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V Pasta

Publications and source records attributed to V Pasta.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

[Monitoring sheet for the management of the diabetic patient in preparation for elective surgery].

Diabetes represents a risk factor for patients undergoing surgery, not only in emergency but also in elective situations. All efforts in such patients are addressed to the restoration of the most physiologic conditions in respect for glucose balance and glucose metabolism since the preoperative phase, and during all the perioperative period. As these patients have to observe a more or less long period of preoperative and perioperative fasting since the day preceding the operation, any oral anti-diabetic regimen has to be timely discontinued, and the use of insulin is necessary. The doses of insulin have to be defined preoperatively with respect of the metabolic needs of the patients in the days preceding the operation, and must be able meanwhile to reduce blood glucose among the physiologic values, in absence on any urinary glucose, to restore a correct metabolism. The simple management form introduced in the paper for this purpose, and in use in our department through many years, makes easier getting and keeping all this aim and is extremely useful not only for the residents but also for the nurse staff. Its main characteristic is to offer daily, and for the single meal, a direct visual comparison of insulin dose and blood glucose level, in respect of a correct and constant caloric alimentation.

Diabetes Mellitus↗
PubMedDate not supplied

[The complications of diagnostic colonoscopy].

Major complications of diagnostic colonoscopy based on a series of 17.583 procedures performed from 1980 throughout 1991 are reported. No higher risk of colon perforation was registered either performing total or partial colonoscopy, for the site of perforation was in most cases the sigmoid colon.

Colon↗
PubMedDate not supplied

[Current diagnostic-therapeutic trends in carcinoids of the papilla of Vater].

Diagnosis and treatment of carcinoid tumor of the ampulla of Vater: case report. The carcinoid tumour of the ampulla of Vater is extremely rare. The authors report one case. Therefore, they dwell upon the problem connected with classifications, symptomatology and diagnosis of these neoplasms which present difficulty to diagnose preoperatively. At last, they reaffirm the primary role of pancreaticoduodenectomy with lymphadenectomy and, if it is possible, the necessity to extirpate the liver metastases.

Adult↗
PubMedDate not supplied

High resolution mini-gammacamera and 99mTc [HMPAO] - leukocytes for diagnosis of infection and radioguided surgery in diabetic foot.

Discovery of osteitis may be delayed because of late appearance of X-ray signs in patients with diabetic foot. Scintigraphy with labelled leukocytes is able to detect flogosis but often misses bone involvement, due to inadequate resolution of Anger camera, the commonest detector used in nuclear medicine. Radioguided surgery and biopsy with high resolution scintigraphy (HRS) started to be studied since 2000: although this method had never been tested for planning and guiding diabetic foot surgery, in our opinion it can help early diagnosis and surgical treatment of diabetic foot. Five patients with diabetic foot and suspected infection were studied with standard 99mTc [HMPAO]-leukocyte scan. In the same patients 2 mm spatial resolution HRS was performed 24 hours after administration of labelled WBC, using our inch2 field-of-view portable mini-gammacamera. Operations were done just after the 24h scan and were guided with the portable high resolution device in the four patients who showed positive scan. Scintigraphy with Anger camera and HRS were positive in four patients. HRS showed a bar-shaped radioactivity corresponding to small phalanges, close to the main inter-digital hot spot. The presence of osteitis on phalanges that had been shown by HRS was confirmed at surgery, that was successfully driven with the high resolution mini-camera. In conclusion HRS is able to diagnose early osteitis of diabetic foot and to guide diabetic foot surgery.

Diabetic Foot↗
PubMedDate not supplied

[Rare malformation of the bile ducts of surgical interest].

Variations from normal anatomy of extrahepatic biliary tract, especially if on the basis of a congenital defect, are often dangerous for the surgeon, as hidden cause of a possible injury during surgery. During a cholecystectomy performed for lithiasis in non functioning gallbladder, whose preoperative cholangiogram revealed nothing of suspect, the dissection of cystic duct was regular at its normal junction with the Common Bile Duct (CBD). Because of the scheduled intraoperative cholangiogram, it was however not severed but only dissected free. The gallbladder was therefore detached from the liver in anterograde progression, after hemostasis and section of a normal cystic artery. During the detaching of gallbladder from the liver what seemed a very large "hepato-cystic" duct coming to the infundibulum was met: for caution the cholangiogram was then made proximally to such "hepato-cystic" duct that instead revealed to be the main right hepatic duct coming to the infundibulum of gallbladder without confluence with the left hepatic duct. The biliary tract going from the gallbladder to the supposed CBD was in fact the cystic duct, as the Heister's valvulae clearly show on the cholangiograms. Cholecystectomy was therefore performed proximally to the confluence of right hepatic duct, and the postoperative course was uneventful. Such kind of extrahepatic tract derangement must be very rare, because of the apparent lacking in literature of any similar case, also if the possibility is mentioned.(ABSTRACT TRUNCATED AT 250 WORDS)

Bile Ducts↗
PubMedDate not supplied

[Correlation between post-cholecystectomy syndrome and biliary reflux gastritis. Endoscopic study].

Experimental reports have proved that bile acids damage the gastric mucosa. Moreover it is now accepted that duodenogastric reflux occurs in 20-30% of cholecystectomized persons. The Authors, with the purpose of defining a correlation between gastric mucosa damage by duodeno-gastric reflux and postcholecystectomy syndrome have taken into consideration two groups of 14 patients each. To the first group belonged cholecystectomized patients, who had episodic, often postprandial pain, constant heart burn, with associated vomiting and Hypochromic anemia. To the second group belonged asymptomatic patients with previous cholecystectomy. All these patients were endoscoped (EGDS), and their endoscopic biopsy specimens were surveyed. 99Tc HIDA cholescintigraphy was performed in all the groups of patients, after endoscopy. In 85% of symptomatic patients we found, during endoscopy, reflux of bile into the stomach with associated reddish and inflammatory change of antral mucosa vs. 7.14% of the control group. Atrophic chronic gastritis was found in 71.43% of endoscopic biopsy specimens of Symptomatic vs. 14.28% of asymptomatic patients. Superficial chronic gastritis was found in 28.57% of symptomatic vs. 50% of asymptomatic patients. At last we found active atrophic or superficial antral gastritis (Whitehead) in 90% of symptomatic patients vs. 0% of asymptomatic people. The Authors conclude that there is a positive correlation between duodenogastric reflux and postcholecystectomy syndrome when biliary reflux is correlated with an histological finding of antral active chronic gastritis.

Bile Reflux↗