Biomedical subjects
Publications and source records attributed to V Testa.
A survey of glove perforation in 16 orthopedic surgeons during a 6-month period was carried out. During this time, the surgeons performed 304 elective operations. In 1,398 pairs of gloves tested, evidence of perforation was found in 26 percent.
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Three hundred eighty-three pairs of gloves were tested for punctures after 100 consecutive pediatric orthopaedic operations to assess the rate, site, procedure, and maneuver during which glove puncture accidents took place. Evidence of perforation was found in 14% of the gloves used. Surgeons appear to be significantly more at risk for glove perforation than do other members of the operating team.
The role of total parenteral nutrition (TPN) in reducing toxicity related to cancer chemotherapy (CT) is presently a controversial issue. To evaluate the effectiveness of TPN in reducing CT-associated toxicity and correcting and preventing CT-related impairments of nutritional status, a prospective crossover controlled study was performed in 43 cancer patients (19 normally nourished and 24 malnourished) randomly divided into two groups (A and B). Group A patients received TPN concomitantly with the first course of chemotherapy, and the second course was administered 21 to 28 days later without TPN support; group B patients were treated in the opposite sequence. The rates of myelotoxicities and gastrointestinal toxicities after CT courses with or without TPN were essentially similar in normally nourished and malnourished patients. No changes in nutritional indexes were detected in normally nourished subjects after each course. Conversely, in undernourished subjects, prealbumin, retinol-binding protein, and nitrogen balance increased in CT+TPN courses (p < .02). In CT-only courses, undernourished subjects showed a decrease in prealbumin and nitrogen balance. Significant changes of nitrogen balance in CT vs CT+TPN courses were detected in malnourished subjects. TPN appears to be unable to reduce CT-associated toxicity. CT administration does not result in any impairment of the nutritional status in normally nourished cancer patients. From our study, it appears that TPN should be limited to severely malnourished neoplastic patients undergoing CT, because of its ability to prevent further impairment of nutritional status and to improve the nitrogen balance and the levels of fast-turnover visceral proteins.
From August 1989 to January 1995 we performed multiple percutaneous longitudinal tenotomies under local anesthetic on 52 middle- and long-distance runners with unilateral Achilles tendinitis or peritendinitis that had failed conservative treatment. Forty-eight patients were reviewed at an average of 22.1 months (SD, 6.5) after surgery. Results were rated as excellent in 25 patients, good in 12, fair in 7, and poor in 4. Four patients developed subcutaneous hematomas. One patient developed a superficial infection at one of the incision sites, which was managed by oral antibiotics with full recovery. Three patients complained of over-sensitivity to the incisions; this was resolved by rubbing hand cream over the incisions several times a day. One patient developed hypertrophic painful scars on three of the five incisions, but corticosteroid injections yielded good functional and cosmetic results. Isometric strength and endurance of the gastrocsoleus complex was measured just before the procedure, and at 6 weeks and 6 months later. Both were within 10% of the normal contralateral limb by the 6th postoperative month. Percutaneous longitudinal tenotomy is simple, can be performed on an outpatient basis, requires minimal follow-up care, and, in our experience, has produced no significant complications. We use this procedure as the operative treatment of choice for cases of chronic tendinitis that have failed conservative treatment.
Bilateral percutaneous muscle biopsies of the triceps surae were analyzed in 12 athletes who had sustained a one-sided subcutaneous rupture of the Achilles tendon while practicing their main sport. No necrosis, atrophy, or significant fiber grouping or regeneration was evident. The soleus muscle in these athletes was composed of approximately 70% of type I fibers in both the noninjured and injured sides, and no significant differences were detected in their histochemical composition. Fiber areas were within described values and not significantly different between the two sides. The noninjured side revealed an insignificant trend to greater average capillary density and average capillary/fiber ratio. Muscle abnormalities do not appear to be a significant factor in determining Achilles tendon rupture in healthy athletes.