Frequency of Pressure Ulcers and Related Risk Factors in Patients Transferred From the Intensive Care Unit to the Internal Diseases Clinic

Purpose: Determination of pressure ulcer frequency and pressure ulcer-related clinical features in patients transferred from intensive care units (ICU) to internal medicine clinics. Material and Methods: A prospective, observational study included 100 consecutive patients aged 18 years and older. Nutritional risk score (NRS-2002) and BRADEN scale at admission to the intensive care unit were calculated. During the transfer to the internal medicine clinic, the frequency, localization and stage of pressure ulcers were determined. Patients with and without pressure ulcers were compared according to clinical and laboratory characteristics. Results: Of the 100 patients included in the study, 52 (52%) were women. The mean age was 69.8±16.5 years. The frequency of pressure ulcer was 50%, the most common location and stage was sacrum (88%), and stage 2 (58%). The mean age (74±13, 66±18 respectively, p=0.022) and length of stay in ICU (p<0.001) were higher in patients with pressure ulcer. Those with cerebrovascular disease and dementia (p=0.016 and p<0.001 respectively), using invasive mechanical ventilation, positive inotropic agents and antibiotics (p<0.001, p=0.005, and p=0.008, respectively), with pressure ulcer before ICU (p<0.001), high risk of malnutrition and pressure ulcer (p<0.001) were more common in patients with pressure ulcer. It was seen that 1 day increase in ICU length of stay increased the risk of pressure ulcer 1.42 times. Conclusion: This study revealed that half of the patients transferred from the ICU to the internal medicine clinics had pressure ulcer, and the risk of developing pressure ulcers increases as the length of stay in the ICU is prolonged

The influence of metabolic syndrome in the outcomes of colorectal cancer patients

Aims: Determine the influence of metabolic syndrome and its different components in the outcomes of colorectal cancer surgery at 30 days. Materials and methods: Prospective study that included all patients submitted to elective colorectal cancer surgery between August 2015 and August 2016 at Hospital de Braga. Clinical and laboratory parameters evaluated pre-operatively were: central obesity, blood pressure, fasting glucose, triglycerides levels and HDL cholesterol levels. Any complications during the first 30-days after surgery were recorded (readmission, reintervention, anastomotic dehiscence, morbimortality). Results: One hundred and thirty-four patients were included. Metabolic syndrome was diagnostic in 40.7% of patients with the ATPIII definition, 67.5% with the AHA definition and 67.0% with the IDF definition. At 30 days after colorectal cancer surgery, 73.1% patients don't have any complication, 15.7% have minor complications (grade I/II of Clavien-Dindo classification), 11.1% have major complications (grade III/IV/V of Clavien-Dindo classification) and 1.5% have died from surgical complications (grade V of Clavien-Dindo classification). The statistic analysis didn't reveal any association between MS, or it's different components, and surgical outcomes. Conclusion: This study seems to indicate that metabolic syndrome don't have any influence in surgical outcomes of colorectal cancer surgery. (C) 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.info:eu-repo/semantics/publishedVersio

Evaluation of patellar tendon with shear wave elastography after anterior cruciate ligament reconstruction using hamstring tendons

Objectives: This study aims to evaluate the characteristics of patellar tendons (PTs) of patients who underwent anterior cruciate ligament reconstruction (ACLR) with hamstring tendon autograft using shear wave elastography (SWE). Patients and methods: This prospective study was conducted between August 2017 and February 2018. We performed brightness mode (B-mode) ultrasound and SWE on 21 patients (20 males, 1 female; mean age 32 years; range, 19 to 42 years) who underwent ACLR with a single-bundle transtibial technique using quadruple hamstring autografts and 14 healthy controls (13 males, 1 female; mean age 35 years; range, 25 to 47 years). Length and thickness of the PT were evaluated with B-mode ultrasound, while elasticity values were evaluated with SWE in the patient and control groups. Results: The mean SWE value of the patient group on the operated side was 25.30 (min-max=16.60-46.20) and on the non-operated side 23.20 (min-max=12.40-44). There were no statistically significant differences regarding PT elasticity, thickness, or length between the groups (p>0.05). Conclusion: There were no differences regarding elasticity, length, or thickness between the operated and healthy knees detected with SWE. Upcoming research should focus on tendon biopsy and biochemical analyses for the identification of possible intrastructural changes of the tendon due to collagen synthesis after ACLR with hamstring autograft

Association between Metabolic Syndrome and Cancer

Growing data show the association of metabolic syndrome (MetS) or its components with cancer development and cancer-related mortality. It is suggested that in MetS and cancer association, insulin resistance and insulin-like growth factor 1 system play a key role, especially adipokines secreted from visceral adipocytes, free fatty acids and aromatase activity contribute to this process. It is also reported that MetS has a link with colorectal, breast, endometrial, pancreas, primary liver and, although controversial, prostate cancer. Although every component of MetS is known to have an association with cancer development, it is still debated whether the effects of these components are additive or synergistic. On the other hand, in the association between MetS and cancer, the role of antidiabetic and antihypertensive treatments including thiazolidinedione, insulin, angiotensin receptor blockers is also suggested. The primary approach in MetS-cancer relation is to prevent risk factors. Life style changes including weight loss and a healthy diet are known to decrease cancer risk in normal population. It is postulated that an insulin-sensitizing agent, metformin, has cancer-preventing effects on diabetic patients. This review discusses the relationship between MetS and cancer from different aspects and examines this relationship in some of the cancers suggested to be linked with MetS. (C) 2016 S. Karger AG, Base

Evaluation of the Glycemic Fluctuation as Defined as the Mean Amplitude of Glycemic Excursion in Hospitalized Patients with Type 2 Diabetes

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