2,345 results match your criteria: "Perioperative Management of the Diabetic Patient"

Article Synopsis
  • Post-transplantation diabetes mellitus (PTDM) poses risks for kidney transplant recipients, affecting both graft and patient survival.
  • A study used continuous glucose monitoring (CGM) to evaluate risk factors and compare its predictive accuracy against capillary blood glucose monitoring (CBGM) in 60 kidney transplant patients.
  • The results indicated that PTDM developed in 23.3% of patients, with male sex and higher glucose levels post-surgery linked to increased risk, and CGM showed greater accuracy than CBGM in predicting PTDM outcomes.
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Causes and predictors of unplanned reoperations within 30 days post laparoscopic pancreaticoduodenectomy: a comprehensive analysis.

Front Oncol

August 2024

Department of Hepatobiliary and Pancreatic Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, China.

Article Synopsis
  • The study aimed to identify risk factors and causes for unplanned reoperations within 30 days following laparoscopic pancreaticoduodenectomy (LPD), reviewing data from 311 patients at a Chinese medical center.
  • Out of these patients, 7.4% (23 individuals) underwent unplanned reoperations primarily due to postoperative bleeding, with other causes like anastomotic leakage and infections also noted.
  • Key independent risk factors for these reoperations included low pre-operative serum prealbumin, high CRP levels on post-operative day 7, vascular reconstruction during surgery, soft pancreatic texture, and a narrow main pancreatic duct diameter.
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Article Synopsis
  • The study examined the prevalence of diagnosed and undiagnosed diabetes mellitus (DM) in patients undergoing elective abdominal aortic aneurysm repair and its impact on perioperative complications.* -
  • Out of 877 patients screened, 15% were found to have DM, with 25% being undiagnosed prior to surgery; however, DM was not significantly linked to increased in-hospital complications or mortality rates.* -
  • Post-analysis suggested that newly diagnosed DM patients had a higher risk of organ-related complications, indicating the importance of early detection before surgery.*
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Background: As the incidence of gestational diabetes mellitus (GDM) increases, its impact on cesarean sections has attracted widespread attention. Omni-directional, insulated care and detailed care are of great significance in this patient population, as they can effectively improve the quality of care in the operating room.

Aim: To explore the effect of the integrated use of comprehensive thermal insulation.

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Comparison of estimated glomerular filtration rate using five equations to predict acute kidney injury following hip fracture surgery.

Orthop Traumatol Surg Res

December 2024

From the Department of Orthopaedic Surgery, Rush University, Chicago, IL, USA; From the Department of Orthopaedic Surgery, University of California San Francisco, University Orthopaedic Associates, Fresno, CA, USA.

Background: Decreased estimated glomerular filtration rate (eGFR) is associated with acute kidney injury (AKI) following hip fracture surgery. Delaying surgery for preoperative treatment of comorbidities is controversial in this patient population. The purpose of this study was 1) to assess differences in demographics and comorbidities between AKI and non-AKI groups, 2) to analyze equations used in calculating eGFR, and 3) to identify the equation which best predicts the development of AKI following hip fracture surgery.

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Introduction: Diabetes mellitus (DM) is a prevalent metabolic disorder associated with various postoperative complications. The association between DM and postoperative opioid use remains unclear, with conflicting evidence in the literature. This systematic review and meta-analysis comprehensively evaluated the association between DM and postoperative opioid consumption, pain sensation, and adverse effects in surgical patients.

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Adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas are known to be associated with behavioural changes but acute presentation including psychosis and delirium are less common. We report the case of a 42-year-old female patient with a known medical history of hypertension and diabetes mellitus, presenting with acute onset behavioural changes suggestive of psychosis to a tertiary care centre in Muscat, Oman in 2022. Further evaluation revealed an ACTH dependent Cushing's disease with a pituitary microadenoma.

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Article Synopsis
  • Cushing's disease (CD) increases the risk of blood clots (VTEs) during and after surgery, yet there are no specific guidelines for preventing these events with medication.
  • A survey sent to neurosurgeons revealed that while most use some form of blood clot prevention post-surgery, practices vary widely regarding which medication is preferred, with low molecular weight heparin being the most common choice.
  • The study emphasizes the need for further research to establish clear recommendations on the best ways to prevent blood clots in patients undergoing surgery for Cushing's disease.
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A pragmatic approach to teaching physician assistant students basic pain management.

Biomol Biomed

August 2024

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA.

Chronic pain is increasing in prevalence, with new cases now outnumbering those of diabetes, depression, or hypertension. Advanced practice providers have reported that their training in pain management inadequately prepared them to care for patients suffering from painful conditions. In response, the authors of this work developed a basic pain management conceptual framework to provide physician assistant (PA) students with the foundational knowledge necessary to manage and treat patients suffering from a wide variety of painful conditions.

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Unlabelled: Appropriate anesthetic technique for fracture fixation in multiple myeloma is crucial in minimizing perioperative complications. The use of pericapsular nerve group block followed by spinal anesthesia for the operative management of pathological fracture in multiple myeloma patient along with proper pre- and postanesthetic care ensures better outcome for the patient.

Abstract: Multiple myeloma is a malignant plasma cell disease that often presents with anemia, renal failure, hyperkalemia and osteolytic bone lesions.

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Article Synopsis
  • Diabetes and cancer are significant global health concerns, and many cancer patients also have diabetes, increasing their risk for surgical complications.
  • A thorough literature review examined the interplay between these two diseases and focused on effective perioperative management strategies for affected patients.
  • Proper management of blood sugar levels, patient education, and adjustments to treatment plans are crucial to minimize complications and improve surgical outcomes, though more research is needed in this area.
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Article Synopsis
  • Acute kidney injury (AKI) is a serious concern after cardiac surgery, especially for patients with existing kidney problems, and NT-proBNP levels can indicate cardiac stress during surgery.
  • This study analyzed 199 cardiac surgery patients with impaired kidney function to see how changes in NT-proBNP levels related to the risk of developing AKI post-surgery.
  • Results showed that higher NT-proBNP levels after surgery were linked to a greater risk of AKI, with those in the highest NT-proBNP group having significantly increased chances of developing AKI and severe AKI stages compared to those in the lowest group.
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Outcomes following carotid revascularization in patients with prior ipsilateral carotid artery stenting in the Vascular Quality Initiative.

J Vasc Surg

December 2024

Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Electronic address:

Article Synopsis
  • This study investigates the outcomes of different carotid revascularization procedures (TCAR, tfCAS, and CEA) in patients with a history of carotid artery stenting (CAS), which has not been extensively studied before.
  • Researchers analyzed Vascular Quality Initiative data from 2016 to 2023, including various patient variables to assess the risks of complications like in-hospital stroke, death, and myocardial infarction.
  • Among the 2,137 patients evaluated, TCAR showed a lower but not statistically significant rate of in-hospital stroke/death compared to tfCAS, particularly in asymptomatic patients.
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Background: Diabetes, which is associated with cardiovascular disease and related microvascular complications, affects life expectancy and decrease quality of life. A trial reports that the risk of patients with diabetes having cardiovascular disease is 2-4 times compared with that in patients without diabetes.

Objective: This study aims to investigate the relationship between depth of general anesthesia in patients with diabetes mellitus.

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Objective: For elective cesarean section patients with gestational diabetes mellitus (GDM), there is a lack of evidence-based research on the use of enhanced recovery after surgery (ERAS). This study aims to compare the ERAS after-surgery protocol and traditional perioperative management.

Research Design And Methods: In this retrospective cohort study, singleton pregnancies with good glucose control GDM, delivered by elective cesarean sections under intravertebral anesthesia at least 37 weeks from January 1 to December 31, 2022, were collected at the Third Affiliated Hospital of Sun Yat-sen University.

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Hidradenitis suppurativa is a chronic inflammatory skin disease that usually presents in young adults with painful abscesses in intertriginous areas. We present a case of severe hidradenitis suppurativa (Hidradenitis Suppurativa Investigator Global Assessment (HS-IGA) = 5; Hurley stage III) investigated by cardiology and respirology specialists for dyspnea. The patient's symptoms required right-sided cardiac catheterization via the right femoral vein in the inguinal area.

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Objective: Perioperative Large Vessel Occlusions (LVOs) occurring during and following surgery are of immense clinical importance. As such, we aim to present risk factors and test if the Society of Thoracic Surgery (STS) mortality and stroke risk scores can be used to assess operative risk.

Methods: Using data containing 7 index cardiac operations at a single tertiary referral center from 2010 to 2022, logistic and multivariate regression analysis was performed to identify factors that correlate to higher operative LVO and stroke rate.

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Hypertension (HTN) is one of the major risk factors for developing atrial fibrillation (AF), and it has been estimated that approximately 70% of hypertensive patients are at risk of developing AF. On the other hand, 60-80% of AF patients have HTN. These two diseases share many risk factors such as diabetes mellitus, obesity, alcohol consumption, and sleep apnea syndrome during their onset and disease progression.

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Background: Dexamethasone is associated with increased blood glucose levels that could impact patient outcomes or management. This study aimed to synthesize the available evidence regarding the impact of an intraoperative single dose of dexamethasone on blood glucose levels.

Methods: We searched CENTRAL, MEDLINE, and clinicaltrials.

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Article Synopsis
  • Sternal non-union is a rare complication after cardiac surgery that involves prolonged sternal pain and instability, typically lasting over six months without infection, and is confirmed via CT scans.
  • The study reports on seven patients who underwent surgery for sternal non-union between 2015 and 2020, using a method involving sternal edge debridement, plate fixation, and autologous iliac crest bone grafting to stabilize the sternum.
  • The patient demographics indicated a median age of 65, with risk factors like diabetes and smoking, and while there were some postoperative complications like iliac crest pain, all patients experienced long-term resolution without needing further surgeries.
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