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Biomedical subjects

M Paluzzi

Publications and source records attributed to M Paluzzi.

5 recordsLinked to original sources
PubMed1997

Abdominal wall endometriosis after amniocentesis. A case report.

BACKGROUND: Amniocentesis is a procedure performed commonly in the evaluation and early diagnosis of fetal chromosomal abnormalities. The procedure is safe, with a major complication rate of 0.5% and the most common minor complication, spotting. CASE: A 27-year-old woman underwent amniocenteses to document pulmonary maturity prior to cesarean section. She presented 18 months later with a 6-month history of left abdominal wall pain and a mass that enlarged 2 days prior to menses and shrank 1 week after. The mass was located at the prior amniocentesis site. Excisional biopsy revealed endometriosis on final pathology. CONCLUSION: To our knowledge, this is the first well-documented case of abdominal wall endometriosis following third-trimester amniocentesis. The procedure should be considered a possible complication of amniocentesis.

Abdominal Muscles↗
PubMed1993

Postlaparoscopic small bowel obstruction.

Laparoscopic surgery continues to grow in popularity as a technique for approaching a variety of clinical problems. With an increase in the number of these procedures performed, unique complications, both early and late, will be identified. Optimal management of complications may differ significantly from the conventional approach. We describe the course of a patient who develops a high-grade partial small bowel obstruction 2 days after an uneventful laparoscopic cholecystectomy for acute cholecystitis. The patient had a history of laparoscopic pelvic surgery 7 years previously. Findings at exploration included a Richter's hernia through a midline fascial defect unrelated to our procedure. This defect, approximately 5 cm below the umbilicus, was most likely secondary to her previous laparoscopic procedure. This finding supports routine fascial closure of 10-mm or greater trochar sites and early, aggressive investigation and intervention in postlaparoscopic bowel obstructions.

Cholecystectomy, Laparoscopic↗
PubMed1987

A prospective randomized study of the optimal source of nonprotein calories in total parenteral nutrition.

We previously showed that providing 30% of nonprotein calories as lipid eliminated glucose intolerance and ameliorated the other troublesome metabolic complications of total parenteral nutrition (TPN): hepatic abnormalities and hypertriglyceridemia. Whether such a mixed-fuel system is as effective as a hypertonic glucose-only TPN fuel system in achieving an anabolic state was tested in 88 consenting patients randomized to either conventional TPN (25% dextrose and 4.25% amino acids) or modified TPN (15% dextrose, fat, and 5% amino acids). Treatment groups were: group A, no surgery, TPN only; group B, postoperative TPN starting 48 hours after surgery; and group C, preoperative TPN, surgery on day 7 and with continued postoperative TPN. In all groups TPN was given for 14 days while patients were given nothing by mouth. Changes in the indexes of body protein metabolism, reflected by nitrogen balance, serum albumin, blood urea nitrogen, and weight, were measured on days 1 and 14. Nitrogen balance improved in patients randomized to either regimen, but there was no significant difference in the degree of improvement. Albumin levels were maintained, and differences between initial and final values were not significant. Blood urea nitrogen increased in all groups (p less than 0.05); however there was no significant difference between regimens. Patients maintained their weight, and fluid balance data indicated no water retention. Observed weight changes were not statistically significant. In each treatment group an anabolic state occurred and gains in measured protein indexes were similar. Isocaloric replacement of 30% of TPN glucose calories with fat was as effective as glucose-only TPN in achieving an anabolic state without the metabolic complications associated with glucose-only TPN.

Blood Urea Nitrogen↗
PubMedDate not supplied

Clinical use of total nutritional admixtures.

The administration of a single mixture of the components of total parenteral nutrition (TPN) constitutes total nutritional admixture (TNA), the safety and efficacy of which in a variety of clinical settings have been confirmed by controlled trials. According to the nitrogen balance and stable isotope methods, TNA is as efficacious as the old system of three bottles with piggyback intravenous fat emulsion in maintaining body nitrogen mass, visceral protein, and liver function. Also, serum concentrations of electrolytes, trace elements, and vitamins can be maintained adequately using the TNA system. The other advantages are the timesaving to the nursing staff, with its hidden savings in cost; the avoidance of a peripheral catheter solely for the infusion of lipid emulsion in addition to the central catheter for TPN in hospitalized patients; and the facility of use in home nutrition programs. The ease of home use has resulted in a greater degree of patient compliance; thus patients receive a mixed-fuel system while avoiding the hazards of a piggyback infusion, with all its potential complications. Among the perceived disadvantages of TNA are a supposed higher frequency of catheter-related sepsis, a view based on in vitro studies that is not borne out by in vivo studies; catheter occlusion by precipitation of calcium salts; and enhanced ability to clear fat and thus fat tolerance with continuous infusion of lipids. Numerous studies have shown that these concerns are unwarranted.

Bacteria↗