ABSTRACT
Background: Myocardial infarction, it still continues to be a major health problem worldwide. The aim of the study is to find out incidence of impaired glucose tolerance in non-diabetic patients with acute coronary syndrome. Methods: The study includes 50 patients. All the cases and controls were subjected to standard 75 gms. Oral Glucose Tolerance Test (OGTT) on admission, at the time of discharge and at three months follow-up and the observations were recorded. Results: Post prandial blood sugar at time 3 month follow up were 6 (12%) in cases and 9 (18%) in control but not significant statistically. There were 17 (34%) cases and 7 (14%) in control with IGT values which was statistically significant p= 0.034. Post prandial blood sugar at time of admission were 131.18 ± 21.52 in cases, 121.86 ± 21.47 in controls and at the time discharge in cases and controls were 139.10 ± 21.27 and 128.88 ± 9.44 respectively with p=0.003. Conclusion: Patients with acute coronary syndrome who have IGT on admission have longer hospital stay and more complications related to acute MI.
ABSTRACT
INTRODUÇÃO: A segurança da administração de anestésicos locais com vasoconstritor em pacientes diabéticos submetidos à cirurgia oral não está bem fundamentada na literatura. OBJETIVO: Investigar a ocorrência de variação da glicemia nos períodos pré, trans e pós-operatório de exodontia de dentes superiores, sob anestesia local com lidocaína 2% sem e com adrenalina 1:100.000, em portadores de diabetes mellitus tipo 2. Secundariamente, avaliar os efeitos hemodinâmicos e o grau de ansiedade. MÉTODOS: Estudo prospectivo e randomizado com pacientes portadores de diabetes acompanhados na Unidade Clinica de Coronariopatia Crônica do Instituto do Coração do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo. A monitorização contínua da glicemia durante 24 horas foi realizada através do MiniMed Continuous Glucose Monitoring System (CGMS, Medtronic). Os pacientes foram divididos em dois grupos: LSA - que recebeu 5,4 mL lidocaína 2% sem adrenalina e LCA - que recebeu 5,4 mL de lidocaína 2% com adrenalina 1:100.000. Os níveis de glicemia foram avaliados nas 24 horas (período basal) e nos tempos determinados: uma hora antes, durantes e até uma hora após a exodontia (período de procedimento). Os parâmetros hemodinâmicos foram avaliados por meio de um medidor de pressão arterial digital automático e o nível de ansiedade através de uma escala. RESULTADOS: Dos 400 pacientes avaliados, 70 foram incluídos no estudo, sendo 35 randomizados no grupo LSA e 35 no grupo LCA. A análise das médias da glicemia nos grupos LSA e LCA durante os períodos (basal e procedimento) não demonstrou diferença estatisticamente significativa (p=0,229 e p=0,811, respectivamente). Também não houve diferença significativa (p=0,748) na glicemia entre os grupos em cada tempo avaliado...
INTRODUCTION: The safety of administration of local anesthetics with epinephrine for diabetic patients undergoing oral surgery is not well grounded in the literature. OBJECTIVE: To investigate the occurrence of variation of glucose in the pre, intra and postoperative extraction of upper teeth under local anesthesia with lidocaine 2% with and without 1:100.000 epinephrine in patients with type 2 diabetes mellitus. Secondly, to evaluate the hemodynamic effects and degree of anxiety. METHODS: A prospective randomized study of patients with diabetes attended in Coronary Chronic Clinics Unit, Heart Institute, Hospital das Clinicas in University of São Paulo Medical School. Continuous monitoring of blood glucose for 24 hours was performed using MiniMed Continuous Glucose Monitoring System (CGMS, Medtronic) and the patients were divided into two groups: LSA - which received 5.4 mL of 2% lidocaine without epinephrine and LCA - which received 5.4 mL of 2% lidocaine with 1:100,000 epinephrine. Blood glucose levels were assessed at 24 hours (baseline period) and at certain times: one hour before, during, and up to one hour after oral surgery (procedure period). We evaluated the hemodynamic parameters through a digital automatic pressure meter and anxiety level was measured by the scale. RESULTS: Of 400 patients evaluated, 70 were included in these study, 35 were randomized in the LSA group and 35 in the group LCA. The analysis of mean glicemia in groups LSA and LCA during the baseline period and procedure showed no statistically significant difference (p = 0.229 and p = 0.811, respectively). There was no difference in blood glucose (p = 0.748) between the groups at each time evaluated. However, in both groups there was a significant decrease in blood glucose (p < 0.001) over the time periods studied. The groups showed no significant differences regarding SBP (p = 0.176), DBP (p = 0.913), HR (p = 0.570) and anxiety level. CONCLUSION:...
Subject(s)
Humans , Male , Female , Adult , Anesthesia, Local , Anesthetics, Local , Blood Glucose , Comparative Study , Diabetes Mellitus , Epinephrine , Lidocaine , Surgery, Oral , Vasoconstrictor AgentsABSTRACT
The expression of CD11b on monocytes and neutrophils were measured by direct immunofluorescence techiques and flow cytometry in controls and type 2 diabetic patients.CD11b expression on monocyte and neutrophil in diabetic patients with macroangiopathy was higher than that in cases without macroangiopathy [3.85±1.46 vs 2.88±0.92,6.36 (4.58-9.79) vs 4.23 (3.70-4.83),both P<0.01].Monocyte CD11b and neutrophil CD11b might be independent risk factors of macroangiopathy in type 2 diabetes mellitus.