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Biomedical subjects

A Lazzari

Publications and source records attributed to A Lazzari.

14 recordsLinked to original sources
PubMed1991

[Monitoring esophageal pressure: comparison of various methods and a unique solution].

Ambulatory monitoring of intraesophageal pressure requires probes and techniques which are different from those used in the laboratory approach. In particular the perfusion system for the measurement of the pressure is not suitable and the development of alternative solutions is mandatory. In this perspective an accurate analysis of the theoretical basis of different methods is necessary in order to avoid incorrect results and difficulties in the subsequent phase of analysis. A prototype probe, which is based on inextensible thin plastic balloons filled with oil or saline, was tested in comparison with traditional (perfused) and microtransducer systems to outline the positive and negative aspects of the solution. The results were satisfactory as regards linear output and frequency response up to 5 Hz for the prototype probe and even superior, for instance, to the response of the perfused system to applied pressure, whose curves of the four open tips resulted different, and to the response of Millar transducer. The new prototype probe seems to be adequate to the clinical and research needs.

Equipment Design↗
PubMed1991

[Intraoperative esophageal manometry].

Intraoperative manometry has been proposed as a supportive procedure during the execution of anti-reflux operations and in the surgical treatment of achalasia. This procedure is not necessary in preparing anti-reflux plasty such as Belsey or Nissen, the outcome of which depends mostly on the correct execution of the surgical technique. Utilization of intra-operative manometry provides considerable benefits during the surgical treatment of achalasia, both when executing the extra-mucous myotomy and for the correct preparation of the anti-reflux plasty according to Dor, which is associated to it. Manometric control has made it possible to define the various anatomical components that, at both the esophageal and gastric levels, constitute the area which functionally corresponds to the lower esophageal sphincter and therefore a correct execution of the myotomy. As demonstrated by the follow-up study of our surgical patients, the intraoperative manometric measurement of the strain and of the length of the anti-reflux plasty is the determining factor affecting outcome over time. The pressure is apt to decrease even 5 year after surgery; maintaining given length and strain standards when executing the plasty can prevent delayed complications, such as esophagitis from gastro-esophageal reflux.

Esophageal Achalasia↗
PubMed1990

Ambulatory 24-hr pH monitoring of esophagus, fundus, and antrum. A new technique for simultaneous study of gastroesophageal and duodenogastric reflux.

A method for outpatient 24-hr simultaneous recording of pH in the distal esophagus, fundus, and antrum was developed in order to detect acid, alkaline, alkalacid gastroesophageal reflux, and duodenogastric reflux and to study these phenomena in patients complaining of gastroesophageal reflux and dyspepsia related symptoms. Two hundred ninety-four studies were performed in 42 healthy volunteers and 237 patients. Three-probe ambulatory 24-hr esophagogastric pH monitoring applicability, tolerability, and capability to determine a relationship between symptoms which occurred during the tests, gastroesophageal reflux, and duodenogastric reflux episodes were assessed. Eighty-nine percent of the three-probe esophagogastric pH studies were easily performed. The examination was tolerated well by 86.1% of the patients and poorly by 13.9%. A temporal correlation between symptoms and pH activities was recognized in 61.3% when the esophageal tracing was considered (acid gastroesophageal reflux recording) and in 95.6% when the three pH traces were simultaneously interpreted. Alkalacid gastroesophageal reflux and duodenogastric reflux total percentage times were significantly higher in patients complaining of dyspeptic symptoms than in patients only affected by typical gastroesophageal symptoms. Three-probe 24-hr ambulatory esophagogastric pH monitoring is a simple, well-tolerated test that should be routinely adopted for the study of patients complaining of unclear upper gastrointestinal tract symptomatology.

Adolescent↗
PubMed1989

Peripheral venous nutrition in surgical patients: techniques, indications and results.

Peripheral venous nutrition (PVN) has been proposed to avoid complications resulting from central venous catheterization in surgical patients. Using lipid emulsions 3 standard diets (with final osmolarity not higher than 900 mOsm/1, non-protein calories from 1675 to 2177, electrolytes 110 mEq, Cal/N ratio from 130/1 to 170/1) were worked out. They are suitable for total nutrition of non-hypercatabolic patients and for nutritional postoperative maintenance of patients undergoing major digestive tract surgery. The three diets were tested in 118 patients. Frequency and type of phlebitis and the nutritional status before and after treatment were evaluated in patients submitted to PVN and in 2 groups of 10 patients who received S-D5W infusions and Protein Sparing Nutrition (N = 12.8 g, total Cal. = 690, electrolytes = 110 mEq, osmolarity = 493 mOsm/l, pH = 7) in the postoperative period. Frequency of phlebitis was significantly lower in PVN patients than in control groups. 15 day treatment did not increase the frequency of phlebitis. In medium-term treated patients the mean daily nitrogen balance was always positive. Perioperative PVN achieved a statistically significant reduction of nitrogen losses with respect to PSN and S-DSW infusion.

Adult↗
PubMed1977

[Myocardial protection during open heart operations].

The need for adequate protection of the myocardial tissue during open heart operations has proved to be of considerable importance in view of the conditioning value of the functional anatomical state of the myocardial fibre on the outcome of the surgery itself. After a review and description of the most widely used methods of protection, the Authors draw on the data in literature in order to trace a critical profile of each method, outlining its merits and defects in the light of present experience.

Cardiac Surgical Procedures↗