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Biomedical subjects

P Pesko

Publications and source records attributed to P Pesko.

At least 55 records · Page 3Linked to original sources

Venous thromboprophylaxis in oesophageal cancer surgery.

In a retrospective study of 127 patients who underwent resection for oesophageal cancer without anticoagulant thromboprophylaxis, the incidence of clinically established postoperative deep vein thrombosis (DVT) was 1.6 per cent. In a prospective study the Sue-Ling DVT risk factor index was calculated for 53 consecutive patients with oesophageal cancer; the mean (s.d.) value was -4.4(3.5). For 29 patients who underwent resection the following policy of thromboprophylaxis was applied. Patients undergoing transthoracic oesophagectomy with risk score > -4 (four patients) and those undergoing transhiatal resection with risk score > -1 (four) received both anticoagulant and mechanical thromboprophylaxis; the remaining 21 patients received only mechanical thromboprophylaxis. No patient developed DVT after operation. There were no haemorrhagic complications in the group undergoing anticoagulant thromboprophylaxis. The selective approach, based on the Sue-Ling risk factor index and type of operation, spared 72 per cent of the patients operated on from undergoing anticoagulant thromboprophylaxis and produced favourable results in this small series.

Aged↗

Atrophic chronic gastritis and esophagogastric anastomotic leak after resection and reconstruction for esophageal carcinoma.

The incidence of anastomotic leakage after esophagectomy for cancer and reconstruction with the stomach was analyzed with respect to the presence of coexistent atrophic chronic gastritis (ACG). Of a total of 28 operated esophageal cancer patients with ACG, 6 patients developed an anastomotic leak at the cervical esophagogastrostomy (21%). Of a total of 8 operated esophageal cancer patients none of the patients developed an anastomotic leak. The ACG positive and the ACG negative patients were found to be well matched for age, sex, type of operation, transplant route, level of the anastomoses, and suture technique, and all were operated on by the same surgeons. The difference in leakage rate did not reach statistical significance.

Aged↗

[Early postoperative complications in elective splenectomy in hematologic diseases].

This study analyses frequency of complications and mortality after elective splenectomy done for various hematological diseases, dependent on the spleen weight. From 1979 to 1988 year, 236 patients were treated by splenectomy for various haematological disorders, including: autoimmune disorders (90), Hodgkin's disease (34), lymphoproliferative diseases (96) and myeloproliferative diseases (16 patients). In the early postoperative period, complications occurred in 51 (21.61%) patients, 10 of which (4.24%) died. Considering the size of the spleen (more or less than 1500 gr) there was no difference in the early postoperative mortality (p greater than 0.05; 3.30%:5.38%), while postoperative complications occurred significantly more often in patients with massive splenomegaly (p greater than 0.05; 1259%:3548%). The most frequent complications were septical (8.90%), prolonged fever (5.51 x), and postoperative bleeding (2.97%), while cardial, pulmonary and urinary complications occurred seldom, but more often caused patient's death. Defining the appropriate indications for splenectomy, performing suitable preoperative preparations and postoperative care, mortality was diminished from 7.14% in the period, 1979-1983 year, to 2.17% in the period 1984-1988.

Adolescent↗

[Paraesophageal hiatal hernia of the diaphragm].

Paraesophageal hernia (type II hiatal hernia) accounts for less than 5-10% of all herniation through the esophageal hiatus. Anatomically, it is distinguished from the more common sliding variety (type I hiatal hernia) by the position of the gastroesophageal junction. The management of paraesophageal hiatal hernia is influenced by the tendency of the herniated stomach to develop volvulus, which potentiates life-threatening complications that include complete gastric obstruction, bleeding, infarction and perforation. In a cases with gastroesophageal reflux one of the antireflux procedures had to be done. In the Institute of Digestive Diseases, in the 16 years period from 1980-1996, 37 patients had treated of paraesophageal hernia. Authors discuss their management strategies, especially the using of antireflux procedures.

Female↗

[Evaluation of enterogastric reflux using a modified scintigraphy method].

The aim of the study is evaluation of the clinical validity of the chosen and modified own model of the nuclear medicine method for the detection and quantification of enterogastric reflux (EGR), as well as evaluation of its clinical validity. The study was performed in 172 patients: with gastric and duodenal ulcer, after Billroth I and Billroth II gastrectomy, with gastroesophageal reflux, after cholecystectomy, with chronic cholecystitis and chronic duodenal disease. Acquisition was performed with gamma camera, during 90 minutes after intravenous application of 185 MBq 99m-Tc-Dietil IDA. Test meal was given in 30th minute, while gastric region was marked at the end of the study. On the basis of the radioactivity changes in the regions of the stomach and hepatobiliary system, presence of enterogastric reflux is determined and its index calculated. In all the groups of patients, values are significantly different from physiological. The most frequent occurrence and the largest quantity of reflux is present in patients after Billroth II gastrectomy with significantly different values from other groups of patients. The obtained results approve clinical value of the chosen and modified scintigraphy of EGR as a non-invasive and physiological method, which provides data about its presence and quantity.

Adolescent↗

Radioimmunodetection of colorectal carcinoma.

BACKGROUND/AIMS: The aim of the study is detection of the recurrences and metastases of colorectal carcinomas using 111In-labeled antibodies B72.3. METHODOLOGY: Fourteen patients underwent planar immunoscintigraphy and/or tomoscintigraphy. RESULTS: With tomography in comparison to planar scintigraphy, we can access better distinction of tumor and estimation of its size. Other imaging methods (computed tomography, ultrasonography) have an advantage in detection of liver metastases, while immunoscintigraphy is more specific for the assessment of malignant abdominal tumors and extrahepatic metastases. CONCLUSIONS: The first results point out that Oncoscint CR-103 can be useful in diagnosis of recurrences and metastases of colorectal carcinoma, viability assessment after radiotherapy and in the choice of the adequate surgical treatment in dependence of the spread of the disease.

Adenocarcinoma↗

Detection of gastrointestinal and abdominal infections by 99mTc-ciprofloxacin.

BACKGROUND/AIMS: The aim of the study is detection and evaluation of the abdominal and gastrointestinal infective foci using 99mTc-ciprofloxacin (Laboratory for radioactive isotopes, Vinca). METHODOLOGY: In total 21 patients with clinical suspicion on abdominal or gastrointestinal infection were investigated. In all the patients, planar liver/spleen scintigraphy was performed. Ciprofloxacin chloride (3.5 mg) was mixed with 555 MBq of 99mTc in 3 mL of physiological solution and incubated for 20 min. After slow i.v. injection in a cubital vein, dynamic acquisition (1 f/min) was performed during the first 60 min in the position of interest, followed by static acquisition (500,000 imp) anterior and posterior view, abdomen and pelvis after 1 h and 4 h in all patients. When necessary, additional scintigrams were acquired after 24 h. In all the patients with negative or equivocal findings of planar scintigraphy, emission computerized tomography (SPECT) was performed (60 positions, 6 degrees). Interpretation was made by three independent observers. Additional data were provided using clinical findings, ultrasonography, computed tomography and magnetic resonance imaging, laboratory analyses, and surgical or microbiological confirmation of infection. RESULTS: There were eleven true-positive findings, seven true negative, two were false negative while one was false positive due to intestinal obstruction. Sensitivity was 79%, specificity 91%, positive predictive value 92%, negative predictive value 77%, accuracy 84%. CONCLUSIONS: According to our results, scintigraphy with radiolabeled ciprofloxacin is a useful method for detection and assessment of exact localization of abdominal and gastrointestinal infections.

Abdomen↗