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Biomedical subjects

A Leutenegger

Publications and source records attributed to A Leutenegger.

At least 73 records · Page 4Linked to original sources
PubMed1985

[Morbid obesity: what is still justified in surgical therapy?].

The main surgical procedures in the treatment of obesity are described. Plastic surgery, e. g. apronectomy or breast reduction, may be discussed in patients after successful weight reduction, but not as a primary operative treatment of massive obesity. Different intestinal bypass procedures inducing malabsorption have been abandoned because of severe metabolic sequels. More physiologic conditions can be achieved with gastric partitioning creating a small upper gastric pouch in continuity with the remainder of the stomach. If strict rules of patient selection and operative technique are observed, satisfactory weight loss without significant late complications may be achieved.

Body Weight↗
PubMed1984

[Comparative study of a new commercially produced combination solution (fat, carbohydrates, aminoacids) for complete parenteral feeding of surgery patients in intensive care].

In 10 randomly selected surgical ICU patients, a new regimen of total parenteral nutrition (TPN) using a so-called all-in-one (AIO) solution was tested prospectively. Another 10 patients receiving conventional TPN served as a control group. For a minimum of 7 days the patients were given either an AIO solution containing 40 g crystalline L-aminoacids, 38 g fat, 75 g sorbitol and 45 g xylitol in 1000 ml or a conventional TPN with glucose and aminoacids. The regimens were identical regarding caloric intake and Joule/N ratio. Amounts of infused solutions were adjusted according to patient's weight. Both regimens were well tolerated and side effects requiring interruption of the protocol did not occur. A set of 36 laboratory parameters underwent detailed statistical analysis. Efficiency of both regimens in improving nutritional status was documented. Comparing the two groups, we found only two important differences: glucose levels in the AIO group were lower than in the control group, and the bilirubin increase observed in both groups (probably a sign of cholestasis) was higher in AIO patients. Immediate postoperative or posttraumatic nutrition with an AIO solution was safe and simple to administer. Because glucose metabolism is only minimally overstrained, AIO compares favorably with conventional TPN and is a promising alternative when stress-induced glucose intolerance occurs.

Adolescent↗
PubMed1982

[Experience with measurements of intracranial pressure in post-hypoxic and post-traumatic coma].

In 27 patients intracranial pressure monitoring (ICP) was carried out for 4-5 days (severe head injury 23, hypoxia after cardiac arrest 3, brain tumor 1). Patients were included who reached a score of 8 or less on the Glasgow Coma Scale and who did not need immediate surgery. The measurements were done with epidural screws (20 patients) and with indwelling ventricular catheters 7). The individually highest ICPs were recorded 3-4 days after incident. 14 patients recovered completely, 3 remained slightly and 3 severely disabled, and 7 patients died. ICP monitoring permitted precise and rational therapeutic management but was of little value prognostically. Poor Glasgow scores were linked to high mortality. The advantages and disadvantages of the two ICP monitoring techniques are discussed. ICP monitoring is recommended as a useful and safe tool for titrated management of deeply comatose patients.

Adult↗
PubMed1982

[Diagnosis of brain death and organ donation].

The Swiss Academy of Medical Sciences published its guidelines for brain death evaluation and removal of donor organs in 1968. Based on this, the authors have designed a formal written protocol for brain death certification with the object of establishing the diagnosis of brain death beyond doubt and within reasonable time. The protocol serves for identification of suitable organ donors.

Brain Death↗
PubMed1980

[Peripheral venous tolerance of hyperosmolar infusion solutions].

Basic nutrition solutions become ever more important in postoperative infusion therapy. We tested the peripheral venous tolerance of an infusion solution which included aminoacids and carbohydrates (1100 mosm/l, 2400 kJ/l). We compared the peripheral venous tolerance of this nutrition solution with those commonly used in hospitals (Ringer-solution 330 mosm/1, 5% glucose solution 280 mosm/l 800 kJ/l, electrolyte glucose solution 407 mosm/l 800 kJ/l). The infusion thrombophlebitis was examined on 30 patients with the radiojodfibrinogen test. Despite three times higher osmolarity the peripheral nutrition solution shows no difference in peripheral venous tolerance after 48 hours.

Gastrointestinal Diseases↗
PubMed1980

[Antibiotic prophylaxis in colon surgery with Cefazolin].

In a prospective randomized and controlled double-blind trial the effect of prophylactic systemic administration of Cefazolin in elective colorectal surgery on postoperative wound infection was investigated. The incidence of wound infection was significantly reduced (P less than 0.01) from 32% in the control group to 10% in the treated group. Furthermore there was a significant reduction (P less than 0.05) in hospital stay of about 3 days.

Cefazolin↗
PubMed1979

[The catabolic patient].

Trauma and stress can cause characteristic changes in metabolism: raised lipolysis and reduced glucose tolerance as well as major renal nitrogen losses are manifestations of a postoperative or posttraumatic excess of catabolism over anabolism. Excess catabolism is caused by immobilisation and inadequate oral or parenteral nutrition. Wasting in seriously ill patients for intensive treatment. Priority must be given to the prevention of insufficiencies of organs and systems, and to the elimination of stress factors. It is only then that mobilisation and the administration of calories and nitrogen will restore a normal anabolism-catabolism balance.

Cachexia↗
PubMed1978

[Management of postoperative intestinal fistulas with elemental diet (author's transl)].

From 1973-1976 sixteen patients with clinically manifest post-operative fistulas (7 small intestinal and 9 colonic) were studied. These patients received an elemental diet (ED) as their only nutritional support for 9-44 days. On ED spontaneous closure was observed in 4 out of 7 small intestinal fistulas and in 7 out of 9 colonic fistulas. Hemoglobin and serum albumin increased significantly on ED and nitrogen balance performed on 7 patients was in equilibrium or positive. Advantages of ED over intravenous nutrition in the treatment of intestinal fistulas are discussed.

Adult↗