Biomedical subjects

M Castagneto

Publications and source records attributed to M Castagneto.

201 records · Page 12Linked to original sources

PubMedDate not supplied

Medium-chain triglycerides for parenteral nutrition: kinetic profile in humans.

Medium-chain triglycerides (MCTs) have been introduced as lipid substrates in parenteral nutrition because of their rapid and complete oxidation. Although there are many clinical studies on the use of MCTs in parenteral nutrition there are only a few studies on their kinetics; most of these studies used indirect methods (such as light scattering) to determine MCT concentrations in plasma. We determined the hydrolysis rate of MCTs to medium-chain fatty acids (MCFAs) and the disposition rate of MCFAs in nine healthy volunteers who received an intravenous bolus of MCTs as 10% MCT + 10% long-chain triglyceride solution. MCTs and MCFAs were analyzed by gas-liquid chromatography. One linear compartment model was used and its parameters were numerically estimated. The first-order transformation constant of the hydrolysis step from MCT to MCFA was 0.0964 +/- 0.0152 min-1(for 8- and 10-carbon pooled together); the rate constant for tissue MCFA uptake from plasma was 0.0725 +/- 0.0230 min-1. The apparent volumes of distribution were about 4.5 L for MCT and 19 L for MCFA in a typical 70-kg subject. The plasma half-life of MCT was 11 min and that of MCFA was 17 min. The limiting step in the clinical use of MCTs seems to be tissue uptake of MCFAs.

Adult↗

PubMedDate not supplied

Lower limb revascularization in diabetics.

Treatment of critical lower limb ischemia in diabetics is often a complex clinical problem for the diabetics' general condition and the local condition of the territory to be revascularized. For these reasons, often the only treatment for diabetics with ischemic-necrotic lesions is amputation. In the symptomatology of arterial disease in diabetics there are three stages: claudication, rest pain, ulcerative-necrotic lesions and two treatment modalities: conservative treatment and revascularization. Conservation is based on the optimization of metabolic control, correction of anemia, control of risk factors, removal of necrotic areas, specific antibiotic treatment based on culture tests. No healing of ulcerative-necrotic lesions after a reasonable period of optimum therapy, quantified in 6 weeks, is suggestive for the presence of absolute or relative ischemia and diagnostic angiography is suitable for the indication for intravascular or surgical revascularization. The latter, in case of diabetics with ischemic complications of the foot, is performed in specialized centers with inverted saphenous veins or in situ in the supragenicular and subgenicular district. Recently intravascular revascularization with balloons, atherotomes, stents, less invasive and less traumatic than bypass revascularization, have become available. At present, with peripheral revascularization, limb salvage at 5-years is feasible in 92% of diabetics with critical lower extremity ischemia.

Amputation, Surgical↗

PubMedDate not supplied

The foot clinic. Multidisciplinary management of the patient with diabetic foot.

Treatment of a complex disease as the diabetic foot requires a multidisciplinary management with the close collaboration of a team for care. The most important members of the team are the diabetologist as coordinator, the vascular surgeon, the orthopedist, the radiologist, the orthopedic technician, the podiatrist and the nurse specialist. The care based on this arrangement should be carried out in dedicated rooms and times to exploit at best the organizational potential in the patient's interest, implemented in the foot clinic.

Diabetic Foot↗