-in-morbidly-obese-patients
#18
Tamer M Said Salama, Mohamed Ibrahim Hassan
BACKGROUND: Omega loop gastric bypass is a successful bariatric surgery with numerous favorable circumstances as being basic, effective on weight reduction and treatment of obesity associated metabolic disorder, the short expectation to learn and adapt, and the simplicity of correction and inversion. However, there are arguments about the possibility of biliary reflux and/or the potential danger of gastroesophageal malignancy after the procedure. METHODS: Fifty patients experiencing morbid obesity with body mass index >40 or >35 kg/m(2) with two related comorbidities, for example, diabetes type II, hypertension, or dyslipidemia, underwent omega loop gastric bypass with a follow-up period up to 18 months, investigating for any symptom of reflux infection by upper gastrointestinal tract endoscopy and pH metry...
February 3, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28153376/predictors-of-postoperative-outcomes-of-cubital-tunnel-syndrome-treatments-using-multiple-logistic-regression-analysis
#19
Taku Suzuki, Takuji Iwamoto, Kanae Shizu, Katsuji Suzuki, Harumoto Yamada, Kazuki Sato
BACKGROUND: This retrospective study was designed to investigate prognostic factors for postoperative outcomes for cubital tunnel syndrome (CubTS) using multiple logistic regression analysis with a large number of patients. METHODS: Eighty-three patients with CubTS who underwent surgeries were enrolled. The following potential prognostic factors for disease severity were selected according to previous reports: sex, age, type of surgery, disease duration, body mass index, cervical lesion, presence of diabetes mellitus, Workers' Compensation status, preoperative severity, and preoperative electrodiagnostic testing...
January 30, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28148559/risk-of-hypertension-among-first-time-symptomatic-kidney-stone-formers
#20
Wonngarm Kittanamongkolchai, Kristin C Mara, Ramila A Mehta, Lisa E Vaughan, Aleksandar Denic, John J Knoedler, Felicity T Enders, John C Lieske, Andrew D Rule
BACKGROUND AND OBJECTIVES: Prior work has suggested a higher risk of hypertension in kidney stone formers but lacked disease validation and adjustment for potential confounders. Certain types of stone formers may also be at higher risk of hypertension. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In our study, incident symptomatic stone formers in Olmsted County from 2000 to 2011 were manually validated by chart review and age and sex matched to Olmsted County controls...
February 1, 2017: Clinical Journal of the American Society of Nephrology: CJASN
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