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Biomedical subjects

E Gianetta

Publications and source records attributed to E Gianetta.

70 records · Page 4Linked to original sources
PubMedDate not supplied

[A new approach to gastric restriction surgery in treatment of obesity. Preliminary data].

Following gastric surgery for obesity, a satisfactory weight loss and, above all, long-term weight maintenance can only be achieved in patients who have succeeded in radically changing their preoperative eating habits. In this preliminary study gastric banding is associated with rehabilitative training which was carried out using similar methods to the programs used for eating disorders. One year after surgery the results were substantially the same as those reported in the literature, with an overall weight loss of approximately 50%. The lack of correlation between weight loss and the degree of gastric banding underlines, even after a short interval, the efficacy and importance of postoperative re-educational training. The utility of this integrated approach will only be more fully evaluated after a longer period.

Adolescent↗
PubMedDate not supplied

[Behavior of serum proteins and lipids after jejuno-ileal bypass for obesity].

Variations in body weight, behaviour of lipidaemic fractions proteinaemia, uricaemia and uricuria, and lipid and protein absorption were studied preoperatively and at varying times following operation in five subjects who had undergone jejuno-ileal bypass for obesity. The results showed high serous NEFA and a definite, early and persistent reduction in all lipidaemic fractions after operation. The post-operative levels of serous proteins, particularly albumin, which were reduced in all subjects, reached pathological levels in two patients where proteic malnutrition following on the operation was associated with serious liver disease. The results agree with reported data. The variations in lipidic and proteic malabsorption proved to be in agreement with weight drop and the serous parameters considered. The reduction in uricaemia encountered in the five patients studied failed to agree with data reported in the Anglo-Saxon literature. This may be explained by alimentary and racial differences between the two populations of patients.

Adult↗
PubMedDate not supplied

[2 cases of death caused by hepatic insufficiency after jejuno-ileal bypass for obesity].

Reference is made to 2 cases of fatal liver failure following jejuno-ileal by-pass for obesity, in which necropsy shown micronodular and the rarer fragmentary necrosis, in addition to serious steatosis. Liver alterations following by-pass are usually reversible and respond to the infusion of medicaments. The indication for surgical re-establishment of continuity, in which, if timely, leads to normalisation of liver shape and function, must be chosen without hesitation when changes, albeit reversible, appear to threaten life and resist treatment, and in all cases where biopsy points to progression towards irreversible sclerosis.

Adult↗
PubMedDate not supplied

[Intestinal transit time in bilio-pancreatic bypass].

Transit times were evaluated in 23 obese subjects before and 1,4 and 12 months after biliopancreatic by-pass. A modified version of the method of Hinton et al. was used to determine emptying of the stomach and partial and total transit times. Emptying of the stomach was normal preoperatively. After surgery, it was almost immediate, except in two subjects with stomitis. Both transit times were virtually unchanged. Since the segment between the stomach and the ileocaecal valve is only half as long as in the normal subject, the results show that the by-pass leads to a slowing of transit that concerns the small intestine only, is quickly established, and does not change in the course of time. Evaluation of the altered anatomical and functional situation, and the absence of a correlation between the long-term behaviour of transit times on one hand and of lipid malabsorption and weight loss on the other-hand, suggest that a slower transit time must not be regarded as a compensation mechanism, except insofar as it restricts the degree of malabsorption set up immediately after surgery. Preliminary studies of enterohormonal changes following the by-pass indicate that increased glucagon and decreased motiline values are mainly responsible for slower transit times.

Adult↗
PubMedDate not supplied

Crohn's-like colitis in glycogen storage disease Ib: a case report.

Association between glycogen storage disease type Ib and Crohn's like disease is rare. We present one such case. A young woman with glycogen storage disease type Ib underwent a right hemicolectomy for stenosis and a blind fistulous tract. The histological picture of the resected bowel was consistent with the diagnosis of Crohn's like disease. A leak in the entero-colostomy occurred during medical treatment with steroids, sulfasalazine, and methronidazole. Partial ileal and colonic resection and a new anastomosis were then performed. Recombinant human colony-stimulating factor (300 mcg/die subcutaneously) was then started. The neutrophils promptly increased to a normal range, and the neutrophil function tests improved. The postoperative course was uneventful and the patient did not have a relapse of the bowel disease.

Adult↗
PubMedDate not supplied

[6 years of experience in inguinal and femoral hernioplasty in patients over 65 years of age].

From April 1990 to November 1996, 313 inguinal and 14 femoral hernias were repaired in 295 subjects with a mean age of 74 years (66 to 97). Concomitant diseases increasing the operative risk were present in 206 subjects (70 per cent). A mesh repair was performed with "tension-free" or "plug" techniques in all but 23 inguinal and 2 femoral herniorrhaphies where the Bassini or the Shouldice procedures were adopted. Fifty-two inguinal hernias were recurrent, 11 emergency herniorrhaphies were performed for strangulation. Almost all operations (305), including 9 emergency herniorrhaphies, were carried out under local anaesthesia. There was no perioperative mortality. Acute intestinal bleeding occurred after surgery in a subject with colon diverticulosis. One urinary retention following emergency hernia repair under general anaesthesia and 2 following elective hernia repair under local anaesthesia in 2 subjects with hypertrophy of the prostate were observed. Some episodes of hypotension and/or bradycardia were observed either during or after surgery. Local complications following inguinal hernioplasty were 5 (1.5%) scrotal hematomas, 3 (0.9%) wound infections and 1 case (0.4%) of orchitis with atrophy after repair of a recurrent hernia. There were 1 recurrence after Bassini, 1 after Shouldice, and 1 (0.4%) after mesh inguinal hernioplasty. Using local anaesthesia and a mesh repair elective surgery of inguinal and femoral hernias can be safely and effectively performed in elderly patients. Consequently, early elective surgery should be recommended to avoid the risk of an emergency operation.

Aged↗