Search PubMed⌕ Search

Biomedical subjects

R Dionigi

Publications and source records attributed to R Dionigi.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

Nutritional and immunological evaluations in cancer patients. Relationship to surgical infections.

Several reports provide evidence of the synergism between malnutrition and infection in hospitalized patients. In this study, preoperative complete nutritional assessment (NA) was performed to: 1) evaluate NA modifications in 21 controls with benign minor surgical diseases and in 71 surgical cancer patients; 2) determine the relative value of nutritional and immunological indicators in relation to the postoperative septic complications in cancer patients. The following parameters were used: percent weight loss/month, percent standard arm circumference, percent standard triceps skinfold; hematocrit, hemoglobin, serum proteins, albumin, iron, transferrin, ceruloplasmin, retinol binding protein (RBP); serum creatinine, urine creatinine, creatinine/height index, percent arm muscle circumference; peripheral lymphocytes, white blood cells, complement (C3c), skin tests. In the cancer group percent usual body weight, percent arm muscle circumference, hematocrit, hemoglobin, albumin, iron, ceruloplasmin, retinol binding protein, C3c and delayed hypersensitivity response (DHR) were significantly different from controls. Ceruloplasmin and DHR were the only tests significantly different in the cancer patients who developed postoperative infections. Duration of anesthesia and operative field contamination are other important causative factors which, if associated with malnutrition, may determine a higher susceptibility to infections in surgical cancer patients.

Adolescent↗
PubMedDate not supplied

Evaluation of possible causes of delayed hypersensitivity impairment in cancer patients.

The separate roles of malnutrition, advanced age, and stage of tumor growth as causes of impairment of delayed hypersensitivity response (DHR) was studied in 111 patients with solid tumors and in 56 nonneoplastic control patients matched for age, anatomical site of disease, degree of illness, and nutritional status. Pretreatment DHR to recall antigens (tuberculin, Candida, streptokinase-streptodornase, trichophyton) and to dinitrochlorobenzene in cancer patients with 9% anergic, 43% hypoergic, and 48% normoergic; the distribution of DHR in controls was not significantly different. In cancer patients, the serum albumin level showed an inverse correlation with the stage of tumor (p less than 0.01) and a positive correlation with the DHR (p less than 0.001); the serum albumin level was also in the controls positively correlated with the DHR (p less than 0.01), indicating that malnutrition in neoplastic or benign disease may cause depression of DHR. In well-nourished controls, age was inversely correlated with DHR (p less than 0.05), showing that aging itself may be another relevant cause of depression of DHR. The results of this study indicate that DHR in patients with solid tumors is similar to the DHR of nonneoplastic patients if matched for age, sex, and nutritional status. DHR impairment in cancer patients appears to be caused mainly by aging and by malnutrition due to the advanced progression of cancer.

Adult↗
PubMedDate not supplied

Cluster analysis of nutritional and immunological indicators for identification of high risk surgical patients.

In spite of the many anthropometric, biohumoral, and immunologic parameters employed in the nutritional assessment of hospitalized patients, it is difficult in clinical practice to evaluate accurately the degree and type of malnutrition and to assess the prognostic significance of this determination. The purpose of this study is to evaluate nutritional status of surgical patients by means of cluster analysis in orderr to identify different nutritional patterns and to evaluate their clinical and prognostic significance. Nutritional assessment of 71 surgical patients was carried out at admission, and the sets of data were evaluated by means of cluster analysis. Four clusters with different nutritional patterns were identified. The incidence of clinical variables (type of disease, postoperative sepsis, palliative procedures, mortality at 6 months, etc.) in each cluster was determined in order to evaluate their clinical and prognostic significance. Cluster 1 showed minor variations of the indicators, including most of the controls presented the lowest incidence of sepsis, palliative procedures, and mortality at 6 months. It was then considered as a reference group representative of the normal nutritional condition at our institution. The other three clusters showed major variations of nutritional indicators and represent poorer risk clinical conditions. Sepsis, palliative procedures and mortality rate were significantly more frequent in these clusters (p less than 0.05, p less than 0.001, p less than 0.05). A different distribution in the clusters was recorded in gastrointestinal tract cancers and other neoplasms. Only the incidence of gastrointestinal tract cancers increases progressively in the clusters with poorer prognosis, suggesting that this type of neoplasia is more frequently associated with major changes of nutritional status.

Adult↗
PubMedDate not supplied

Nutritional assessment and surgical infections in patients with gastric cancer or peptic ulcer.

Recent reports provide evidence that cancer is frequently associated with malnutrition and infection. This is particularly evident when the gastrointestinal tract is involved. The purpose of this study is to investigate the difference between the nutritional status of patients with gastric cancer and with peptic ulcer, and to determine which of the nutritional indicators may be of value in identifying patients with high risk of postoperative infections. A complete nutritional assessment was performed at admission and the following parameters were determined: hemoglobin, total serum protein, albumin, ceruloplasmin, retinol binding protein, transferrin; Fe; urine creatinine, creatinine/height index, arm muscle circumference; ideal body weight, usual body weight, arm circumference, triceps skinfold; lymphocytes, white blood cells, C3c, skin tests to recall and primary antigens. In the cancer patient group, hemoglobin, total protein, albumin, Fe, percentage usual body weight, and delayed hypersensitivity response to skin antigens were significantly more impaired than in controls. Preoperative delayed hypersensitivity response was the only test in correlation with the tumor stage. It was also significantly different in the gastric cancer patients who developed postoperative infections.

Aged↗
PubMedDate not supplied

Immunological function and nutritional assessment.

Theoretically, a large number of tests of immunologic functions could be used for nutritional assessment. However, many of these immunologic tests require specialized laboratory skills and take a long time to perform. These tests provide little additional information to the clinician concerning the nutritional status of the patient, compared to the data that can be obtained from a few simple, selected immunologic measurements. Only a few immunologic tests are sufficiently simple, reproducible, and reliable indicators of nutritional status to be of practical value for routine nutritional assessment. These are the total lymphocyte count and skin tests. At present, all of the other immunologic measurements that have been reviewed should be considered as research tools for nutritional assessment. Immunological tests can be affected by many clinical variables unrelated to nutrition, such as specific pathologic conditions, immunodepressive therapies, accidental or surgical trauma, and infection, and this fact should be considered when using immunological tests to assess nutritional status. Malnutrition suppresses the acute-phase response of plasma proteins. The measurement of the acute-phase response of selected acute-phase proteins can be a functional measurement of nutritional status.

Acute-Phase Proteins↗
PubMedDate not supplied

[Experimental models of acute pancreatitis. Critical review].

Experimental models of acute pancreatitis have been developed for more than a century. Although not closely comparable to human disease, they have contributed to our understanding of the physiopathology and cell biology of the disease. The methods used for the induction are subjected to critical examination. In the relevant literature findings, the advantages of each group are underscored, and reference is made to their defects with regard to reproducibility and reliability, with a view to extending the results obtained to human pathology. A proper understanding and standardization of these models may enable us to choose the most suitable model for studying a given aspect of the disease or for evaluating new treatment protocols. The data collected has made it possible to select standardization criteria for a comparative experimental study in the laboratory.

Acute Disease↗
PubMedDate not supplied

[Differential diagnosis of hematoma, pulsating hematoma and pseudoaneurysm of the femoral artery using color Doppler].

Color Doppler and Duplex Doppler US were employed on 4 patients with clinically suspected pseudoaneurysms as a complication of femoral artery puncture after cardiac catheterization. Pseudoaneurysms were identified with Color Doppler US and their typical appearance was confirmed. The grey-scale findings did not allow an adequate differentiation between hematoma and pulsed hematoma without fibrous encapsulation: only Color Doppler US easily detected the track between damaged artery and blood collection and allowed a sample to be obtained for pulsed Doppler examination. Color Doppler US allowed an accurate and non-invasive diagnosis of groin masses after femoral artery catheterization.

Aneurysm↗
PubMedDate not supplied

[Antibiotic prevention of surgical infections].

Postoperative infections are the most frequent cause of morbidity and mortality in surgical patients, considerably increasing the duration and cost of hospitalization. During the past decade the criteria for the administration of prophylactic antibiotics have been established and their proper use has caused a significant reduction of postoperative infections. The Authors review the indications to the use of local and systemic antibiotic prophylaxis; moreover, the general principles of antibiotic prophylaxis are presented and discussed, including problems related to the choice of antibiotic, dosage, timing and duration of administration, under different clinical circumstances and in various types of surgical operations.

Anti-Bacterial Agents↗