Publications by authors named "Karen A Beer"
Chylous ascites is an uncommon complication of laparoscopic live donor nephrectomy, occurring when milky chyle from the lymphatic system leaks into the peritoneal cavity. This can occur after trauma or be caused by obstruction of the lymphatic system. Treatment may include a fat-free diet, total parenteral nutrition, subcutaneous somatostatin, lymphangiography, and/or surgical closure of the leaking lymph vessel.
View Article and Find Full Text PDFBackground: An institutional policy was previously established for patients with diabetes on insulin pump therapy undergoing elective surgical procedures.
Method: Electronic medical records were reviewed to assess documentation of insulin pump status and glucose monitoring during preoperative, intraoperative, and postanesthesia care unit (PACU) phases of care.
Results: Twenty patients with insulin pumps underwent 23 procedures from March 1 to December 31, 2011.
Background: We reviewed the care of a large cohort of patients with diabetes mellitus on insulin pump therapy who required an inpatient stay.
Methods: Records were reviewed of patients hospitalized between January 1, 2006, and December 31, 2011.
Results: A total of 136 patients using insulin pumps had 253 hospitalizations.
Case reports indicate that diabetes patients receiving outpatient insulin pump therapy have been allowed to continue treatment during surgical procedures. Although allowed during surgery, there is actually little information in the medical literature on how to manage patients receiving insulin pump therapy during a planned surgical procedure. A multidisciplinary work group reviewed current information regarding the use of insulin pumps in the perioperative period.
View Article and Find Full Text PDFObjective: To assess perioperative management of patients with diabetes mellitus who were being treated with insulin pump therapy.
Methods: We reviewed records for documentation of insulin pump status and glucose monitoring during preoperative, intraoperative, and postanesthesia care unit (PACU) phases of surgery.
Results: Thirty-five patients (21 men) with insulin pumps underwent surgical procedures between January 1, 2006, and December 31, 2010.
Background: Hypoglycemia is often cited as a barrier to achieving inpatient glycemic targets. We sought to characterize hypoglycemic events in our institution by work-shift cycle and by specific treatment area.
Methods: Capillary (bedside) and blood (laboratory) glucose values of <70 mg/dl for patients with either a known diagnosis of diabetes or with evidence of hyperglycemia were abstracted from our laboratory database for hospitalizations between October 1, 2007, and February 3, 2008.
Background: This article reviews the performance of our hospital's inpatient insulin pump policy.
Methods: Twenty-five hospital admissions of 21 unique patients receiving outpatient insulin pump therapy were reviewed.
Results: Between November 1, 2005, and November 30, 2006, there were 25 hospital admissions involving 21 patients receiving outpatient insulin pump therapy.
Purpose: The purpose of this study is to explore attitudes among inpatient midlevel practitioners about hospital hyperglycemia and to identify perceived barriers to care.
Methods: A questionnaire previously applied to resident physicians was administered to midlevel providers (physician assistants and nurse practitioners) to determine their beliefs about the importance of inpatient glucose control, their perceptions about what glucose ranges were desirable, and the problems they encountered when trying to manage hyperglycemia in the hospital. Barriers to care reported in this study were also combined with responses from the prior resident survey.