The Experts below are selected from a list of 2112 Experts worldwide ranked by ideXlab platform
Gregory W Roberts - One of the best experts on this subject based on the ideXlab platform.
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relative Hyperglycemia a marker of critical illness introducing the Stress Hyperglycemia ratio
The Journal of Clinical Endocrinology and Metabolism, 2015Co-Authors: Gregory W Roberts, Stephen Quinn, Nyoli Valentine, Tariq M Alhawassi, Hazel Odea, Stephen Stranks, Morton G Burt, Matthew P DoogueAbstract:Context: Hyperglycemia in hospitalized patients is associated with increased morbidity and mortality. Objective: We examined whether critical illness is more strongly associated with relative or absolute Hyperglycemia. Design: The study was an observational cohort study. Patients and Setting: A total of 2290 patients acutely admitted to a tertiary hospital. Main Outcome Measure: The relative Hyperglycemia (Stress Hyperglycemia ratio [SHR]) was defined as admission glucose divided by estimated average glucose derived from glycosylated hemoglobin. The relationships between glucose and SHR with critical illness (in-hospital death or critical care) were examined. Results: In univariable analyses, SHR (odds ratio, 1.23 per 0.1 increment [95% confidence interval, 1.18–1.28]; P < .001) and glucose (odds ratio, 1.18 per mmol/L [1.13–1.23]; P < .001) were associated with critical illness. In multivariable analysis, the association was maintained for SHR (odds ratio, 1.20 per 0.1 increment [1.13–1.28]; P < .001), b...
Charalambos Gogos - One of the best experts on this subject based on the ideXlab platform.
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cytokine production and hospital mortality in patients with sepsis induced Stress Hyperglycemia
Journal of Infection, 2007Co-Authors: Leonidia Leonidou, Athanassia Mouzaki, Marina Michalaki, Anna Lisa Delastic, Venezana Kyriazopoulou, Harry P Bassaris, Charalambos GogosAbstract:Summary Objectives To investigate whether Stress Hyperglycemia affects the production of the main pro- and anti-inflammatory cytokines and the 28-day hospital mortality in patients with severe sepsis. Methods The study included 62 patients with severe sepsis, divided in three groups according to their glycemic profile within 24h after admission: patients with Stress Hyperglycemia (group SH, n =16), diabetes mellitus type II (group DM, n =27), and normal glucose levels (group NG, n =19). The serum levels of the cytokines TNF-alpha, IL-6, IL-10 and TGFbeta-1 were measured within 24h after admission. Results A higher percentage of septic patients with Stress Hyperglycemia died compared to diabetic patients (43.7 vs. 14.8%) and group NG (43.7 vs. 5.2%). Group SH had higher SOFA score and levels of IL-6 and IL-10 than group DM and group NG. It also had higher levels of TNF-alpha than group DM but not group NG. There was no difference in the levels of TGFbeta-1 among the three groups. Non-survivors had higher levels of IL-10, no difference was detected for IL-6, TNF-alpha, IL-10/TNF-alpha ratio and TGFbeta-1. Interleukin-10 values, mean fasting glucose values and age were found as prognostic factors associated with outcome. Conclusions Stress Hyperglycemia is associated with increased cytokine production and an adverse clinical outcome in patients with severe sepsis.
Matthew P Doogue - One of the best experts on this subject based on the ideXlab platform.
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relative Hyperglycemia a marker of critical illness introducing the Stress Hyperglycemia ratio
The Journal of Clinical Endocrinology and Metabolism, 2015Co-Authors: Gregory W Roberts, Stephen Quinn, Nyoli Valentine, Tariq M Alhawassi, Hazel Odea, Stephen Stranks, Morton G Burt, Matthew P DoogueAbstract:Context: Hyperglycemia in hospitalized patients is associated with increased morbidity and mortality. Objective: We examined whether critical illness is more strongly associated with relative or absolute Hyperglycemia. Design: The study was an observational cohort study. Patients and Setting: A total of 2290 patients acutely admitted to a tertiary hospital. Main Outcome Measure: The relative Hyperglycemia (Stress Hyperglycemia ratio [SHR]) was defined as admission glucose divided by estimated average glucose derived from glycosylated hemoglobin. The relationships between glucose and SHR with critical illness (in-hospital death or critical care) were examined. Results: In univariable analyses, SHR (odds ratio, 1.23 per 0.1 increment [95% confidence interval, 1.18–1.28]; P < .001) and glucose (odds ratio, 1.18 per mmol/L [1.13–1.23]; P < .001) were associated with critical illness. In multivariable analysis, the association was maintained for SHR (odds ratio, 1.20 per 0.1 increment [1.13–1.28]; P < .001), b...
David Reyesumpierrez - One of the best experts on this subject based on the ideXlab platform.
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sitagliptin for prevention of Stress Hyperglycemia in patients without diabetes undergoing general surgery a pilot randomized study
Journal of Diabetes and Its Complications, 2018Co-Authors: Maya Fayfman, Georgia Davis, Francisco J. Pasquel, Priyathama Vellanki, Elizabeth W Duggan, Maria A Urrutia, David Chachkhiani, Joanna Schindler, Rodolfo J Galindo, David ReyesumpierrezAbstract:Abstract Aim We investigated if a dipeptidyl peptidase-4 inhibitor, sitagliptin, can prevent perioperative Stress Hyperglycemia in patients without prior history of diabetes mellitus undergoing general surgery. Methods This double-blind pilot trial randomized general surgery patients to receive sitagliptin (n = 44) or placebo (n = 36) once daily, starting one day prior to surgery and continued during the hospital stay. The primary outcome was occurrence of Stress Hyperglycemia, defined by blood glucose (BG) >140 mg/dL and >180 mg/dL after surgery. Secondary outcomes included: length-of-stay, ICU transfers, hypoglycemia, and hospital complications. Results BG >140 mg/dL was present in 44 (55%) of subjects following surgery. There were no differences in Hyperglycemia between placebo and sitagliptin (56% vs. 55%, p = 0.93). BG >180 mg/dL was observed in 19% and 11% of patients treated with placebo and sitagliptin, respectively, p = 0.36. Both treatment groups had resulted in similar postoperative BG (148.9 ± 29.4 mg/dL vs. 146.9 ± 35.2 mg/dL, p = 0.73). There were no differences in length-of-stay (4 vs. 3 days, p = 0.84), ICU transfer (3% vs. 5%, p = 1.00), hypoglycemia Conclusion Preoperative treatment with sitagliptin did not prevent Stress Hyperglycemia or complications in individuals without diabetes undergoing surgery.
Marina Michalaki - One of the best experts on this subject based on the ideXlab platform.
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cytokine production and hospital mortality in patients with sepsis induced Stress Hyperglycemia
Journal of Infection, 2007Co-Authors: Leonidia Leonidou, Athanassia Mouzaki, Marina Michalaki, Anna Lisa Delastic, Venezana Kyriazopoulou, Harry P Bassaris, Charalambos GogosAbstract:Summary Objectives To investigate whether Stress Hyperglycemia affects the production of the main pro- and anti-inflammatory cytokines and the 28-day hospital mortality in patients with severe sepsis. Methods The study included 62 patients with severe sepsis, divided in three groups according to their glycemic profile within 24h after admission: patients with Stress Hyperglycemia (group SH, n =16), diabetes mellitus type II (group DM, n =27), and normal glucose levels (group NG, n =19). The serum levels of the cytokines TNF-alpha, IL-6, IL-10 and TGFbeta-1 were measured within 24h after admission. Results A higher percentage of septic patients with Stress Hyperglycemia died compared to diabetic patients (43.7 vs. 14.8%) and group NG (43.7 vs. 5.2%). Group SH had higher SOFA score and levels of IL-6 and IL-10 than group DM and group NG. It also had higher levels of TNF-alpha than group DM but not group NG. There was no difference in the levels of TGFbeta-1 among the three groups. Non-survivors had higher levels of IL-10, no difference was detected for IL-6, TNF-alpha, IL-10/TNF-alpha ratio and TGFbeta-1. Interleukin-10 values, mean fasting glucose values and age were found as prognostic factors associated with outcome. Conclusions Stress Hyperglycemia is associated with increased cytokine production and an adverse clinical outcome in patients with severe sepsis.
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metabolic endocrine and immune effects of Stress Hyperglycemia in a rabbit model of prolonged critical illness
Endocrinology, 2003Co-Authors: Frank Weekers, Marina Michalaki, Annapaula Giulietti, Willy Coopmans, Erik Van Herck, Chantal Mathieu, Greet Van Den BergheAbstract:Stress Hyperglycemia is frequent in critically ill patients. The aim of this study was to investigate the effect of blood glucose control with insulin on endocrine, metabolic, and immune function in an animal model of severe injury. Seventy-two hours after alloxan injection and exogenous insulin infusion combined with continuous iv parenteral nutrition, male New Zealand White rabbits received a burn injury and were allocated to a normoglycemic (n = 17) or hyperglycemic (n = 13) group. In the normoglycemic group, blood glucose levels were kept between 3.3 and 6.1 mmol/liter by insulin infusion, whereas in the hyperglycemic group blood glucose levels were maintained at 13.8–16.6 mmol/liter. Blood was drawn for biochemical analysis at regular time points. At 24 and 72 h after burn injury, immune function of monocytes was assessed in vitro. Maintenance of normoglycemia with exogenous insulin after severe trauma to a large extent prevented weight loss, lactic acidosis, and hyponatremia. Furthermore, within 3 d...