ABSTRACT
Changes in tissue oxygen saturation determined by near-infrared spectroscopy (NIRS) may help predict and determine the success of a lateral infraclavicular (LIC) block.We investigated whether evaluation of tissue oxygen saturation determined by NIRS couldbe an indicator of LIC block success.Methods: Forty patients scheduled for hand or forearm surgery under LIC block were studied. NIRS sensors were placed on the ventral aspect of both mid-forearms, and the contralateral hand was used as the control group. NIRS values were recorded before the block andat regular intervals during the following 30 min.Results: NIRS values were significantly higher in the successfully blocked patients whencompared to the complete failure, partial failure, and contralateral hand groups at the 10thmin. In the successfully blocked patients, NIRS values (mean ± SD [change in %]) increasedby 11.09 ± 4.86 (16.03%), 15.00 ± 4.53 (21.76%), 16.35 ± 5.14 (23.77%), 16.38 ± 4.88(23.85%), 16.67 ± 5.04 (24.29%), and 16.96 ± 5.71 (24.78%), respectively, from baselineto 5, 10, 15, 20, 25, and 30 min. ΔTs values were significantly higher in the successfullyblocked patients than in the complete failure patients and contralateral hand at the 30thmin. However, there was no statistically significant difference when comparing ΔTs values ofsuccessful block and partial failure block patients at the 30th min.Conclusions: We conclude that measurement of tissue oxygen saturation by NIRS withinthe scope of evaluation of the lateral infraclavicular block is a rapid, effective, and applicabletechnique.
ABSTRACT
Objective: To assess the frequency of sarcopenia in type 2 diabetes mellitus [DM] patients using different formulas of bioimpedance analysis [BIA]
Study Design: Cross-sectional study. Place and Duration of Study: Obesity Clinic, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey, between March and June 2015
Methodology: The present study included DM patients at >/= 18 years of age with BMI >/= 30 kg/m[2]. BIA measurements consisted of body weight, height, total muscle mass and sum of the muscle masses of the four limbs [ALM]. Skeletal muscle index, total muscle index, skeletal muscle percentage, total muscle percentage, and ALM/BMI were used for muscle-related analyses. The data were presented as frequency, mean +/- standard deviation, and percentage. Student t-test was used to compare differences between two independent groups
Results: A total of 295 DM patients were enrolled in the study, of whom 176 [59.66%] were females, 119 [40.34%] were males, 47 [15.93%] were over the age of 65 years, and the mean age was 53.39 +/- 10.39 years. Sarcopenia was determined in 40 males [33.61%] by body muscle ratio, in 15 males [12.60%] by ALM/BMI ratio, and in one male participant [0.84%] by skeletal muscle index. Among female participants, while sarcopenia was determined in 61 [34.65%] by body muscle ratio and in 1 [0.56%] by ALM/BMI ratio, no sarcopenia case was detected using skeletal muscle index
Conclusion: The frequency of sarcopenia in obese diabetic patients is found to be lower when skeletal muscle index and ALM/BMI ratio is used, but higher with body muscle ratio
ABSTRACT
Objective: To assess the relation between bioimpedance measurements and metabolic parameters and C-peptide in patient with type 2 diabetes mellitus [DM]. Study Design: Cross-sectional study. Place and Duration of Study: Kartal Dr Lutfi Kirdar Training and Research Hospital, Pendik Kaynarca Diabetes Center, Exercise and Metabolism Unit, between January and March 2015
Methodology: Patients with DM, aged less than 65 years, were assessed for bioimpedance analysis, fasting plasma glucose [FPG], HbA1c, C-peptide levels, triglyceride levels, LDL-cholesterol, and HDL-cholesterol levels. Skeletal muscle index, total muscle index, skeletal muscle percentage, and total muscle percentage were used for muscle-related analyses. Mann-Whitney U-test or independent t-test were used to compare differences between two independent groups. Pearson correlation test or Spearman correlation test were used to find out correlation between variables
Results: A total of 359 DM patients were enrolled in the study. Mean age was 51.6 +/- 8.0 years, and 278 [77.7%] of the participants were females. After adjusting age and gender variables, there was no relation between muscle-related measurements and FPG, triglyceride, LDL-cholesterol [p>0.05]. However, there was muscle-related indexes [MRI] positively correlation with C-peptide and inversely associated with HDL-cholesterol [p<0.05]
Conclusion: Muscle-related indices positively correlated with C-peptide, which showed endogenous insulin reserve
ABSTRACT
Gallstone [GS] formation is a multifactorial process and one of the associated factors is hyperinsulinemia. The aim of this cross-sectional study was to determine the association between size and count of gallstones, and insulin levels and resistance. The study group composed of 84 patients who have ultrasonographically confirmed gallstone[s]. Insulin level of all participants were measured and insulin resistance was calculated with the homeostasis model assessment of insulin resistance [HOMA-IR] index. All p-values < 0.05 were considered statistically significant. There were 28 patients with single stone and 56 with multiple stones. Mean insulin level was 12.54 +/- 11.66 ml/U [median 9.91 ml/U, IQR 6.33] and 56.3% of patients had insulin resistance. Mean stone size was 7.82 +/- 7.52 mm [median 6 mm and IQR 11.75]. There was a non-significant association and correlation between insulin level and size of GS [p=0.129; r =0.16]. There was significant difference between single stone group and multiple stones group, according to the insulin level
ABSTRACT
Objective: The McGrath Video laryngoscope is a newly developed video laryngoscope that significantly improves laryngeal view and facilitates endotracheal intubation in difficult airways. However in patients with normal airway that is not mentioned before. The aim of this study was to compare the McGrath video laryngoscope with the Macintosh laryngoscope in patients with normal airways
Methods: A total of 100 patients requiring orotracheal intubation, were randomized to either having intubation with the McGrath video laryngoscope or the Macintosh laryngoscope. The primary outcome was the laryngoscopy view using percentage of glottic opening [POGO] score. Secondary outcomes included Cormack and Lehane grading system, time to intubation, number of failed intubations, number of attempts before successful intubation and hemodynamic parameters during intubation
Results: POGO scores were significantly higher in the McGrath group compared with the Macintosh group [p<0.001] despite time to successful intubation was similar in both groups. The McGrath video laryngoscope provided more Grade-l laryngoscopic views than the Macintosh laryngoscope [p<0.001]. Number of more than one attempts in order to achieve success was significantly higher in the Macintosh group [p=0.001]
The number of minor complications were significantly higher in the Macintosh group [p=0.004].There were no significant changes in hemodynamic responses between the two groups [p>0.05]
Conclusion: McGrath video laryngoscope allows patients with normal airways to achieve higher POGO scores and significantly more Grade-l laryngoscopic views when compared with the Macintosh laryngoscope
ABSTRACT
<p><b>INTRODUCTION</b>In this study, we sought to determine whether insulin resistance, which is investigated by homeostatic modelling, is related to slow coronary flow (SCF).</p><p><b>MATERIALS AND METHODS</b>A total of 24 patients with SCF (4 females/20 males, mean age 47 +/- 12 years) and 32 patients with normal coronary artery (10 females/22 males, mean age 52 +/- 12 years) were included in the study. Baseline glucose, insulin and plasma lipid levels were measured. A standard oral glucose tolerance test (OGTT) was performed and post-challenge insulin levels were also measured. The index of insulin resistance was calculated with the homeostatic modelling [homeostatic model assessment for insulin resistance index (HOMA-IR)].</p><p><b>RESULTS</b>There were no differences between the 2 groups with regard to age, lipid levels, blood pressure levels, history of smoking, fasting and post-challenge plasma glucose. Baseline insulin levels were augmented in the SCF group (9.64 +/- 5.93 vs 7.04 +/- 3.26, P = 0.041). HOMA-IR levels were not different between the study groups (2.20 +/- 1.44 vs 1.69 +/- 0.86, P = 0.129). Manifest insulin resistance was significantly higher in the CSF group as compared with the control group (25% vs 3%, P = 0.01).</p><p><b>CONCLUSION</b>Manifest insulin resistance is seen more frequently in patients with SCF.</p>