The Impact of Glycemic Control and Diabetes Mellitus on Perioperative Outcomes After Total Joint Arthroplasty

2009 ◽  
Vol 91 (7) ◽  
pp. 1621-1629 ◽  
Author(s):  
Milford H Marchant ◽  
Nicholas A Viens ◽  
Chad Cook ◽  
Thomas Parker Vail ◽  
Michael P Bolognesi
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Perioperative Outcomes ◽  
The Impact

scholarly journals Efficacy of hydrofibre dressing following total joint arthroplasty: a meta-analysis of randomised controlled trials

2021 ◽  
pp. 112070002110126
Author(s):  
Raman Mundi ◽  
Harman Chaudhry ◽  
Seper Ekhtiari ◽  
Prabjit Ajrawat ◽  
Daniel M Tushinski ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Joint Arthroplasty ◽  
Meta Analysis ◽  
Joint Infection ◽  
The United States ◽  
Joint Arthroplasty ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Observable Effect ◽  
The Impact

Introduction: In the United States, over 1,000,000 total joint arthroplasty (TJA) surgeries are performed annually and has been forecasted that this number will exceed 4,000,000 by the year 2030. Many different types of dressing exist for use in TJA surgery, and it is unclear if any of the newer, hydrofibre dressings are superior to traditional dressings at reducing rates of infections or improving wound healing. Thus, the aim of this systematic review and meta-analysis was to assess the impact of hydrofiber dressings on reducing complications. Methods: A systematic review and meta-analysis was performed using the online databases MEDLINE and the Cochrane Library. Randomized controlled trials (RCTs) comparing hydrofibre dressings to a standard dressing were included. Summary measures are reported as odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs). Our primary outcome was prosthetic joint infection (PJI). Secondary outcomes included blisters, dressing changes and wound irritation. Results: 5 RCTs were included. Hydrofibre dressing had no observable effect on PJI or wound irritation (OR 0.53; 95% CI, 0.14–1.98; p = 0.35). Hydrofibre dressings reduced the rate of blisters (OR 0.36; 95% CI, 0.14–0.90; p = 0.03) and number of dressing changes (MD -1.89; 95% CI, -2.68 to -1.11). Conclusions: In conclusion, evidence suggests hydrofibre dressings have no observable effect on PJI and wound irritation. Evidence for reduction in blisters and number of dressings is modest given wide CIs and biased trial methodologies. Use of hydrofibre dressings should be considered inconclusive for mitigating major complications in light of current best evidence.

Impact of Weight-Band Dosing of Tinzaparin for Venous Thromboembolism Prophylaxis on Persistent Wound Drainage in Adult Patients Undergoing Hip and Knee Arthroplasty

2021 ◽  
pp. 106002802110242
Author(s):  
Cassandra Cooper ◽  
Ouida Antle ◽  
Jennifer Lowerison ◽  
Deonne Dersch-Mills ◽  
Ashley Kenny
Keyword(s):  
Body Weight ◽  
Venous Thromboembolism ◽  
Knee Arthroplasty ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Thromboembolism Prophylaxis ◽  
Wound Drainage ◽  
Increased Risk ◽  
Significant Difference ◽  
The Impact

Background: Persistent wound drainage and venous thromboembolism (VTE) are potential complications of total joint arthroplasty, and these risks can be challenging to balance in clinical practice. Anecdotal observation has suggested that following joint arthroplasty, persistent wound drainage occurs more frequently with higher body weight and higher doses of tinzaparin when compared with lower body weight and lower doses of tinzaparin. Objective: The overall purpose of this study was to describe the impact of a tinzaparin weight-band dosing table for VTE prophylaxis on wound healing, thrombosis, and bleeding outcomes in patients undergoing total joint arthroplasty. Methods: This retrospective chart review included patients who underwent total hip or knee arthroplasty and received tinzaparin for thromboprophylaxis per their weight-banding category. The primary outcome was the incidence of persistent wound drainage. Secondary outcomes include the occurrence of VTE and clinically important bleeding during hospital admission. Results: A total of 231 patients were included in the analysis. There was no significant difference in persistent wound drainage between the 3 weight categories, and there were no differences in rates of VTE or clinically important bleeding. Concurrent use of low-dose acetylsalicylic acid was associated with a 3-fold increased risk of persistent wound drainage (risk ratio = 3.35; 95% CI = 2.14-5.24; P = 0.00003). Conclusion and Relevance: In joint arthroplasty patients, we observed no significant difference in rates of persistent wound drainage between various weight categories receiving different weight-banded doses of tinzaparin. Our results do not suggest that the current weight-band dosing table for tinzaparin needs to be adjusted to optimize patient outcomes.

An Observational Longitudinal Study of the Impact of Sleeve Gastrectomy on Glycemic Control in Type 2 Diabetes Mellitus

2013 ◽  
Vol 15 (12) ◽  
pp. 990-995 ◽  
Author(s):  
Arundhati Dasgupta ◽  
Jasjeet Wasir ◽  
Maria Beloyartseva ◽  
Sandeep Malhotra ◽  
Ambrish Mithal
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Sleeve Gastrectomy ◽  
Longitudinal Study ◽  
Glycemic Control ◽  
The Impact

scholarly journals Using Resistance Training in Women with Gestational Diabetes Mellitus to Improve Glucose Regulation

2021 ◽  
Author(s):  
Brittany R. Allman ◽  
Samantha McDonald ◽  
Linda May ◽  
Amber W. Kinsey ◽  
Elisabet Børsheim
Keyword(s):  
Diabetes Mellitus ◽  
Resistance Training ◽  
Glycemic Control ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Type Ii Diabetes Mellitus ◽  
Glucose Regulation ◽  
Pharmacological Treatments ◽  
Short And Long Term ◽  
The Impact

Gestational diabetes mellitus (GDM) poses a significant threat to the short- and long-term health of the mother and baby. Pharmacological treatments for GDM do not fully correct the underlying problem of the disease; however, non-pharmacological treatments such as exercise are increasingly recognized as foundational to glycemic management in other populations with disordered glucose regulation, such as non-gravid women with type II diabetes mellitus (T2DM). Much of the research regarding the impact of exercise on glycemic control in T2DM leverages aerobic training as the primary modality; yet research has demonstrated the effectiveness of resistance training on improving glycemic control in T2DM. This chapter will review the rationale for resistance training in the management of GDM using evidence from individuals with T2DM; then the chapter will review available studies on the effectiveness of resistance training on glucose control in women with GDM.

scholarly journals Glucose levels during gestational diabetes pregnancy and the risk of developing postpartum diabetes or prediabetes

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Chadakarn Phaloprakarn ◽  
Siriwan Tangjitgamol
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Gestational Diabetes ◽  
Confidence Interval ◽  
Control Group ◽  
Oral Glucose ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
The Impact

Abstract Background Blood glucose levels during pregnancy may reflect the severity of insulin secretory defects and/or insulin resistance during gestational diabetes mellitus (GDM) pregnancy. We hypothesized that suboptimal glycemic control in women with GDM could increase the risk of postpartum type 2 diabetes mellitus (T2DM) or prediabetes. Our objective was to evaluate the impact of plasma glucose levels throughout GDM pregnancy on the risk of postpartum T2DM or prediabetes. Methods The medical records of 706 women with GDM who underwent a postpartum 75-g, 2-hour oral glucose tolerance test at our institution between January 2011 and December 2018 were reviewed. These women were classified into 2 groups according to glycemic control during pregnancy: ≤ 1 occasion of either fasting glucose ≥ 95 mg/dL or 2-hour postprandial glucose ≥ 120 mg/dL was defined as optimal glycemic control or else was classified as suboptimal glycemic control. Rates of postpartum T2DM and prediabetes were compared between women with optimal (n = 505) and suboptimal (n = 201) glycemic control. Results The rates of postpartum T2DM and prediabetes were significantly higher in the suboptimal glycemic control group than in the optimal glycemic control group: 22.4% vs. 3.0%, P < 0.001 for T2DM and 45.3% vs. 23.5%, P < 0.001 for prediabetes. In a multivariate analysis, suboptimal glucose control during pregnancy was an independent risk factor for developing either postpartum T2DM or prediabetes. The adjusted odds ratios were 8.4 (95% confidence interval, 3.5–20.3) for T2DM and 3.9 (95% confidence interval, 2.5–6.1) for prediabetes. Conclusion Our findings suggest that blood glucose levels during GDM pregnancy have an impact on the risk of postpartum T2DM and prediabetes.

Does the Timing of the Second Surgery of a Staged Bilateral Total Joint Arthroplasty Affect the Rate of Hospital Adverse Events and Perioperative Outcomes?

2020 ◽  
Vol 35 (6) ◽  
pp. 1516-1520
Author(s):  
Jesus M. Villa ◽  
Tejbir S. Pannu ◽  
Carlos A. Higuera ◽  
Juan C. Suarez ◽  
Preetesh D. Patel ◽  
...  
Keyword(s):  
Adverse Events ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Perioperative Outcomes ◽  
Second Surgery

Diabetes Mellitus and Hyperglycemia and the Risk of Aseptic Loosening in Total Joint Arthroplasty

2017 ◽  
Vol 32 (9) ◽  
pp. S251-S253 ◽  
Author(s):  
Hilal Maradit Kremers ◽  
Cathy D. Schleck ◽  
Eric A. Lewallen ◽  
Dirk R. Larson ◽  
Andre J. Van Wijnen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Aseptic Loosening ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty

The Impact of Pre-Operative Weight Loss on Incidence of Surgical Site Infection and Readmission Rates After Total Joint Arthroplasty

2014 ◽  
Vol 29 (3) ◽  
pp. 458-464.e1 ◽  
Author(s):  
Maria C.S. Inacio ◽  
Donna Kritz-Silverstein ◽  
Rema Raman ◽  
Caroline A. Macera ◽  
Jeanne F. Nichols ◽  
...  
Keyword(s):  
Weight Loss ◽  
Surgical Site Infection ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Site Infection ◽  
Readmission Rates ◽  
The Impact

The Impact of Fasting during Ramadan on the Glycemic Control of Patients with Type 2 Diabetes Mellitus

2013 ◽  
Vol 121 (09) ◽  
pp. 531-534 ◽  
Author(s):  
S. Sahin ◽  
T. Ayaz ◽  
N. Ozyurt ◽  
K. Ilkkilic ◽  
A. Kirvar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
The Impact
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