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Hyperglycemia in hospital

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https://www.readbyqxmd.com/read/29237289/safely-converting-an-entire-academic-medical-center-from-sliding-scale-to-basal-bolus-insulin-via-implementation-of-the-eglycemic-management-system
#1
Rosalina Newsom, Christopher Patty, Emma Camarena, Regina Sawyer, Raymie McFarland, Thomas Gray, Melanie Mabrey
OBJECTIVE: Hyperglycemia is common in the inpatient setting and providers frequently rely on sliding scale insulin. This case study reviews the experience of one hospital moving from high utilization of sliding scale to basal bolus insulin therapy. METHOD: This Retrospective Quality Improvement Study describes the journey of clinicians at a 580-bed hospital to convert from high usage of SSI to BBI. Hyperglycemic adult patients prescribed insulin, with/without a diagnosis of diabetes, were included...
December 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29237288/the-effect-of-continuous-glucose-monitoring-in-preventing-inpatient-hypoglycemia-in-general-wards-the-glucose-telemetry-system
#2
Elias K Spanakis, David L Levitt, Tariq Siddiqui, Lakshmi G Singh, Lillian Pinault, John Sorkin, Guillermo E Umpierrez, Jeffrey C Fink
BACKGROUND: Few studies have examined the use of continuous glucose monitoring (CGM) devices in the general wards. The aim of this pilot study was to examine whether CGM readings can be successfully transmitted from the bedside to a central monitoring device in the nursing station, and whether a glucose telemetry system can prevent hypoglycemic events. METHODS: We present pilot data on 5 consecutive insulin treated general medicine patients with type 2 diabetes (T2DM) whose glucose values were observed with CGM (DEXCOM) and the results were transmitted to a central nursing station monitoring system using DEXCOM Follow and Share 2 software...
December 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29232673/association-between-urinary-alpha1-microglobulin-levels-and-nonalcoholic-fatty-liver-disease-a-cross-sectional-study
#3
Juanwen Zhang, Xuyao Zhang, Ying Zhao, Guocai Lv
BACKGROUND: We aimed to explore the association between urinary alpha1-microglobulin (A1M) levels and nonalcoholic fatty liver disease (NAFLD) in a Chinese population. STUDY: We performed a cross-sectional study among 2,215 Chinese who attended their annual health examination at First Affiliated Hospital, College of Medicine, Zhejiang University. Urinary A1M-creatinine ratio and other clinical and laboratory parameters were measured. RESULTS: A total of 20...
December 12, 2017: Annals of Nutrition & Metabolism
https://www.readbyqxmd.com/read/29223421/a-prospective-multi-institutional-cohort-study-of-mediastinal-infections-after-cardiac-operations
#4
Louis P Perrault, Katherine A Kirkwood, Helena L Chang, John C Mullen, Brian C Gulack, Michael Argenziano, Annetine C Gelijns, Ravi K Ghanta, Bryan A Whitson, Deborah L Williams, Nancy M Sledz-Joyce, Brian Lima, Giampaolo Greco, Nishit Fumakia, Eric A Rose, John D Puskas, Eugene H Blackstone, Richard D Weisel, Michael E Bowdish
BACKGROUND: Mediastinal infections are a potentially devastating complication of cardiac operations. This study analyzed the frequency, risk factors, and perioperative outcomes of mediastinal infections after cardiac operations. METHODS: In 2010, 5,158 patients enrolled in a prospective study evaluating infections after cardiac operations and their effect on readmissions and mortality for up to 65 days after the procedure. Clinical and demographic characteristics, operative variables, management practices, and outcomes were compared for patients with and without mediastinal infections, defined as deep sternal wound infection, myocarditis, pericarditis, or mediastinitis...
December 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29218822/european-academy-of-neurology-european-stroke-organisation-consensus-statement-and-practical-guidance-for-pre-hospital-management-of-stroke
#5
A Kobayashi, A Czlonkowska, G A Ford, A C Fonseca, G J Luijckx, J Korv, N Pérez de la Ossa, C Price, D Russell, A Tsiskaridze, M Messmer-Wullen, J De Keyser
Reduction of delay between onset and hospital arrival and adequate pre-hospital care of persons with acute stroke are important for improving chances of a favorable outcome. The objective is to recommend evidence-based practices for the management of patients with suspected stroke in the pre-hospital setting. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to define the key clinical questions. An expert panel then reviewed the literature, established the quality of the evidence, and made recommendations...
December 7, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29218064/non-diabetic-hyperglycemia-and-some-of-its-correlates-in-icu-hospitalized-patients-receiving-enteral-nutrition
#6
Mohammad Amin Valizadeh Hasanloei, Zahra Vahdat Shariatpanahi, Davoud Vahabzadeh, Zakaria Vahabzadeh, Leila Nasiri, Ali Shargh
Introduction: Hyperglycemia is a common occurrence in critically ill patients, and its prevalence in patients receiving nutritional support is much higher than in other patients. The non-diabetic form is associated with more undesirable outcomes. This study was performed to determine the prevalence of non-diabetic hyperglycemia and its correlates in patients receiving enteral nutrition. Material and Methods: This cross-sectional study was performed between March and December 2015...
September 2017: Mædica
https://www.readbyqxmd.com/read/29217372/acute-peritoneal-dialysis-in-neonatal-intensive-care-unit-an-8-year-experience-of-a-referral-hospital
#7
Aslihan Kara, Metin Kaya Gurgoze, Mustafa Aydin, Erdal Taskin, Unal Bakal, Aysen Orman
BACKGROUND: The aim of present study was to evaluate the indications, complications and outcomes of acute peritoneal dialysis (APD) in neonates at a referral university hospital during the previous 8 years. METHODS: This retrospective analysis included a total of 52 newborn infants who underwent APD in a neonatal intensive care unit between January 2008 and March 2016. Demographic, clinical, laboratory and microbiological data were extracted from patients' medical files...
November 16, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29216950/-effect-of-early-enteral-nutrition-standardized-treatment-on-blood-glucose-and-prognosis-in-acute-respiratory-distress-syndrome-patients-with-mechanical-ventilation
#8
Chunmiao Zhong, Chaohui Ji, Zhuquan Dai, Kai Fu, Xiaohong Wen, Huibin Pan
OBJECTIVE: To study the effect of early entreat nutrition (EN) standardized treatment on optimization of blood glucose control and prognosis in acute respiratory distress syndrome (ARDS) patients with mechanical ventilation (MV). METHODS: Forty-two patients with MV of ARDS admitted to Huzhou First Municipal People's Hospital from April 2015 to March 2017 were enrolled. April 1st, 2016 was taken as the time node, the patients treated from April 1st, 2015 to March 31st, 2016 were assigned in the control group (n = 20), while the patients treated from April 1st, 2016 to March 31st, 2017 were included in the experimental group (n = 22)...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29215581/stress-induced-hyperglycemia-in-diabetes-a-cross-sectional-analysis-to-explore-the-definition-based-on-the-trauma-registry-data
#9
Cheng-Shyuan Rau, Shao-Chun Wu, Yi-Chun Chen, Peng-Chen Chien, Hsiao-Yun Hsieh, Pao-Jen Kuo, Ching-Hua Hsieh
Background: The diagnosis of diabetic hyperglycemia (DH) does not preclude a diabetes patient from having a stress-induced hyperglycemic response. This study aimed to define the optimal level of elevated glucose concentration for determining the occurrence of stress-induced hyperglycemia (SIH) in patients with diabetes. Methods: This retrospective study reviewed the data of all hospitalized trauma patients, in a Level I trauma center, from 1 January 2009 to 31 December 2016. Only adult patients aged ≥20 years, with available data on serum glucose and glycated hemoglobin A1c (HbA1c) levels upon admission, were included in the study...
December 7, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29208515/effectiveness-of-sitagliptin-in-a-patient-with-late-dumping-syndrome-after-total-gastrectomy
#10
Kotomi Kurihara, Anna Tamai, Yoko Yoshida, Yosuke Yakushiji, Hiroki Ueno, Mariko Fukumoto, Masayuki Hosoi
An 83-year-old man developed hypoglycemia after undergoing total gastrectomy for gastric cancer in 200X-4. The patient was admitted to our hospital in May 200X and placed on continuous glucose monitoring (CGM). Glycemic excursions were examined while on 3-meal/day (1700kcal) and 6-meal/day (1800kcal) diets. Oxyhyperglycemia followed about 2h later by a sudden drop in glucose levels was seen with both regimens. These findings were consistent with late dumping syndrome. CGM was continued, oral miglitol at 150mg/day or sitagliptin at 50mg/day was started, and glycemic excursions were compared...
November 29, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/29204757/prevalence-of-comorbidities-and-evaluation-of-screening-in-chinese-patients-with-spondyloarthritis
#11
Yutong Jiang, Pingping Zhang, Liudan Tu, Qing Lv, Jun Qi, Zhiming Lin, Zetao Liao, Shuangyan Cao, Jieruo Gu
The aim of the study was to determine whether the presence of spondyloarthritis (SpA) is associated with particular comorbidities and evaluate the prevalence of comorbidities, risk factors, and monitoring status in China. Three hundred forty-six patients fulfilling ASAS criteria for SpA were recruited from the Third Affiliated Hospital of Sun Yat-sen University. The prevalence of comorbidities and percentage of patients optimally monitored for comorbidities were calculated. The most frequent comorbidities were osteoporosis (31...
December 4, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/29203688/antihyperglycemic-agents-are-inversely-associated-with-intracranial-aneurysm-rupture
#12
Anil Can, Victor M Castro, Sheng Yu, Dmitriy Dligach, Sean Finan, Vivian S Gainer, Nancy A Shadick, Guergana Savova, Shawn Murphy, Tianxi Cai, Scott T Weiss, Rose Du
BACKGROUND AND PURPOSE: Previous studies have suggested a protective effect of diabetes mellitus on aneurysmal subarachnoid hemorrhage risk. However, reports are inconsistent, and objective measures of hyperglycemia in these studies are lacking. Our aim was to investigate the association between aneurysmal subarachnoid hemorrhage and antihyperglycemic agent use and glycated hemoglobin levels. METHODS: The medical records of 4701 patients with 6411 intracranial aneurysms, including 1201 prospective patients, diagnosed at the Massachusetts General Hospital and Brigham and Women's Hospital between 1990 and 2016 were reviewed and analyzed...
December 4, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29190873/-segmental-portal-hypertension-with-splenic-vein-thrombosis-caused-by-pancreatitis
#13
Luis Franco-Avilés, Federico I Hernández-Rocha, Ulises Mercado, Cristian G Malvido-Torres
BACKGROUND: Splenic vein thrombosis is a complication of pancreatic carcinoma, pancreatitis or pancreatic pseudocyst. It may lead to segmental portal hypertension and bleeding from gastric varices. CLINICAL CASE: A 31 year-old man was diagnosed with pancreatitis of two weeks of evolution and was referred to our hospital in 2013. He had a history of alcohol consumption. Physical examination showed no stigmata of liver cirrhosis. Laboratory analyses revealed hemoglobin 9...
November 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/29188429/spike-in-glucose-levels-after-reperfusion-during-aortic-surgery-assessment-by-continuous-blood-glucose-monitoring-using-artificial-endocrine-pancreas
#14
Koji Kawahito, Hirotaka Sato, Mamoru Kadosaki, Atsushi Egawa, Yoshio Misawa
OBJECTIVES: Although strict blood glucose control during cardiovascular surgery is essential to avoid postoperative complications, the various changes in glucose levels that occur during surgery have not been investigated in detail. In this study, we continuously monitored blood glucose changes during aortic surgery using the STG-55Ⓡ artificial endocrine pancreas (Nikkiso Inc., Tokyo). METHODS: Between December 2015 and 2016, we performed continuous blood glucose monitoring in 22 patients (14 men and 8 women, 72 ± 11 years old), who required hypothermic circulatory arrest during an ascending/aortic arch surgery, at the Jichi Medical University Hospital...
November 29, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29187664/-clinical-characteristics-of-hemichorea-associated-with-non-ketotic-hyperglycemia-in-3-patients-case-report-and-literature-review
#15
Yacen Hu, Yafang Zhou, Fang Yi, Lingyan Yao, Hongwei Xu, Lin Zhou
To investigate the pathophysiology, clinical manifestation and neuroimaging characteristics and therapeutic experiences for hemichore associated with non-ketotic hyperglycemia (HC-NH).
 Methods: Clinical data of three patients with HC-NH from Xiangya Hospital, Central South University were analyzed retrospectively, and the related literature was reviewed.
 Results: The core clinical features of HC-NH were characterized by acute/subacute onset of hemichorea with non-ketotic hyperglycemia in the elderly females...
November 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29178236/prevalence-predictors-and-challenges-of-gestational-diabetes-mellitus-screening-among-pregnant-women-in-northern-tanzania
#16
Hassan Ismail Njete, Beatrice John, Pendo Mlay, Michael Johnson Mahande, Sia Emmanueli Msuya
OBJECTIVES: To determine the prevalence and predictors of gestational diabetes mellitus (GDM) as well as acceptability of returning for glucose tolerance testing among pregnant women in Moshi municipality, northern Tanzania. METHODS: Cross-sectional study from October 2015 to April 2016 among women with gestation age of 24-28 weeks of pregnancy attending at Kilimanjaro Christian Medical Centre (KCMC) referral hospital, Majengo and Pasua Health Centres. Women were interviewed and requested to return the next day (window within a month, depending on gestational age) for Fasting Plasma Glucose (FPG) testing, followed immediately by a 75 g oral glucose tolerance test (OGTT)...
November 25, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/29161713/clinical-benefits-of-high-volume-hemofiltration-in-critically-ill-pediatric-patients-with-severe-sepsis-a-retrospective-cohort-study
#17
Huijie Miao, Fei Wang, Xi Xiong, Chunxia Wang, Yucai Zhang
AIMS: The study aimed to assess the clinical benefits of high-volume hemofiltration (HVHF) in pediatric patients with severe sepsis compared with standard-volume continuous veno-venous hemofiltration (CVVH). METHODS: We retrospectively analyzed the medical records of 155 pediatric patients with severe sepsis admitted to the pediatric intensive care unit of Shanghai Children's Hospital from January 2010 to June 2016. A total of 93 patients were treated with HVHF and 62 patients were treated with CVVH...
November 22, 2017: Blood Purification
https://www.readbyqxmd.com/read/29157245/low-1-5-anhydroglucitol-levels-are-associated-with-long-term-cardiac-mortality-in-acute-coronary-syndrome-patients-with-hemoglobin-a1c-levels-less-than-7-0
#18
Shohei Ouchi, Kazunori Shimada, Tetsuro Miyazaki, Shuhei Takahashi, Yurina Sugita, Megumi Shimizu, Azusa Murata, Tomoyasu Kadoguchi, Takao Kato, Tatsuro Aikawa, Shoko Suda, Eiryu Sai, Masaru Hiki, Hiroshi Iwata, Takatoshi Kasai, Katsumi Miyauchi, Hiroyuki Daida
BACKGROUND: Diabetes mellitus is considered an important risk factor for cardiovascular diseases. High hemoglobin A1c (HbA1c) levels, which indicate poor glycemic control, have been associated with occurrence of cardiovascular diseases. There are few parameters which can predict cardiovascular risk in patients with well-controlled diabetes. Low 1,5-anhydroglucitol (1,5-AG) levels are considered a clinical marker of postprandial hyperglycemia. We hypothesized that low 1,5-AG levels could predict long-term mortality in acute coronary syndrome (ACS) patients with relatively low HbA1c levels...
November 21, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29155440/severe-hypoglycemia-caused-by-lenalidomide
#19
Daniel J Przybylski, Ruemu Birhiray, David J Reeves
Lenalidomide is commonly used for multiple myeloma as either induction or maintenance therapy. The agent is associated with a host of adverse effects, but hypoglycemia has only been reported in one phase I trial in patients with solid tumors. We describe a 74-year-old woman who experienced grade 3 hypoglycemia (blood glucose level 35 mg/dL) likely related to lenalidomide. Her medical history was significant for refractory myeloma and type 2 diabetes mellitus. Lenalidomide was started as maintenance therapy following autologous bone marrow transplantation...
November 20, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29151317/prevalence-and-risk-factors-for-helicobacter-pylori-infection-in-southwest-china-a-study-of-health-examination-participants-based-on-13c-urea-breath-test
#20
Jie Liu, Yonghong Wang, Qinghua Zhao, Rong Luo, Mingzhao Xiao, Mingjun Zhang, Weibo Xie
Background/aim: Helicobacter pylori (H. pylori) has a high prevalence in developing countries. We aimed to investigate the current prevalence of H. pylori, as well as its potential serum risk factors, in a population from southwest China.Materials and methods: This cross-sectional study included 10,912 subjects who received medical examinations at the First Affiliated Hospital of Chongqing Medical University in 2014. Data regarding physical examinations and biochemical measurements were collected, and H. pylori infection was diagnosed with a 13C-urea breath test...
November 13, 2017: Turkish Journal of Medical Sciences
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