Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
-
Clinical Trial Controlled Clinical Trial
Effect of hyperglycemia and continuous intravenous insulin infusions on outcomes of cardiac surgical procedures: the Portland Diabetic Project.
To describe the main findings of the Portland Diabetic Project, which elucidates the adverse relationship between hyperglycemia and outcomes of cardiac surgical procedures in patients with diabetes and delineates the protective effects of intravenous insulin therapy in reducing those adverse outcomes. ⋯ Perioperative hyperglycemia in patients undergoing a cardiac surgical procedure affects biochemical and physiologic functions, which, in turn, adversely alter mortality, LOS, and infection rates. The Portland CII Protocol is a cost-efficient method that effectively eliminates hyperglycemia and reduces postoperative morbidity and mortality in patients with diabetes undergoing an open-heart operation. CII protocols should be the standard care for glycometabolic control in all patients undergoing cardiac surgical procedures.
-
Randomized Controlled Trial Clinical Trial
Role of insulin-glucose infusion in outcomes after acute myocardial infarction: the diabetes and insulin-glucose infusion in acute myocardial infarction (DIGAMI) study.
To review the Diabetes and Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) study for findings regarding effects on morbidity and mortality. ⋯ The DIGAMI study supports the theory that intensive metabolic care in patients with diabetes who have had an acute myocardial infarction improves the prognosis. The study, however, could not answer whether this result was due to the initial insulin-glucose infusion or to the long-term subcutaneous treatment with insulin. This question is currently being addressed in the DIGAMI-2 study.
-
To describe a case of pituitary apoplexy complicated by diabetes insipidus and to review management of patients with pituitary apoplexy and water excretion disturbances associated with transsphenoidal surgery. ⋯ Pituitary apoplexy may be rarely associated with diabetes insipidus.
-
To determine whether 1990 guidelines established by the National Institutes of Health (NIH) for the optimal management (surgical versus nonsurgical) of patients with asymptomatic primary hyperparathyroidism (PHPT) are known and followed by endocrinologists. ⋯ Suboptimal awareness of the 1990 NIH panel recommendations and the substantial variation in clinical management of PHPT indicate that newer NIH guidelines developed in 2002 must be more widely disseminated and strongly recommended if practice patterns are to be influenced and clinical outcomes improved.