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Biomedical subjects

A Pezzana

Publications and source records attributed to A Pezzana.

At least 19 recordsLinked to original sources
PubMed2002

[The team approach].

Teamwork is emerging like a model of prevailing reference in many working fields: the interaction and, above all, integration between several persons can be an instrument to empower the individual skills, allowing to reach different and higher levels of creativity and efficiency than the sum of the single members' capacities. However, the capacity of interaction, tolerance, and focusing on the problem is required to the members who also need training for this way of working. After a brief historical summary of some ''creative groups'' experiences in the fields of literature, science and arts, a vast review of theoretical model references is presented. Starting from specific North-American guidelines, a hypothesis of nutritional teamwork is introduced. This hypothesis aims at optimizing therapeutic interventions, at the critical review of the provided services and at a greater care for the cost-benefit ratio.

English Abstract↗
PubMed1996

[Postoperative fistulas after gastrectomy: risk factors in relation to incidence and mortality].

The relations between incidence and prognosis of postoperative fistulas after gastrectomy and some different variables were analysed in the present retrospective study. Thirteen digestive fistulas of 113 patients (11.9%) submitted to gastrectomy during the period 1989-1994 represent the study population. The incidence of postoperative fistulas was compared to the kind of gastric pathology, to the extension of gastrectomy, to different nutritional (serum haemoglobin, albumin and transferrin level, weight loss) and immunological factors (serum lymphocytes) and, for oncological patients, to the stage of the disease. Incidence was directly related to the extension of gastrectomy, to serum albumin and haemoglobin level, and to weight loss rate. The results were not statistically significant at Kruskal-Wallis and ANOVA tests. No relation was found between incidence of fistulas and serum transferrin level, number of lymphocytes and adoption of early postoperative enteral nutrition. Six patients had spontaneous closure of the fistula with conservative therapy. Seven patients required reoperation because of abdominal sepsis (53.8%). Three patients died (23%). Although spontaneous closure, reoperation and mortality were related to nutritional and immunological state, no examined variables showed a statistically significative relation. The adoption of early postoperative enteral nutrition was not related to the prognosis, unlike the stage of the disease: patients submitted to reoperation had a TNM III or IV stage; dead patients had a TNM IV stage. Treatment of metabolic-nutritional unbalance can prevent anastomotic failure and fistula after gastrectomy and improve the prognosis. The relation between early postoperative enteral nutrition and incidence and prognosis of postoperative fistulas remains unclear.

Analysis of Variance↗
PubMed1994

[Total parenteral nutrition in critical patients. The metabolic-nutritional aspects and effects on immune function of 2 different isocaloric-isonitrogenous regimens].

The aim of this investigation was to compare, in a randomized short-term study the effects on some parameters evaluating lipid metabolism, nutritional status and immune function of two different patients. Particularly, the influence of the intravenous (i.v.) infusion of a fat emulsion on above-mentioned parameters was evaluated. The two regimens (G and GL) were isocaloric (about 30 kcal.kg-1.d-1 non protein energy) and isonitrogenous (about 0.27 g.kg-1.d-1 nitrogen); the only difference was the source of non-protein calories administered. Regimen G consisted of glucose-based TPN (100% of non-protein energy as glucose) whereas, in regimen GL (glucose-lipid-based TPN), the 55% of non-protein caloric supply was given as glucose and 45% as lipids. 9 of the patients were randomly assigned to receive regimen GL (group GL) and 8 to receive regimen G (group G). TPN was delivered through a central vein catheter for 8 days; during this period no hepatic or metabolic complications have been observed. Clinical and laboratory tests were performed at day 0 (enrollment), at day 4 (after 4 days of TPN) and at day 8 (at the end of TPN). Both regimens of TPN were able to induce an improvement of the nutritional status and serum prealbumin (TBPA) significantly increased in all patients (p < 0.05). The results of the immune measurements showed that no significant change in immune function during the administration of either regimen occurred. However, in group GL, we observed a slight, non significant change in the percentage numbers of T-cells subpopulations that resulted in a decrease in the ratio of helper to suppressor T-cells (H:S). Serum lipids and lipoprotein profile didn't change significantly in group GL. On the contrary, in group G, we observed a significant decrease in serum concentrations of HDL cholesterol (p < 0.05), LDL cholesterol and apo A1 (p < 0.01) while total cholesterol remained unchanged; a non significant rise in serum triglyceride also occurred, These results show that the two regimens had a similar impact on nutritional status in both groups. The i.v. infusion of the fat emulsion didn't alter lipid profile and was not associated with an impairment of some aspects of the immune function. In conclusion, our results confirm that fat emulsions represent an important component of i.v. nutritional support regimens and should continue to be used when and where indicated in short-term TPN. However, long-term effects of i.v. infusion of fat emulsions on the immune systems should be further investigated, in a more substantial number of patients.

Adult↗
PubMed1993

[Percutaneous endoscopic gastrostomy].

Surgical gastrostomies were first performed in the middle of the 19th century and modified during the following years, but the most important technical improvement was percutaneous endoscopic placement (PEG), in 1980 by Ponsky and Gauderer. This technique doesn't require anesthesia and it in possible also in patients with contraindications to surgical gastrostomy. The simple procedure involves a shorter hospitalization, lower risks and reduced costs. Many authors already reported the good results of this new technique, that can be performed on a day-hospital regimen as well. The main indications are head and neck cancers, neurologic diseases involving food intake capacity, cancer cachexia, obstruction of the GI tract when there is enough space for an endoscopic procedure. Every disease that can compromise food intake for a period longer than 60 days can find an indication in placing a percutaneous gastrostomy. The advantage for the patient is a much better psychological tolerance compared with a naso-gastric tube. Also the incidence of mechanical complications of a PEG is much lower. In our experience from October '90 to July '92 we followed 34 patients with PEG, 22 males and 12 females, with mean age of 69 years (range 41-88). We used 9-French tube placed using the pull-method technique. All patients received antibiotic therapy for 5 days. About 12 hours after PEG placement all patients began using the gastrostomy, initially with the administration of electrolyte solutions and later with enteral polymeric formulas. The constant increase led all patients to a 1500 non protein calories daily intake in 3-4 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Possibilities and limitations of nutritional support in Crohn disease].

Crohn's disease involves a great risk of malnutrition. Malabsorption, bacterial contamination, frequent abdominal surgery, meal-related pain, protein loss through the damaged mucosa contribute to creating nutritional problems. Malnutrition can worsen the outcome, both in medical and surgical patients, and deteriorate an often already altered immune response. Weight loss, low levels of blood protein, electrolytes, micronutrients and vitamins are usually related to the extension of the mucosal damage. Nutritional assessment can be difficult due to oedema and bleeding, who interfere with both clinical and laboratory evaluation. The exact amount of nitrogen, lipids, minerals stool loss can be useful. It is widely accepted the use of nutritional support in Crohn's disease, but many Authors do not agree concerning the route (enteral or parenteral) and the kind of nutrient to be used. Still controversial is the role of nutrition: just support or real therapy? Most recent hypothesis concerning the pathogenesis of Crohn's disease indicate food and/or bacterial antigens as involved in determining the pathology. The "bowel rest", considered for many years as a fasting period necessarily supported by parenteral nutrition, can also be obtained by the temporarily reduction or stop in presenting those antigens to the bowel mucosa. This new concept can be achieved not only by parenteral nutrition, but with an enteral elemental diet as well. The elemental diet contains all nutrients in the simplest way and thus succeeds in lowering or eliminating the antigenic power. The reported results seem to indicate an equivalence of enteral and parenteral nutrition; anyway enteral is advisable when feasible, being more physiological and less expensive and involving a lower risk of serious complications.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMedDate not supplied

[Nutritional support in non-Hodgkin's lymphoma treated with polychemotherapy MACOP-B cycle].

The collateral effects of antineoplastic therapy often lead to a deterioration of the cachectic condition induced by the presence of the tumour itself. This study analysed the effects of a programme of dietary surveillance/support in patients with non-Hodgkin's lymphoma undergoing a cycle of MACOP-B polychemotherapy. During the entire course of therapy patients were followed weekly by a nutritional specialist and a dietician in order to assess and if necessary modify food intake, also in relation to the onset of collateral effects. Using this programme it was observed that a satisfactory nutritional state was maintained during the entire cycle, with an increased food intake compared to the start of the cycle and to conditions of good health.

Adult↗
PubMedDate not supplied

[Role of nutritional support and physical exercise in the dyslipidemia of renal transplantation].

The purpose of the study is to evaluate the effect of diet and physical exercise on the dyslipemia of renal transplant (RT) patients 52 pts, transplanted between 12/85 and 4/87, subdivided into 2 groups (A and B), were studied. Characteristics of the diet adopted in patients in group A are: low carbohydrates, moderate animal protein, unsaturated and polyunsaturated fat in high rate. The second group had a lower animal protein and more fiber rich diet than the first one and a program of PE. By comparing A and B1 we noticed and increase in body weight, more slight in the group B, at the 24 months (56 +/- 8 59 +/- 10 vs 59 +/- 10 61 +/- 10). The study of lipid behaviour has showed a trend to normalization of triglycerides at 24 months in A (189 +/- 88 106 +/- 33) and in B1 (173 +/- 81 103 +/- 40), more evident normalization of cholesterol in group B1 (195 +/- 72 185 +/- 42), and increase of CT-HDL in A (42 +/- 12 63 +/- 17) and in B1 (44 +/- 10 61 +/- 14, p less than 0.05). It should be noted that CT-LDL increase in A (100 +/- 34 131 +/- 40) but not in B1 (103 +/- 35 111 +/- 33). With the aim of this program we obtained a positive effect on DL with a slight increase in body weight, a significant increase in CT-HDL without variation of total CT and CT-LDL levels.

Adult↗
PubMedDate not supplied

[The role of the intestine in the pathogenesis and treatment of multiple organ failure].

Infection and sepsis remain major causes of death in medical and surgical services, despite the availability of potent antibiotics, aggressive surgery and close monitoring of patients in intensive-care units. Actually the terminology to define this type of events in multiple organ failure: we considered the role of intestine in its pathogenesis and its management.

Animals↗
PubMedDate not supplied

[Role of diet in the treatment of constipation. Review of the literature].

Constipation represents a common social phenomenon today, correlated with the habits of diet and life. Many studies have shown the lack of alimentary fiber as a cause of constipation. In analyzing the different types, the characteristics, the physical and metabolical action of fiber, it has been shown that it is necessary to introduce fiber into the everyday diet to be able to prevent or cure constipation. In addition, it has been seen that there has been a reduction in the consumption of fiber in many nations and some reasons have been investigated.

Constipation↗
PubMedDate not supplied

[The role of early protein restriction in patients with initial renal insufficiency].

The effect of early protein restriction (0.6 g:kg/p.i./die) in patients suffering from initial kidney failure for a period of two years has been studied. The hypoprotein diet proved effective in slowing development of kidney damage in so far as a stabilization was observed in renal function parameters during the hypoprotein diet period compared to the non-diet period.

Adult↗
PubMedDate not supplied

[Influence of coffee on plasma lipids].

The influence of coffee on plasma lipids has been largely investigated during the last twenty years, but still many doubts remain about this subject. For this reason the influence of the assumption of coffee on plasma lipids, in healthy people, during six weeks has been studied. The coffee was prepared with an Italian coffee-machine (moka). No relationship was found between coffee assumption and increase of hematic cholesterol.

Adult↗