Randomised controlled trial of the effect of oral premedication with dexamethasone on hyperglycaemic response to abdominal hysterectomy
Bibliographic record
Abstract
BACKGROUND: This study was performed to evaluate the metabolic effects of a single oral dose of 8 mg dexamethasone in women undergoing hysterectomy. METHODS: Ninety non-diabetic women undergoing abdominal hysterectomy were randomised to receive 8 mg dexamethasone or placebo 2 h before surgery. Patients' perioperative care was standardised (fasting from midnight before surgery, balanced anaesthesia using propofol, fentanyl, remifentanil, cisatracurium, desflurane in oxygen/air). At five defined time points after drug administration (approximately 2, 4, 6, 10 and 14 h), blood samples were drawn under fasting conditions to measure blood glucose and free (non-esterified) fatty acids (NEFA). Data were analysed using analysis of variance for repeated measures. RESULTS: Data of 82 patients (dexamethasone: 44 and placebo: 38) were eligible for analysis. There was a statistically significant increase in blood glucose in both groups (P = 0.008). This increase was more pronounced in patients receiving dexamethasone (interaction term: P = 0.02) with maximum values at 6 h after surgery (or approximately 10 h after dexamethasone administration). There were 36 patients (placebo: 9 = 24% and dexamethasone: 27 = 61%) presenting with elevated glucose concentrations (>7 mmol l⁻¹) and 11 patients (placebo: 2 = 5% and dexamethasone: 9 = 20%) with hyperglycaemia (>8.5 mmol l⁻¹). There were no statistically significant changes in the plasma concentrations of NEFA during the perioperative period. CONCLUSION: Amounts of dexamethasone frequently used for prophylaxis of post-operative nausea and vomiting can cause short-lasting hyperglycaemia in the post-operative period, but no relevant alterations in fat metabolism. Thus, the benefits of administering corticosteroids should be weighed against the potential side-effects of short-lasting hyperglycaemia.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".