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F Kalfarentzos

Publications and source records attributed to F Kalfarentzos.

46 records · Page 3Linked to original sources
PubMedDate not supplied

Comparison of forearm muscle dynamometry with nutritional prognostic index, as a preoperative indicator in cancer patients.

We studied 95 patients with cancer of the gastrointestinal tract in various sites. The aim of the study was to compare the forearm dynamometry vs the prognostic nutritional index which was reported by Busby et al, 1890. We used these methods as preoperative prognostic indicators for postoperative mortality and morbidity. The forearm muscle dynamometry has greater positive predictive value (58.33 vs 32.4%), higher sensitivity (77.78 vs 66.6%), and specificity (86.11 vs 65.28%) than the prognostic nutritional index. The forearm muscle dynamometry predicted the patients mortality with a high rate of sensitivity (100%). The results suggest that dynamometry is a useful, rapid, and inexpensive test. It is more accurate than the nutritional index, and can identify cancer patients at a high risk of developing major postoperative complications, and predict the postoperative morbidity and mortality.

Adult↗
PubMedDate not supplied

The role of nasogastric tube after elective abdominal surgery.

PURPOSE: Nasogastric tube (NGT) is routine employed after abdominal surgery still in our country and abroad too, but the patients' discomfort is severe and several serious complications were referred as related to its use. The aim of this study was to evaluate the pros and cons of routine use of NGT in elective uncomplicated abdominal surgery. PATIENTS AND METHODS: In order to evaluate the routine use of NGT we performed a prospective randomized trial on 100 patients who had elective uncomplicated abdominal surgery: 50 subjects had the early removal of NGT and in 50 patients it was maintained until passage of flatus/feces. RESULTS: The relevant differences between the two groups were the earlier passage of flatus and feces and the lower incidence of postoperative gastrectasy in the group where NGT was early removed. No statistical difference was recorded concerning the occurrence of postoperative nausea, vomiting, abdominal distension, complications and day of clinical release. CONCLUSIONS: The routine application of NGT in elective abdominal surgery could be omitted if the surgeon and nursing team are willing to renounce a useful tool in providing informations about the resolution of postoperative intestinal atony to the patient's benefit: in fact a severe discomfort due to the NGT was recorded in the 70% of our series.

Abdomen↗
PubMedDate not supplied

Tumor necrosis factor production by human mononuclear cells during total parenteral nutrition containing long-chain triglycerides.

The effect of fat contained in total parenteral nutrition (TPN) regimens on the immune system is controversial. The purpose of our study was to examine whether the synthesis of tumor necrosis factor (TNF), a macrophage-derived protein with several immunomodulating effects, is influenced by the duration of TPN. We studied 20 patients on glucose- and fat-based TPN with lipid emulsions containing long-chain triglycerides (LCTs). Ten of our patients received TPN for 15 days (group A) and the other 10 for 30-40 days (group B). We measured TNF production by phytohemagglutinin- and endotoxin-stimulated peripheral blood mononuclear cells before and after TPN via enzyme-linked immunosorbent assay. The production of TNF before and after TPN was similar in group A but significantly (p less than 0.01) elevated in group B after long-term TPN. Therefore, long-term TPN containing LCTs may increase TNF production, and this may be the result of an immunomodulating effect of fat.

Adult↗
PubMedDate not supplied

Gallbladder contraction after administration of intravenous amino acids and long-chain triacylglycerols in humans.

We examined the possible physiologic effects of intravenous (IV) amino acids (AAs) and long-chain triacylglycerols (LCTs) on gallbladder (GB) motility and release of cholecystokinin (CCK) on humans. GB contraction was studied in normal volunteers after administration of a fatty meal and IV infusion of AA and LCT. The GB contraction volume was calculated with ultrasound. Cholecystokinin-8 (CCK-8) and cholecystokinin-33/39 (CCK-33/39) were measured by radio-immunoassay. Administration of a fatty meal resulted in GB contraction by 60% of its basal volume and was accompanied by an increase in the serum levels of both CCK-8 and CCK-33/39. Administration of IV AA and LCT resulted in GB contraction by 17 and 37%, respectively, of its basal volume. The latter contractions were accompanied by increased levels of CCK-8 only. We conclude that IV administration of AA and LCT can result in human GB contraction and induce the release of only CCK-8. Continuous IV administration of AA and LCT for greater than 2h causes exhaustion of CCK-8 release, so that the GB returns to its initial volume.

Adult↗
PubMedDate not supplied

Central venous catheter replacement with the aid of wire introducer in patients receiving total parenteral nutrition: short report.

During a 1-year period, 24 of 71 patients receiving total parenteral nutrition, underwent replacement of their central venous catheter (CVC) for presumed CVC sepsis or catheter malposition with the use of a wire inducer, according to the Seldinger technique. Catheters were defined as sterile when cultures of both the catheter tip and the peripheral blood were negative, contaminated when culture of the tip was positive whereas the peripheral blood culture(s) was either sterile or positive with different bacteria than those obtained from the tip culture, and septic when cultures from the catheter tip and peripheral blood grew identical microorganisms. Among 19 catheters with suspected sepsis, six were sterile, ten contaminated and three septic. Guidewire catheter replacement was easily and safely performed, and succeeded in sterilizing all contaminated catheters but only one of three septic catheters.

Bacteremia↗
PubMedDate not supplied

Total parenteral nutrition--associated liver dysfunction.

We have reviewed all available data related to the development of liver dysfunction in patients receiving total parenteral nutrition (TPN). It seems that TPN-related liver dysfunction is multifactorial. Among all factors involved, two are most significant in the development of liver dysfunction, i.e. underlying disease and illness severity. In most cases, liver dysfunction is both self-limiting and reversible after cessation of TPN.

Cholestasis, Intrahepatic↗
PubMedDate not supplied

Total parenteral nutrition and immune system activity: a review.

Malnutrition has been associated with immunosuppression, reduced host defenses, and increased incidence of infections and mortality. Improvement of nutritional status through various nutritional support regimens may restore immunocompetence and consequently reduce the rate and severity of infections in hospitalized patients. However, several investigators, exploring the effect of total parenteral nutrition (TPN) on the immune system, have suggested that TPN may adversely affect immune function. During the past 20 yr special interest was given to the possible immunosuppressive effect of parenteral fat emulsions and conflicting reports have been published. This review focuses on the consequences of TPN on immune response and investigates whether there might be a link between the nutrients, the immune system, and possibly the central nervous system, which also seems to affect immune response.

Antibody Formation↗
PubMedDate not supplied

Gallbladder contraction induced by intravenous erythromycin administration. Relation to body mass index.

BACKGROUND/AIMS: To study the action of intravenously administered erythromycin lactobionate on human gallbladder volume, as a possible preventive method against gallbladder stone formation, in high risk patients such as those in sepsis, long standing fasting periods or those receiving prolonged total parenteral nutrition or octreotide. MATERIALS AND METHODS: Twenty-two volunteers randomized to receive intravenously either erythromycin lactobionate 7 mg per kg (study group) or normal saline (controls). We measured ultrasonographically the gallbladder volume before and at 5, 15, 35, 55, 90, 120 and 180 min after the infusion. RESULTS: Erythromycin induced a biphasic gallbladder contraction, with maximum contractility at 15 min (10.2%) and between 120 and 180 min (22.6%), compared to normal saline controls. Late contractility was correlated to body mass index (BMI). CONCLUSIONS: Erythromycin activity on gallbladder contraction is proved. Its biphasic action needs further investigation to find the involved mechanism(s). Long term administration is also necessary to test its efficacy in preventing gallbladder dilatation.

Adult↗