Accuracy of Ultrasonography in Breast Implant Rupture Diagnosis: Systematic Review and Meta-Analysis.

Background: Breast augmentation is the most common aesthetic operation performed in the United States and worldwide; 1,862,506 breast augmentation procedures were performed in 2018, an increase of 27.6 percent compared to 2014 data.

Methods: In the present study, the authors performed a systematic review to identify the accuracy of ultrasonography for diagnosing breast prosthesis rupture.

Larvicidal and pupicidal activities of eco-friendly phenolic lipid products from Anacardium occidentale nutshell against arbovirus vectors.

Aedes aegypti and Culex quinquefasciatus are vectors of diseases that constitute public health problems. The discovery of products capable of inhibiting their development which are less harmful to the environment would have a huge impact on vector control. Here, natural cashew nut shell liquid (CNSL), technical CNSL, anacardic acid, cardanol, and cardol were isolated from Anacardium occidentale and evaluated for larvicidal and pupicidal activity against Ae.

Hyperinsulinemic Normoglycemia during Cardiac Surgery Reduces a Composite of 30-day Mortality and Serious In-hospital Complications: A Randomized Clinical Trial.

Background: Hyperinsulinemic normoglycemia augments myocardial glucose uptake and utilization. We tested the hypothesis that hyperinsulinemic normoglycemia reduces 30-day mortality and morbidity after cardiac surgery.

Methods: This dual-center, parallel-group, superiority trial randomized cardiac surgical patients between August 2007 and March 2015 at the Cleveland Clinic, Cleveland, Ohio, and Royal Victoria Hospital, Montreal, Canada, to intraoperative glycemic management with (1) hyperinsulinemic normoglycemia, a fixed high-dose insulin and concomitant variable glucose infusion titrated to glucose concentrations of 80 to 110 mg · dl; or (2) standard glycemic management, low-dose insulin infusion targeting glucose greater than 150 mg · dl.

Insulin preconditioning elevates p-Akt and cardiac contractility after reperfusion in the isolated ischemic rat heart.

Insulin induces cardioprotection partly via an antiapoptotic effect. However, the optimal timing of insulin administration for the best quality cardioprotection remains unclear. We tested the hypothesis that insulin administered prior to ischemia provides better cardioprotection than insulin administration after ischemia.

The anabolic effect of perioperative nutrition depends on the patient's catabolic state before surgery.

Objective: We tested the hypothesis that the anabolic effect of hypocaloric, isonitrogenous nutrition in patients undergoing colorectal surgery depends on the patient's preoperative catabolic state.

Background: Although there is evidence to suggest that total parenteral nutrition more effectively spares protein in depleted than in nondepleted cancer patients, the influence of preoperative catabolism on the anabolic effects of hypocaloric nutrition in patients undergoing elective surgery is unknown.

Methods: Seventeen patients undergoing colorectal surgery received intravenous infusion of glucose with amino acids.

Statin intake is associated with decreased insulin sensitivity during cardiac surgery.

Objective: Surgical trauma impairs intraoperative insulin sensitivity and is associated with postoperative adverse events. Recently, preprocedural statin therapy is recommended for patients with coronary artery disease. However, statin therapy is reported to increase insulin resistance and the risk of new-onset diabetes.

High-dose insulin administration improves left ventricular function after coronary artery bypass graft surgery.

Objective: To test the hypothesis that the intravenous administration of high doses of insulin while maintaining normoglycemia (GIN therapy) improves myocardial function after coronary artery bypass graft (CABG) surgery.

Design: A prospective, randomized clinical trial.

Setting: A university hospital.

High-dose insulin administration is associated with hypoaminoacidemia during cardiac surgery.

Although the effects of insulin on glucose homeostasis are well recognized in surgical patients, its effect on perioperative protein metabolism has received little attention. The purpose of this study was to examine the effect of high-dose insulin therapy on the plasma concentrations of amino acids (AAs) in patients undergoing coronary artery bypass grafting surgery. We studied 20 nondiabetic patients scheduled for elective coronary artery bypass grafting surgery.

Cardioprotective effects of glucose and insulin administration while maintaining normoglycemia (GIN therapy) in patients undergoing coronary artery bypass grafting.

Context: Coronary artery bypass grafting (CABG) is complicated by ischemia-reperfusion injury jeopardizing myocyte survival.

Objective: The aim of the study was to investigate whether glucose and insulin administration, while maintaining normoglycemia (GIN therapy) using a hyperinsulinemic-normoglycemic clamp technique, is cardioprotective in patients undergoing CABG.

Design And Setting: We conducted a randomized controlled trial at a tertiary care university teaching hospital.

Glucose and insulin administration while maintaining normoglycemia during cardiac surgery using a computer-assisted algorithm.

Background: applying the principles of the hyperinsulinemic-normoglycemic clamp technique we have introduced glucose and insulin administration while maintaining normoglycemia (GIN therapy) to surgical patients. The objective of this study was to evaluate a novel computer software (GIN Computer Software [GINCS]) program using an algorithm based on the original clamp equation and modified for its use during cardiac surgery.

Methods: thirty-six patients without diabetes undergoing elective cardiac surgery were randomly assigned to manually controlled or computer-guided GIN therapy.

The association of preoperative glycemic control, intraoperative insulin sensitivity, and outcomes after cardiac surgery.

Context: The impairment of insulin sensitivity, a marker of surgical stress, is important for outcomes.

Objective: The aim was to assess the association between the quality of preoperative glycemic control, intraoperative insulin sensitivity, and adverse events after cardiac surgery.

Design And Setting: We conducted a prospective cohort study at a tertiary care hospital.

Fasting blood glucose levels in patients presenting for elective surgery.

Objective: The incidence of diabetes mellitus (DM) is increasing worldwide; however, its diagnosis is often delayed. Identifying patients with abnormal fasting blood glucose (FBG) levels preoperatively may have important implications for immediate and long-term outcomes. The aim of the present study was to determine the prevalence of impaired fasting glucose (IFG) and provisional diagnosis of DM (PDD) with potential risk factors in patients presenting for elective surgery.

Perioperative glucose and insulin administration while maintaining normoglycemia (GIN therapy) in patients undergoing major liver resection.

Background: Although hyperglycemia is a well-recognized risk factor in the context of cardiac surgery, the relevance of perioperative glycemic control for patients undergoing major noncardiac operations has received little attention. We designed this study to assess the hyperglycemic response to liver resection, and to test the hypothesis that perioperative glucose and insulin administration while maintaining normoglycemia (GIN therapy) provides glycemic control superior to that achieved by the conventional use of insulin.

Methods: Patients were randomly assigned to GIN therapy or standard therapy (control group).

Perioperative tight glucose control with hyperinsulinemic-normoglycemic clamp technique in cardiac surgery.

Objective: Previous attempts to achieve tight glucose control in surgical patients were associated with a significant incidence of hypoglycemia. The purpose of this study was to evaluate the efficacy of perioperative glucose and insulin administration while maintaining normoglycemia using a hyperinsulinemic-normoglycemic clamp technique.

Methods: We studied 70 non-diabetic and 40 diabetic patients undergoing cardiac procedures.

Hepatic protection by perioperative metabolic support?

Objective: We report the case of a 63-y-old woman undergoing left hepatectomy for hilar cholangiocarcinoma who was at high risk of postoperative liver failure due to an atrophic right liver lobe. She participated in a randomized clinical trial investigating the effect of perioperative glucose infusion on hepatic function after major liver resection.

Methods: Intravenous glucose was initiated the night before the operation at 2 mg x kg(-1) x min(-1).

High-dose insulin therapy attenuates systemic inflammatory response in coronary artery bypass grafting patients.

Background: Cardiac surgery with cardiopulmonary bypass (CPB) induces an acute phase reaction that is implicated in the pathogenesis of several postoperative complications. Studies have shown that proinflammatory cytokines are increased by acute hyperglycemia. Recent evidence suggests that insulin has antiinflammatory properties.

Myocardial protection during elective coronary artery bypass grafting using high-dose insulin therapy.

Background: Coronary artery bypass grafting (CABG) with cardioplegic cardiac arrest and cardiopulmonary bypass (CPB) is associated with myocardial injury. The aim of this study was to investigate whether high-dose insulin therapy has a myocardial protective effect by enhancing early metabolic recovery of the arrested heart during revascularization.

Methods: A total of 44 patients undergoing elective CABG were randomized to receive intraoperative titrated intravenous insulin infusion (n = 22) or a fixed high-dose systemic insulin infusion at 5 mU/kg/min (n = 22).

Perioperative amino acid supplementation of hypocaloric glucose does not impair glucose metabolism after surgery.

We tested the hypothesis that perioperative amino acid supplementation of hypocaloric dextrose would attenuate the inhibitory effect of glucose on endogenous glucose production after surgery. Sixteen patients undergoing colorectal cancer surgery were randomly assigned to receive intravenous glucose either with or without amino acids. Nutrition was administered over 48 hours from surgical skin incision until the second postoperative day.

Parenteral nutrition and protein sparing after surgery: do we need glucose?

Although capable of inducing an anabolic state after surgery, parenteral nutrition, including glucose, leads to hyperglycemia. Even moderate increases in blood glucose are associated with poor surgical outcome. We examined the hypothesis that amino acids, in the absence of glucose supply, spare protein while preventing hyperglycemia.