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    265 results match your criteria Perioperative Management of the Diabetic Patient

    1 OF 6

    Ischemic Optic Neuropathy in Cardiac Surgery: Incidence and Risk Factors in the United States from the National Inpatient Sample 1998 to 2013.
    Anesthesiology 2017 May;126(5):810-821
    From the Department of Anesthesia and Critical Care (D.S.R., A.T.), and Department of Anesthesia and Critical Care, The Center for Health and the Social Sciences (S.R.), The University of Chicago Medicine, Chicago, Illinois; Pritzker School of Medicine of the University of Chicago, Chicago, Illinois (M.M.M.); Department of Ophthalmology and Visual Science, Department of Neurology and Rehabilitation, College of Medicine, University of Illinois at Chicago, Chicago, Illinois (H.E.M.); Department of Ophthalmology and Visual Science, College of Medicine, Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois (C.E.J.); and Department of Anesthesiology, Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois at Chicago, Chicago, Illinois (S.R.). Current position: Department of Ophthalmology, Byers Eye Center, Stanford University, Palo Alto, California (H.E.M.).
    Background: Ischemic optic neuropathy is the most common form of perioperative visual loss, with highest incidence in cardiac and spinal fusion surgery. To date, potential risk factors have been identified in cardiac surgery by only small, single-institution studies. To determine the preoperative risk factors for ischemic optic neuropathy, the authors used the National Inpatient Sample, a database of inpatient discharges for nonfederal hospitals in the United States. Read More

    A Perioperative Systems Design to Improve Intraoperative Glucose Monitoring Is Associated with a Reduction in Surgical Site Infections in a Diabetic Patient Population.
    Anesthesiology 2017 Mar;126(3):431-440
    From the Departments of Anesthesiology, Surgery, Biomedical Informatics, Health Policy, Vanderbilt University School of Medicine, Nashville, Tennessee (J.M.E.); Department of Surgery, Uniformed Services University of the Health Sciences, Vanderbilt University Hospital, Nashville, Tennessee (J.M.E.); Departments of Anesthesiology and Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee (J.P.W.); and Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, Tennessee (M.T., B.S.R., W.S.S.).
    Background: Diabetic patients receiving insulin should have periodic intraoperative glucose measurement. The authors conducted a care redesign effort to improve intraoperative glucose monitoring.

    Methods: With approval from Vanderbilt University Human Research Protection Program (Nashville, Tennessee), the authors created an automatic system to identify diabetic patients, detect insulin administration, check for recent glucose measurement, and remind clinicians to check intraoperative glucose. Read More

    Long-Term Outcomes in the Management of Painful Diabetic Neuropathy.
    Can J Neurol Sci 2017 Jan 9:1-6. Epub 2017 Jan 9.
    1Department of Clinical Neurological Sciences,Western University,London,Canada.
    Background: Painful diabetic neuropathy (PDN) is a frequent complication of diabetes mellitus. Current treatment recommendations are based on short-term trials, generally of ≤3 months' duration. Limited data are available on the long-term outcomes of this chronic disease. Read More

    Patients With Type 2 Diabetes: Anesthetic Management in the Ambulatory Setting. Part 1: Pathophysiology and Associated Disease States.
    Anesth Prog 2016 ;63(4):208-215
    Assistant Professor, Department of Dental Anesthesiology, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania.
    The increasing prevalence of diabetes mellitus in the general population has many implications for the ambulatory anesthesia provider. Complications, particularly associated with poor glycemic control, can affect multiple organ systems and jeopardize the safety of any planned anesthetic. It is essential that anesthesiologists and sedation providers have in-depth knowledge of the pathophysiology of diabetes mellitus and the comorbid conditions that commonly accompany it. Read More

    Pre-treatment clinical assessment in head and neck cancer: United Kingdom National Multidisciplinary Guidelines.
    J Laryngol Otol 2016 May;130(S2):S13-S22
    Department of Anaesthesia,Freeman Hospital,Newcastle upon Tyne NHS Foundation Trust,Newcastle upon Tyne,UK.
    This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. This paper provides recommendations on the pre-treatment clinical assessment of patients presenting with head and neck cancer. Recommendations • Comorbidity data should be collected as it is important in the analysis of survival, quality of life and functional outcomes after treatment as well as for comparing results of different treatment regimens and different centres. Read More

    Diabetes Mellitus with Chronic Complications in Relation to Carotid Endarterectomy and Carotid Artery Stenting Outcomes.
    J Stroke Cerebrovasc Dis 2017 Jan 31;26(1):217-224. Epub 2016 Oct 31.
    Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama. Electronic address:
    Background: Carotid endarterectomy and carotid artery stenting are effective treatment procedures for carotid artery stenosis. Although diabetes mellitus is highly prevalent among patients undergoing these revascularization procedures, few studies have examined their impact on periprocedural outcomes.

    Objectives: The study aimed to determine whether perioperative outcomes among patients undergoing carotid artery stenting and carotid endarterectomy varied depending on the presence of diabetes with or without chronic complications. Read More

    Aortic Valve Stenosis in a Dialysis Patient Waitlisted for Kidney Transplantation.
    Ann Thorac Surg 2016 Nov;102(5):e437-e438
    Medical Clinic III, Department of Cardiology, University Hospital Frankfurt, Frankfurt, Germany. Electronic address:
    Management of dialysis patients with valvular heart disease waitlisted for kidney transplantation is challenging. Development of severe aortic valve stenosis can lead to the exclusion from the transplant program or even death while on the waiting list. In dialysis patients, surgical aortic valve replacement is associated with a high perioperative risk with increased morbidity and mortality. Read More

    Acute post-operative diabetic ketoacidosis: Atypical harbinger unmasking latent diabetes mellitus.
    Indian J Anaesth 2016 Oct;60(10):763-765
    Department of Anaesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
    Hyperglycaemia following surgical and anaesthetic stress is a well-established entity which might have undesirable clinical consequences in known diabetics. We encountered a rare event where an undiagnosed diabetic patient developed ketoacidosis in the immediate post-operative period which was her initial presenting symptom of deranged glucoregulation. Presumably, the stress induced by surgery and anaesthesia lead to the genesis of this event. Read More

    The perioperative outcomes of eversion carotid endarterectomy in diabetic patients aged 80 years or older.
    J Vasc Surg 2016 Aug 22;64(2):348-353. Epub 2016 Mar 22.
    Department of Neurosciences, University of Padua, School of Medicine, Padova, Italy.
    Background: Uncertainty exists about the influence of advanced age and diabetes mellitus on the clinical effect of carotid endarterectomy (CEA). This study analyzed the perioperative (30-day) outcomes of CEA in diabetic patients aged ≥80 years.

    Methods: Data of 1872 consecutive patients who underwent 2125 primary eversion CEAs from 1990 to 2014 at our institution were prospectively stored in a vascular surgery registry. Read More

    Starvation Ketoacidosis as a Cause of Unexplained Metabolic Acidosis in the Perioperative Period.
    Am J Case Rep 2016 Oct 18;17:755-758. Epub 2016 Oct 18.
    Department of Anesthesiology and Perioperative Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.
    BACKGROUND Besides providing anesthesia for surgery, the anesthesiologist's role is to optimize the patient for surgery and for post-surgical recovery. This involves timely identification and treatment of medical comorbidities and abnormal laboratory values that could complicate the patient's perioperative course. There are several potential causes of anion and non-anion gap metabolic acidosis in surgical patients, most of which could profoundly affect a patient's surgical outcome. Read More

    Postoperative dysglycemia in elective non-diabetic surgical patients: a prospective observational study.
    Can J Anaesth 2016 Dec 3;63(12):1319-1334. Epub 2016 Oct 3.
    Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston General Hospital, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.
    Purpose: Elevated glycosylated hemoglobin (HbA1c) is often found in surgical patients with no history of diabetes. The purpose of this prospective observational study was to determine if elevated preoperative HbA1c is associated with postoperative hyperglycemia in non-diabetic surgical patients and to identify predictors of elevated HbA1c.

    Methods: This study included 257 non-diabetic adults scheduled for inpatient surgery. Read More

    The effects of optimal perioperative glucose control on morbidly obese patients undergoing bariatric surgery.
    Surg Endosc 2017 Mar 22;31(3):1407-1413. Epub 2016 Jul 22.
    Department of Surgery, University of Wisconsin - Madison, 600 Highland Avenue, CSC K7/728, Madison, WI, 53792, USA.
    Background: Bariatric surgery is the most effective treatment for morbidly obese type II diabetics. However, guidelines for perioperative glucose control are not well established. We examined management of perioperative glucose levels in diabetic patients undergoing bariatric surgery and determined the impact of optimal glucose control as defined by the American Society for Metabolic and Bariatric Surgery (ASMBS) on patient outcomes, including long-term diabetes resolution. Read More

    Comparison of the effects of remifentanil-based general anesthesia and popliteal nerve block on postoperative pain and hemodynamic stability in diabetic patients undergoing distal foot amputation: A retrospective observational study.
    Medicine (Baltimore) 2016 Jul;95(29):e4302
    aDepartment of Anesthesiology and Pain Medicine bAnesthesia and Pain Research Institute cDepartment of Research Affairs, Biostatistics Collaboration Units dDepartment of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
    Diabetic foot ulcer is the most common cause of diabetes-associated nontraumatic lower extremity amputation. Most patients who undergo lower extremity amputation for a diabetic foot have had diabetes for a long time and suffer from multiorgan disorder; thus, it can be a challenge to ensure sufficient anesthetic and analgesic effects while maintaining stable hemodynamics. Recently, peripheral nerve block has gained popularity owing to its attenuating effects of systemic concerns. Read More

    Consensus on surgical aspects of managing osteomyelitis in the diabetic foot.
    Diabet Foot Ankle 2016 12;7:30079. Epub 2016 Jul 12.
    Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine / Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas;
    Background: The aim of this study was to develop consensus statements that may help share or even establish 'best practices' in the surgical aspects of managing diabetic foot osteomyelitis (DFO) that can be applied in appropriate clinical situations pending the publication of more high-quality data.

    Methods: We asked 14 panelists with expertise in DFO management to participate. Delphi methodology was used to develop consensus statements. Read More

    Association between registered nurse staffing and management outcomes of patients with type 2 diabetes within primary care: a cross-sectional linkage study.
    CMAJ Open 2016 Apr-Jun;4(2):E264-70. Epub 2016 Jun 3.
    School of Nursing (Lukewich), Memorial University of Newfoundland, St. John's, Nfld.; School of Nursing (Edge, VanDenKerkhof, Tranmer), Department of Anesthesiology and Perioperative Medicine (VanDenKerkhof), School of Medicine, and Department of Public Health Sciences (Tranmer), Faculty of Health Sciences, Queen's University, Kingston, Ont.; Department of Community Health Sciences (Williamson), Cumming School of Medicine, University of Calgary, Calgary, Alta.
    Background: As the organization of primary care continues to evolve toward more interdisciplinary team structures, demonstrating effectiveness of care delivery is becoming important, particularly for nonphysician providers. Nurses are the most common nonphysician provider within primary care. The purpose of this study was to examine the relation between primary care delivery models that incorporate registered nurses and clinical outcomes of patients with type 2 diabetes. Read More

    Pre and postoperative evaluation of transcranial Doppler pulsatility index of the middle cerebral artery in patients with severe carotid artery stenosis.
    Ann Ital Chir 2016 ;87:209-13
    Unlabelled: In the management of severe carotid artery stenosis particular importance must be given to the evaluation of the risk of perioperative cerebral ischemic events. Our study analysed the possible relationship between the pre-operative middle cerebral artery Gosling Index, calculated after transcranial Doppler (TCD), and intra-operative stump pressure (SP), in order to identify patients with higher risk of ischemic accidents. Moreover, we studied pre- and post- operative Gosling Index values in association with possible events during follow-up. Read More

    Readmissions After Colectomy: The Upstate New York Surgical Quality Initiative Experience.
    Dis Colon Rectum 2016 May;59(5):419-25
    1 Department of Surgery, Surgical Health Outcomes and Research Enterprise, University of Rochester Medical Center, Rochester, New York 2 Department of Surgery, State University of New York, Upstate Medical University, Syracuse, New York 3 Department of Surgery, Basset Healthcare, Cooperstown, New York.
    Background: Hospital readmissions remain a major medical and financial concern to the healthcare system and have become an area of interest in health outcomes performance metrics. There is a pressing need to identify process measures that may help reduce readmissions.

    Objective: Our aim was to assess the patient characteristics and surgical factors associated with 30-day readmissions for colorectal surgery in Upstate New York. Read More

    Impact of diabetes on carotid artery revascularization.
    J Vasc Surg 2016 Apr;63(4):1099-107.e4
    Division of Vascular Surgery, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada; King Saud University-Li Ka Shing Collaborative Research Program and Department of Surgery, King Saud University, Riyadh, Saudi Arabia. Electronic address:
    Objective: Diabetes has been suggested as a marker of higher operative risk during carotid artery revascularization. The aim of this study was to summarize the current evidence comparing the effectiveness of carotid revascularization in diabetic vs nondiabetic patients.

    Methods: We conducted a systematic search of MEDLINE, Embase, and the Cochrane Library databases (1946 to January 2015) for all studies comparing the clinical outcomes of diabetic vs nondiabetic patients who underwent carotid endarterectomy (CEA) or carotid artery stenting (CAS) in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Read More

    A "Diabetes Acute Care Day" for medical students increases their knowledge and confidence of diabetes care: a pilot study.
    BMC Med Educ 2016 Mar 9;16:88. Epub 2016 Mar 9.
    Department of Endocrinology and Diabetes, Medical Block, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, Scotland.
    Background: Evidence suggests that junior doctors lack the confidence and skills to manage acute/inpatient diabetes. We investigated the impact of the introduction of a "Diabetes Acute Care Day" on undergraduate medical students' knowledge and confidence in acute/inpatient diabetes.

    Methods: Participants attended four short lectures on the basics of diabetes, diabetic emergencies, inpatient diabetes management and peri-operative/procedure care followed by case-based learning tutorials on diabetic ketoacidosis (DKA), hyperosmolar hyperglycaemic state (HHS) and hypoglycaemia using capillary blood glucose charts to interpret and practice subsequent insulin prescription and adjustment. Read More

    Prevalence, Diagnosis, Perioperative Monitoring and Treatment of Right Ventricular Dysfunction and/or Pulmonary Arterial Hypertension in Cardiac Surgical Patients in Germany-A Postal Survey.
    Thorac Cardiovasc Surg 2016 Feb 24. Epub 2016 Feb 24.
    Department of Anesthesiology, Heart and Diabetic Center NRW, Ruhr University of Bochum, Bad Oeynhausen, Germany.
    Background Sparse data are available on the prevalence of right ventricular dysfunction and/or pulmonary arterial hypertension in patients scheduled for cardiac surgery in Germany as well as on the intensity and modalities used for diagnosis, perioperative monitoring, and treatment of these comorbidities. Methods A postal survey including questions on the prevalence of preoperative right ventricular dysfunction and/or pulmonary arterial hypertension in patients undergoing cardiac surgery in 2009 was sent to 81 German heart centers. Total 47 of 81 (58%) heart centers returned the questionnaires. Read More

    Perioperative glycaemic control in diabetic patients undergoing cataract surgery under local anaesthesia: a survey of practices of Singapore ophthalmologists and anaesthesiologists.
    Singapore Med J 2016 Feb;57(2):64-8
    Department of Anaesthesia, Khoo Teck Puat Hospital, Singapore.
    Introduction: Perioperative glycaemic control is an important aspect of clinical management in diabetic patients undergoing cataract surgery under local anaesthesia. While poor long-term glycaemic control has significant implications for surgery, perioperative hypoglycaemia or hyperglycaemia may also compromise patient safety and surgical outcomes. We aimed to survey ophthalmologists and anaesthesiologists on their approach and to identify the prevalent practice patterns in Singapore. Read More

    Impact of Perioperative Complications After Endovascular Therapy in Diabetic Patients With Critical Limb Ischemia due to Isolated Infrapopliteal Lesions.
    J Endovasc Ther 2016 Apr 12;23(2):371-7. Epub 2016 Feb 12.
    Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan.
    Purpose: To investigate the thus far poorly defined impact of perioperative complications (POCs) on clinical outcomes after endovascular therapy (EVT) of diabetic patients with critical limb ischemia (CLI) due to isolated infrapopliteal lesions.

    Methods: A multicenter registry of CLI patients was interrogated to identify 780 consecutive diabetic patients (mean age 71 ± 10 years; 553 men) who successfully underwent balloon angioplasty for isolated infrapopliteal lesions. More than half of the population (487 patients) was on dialysis. Read More

    Diabetes Is Related to Worse Patient-Reported Outcomes at Two Years Following Spine Surgery.
    J Bone Joint Surg Am 2016 Jan;98(1):15-22
    Department of Orthopaedics, Vanderbilt Orthopaedic Institute, Medical Center East, South Tower, 1215 21st Avenue South, Suite 4200, Nashville, TN 37232-8774. E-mail address for C.J. Devin:
    Background: Diabetes has been associated with poor outcomes following elective spine surgery. The purpose of our study was to determine if diabetes predicts worse patient-reported outcomes at two years postoperatively and to evaluate the effect of perioperative blood glucose levels and control on patient-reported outcomes in patients with diabetes.

    Methods: One thousand and five patients undergoing elective spine surgery were included in this prospective cohort study. Read More

    Preoperative HBA1c and risk of postoperative complications in patients with gynaecological cancer.
    Arch Gynecol Obstet 2016 Jul 16;294(1):161-4. Epub 2015 Dec 16.
    Gynaecological Oncology Department, Christie Hospital, 550 Wilmslow Rd, Manchester, M20 4BX, UK.
    Background: HBA1c is used as an indicator for the long-term control of the glycaemic state and outcome predictors in diabetic patients. Diabetic patients have an increased risk of post-operative complications especially those related to infection. The aim of our study is to ascertain the relationship between HBA1c levels and post-operative recovery within the subspecialty of gynaecological oncology. Read More

    Successful Spinal Cord Stimulator Trial and Permanent Implant in Patient with Diabetic Peripheral Neuropathy on Chronic Dual Antiplatelet Therapy.
    Pain Physician 2015 Sep-Oct;18(5):E905-9
    Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC.
    The safety of neuraxial anesthetic techniques in the setting of oral and parenteral anticoagulation is an area of growing interest and clinical inquiry as the multitude of anticoagulant medications rapidly increases. Additionally, the indications for spinal cord stimulation therapy are evolving as both technique and technology in the field continue to advance. The estimated incidence of spinal hematoma following epidural injection has been estimated to be 1 in 150,000-200,000. Read More

    Anti-vascular endothelial growth factor for prevention of postoperative vitreous cavity haemorrhage after vitrectomy for proliferative diabetic retinopathy.
    Cochrane Database Syst Rev 2015 Aug 7(8):CD008214. Epub 2015 Aug 7.
    Sunderland Eye Infirmary, Queen Alexandra Road, Sunderland, UK, SR2 9HP.
    Background: Postoperative vitreous cavity haemorrhage (POVCH) is a significant complication following vitrectomy for proliferative diabetic retinopathy (PDR). It delays visual recovery and can make further treatment difficult if the view of the fundus is significantly obscured. A number of interventions to reduce the incidence of POVCH have been proposed, including the perioperative use of anti-vascular endothelial growth factor (anti-VEGF). Read More

    Perioperative Glycemic Control and the Effect on Surgical Site Infections in Diabetic Patients Undergoing Foot and Ankle Surgery.
    Foot Ankle Spec 2016 Feb 30;9(1):24-30. Epub 2015 Jun 30.
    UPMC Mercy Center for Healing and Amputation Prevention, Pittsburgh, Pennsylvania (DS, DKW)University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania (NCS)
    Introduction: Diabetes mellitus is one of the leading causes of hyperglycemia in the perioperative setting. Hyperglycemia has been shown to cause increased risk of surgical site infections (SSIs) in multiple surgical specialties, but to our knowledge it has not been investigated for orthopaedic foot and ankle surgery. The aim of this study was to determine if hyperglycemia increased the rate of SSI in elective, diabetic patients that required perioperative hospitalization. Read More

    Pancreatic cancer and diabetes: A two-way relationship in the perspective of diabetologist.
    Int J Surg 2015 Sep 27;21 Suppl 1:S72-7. Epub 2015 Jun 27.
    Depart. of Internal and Experimental Medicine "Magrassi - Lanzara", Second University of Naples, Italy. Electronic address:
    Diabetes is a risk factor for pancreatic cancer as roughly half of all patients with pancreatic cancer are found to have diabetes at time of diagnosis. Moreover, an around 2-fold risk of pancreatic malignancy in diabetic patients has even be recently resulted from two meta-analysis. Actually, there is a bidirectional association between the two entities that implies a complex and reverse causality. Read More

    Guidelines for Perioperative Management of the Diabetic Patient.
    Surg Res Pract 2015 19;2015:284063. Epub 2015 May 19.
    Division of Pulmonary, Critical Care & Sleep Medicine, Texas A&M Health Science Center, Corpus Christi, 1177 West Wheeler Avenue, Suite 1, Aransas Pass, TX 78336, USA.
    Management of glycemic levels in the perioperative setting is critical, especially in diabetic patients. The effects of surgical stress and anesthesia have unique effects on blood glucose levels, which should be taken into consideration to maintain optimum glycemic control. Each stage of surgery presents unique challenges in keeping glucose levels within target range. Read More

    Intraoperative blood glucose management: impact of a real-time decision support system on adherence to institutional protocol.
    J Clin Monit Comput 2016 Jun 12;30(3):301-12. Epub 2015 Jun 12.
    Division of General Surgery, Department of Surgery, University of Washington, Seattle, WA, USA.
    Poor perioperative glycemic management can lead to negative surgical outcome. Improved compliance to glucose control protocol could lead to better glucose management. An Anesthesia Information Management System based decision support system-Smart Anesthesia Manager™ (SAM) was used to generate real-time reminders to the anesthesia providers to closely adhere to our institutional glucose management protocol. Read More

    INTRAOPERATIVE OPTICAL COHERENCE TOMOGRAPHY DURING VITREORETINAL SURGERY FOR DENSE VITREOUS HEMORRHAGE IN THE PIONEER STUDY.
    Retina 2015 Dec;35(12):2537-42
    *Ophthalmic Imaging Center, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio; and †Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.
    Purpose: To evaluate the feasibility and utility of intraoperative optical coherence tomography (OCT) during pars plana vitrectomy surgery for dense vitreous hemorrhage.

    Methods: The Prospective Assessment of Intraoperative and Perioperative OCT for Ophthalmic Surgery study examined the utility of intraoperative OCT in ophthalmic surgery. Intraoperative scanning was performed with a microscope-mounted spectral domain OCT system. Read More

    Impact of perioperative management of glycemia in severely obese diabetic patients undergoing gastric bypass surgery.
    Surg Obes Relat Dis 2015 May-Jun;11(3):578-84. Epub 2014 Nov 13.
    Metabolic Medicine Research Unit, Imperial College London, United Kingdom; Gastro Surgical Laboratory, University of Gothenburg, Sweden; Diabetes Complications Research Center, Conway Institute, University College Dublin, Ireland.
    Background: Roux-en-Y gastric bypass (RYGB) surgery is associated with rapid postsurgical improvement in glycemic control in patients with type 2 diabetes mellitus (T2 DM). However, there is little outcome-based evidence to guide the glycemic management of this patient group preoperatively.

    Objectives: We conducted 2 pilot studies randomizing patients to assess the impact of intensive glucose management pre- and post-RYGB on clinical outcomes after surgery. Read More

    Does perioperative nutrition and oral carbohydrate load sustainably preserve muscle mass after bariatric surgery? A randomized control trial.
    Surg Obes Relat Dis 2015 Jul-Aug;11(4):920-6. Epub 2014 Oct 22.
    Gastrointestinal & Transplant Surgery Service, Department of Surgery, Geneva University Hospital, Geneva, Switzerland.
    Background: Perioperative nutrition and preoperative oral carbohydrate loading (CHL) have a beneficial impact on the outcomes of gastrointestinal oncological surgery. However no data exists on their effect on morbidly obese patients.

    Objectives: Our aim was to establish the short-term and long-term impact of these modalities, notably on metabolically active lean body mass (LBM) - an important factor in maintaining long-term weight loss. Read More

    Predictors of stroke associated with coronary artery bypass grafting in patients with diabetes mellitus and multivessel coronary artery disease.
    Am J Cardiol 2015 May 19;115(10):1382-8. Epub 2015 Feb 19.
    Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain.
    This study assesses demographic and clinical variables associated with perioperative and late stroke in diabetes mellitus patients after multivessel coronary artery bypass grafting (CABG). Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease (FREEDOM) is the largest randomized trial of diabetic patients undergoing multivessel CABG. FREEDOM patients had improved survival free of death, myocardial infarction, or stroke and increased overall survival after CABG compared to percutaneous intervention. Read More

    Staphylococcus aureus Infections After Elective Cardiothoracic Surgery: Observations From an International Randomized Placebo-Controlled Trial of an Investigational S aureus Vaccine.
    Open Forum Infect Dis 2014 Sep 26;1(2):ofu071. Epub 2014 Aug 26.
    Merck Sharp and Dohme , Whitehouse Station, New Jersey.
    Background: An unmet need to prevent Staphylococcus aureus (SA) infections after cardiothoracic surgery persists despite current practices. Cost-effective implementation of preventive strategies requires contemporary knowledge about modifiable risk factors.

    Methods: From 2007 to 2011, an international, double-blind, randomized placebo-controlled trial of a novel SA vaccine (V710) was conducted in 7664 adults scheduled for median sternotomy at 164 sites. Read More

    Combining superficial femoral artery endovascular treatment with distal vein bypass.
    J Cardiovasc Surg (Torino) 2015 Jun 3;56(3):383-91. Epub 2015 Feb 3.
    Unit of Vascular and Endovascular Surgery Ospedale San Paolo, Civitavecchia, Rome, Italy -
    Aim: Significant strides have been made using endovascular solutions for the treatment of patients with peripheral vascular disease (PAD) and for tissue loss. But the Trans-Atlantic Inter-Society Consensus (TASC) II classification states that surgery still remains the best solution for C and D lesions, though endovascular management of superficial femoral artery (SFA) can improve inflow for distal origin bypass grafts. Our aim was to evaluate the results of combining endovascular treatment of SFA with distal vein bypass in patients with critical limb ischemia (CLI) and great tissue loss or in the cases where the below-knee endoluminal techniques alone were unable to salvage limbs. Read More

    Relationship between nadir hematocrit during cardiopulmonary bypass and postoperative hyperglycemia in nondiabetic patients.
    Heart Surg Forum 2014 Dec;17(6):E302-7
    Department of General Surgery, Dicle University, Diyarbakir, Turkey.
    Background: Hyperglycemia is common after cardiac surgery in both diabetic and nondiabetic patients and is associated with increased morbidity and mortality. Association between nadir hematocrit levels on cardiopulmonary bypass (CPB) and postoperative hyperglycemia is not clear. This study was carried out to determine the relationship between nadir hematocrit during CPB and postoperative hyperglycemia in nondiabetic patients. Read More

    A case-control study to assess aspirin as a risk factor of bleeding in rhegmatogenous retinal detachment surgery.
    Graefes Arch Clin Exp Ophthalmol 2015 Nov 11;253(11):1899-905. Epub 2015 Jan 11.
    UJF-Grenoble 1, Grenoble, F-38041, France.
    Purpose: The purpose of this study was to evaluate the hemorrhagic risk factors during the management of primary rhegmatogenous retinal detachment (RD).

    Methods: Three hundred and twenty-two patients with (n = 74) or without (n = 248) bleeding (anterior segment, choroidal, intravitreal and/or subretinal) during or after RD surgery were included in this case-control study. Exclusion criteria were: history of trauma, vitreoretinal surgery, diabetic retinopathy, and taking clopidogrel and/or a vitamin K antagonist. Read More

    Diabetic patients have increased perioperative cardiac risk in heart-type fatty acid-binding protein-based assessment.
    Med Princ Pract 2015 29;24(1):53-7. Epub 2014 Nov 29.
    Cardiology Clinic, Ministry of Health, Birecik State Hospital, Sanliurfa, Turkey.
    Objective: To test the potential role of heart-type fatty acid-binding protein (H-FABP) in detecting increased perioperative cardiac risk in comparison with cardiac troponin I (cTnI) in the early postoperative period.

    Subjects And Methods: Sixty-seven patients who had clinical risk factors and underwent elective intermediate - or high-risk noncardiac surgery were included in this study. Serum specimens were analyzed for H-FABP and cTnI levels before and at 8 h after surgery. Read More

    Simultaneous pancreas and kidney transplantation for liver transplant recipients with diabetes and uremia.
    Clin Res Hepatol Gastroenterol 2015 Jun 4;39(3):399-404. Epub 2014 Nov 4.
    Organ Transplantation Center of the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China. Electronic address:
    Background And Objectives: Chronic kidney disease (CKD) has become a critical problem due to immunosuppressant related nephrotoxicity in liver transplant (LTx) recipients, especially in patients with pre-transplant risk factors. LTx recipients with uraemia and diabetes have poor prognosis even when treated with dialysis and insulin. Simultaneous pancreas and kidney transplantation (SPK) has been proven to be an effective treatment for patients with diabetic uraemia, but rarely performed in patients after LTx. Read More

    Unrecognized arteriosclerosis is associated with wound complications after below-knee amputation.
    Ann Vasc Surg 2015 Feb 26;29(2):266-71. Epub 2014 Nov 26.
    Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA. Electronic address:
    Background: Guillotine below-knee amputation (BKA) for wet gangrene is an unfortunate complication of poorly controlled diabetes. We examined risk factors associated with wound complications after amputation formalization in this patient population.

    Methods: Retrospective data over a 4-year period were collected for patients undergoing guillotine BKA for wet gangrene followed by staged formalization. Read More

    Management in high-risk patients.
    Clin Podiatr Med Surg 2014 Oct 8;31(4):523-38. Epub 2014 Aug 8.
    Legacy Medical Group - Foot and Ankle, 2800 North Vancouver Street, Suite #130, Portland, OR 97229.
    Injuries to the foot and ankle are often missed or underestimated in patients with polytrauma and are a source of long-term limitations. Injures below the knee are among the highest causes for unemployment, longer sick leave, more pain, more follow-up appointments, and decreased overall outcome. As mortalities decrease for patients with polytrauma a greater emphasis on timely diagnosis and treatment of foot and ankle injuries is indicated. Read More

    Long-term outcomes after total pancreatectomy and islet cell autotransplantation: is it a durable operation?
    Ann Surg 2014 Oct;260(4):659-65; discussion 665-7
    Departments of *Surgery †Gastroenterology ‡Endocrinology §Radiology, University of Cincinnati Medical Center ¶Department of Surgery, University of California San Diego School of Medicine ‖Department of Surgery, University of Chicago Medical Center; and **Department of Surgery, University of Arizona Medical Center.
    Objective: Total pancreatectomy and islet cell autotransplantation (TPIAT) has been increasingly utilized for the management of chronic pancreatitis (CP) with early success. However, the long-term durability of this operation remains unclear.

    Methods: All patients undergoing TPIAT for the treatment of CP with 5-year or greater follow-up were identified for inclusion in this single-center observational study. Read More

    Laparoscopic bariatric surgery for the treatment of severe hypertriglyceridemia.
    Asian J Surg 2015 Apr 23;38(2):96-101. Epub 2014 Aug 23.
    Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
    Background: It is well established that severe hypertriglyceridemia can lead to pancreatitis. At present, medical treatment for patients with severe hypertriglyceridemia and repeat pancreatitis attacks is not adequate. The aim of this study was to assess the effectiveness of laparoscopic bariatric surgery in these patients. Read More

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