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diabetic intubation

Xiaoyu Kang, Lina Zhao, Zhiyong Zhu, Felix Leung, Limei Wang, Xiangping Wang, Hui Luo, Linhui Zhang, Tao Dong, Pingying Li, Zhangqin Chen, Gui Ren, Hui Jia, Xiaoyang Guo, Yanglin Pan, Xuegang Guo, Daiming Fan
OBJECTIVES: Split dose of 4 l polyethylene glycol (PEG) is currently the standard regimen for bowel preparation (BP). However, it may be unnecessary for patients without high risks (e.g., old age, constipation, and diabetes, and so on) for inadequate BP. The study aimed to compare the efficacy of bowel cleansing between low-risk patients receiving same-day, single dose of low-volume (SSL) PEG vs. standard regimen. METHODS: This prospective, randomized, observer-blinded, non-inferiority study enrolled low-risk patients in three centers...
March 13, 2018: American Journal of Gastroenterology
Arjun Agrawal, Rachael Snow, Erik Lehman, Faisal Aziz
OBJECTIVE: Despite advances in surgical techniques, ruptured abdominal aortic aneurysm (rAAA) remains associated with extremely high mortality. Several preoperative risk factors have been shown to predict poor prognosis after rAAA repair. Notably, a preoperative dependent functional status has previously been shown to be associated with poor outcomes after several vascular surgery procedures. The purpose of this study was to examine the effect of preoperative functional status on postoperative outcomes for patients undergoing repair of rAAA...
March 1, 2018: Journal of Vascular Surgery
Pooja Bhangui, Prashant Bhangui, Nikunj Gupta, Annu Sarin Jolly, Seema Bhalotra, Nishant Sharma, A S Soin, Vijay Vohra
Background and Aims: Fast tracking (FT) for more efficacious use of resources may be difficult after living donor liver transplantation (LDLT) due to a partial liver graft, complex vascular anastomoses and longer operating time. Our study was aimed at reporting our experience with FT (on table extubation) in LDLT recipients. A secondary objective of our study was to look at defining a subgroup of patients who could be prospectively planned for FT. Methods: We studied the demographics and outcomes of 15 LDLT recipients extubated immediately in the operating suite based on an uneventful intraoperative course, haemodynamic stability after graft reperfusion and improvement of metabolic parameters post-implantation and vascular anastomoses...
February 2018: Indian Journal of Anaesthesia
Ian C Bostock, Devin S Zarkowsky, Caitlin W Hicks, David H Stone, Mahmoud B Malas, Philip P Goodney
BACKGROUND: Time to discharge has decreased for aortic surgery since the advent of EVAR, partially due to improved perioperative management. We aimed to investigate outcomes and risk factors associated with prolonged intubation following EVAR. METHODS: The VSGNE database was queried to select all patients who underwent elective EVAR between 01/2003 and 12/2014. Patients who were not extubated in the operating room were classified as having prolonged intubation. Patients requiring prolonged intubation were compared to those extubated in the OR using t-test and chi-square statistics...
February 23, 2018: Annals of Vascular Surgery
Shatha Alharbi, Griffith Harsh, Abdulrazag Ajlan
OBJECTIVE: To evaluate lumbar drain (LD) efficacy in transnasal resection of pituitary macroadenomas in preventing postoperative cerebrospinal fluid (CSF) leak, technique safety, and effect on length of hospital stay. METHODS: We conducted a retrospective data review of pituitary tumor patients in our institution who underwent surgery between December 2006 and January 2013. All patients were operated on for complete surgical resection of pituitary macroadenoma tumors...
January 2018: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
Meriem Bensalah, Malcolm Donaldson, Yamina Aribi, Malek Iabassen, Lyes Cherfi, Mustapha Nebbal, Meriem Medjaher, ElMehdi Haffaf, Benaissa Abdennebi, Mustapha Guenane, Adel Djermane, Zahra Kemali, Samia OuldKablia
BACKGROUND: Biochemical diagnosis of adrenal insufficiency (AI) is difficult in the context of traumatic brain injury (TBI) AIM: to assess the frequency and predictive factors of AI in victims of TBI from Algiers. METHODS: Between November 2009 and December 2013, TBI victims had a single 8-9 a.m. serum cortisol measurement during the acute post injury period (0-7 days). AI was defined according to basal cortisol levels of 83, 276 and 414 nmol/L. Variables studied were TBI severity according to Glasgow coma scale, duration of intubation and coma, pupillary status, hypotension, anemia, brain imaging findings, diabetes insipidus and medication...
February 5, 2018: Clinical Endocrinology
Fátima R Oliveira, Victor H Oliveira, Ítalo M Oliveira, José W Lima, Daniela Calderaro, Danielle M Gualandro, Bruno Caramelli
BACKGROUND: Delirium is a common complication after cardiac surgery in older adult patients. However, risk factors and the influence of delirium on patient outcomes are not well established. We aimed to determine the incidence, predisposing and triggering factors of delirium following cardiac surgery. METHODS: One hundred seventy-three consecutive patients aged ≥60 years were studied. Patients' characteristics and two cognitive function assessment tests were recorded preoperatively...
February 1, 2018: BMC Anesthesiology
V Thiruvenkatarajan, J Jeyadoss, V Rao Kadam, L Y Du, W-M Liu, R M Van Wijk
The 'torsadogenic' property of a drug is linked to its ability to increase the transmural dispersion of repolarisation, represented by the interval between the peak of, and the end of, the T-wave (Tp-e interval) in an electrocardiogram. Reports have consistently shown that sevoflurane does not increase the Tp-e interval. Type 2 diabetes is a risk factor for increased QTc (rate-corrected QT interval), QTcd (rate-corrected QTc dispersion: difference between the maximum and the minimum QTc interval), and Tp-e, as well as the rate-corrected Tp-e (Tp-e/QTc ratio)...
January 2018: Anaesthesia and Intensive Care
Jeremy Zaworski, Pierre-Yves Delannoy, Nicolas Boussekey, Damien Thellier, Hugues Georges, Olivier Leroy
Background: Lithium poisoning could trigger multiple complications. We report the case of a lithium poisoning with five complications that are described for the first time together. Case report: A 60-year-old woman was admitted in our intensive care unit for altered consciousness. Severe lithium intoxication was diagnosed (lithium plasmatic level 8.21 mmol/l) associated with acute oliguric kidney failure. Continuous renal replacement therapy was started immediately...
2017: Journal of Intensive Care
Takushi Kohmoto, Satoru Osaki, Dixon B Kaufman, Glen Leverson, Nilto DeOliveira, Shahab A Akhter, Susan Ulschmid, Lucian Lozonschi, Entela B Lushaj
BACKGROUND: Cardiovascular disease is a cause of morbidity and mortality in organ transplant recipients. Cardiac surgery after organ transplantation is not uncommon in this population. We evaluated 30-day outcomes and long-term survival of abdominal transplant recipients undergoing cardiac surgery at our institution. METHODS: In all, 138 patients with previous kidney, kidney-pancreas, and liver transplants underwent cardiac surgery from 2000 to 2016. Propensity score (ratio 1:3) matched 115 abdominal transplant with 345 patients undergoing cardiac surgery without a history of abdominal transplant...
March 2018: Annals of Thoracic Surgery
Eleni Geladari, Vasilios Papademetriou, Hans Moore, David Lu
We present a 59-year-old black male with history of type-1 diabetes and alcohol abuse. Patient became critically ill after a 5-day period of burning throat discomfort. On arrival patient was lethargic, in cardiogenic shock with a blood pressure of 81/47mmHg. Immediate diagnoses included diabetic ketoacidosis, acute renal failure, and possible septic shock. He was intubated, resuscitated with intravenous fluids, maintained on three inotropic agents, and given empiric wide spectrum antibiotics. An ECG showed a new ST elevation MI and an echocardiogram showed severe LV dysfunction...
May 2, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Anca Orzan, Carmen Novac, Mihaela Mihu, Constantin Ionescu Tirgoviste, Mihaela Balgradean
The present case report aims to describe and discuss the approach for the management of difficult endotracheal intubation in an adult with Down syndrome undergoing cataract surgery. A 26-year-old female with Down syndrome and a validated diagnosis of cataract requiring surgery was examined in order to assess the degree of difficulty of endotracheal intubation. Patients with Down syndrome have characteristic craniofacial abnormalities which require a thorough pre-operative assessment to anticipate and prepare for a difficult endotracheal intubation...
June 2017: Mædica
Melanie J Winningham, Diogo C Haussen, Raul G Nogueira, David S Liebeskind, Wade S Smith, Helmi L Lutsep, Tudor G Jovin, Bin Xiang, Fadi Nahab
BACKGROUND: The use of periprocedural heparin has previously been reported to be safe and potentially beneficial during thrombectomy with older generation devices. We aimed to evaluate the safety and clinical outcomes of heparin use in the stent retriever era. METHODS: A post hoc analysis of the TREVO 2 trial was performed comparing baseline characteristics and clinical outcomes between patients who received (HEP+) and those who did not receive periprocedural heparin (HEP-) while undergoing MERCI or TREVO clot retrieval...
October 31, 2017: Journal of Neurointerventional Surgery
Kuo-Shao Sun, Ching-Fang Tsai, Solomon Chih-Cheng Chen, Wan-Chun Huang
BACKGROUND: Invasive pulmonary aspergillosis (IPA) has high mortality rate but prognostic factors are not well established. The aim of our study was to evaluate the trend in in-hospital mortality over a period of 11 years and identify factors affecting the clinical outcomes of patients with IPA. METHOD: We conducted a nationwide inpatient population study using data from the Taiwan National Health Insurance Research Database. A total of 407 IPA patients from 2002 to 2012 were included in the study...
2017: PloS One
Ashley M Morgan, R Claire Roden, Steven C Matson, Grant M Wallace, Hannah L H Lange, Andrea E Bonny
BACKGROUND: Although generally asymptomatic, severe Chlamydia trachomatis (C. trachomatis) infections have been documented. C. trachomatis has been associated with both myocarditis and sepsis. CASE: A 19-year-old female with type 1 diabetes mellitus developed sudden-onset mental status change and shock after resolution of diabetic ketoacidosis. Abdominal and pelvic imaging demonstrated uterine and adnexal inflammation, and pelvic exam confirmed a diagnosis of pelvic inflammatory disease...
October 13, 2017: Journal of Pediatric and Adolescent Gynecology
Lingling Zhao, Qianru Gu, Lanting Xiang, Xidan Dong, Huimin Li, Jinyao Ni, Li Wan, Guoping Cai, Guorong Chen
SCOPE: The present study was designed to examine the damage caused by high-fat diet and streptozotocin-induced diabetes on the testis of rats and the effects of curcumin against oxidative stress and apoptosis from high-fat diet and diabetes. METHODS: Diabetes was induced by intraperitoneal injection of streptozotocin (30 mg/kg in 0.1 M sodium citrate buffer, pH 4.5) in obese rats. The rats in the obese and diabetic groups were treated with a daily dose of curcumin by intragastric intubation (100 mg/kg body weight) for 8 weeks...
2017: Therapeutics and Clinical Risk Management
Wendy Gerstein, Ziyang Liu
BACKGROUND: A significant percentage of elderly patients suffer from both polypharmacy and visual impairment. This combination can increase the risk of an adverse event related to medication. This case highlights an unusual, but potentially deadly, medication adverse event. CASE PRESENTATION: A 77-year-old male, visually impaired, ingested a pill desiccant, believing it was the ampicillin/sulbactam tablet he was prescribed for an infected diabetic foot ulcer. He presented to the emergency room with inability to swallow, and imaging revealed the pill desiccant lodged in his upper esophagus...
July 28, 2017: BMC Geriatrics
Pieter Francsois Fouche, Paul Andrew Jennings, Karen Smith, Malcolm Boyle, Gabriel Blecher, Jonathan Knott, Mani Raji, Pamela Rosengarten, Michael Roberto Augello, Stephen Bernard
INTRODUCTION: Rapid sequence intubation (RSI) is not only used in traumatic brain injuries in the out-of-hospital setting, but also for non-traumatic brain pathologies (NTBP) such as brain tumors, meningitis, encephalitis, hypoxic/anoxic brain injury, stroke, arteriovenous malformations, tumors, aneurysms, brain hemorrhage, as well as brain injury due to diabetes, seizures and toxicity, metabolic conditions, and alcohol and drug overdose. Previous research suggests that RSI is common in non-traumatic coma, but with an unknown prevalence of NTBP in those that receive RSI...
November 2017: Prehospital Emergency Care
Eirini Martinou, Piers Gatenby
A 70-year-old female patient presented with acute severe respiratory distress at a district general hospital. Medical history included type 2 diabetes, recurrent pulmonary embolisms and pre-existing diaphragmatic hernia containing part of the liver. Despite initial treatment with steroid inhalers, her clinical picture rapidly deteriorated requiring emergency intubation and positive pressure ventilation. Imaging investigations revealed tension enterothorax and hepatothorax with tracheal deviation. The patient was transferred and underwent an emergency laparotomy at the Regional Oesophagogastric Unit...
June 14, 2017: BMJ Case Reports
Hiroki Taenaka, Sho Carl Shibata, Kenta Okitsu, Takeshi Iritakenishi, Tatsuyuki Imada, Akinori Uchiyama, Yuji Fujino
BACKGROUND: Vocal cord paralysis (VCP) is a rare complication of thoracic cardiovascular surgery. In severe cases, life-threatening airway obstruction may occur. OBJECTIVE: To evaluate the incidence and severity of VCP among patients who underwent thoracic cardiovascular surgery and to identify possible risk factors. DESIGN: Single-centre retrospective review of adult patients. SETTING: Osaka University Hospital, Suita, Japan, from January 2013 to August 2015...
July 2017: European Journal of Anaesthesiology
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