2,345 results match your criteria: "Perioperative Management of the Diabetic Patient"
The Year in Cardiothoracic Transplant Anesthesia: Selected Highlights From 2022 Part II: Cardiac Transplantation.
J Cardiothorac Vasc Anesth
October 2024
University of Pittsburgh, Pittsburgh, PA. Electronic address:
Article Synopsis
- The highlights cover research from 2022 divided into three sections: preoperative, intraoperative, and postoperative, focusing on advancements in heart transplantation.
- The preoperative section discusses candidate assessment, donor optimization, and factors like cannabis use and comorbidities that impact transplantation success.
- The intraoperative section emphasizes teamwork and surgical techniques while the postoperative section highlights managing complications like tricuspid regurgitation and exploring xenotransplantation options.
Generating pregnant patient biological profiles by deconvoluting clinical records with electronic health record foundation models.
Brief Bioinform
September 2024
Immunology Program, Stanford University School of Medicine, 240 Pasteur Drive, Palo Alto CA, 94304, United States.
Article Synopsis
- Translational biology emphasizes the connection between clinical phenotypes and biological profiles, helping to transform existing clinical data into actionable biological insights.
- Traditional computational tools struggle with small datasets and complex clinical data, but state-of-the-art foundation models can effectively analyze electronic health records (EHR) to generate detailed proteomics profiles for pregnant patients.
- This research identifies a proteomic signature related to gestational diabetes, highlighting the potential of using FM-derived EHR data to enhance disease understanding and improve therapeutic strategies in a more efficient and economical way.
Long-term recovery in critically ill COVID-19 survivors: A prospective cohort study.
Acta Anaesthesiol Scand
January 2025
Neurology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden.
Article Synopsis
- * Results showed a significant increase in good functional outcomes, from 35% to 64%, and improvements in physical HRQoL, while mental HRQoL remained stable over the year.
- * Factors like increasing age, lower clinical frailty, lack of diabetes, and shorter mechanical ventilation periods were linked to better functional outcomes and physical HRQoL at 12 months.
Reversal of Roux-en-Y Gastric Bypass to Normal Anatomy in a Severely Malnourished Patient After Metabolic Bariatric Surgery.
Cureus
October 2024
Upper Gastrointestinal and Metabolic Surgery Unit, Department of Surgery, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS.
Article Synopsis
- Obesity is a major health issue, and metabolic bariatric surgery (MBS) like Roux-en-Y gastric bypass (RYGB) is a common treatment for obesity-related type 2 diabetes mellitus (T2DM), despite potential complications.
- A case study of a 52-year-old woman highlights the risks of RYGB, including severe weight loss and electrolyte imbalances, leading to the decision for a complex reversal surgery.
- The reversal of RYGB requires careful patient selection and preoperative management, with a collaborative approach involving various healthcare professionals for optimal outcomes.
The association of the perioperative neutrophil-to-lymphocyte ratio with wound healing in patients with Wagner grade 3 and 4 diabetic foot ulcers after tibial cortex transverse transport surgery: a prospective observational cohort study.
Front Endocrinol (Lausanne)
November 2024
Orthopaedics, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China.
Article Synopsis
- Diabetic foot ulcers (DFUs) are serious complications of diabetes, caused by factors like nerve damage and poor blood flow, leading to high healthcare costs and suffering.
- A study involving 82 patients treated with a new technique called tibial cortex transverse transport (TTT) found that a lower level of the neutrophil-to-lymphocyte ratio (NLR) before surgery correlated with faster wound healing.
- The findings suggest that monitoring NLR can help predict healing outcomes for DFUs, indicating that TTT is an effective treatment that should be included in clinical practices.
The effect of comorbidity on 28-day perioperative mortality rate among non-cardiac surgical patients in Northwest Ethiopia: a prospective cohort study using propensity score matching.
BMC Public Health
November 2024
Department of Anesthesia, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Article Synopsis
- Non-communicable diseases greatly impact global health, causing about three-fourths of deaths and complicating surgical care, especially in low-income countries where there's limited research on this issue.
- A study conducted in Ethiopia assessed 3030 surgical patients, finding that 23.59% had comorbidities like hypertension and diabetes, which significantly increased the risk of dying within 28 days post-surgery.
- The results indicated that patients with comorbid conditions had a 2.52% higher risk of perioperative mortality compared to those without, highlighting the importance of managing comorbidities in surgical patients.
Glucagon-like Peptide-1 Receptor Agonist Use is Associated With Increased Risk of Perioperative Complication and Readmission Following Shoulder Arthroplasty.
J Shoulder Elbow Surg
November 2024
Division of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute, Philadelphia, PA.
Article Synopsis
- GLP-1 receptor agonists, used for managing diabetes and weight loss, may increase complications post total shoulder arthroplasty (TSA), including higher rates of deep vein thrombosis and myocardial infarction.
- A study analyzed data from 2010 to 2023, matching 1,259 patients on GLP-1 receptor agonists with a control group to assess postoperative medical complications and readmission rates.
- Results showed users had significantly more complications and readmissions within 90 days, but no difference in revision surgery rates within 2 years; further research is needed on the risks involved.
Management of Venoarterial Extracorporeal Membrane Oxygenation Cannulation-Associated Groin Wound Complications With Muscle Flaps at a High-Acuity Cardiac Referral Center.
Ann Plast Surg
December 2024
From the Division of Plastic Surgery, Department of Surgery, Columbia University Irving Medical Center, New York, NY.
Article Synopsis
- This study examines the use of muscle flap reconstruction for patients who developed complications at the groin site after undergoing venous-arterial extracorporeal membrane oxygenation (VA-ECMO), which is often necessary for patients with severe medical issues.
- Fifteen patients were analyzed, with common issues including groin lymphocele and exposed femoral vessels; the most frequently used reconstruction method was a rectus femoris flap.
- The results indicated that muscle flap reconstruction was generally successful, with no cases of lymphocele recurrence and minimal flap-specific complications, although some patients did experience other postoperative issues.
A Scoping Review of GLP-1 Receptor Agonists: Are They Associated with Increased Gastric Contents, Regurgitation, and Aspiration Events?
J Clin Med
October 2024
Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
Article Synopsis
- The use of GLP-1 receptor agonists (GLP-1 RAs) is rising for treating diabetes, heart failure, and obesity, but concerns about their potential to increase the risk of perioperative aspiration due to delayed gastric emptying are growing.
- A scoping review was conducted to gather evidence about the aspiration risk associated with GLP-1 RAs, searching multiple medical databases for relevant studies and data on gastric residual volumes and regurgitation incidents.
- Among 3,712 citations, only 24 studies met the criteria, with most reporting patients who had various confounding factors (like diabetes and other health issues) that could affect the results on retained gastric contents and aspiration risk.
Continuous peri-operative glucose monitoring in noncardiac surgery: A systematic review.
Eur J Anaesthesiol
November 2024
From the Division of Anaesthesiology, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals (AP, EG, RS, ES), Faculty of Medicine, University of Geneva (ES) and Division of Endocrinology, Diabetes, Nutrition and Therapeutic Patient Education, Department of Medical Specialties, Geneva University Hospitals, Geneva, Switzerland (KG).
Article Synopsis
- Continuous glucose monitoring (CGM) is being evaluated for its effectiveness in managing glucose levels during noncardiac surgeries, though its benefits remain unclear.
- A systematic review analyzed data from 26 studies involving 1,016 patients, focusing on glycemic control and clinical outcomes in those using CGM devices.
- The results showed that patients with diabetes generally had higher mean glucose levels and variability compared to non-diabetic patients, with few reported complications, although device malfunctions occurred in about 9.21% of cases.
Anaesthetic and Procedural-Related Complications in Transcatheter Aortic Valve Implantation (TAVI) and Its Outcome: A Retrospective Observational Study.
Cureus
October 2024
Anaesthesiology, Aga Khan University Hospital, Karachi, PAK.
Article Synopsis
- The study investigates the challenges and complications associated with Transcatheter Aortic Valve Implantation (TAVI) in elderly patients, often with multiple health issues, emphasizing the complexity of the procedure and post-operative care.
- It analyzed the medical records of patients suffering from severe aortic stenosis who were deemed high-risk for traditional surgeries, focusing on their demographics, comorbidities, and outcomes after one year.
- Results showed the patients had a low rate of complications, including minimal anesthesia-related issues, and outcomes comparable to leading global centers, indicating that TAVI might be a safe option for high-risk individuals.
The peri-operative implications of sodium-glucose co-transporter 2 inhibitors: a narrative review.
Anaesthesia
January 2025
Department of Anaesthesiology, University of Hong Kong, Hong Kong.
Introduction: Sodium-glucose co-transporter 2 inhibitors are a novel class of antihyperglycaemic drugs used in the management of type 2 diabetes, that improve glycaemic control, cardiovascular outcomes and promote weight loss. They are also approved for the treatment of heart failure and chronic kidney disease in patients with or without diabetes. This narrative review discusses the peri-operative effects and implications of sodium-glucose co-transporter 2 inhibitors and gives an overview of current evidence and existing peri-operative guidelines.
View Article and Find Full Text PDFConstruction and validation of a risk prediction model for postoperative lung infection in elderly patients with lung cancer.
Medicine (Baltimore)
November 2024
Department of Pulmonary and Critical Care Medicine, Zhejiang Rongjun Hospital, Jiaxing City, Zhejiang Province, China.
This study aimed to analyze the risk factors for postoperative lung infection in elderly patients with lung cancer (LC) and construct a predictive model. A retrospective analysis was conducted on 192 elderly patients with LC who underwent surgical treatment in our hospital between February 2020 and May 2023. According to whether there is lung infection after surgery, they were divided into an infected group (n = 55) and a noninfected group (n = 137).
View Article and Find Full Text PDFAn Update on Emerging Regenerative Medicine Applications: The Use of Extracellular Vesicles and Exosomes for the Management of Chronic Pain.
Curr Pain Headache Rep
November 2024
Department of Anesthesiology, Perioperative, and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
Article Synopsis
- * EVs and exosomes, tiny structures released by cells, show promise in treating conditions like osteoarthritis and intervertebral disc disease by reducing inflammation and promoting tissue repair in animal models.
- * While clinical use of EVs and exosomes for chronic pain management is still developing, ongoing research and clinical trials suggest they have substantial potential for future therapies.
Association between stress hyperglycemia ratio and postoperative major adverse cardiovascular and cerebrovascular events in noncardiac surgeries: a large perioperative cohort study.
Cardiovasc Diabetol
November 2024
School of Big Data and Artificial Intelligence, Chizhou University, Chizhou, Anhui, China.
Background: There has been a concerning rise in the incidence of major adverse cardiovascular and cerebrovascular events (MACCE) following noncardiac surgeries (NCS), significantly impacting surgical outcomes and patient prognosis. Glucose metabolism abnormalities induced by stress response under acute medical conditions may be a risk factor for postoperative MACCE. This study aims to explore the association between stress hyperglycemia ratio (SHR) and postoperative MACCE in patients undergoing general anesthesia for NCS.
View Article and Find Full Text PDFCirculatory characteristics of early mobilization after surgery for bilateral pheochromocytoma: a case report.
J Med Case Rep
October 2024
Department of Rehabilitation Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami, Hiroshima, 734-8551, Japan.
Background: Surgical treatment of pheochromocytomas is associated with circulatory dynamics instability, necessitating systemic management of the patient in the intensive care unit after surgery. Early mobilization after pheochromocytoma surgery is not described in the guidelines, and to our knowledge, no reports have specifically focused on circulatory dynamics during early mobilization after surgery.
Case Presentation: A 31-year-old Japanese woman was diagnosed with bilateral pheochromocytoma and underwent a second-stage adrenalectomy for bilateral pheochromocytoma at our hospital.
Caring for patients with diabetes in the outpatient surgical setting: current recommendations and controversies.
Curr Opin Anaesthesiol
December 2024
Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Purpose Of Review: Perioperative outpatient (ambulatory) care of the adult patient with diabetes requires unique considerations that vary from the inpatient setting. This review highlights specific pre, intra, and postoperative care steps for patients with diabetes undergoing ambulatory surgery, summarizing recent clinical trials, expert reviews, and emerging evidence.
Recent Findings: There is a paucity of evidence examining optimal diabetes management in the outpatient setting.
Impact of SCN10A Polymorphism on Abdominal Pain Perception and Visceral Hypoalgesia in Crohn's Disease and Ulcerative Colitis.
Clin Transl Gastroenterol
October 2024
Department of Pharmacology, Penn State College of Medicine, Hershey, PA, USA.
Introduction: Hypoalgesic inflammatory bowel disease (IBD) may provide critical insights into human abdominal pain. This condition was previously associated with homozygosity for a polymorphism (rs6795970,A1073V;1073val/val) related to Nav1.8, a voltage-gated sodium channel preferentially expressed on nociceptors.
View Article and Find Full Text PDFMultifactorial analysis of risk factors for foot ulcers in patients with neurovascular complications of diabetes.
Front Endocrinol (Lausanne)
October 2024
Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangdong Provincial Key Laboratory of Precision Anaesthesia and Perioperative Organ Protection, Guangzhou, Guangdong, China.
Background: Diabetic foot ulcers (DFU) are a major complication associated with significant morbidity and mortality. While numerous studies have investigated risk factors for these ulcers in general, few have focused specifically on patients with Neurovascular Complications of Diabetes. This study aimed to evaluate the prevalence and risk factors for DFU in this specific population.
View Article and Find Full Text PDFMonocytes perturbation implicated in the association of stress hyperglycemia with postoperative poor prognosis in non-diabetic patients with Stanford type-A acute aortic dissection.
Cardiovasc Diabetol
October 2024
Department of Anesthesiology, the Second XiangYa Hospital, Central South University, Changsha, 410011, China.
Objectives: The study aimed to investigate the interaction of intraoperative stress hyperglycemia with monocyte functions and their impact on major adverse events (MAEs) in acute aortic dissection (AAD) patients who underwent open repair surgery.
Methods: A total of 321 adults who underwent open surgery for AAD at two tertiary medical centers in China were enrolled in the study. The primary endpoint was defined as the incidence and characteristics of perioperative stress hyperglycemia.
Anti-Hyperglycemic Medication Management in the Perioperative Setting: A Review and Illustrative Case of an Adverse Effect of GLP-1 Receptor Agonist.
J Clin Med
October 2024
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA 19104, USA.
Article Synopsis
Reversible postoperative vision loss (POVL): A tale of four patients.
Qatar Med J
October 2024
Hamad Medical Corporation, Doha, Qatar *Email:
Article Synopsis
- Posterior reversible encephalopathy syndrome (PRES) is a rare condition that can cause reversible postoperative vision loss (POVL) and is characterized by acute neurological symptoms, specific imaging findings, and reversal of symptoms.
- This report details a case series of four patients who developed PRES and POVL following surgeries other than spinal, cardiac, or orthopedic procedures, illustrating its occurrence outside typical contexts.
- The cases highlight a young female with laparoscopic surgery and hypertension, another with an appendectomy and septic shock, and a woman with diabetes following an embolectomy, all showing gradual recovery of vision with proper management.
Article Synopsis
- The study evaluated mid-term outcomes of "short" inframalleolar vein bypasses in patients with chronic limb-threatening ischemia (CLTI) who previously experienced failed tibial endovascular treatments.
- A total of 107 CLTI patients were analyzed for early and 3-year outcomes, focusing on survival rates and patency levels; results indicated a 66.7% overall survival at three years.
- Insulin treatment and long-term corticosteroid use were found to negatively impact patency and limb salvage rates, emphasizing the need for careful management of these conditions in patients undergoing such procedures.
Accuracy of continuous glucose monitoring systems in intensive care unit patients: a scoping review.
Intensive Care Med
December 2024
Department of Anesthesiology and Intensive Care, Copenhagen University Hospital-North Zealand, Hilleroed, Denmark.
Article Synopsis
- Glycemic control in ICU patients is crucial as dysglycemia can lead to negative outcomes, prompting interest in using Continuous Glucose Monitoring (CGM) systems for better monitoring in these settings.
- A systematic review identified 2133 studies on CGM accuracy, narrowing it down to 96 relevant studies that primarily focused on adult patients and various CGM systems, with most studies indicating varied levels of accuracy.
- The review found that the accuracy of CGM devices differed based on the type of device and reference methods used, with intravascular CGM showing better accuracy compared to subcutaneous systems, particularly during episodes of hypoglycemia.
Insulin requirement trajectories during COVID-19 versus non-COVID-19 critical illness-A retrospective cohort study.
Acta Anaesthesiol Scand
January 2025
Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
Article Synopsis
- The study investigated the glycemic response of critically ill COVID-19 patients compared to non-COVID-19 ICU patients, focusing on insulin requirements, glycemic control, and mortality rates.
- It found that COVID-19 patients had higher insulin-to-carbohydrate ratios (ICR) and greater hypoglycemia prevalence, regardless of their diabetes status.
- The research concluded that higher daily insulin requirements were linked to increased 90-day mortality risk, indicating significant impacts of COVID-19 on glycemic management in ICU settings.