NUTRITIONAL AND DIGESTIVE EFFECTS OF GASTRECTOMY FOR GASTRIC CANCER

Background: Gastrectomy often leads to malnutrition. Objective: The aim of this study was to analyze nutritional and digestive effects of gastrectomy for cancer. Patients and methods: Gastrectomized patients were studied by nutritional assessment including a weekly nutritional diary exploring digestive symptoms. Results: Thirty-two patients were analyzed after a mean follow-up of 41.8 months. The mean percentage of weight loss was 12.9% \ub1 13.5%. After total gastrectomy, mean weight loss was 22% \ub1 1.2%, against 7.4% \ub111.9% for subtotal gastrectomy (p = 0.002). Moreover, advancing age was related to weight loss (p = 0.02), with a peak around 70 years. The most frequent postprandial symptoms were abdominal swelling (62%) and early satiety (59%). Finally, findings of the present study imply that overm a long follow-up, there are no specific intolerances related to gastrectomy. Conclusions: Patients who have undergone a total gastrectomy and elderly gastrectomized patients are at risk of malnutrition and need postoperative nutritional support

Minimally-invasive treatments for benign thyroid nodules: recommendations for information to patients and referring physicians by the Italian Minimally-Invasive Treatments of the Thyroid group

Purpose: In this paper, the members of the Italian Working Group on Minimally-Invasive Treatments of the Thyroid (MITT group) aim to summarize the most relevant information that could be of help to referring physicians and that should be provided to patients when considering the use of MITT for the treatment of benign thyroid nodules. Methods: An interdisciplinary board of physicians with specific expertise in the management of thyroid nodules was appointed by the Italian MITT Group. A systematic literature search was performed, and an evidence-based approach was used, including also the knowledge and the practical experience of the panelists to develop the paper. Results: The paper provides a list of questions that are frequently asked by patients to operators performing MITT, each with a brief and detailed answer and more relevant literature references to be consulted. Conclusions: This paper summarizes the most relevant information to be provided to patients and general practitioners/referring physicians about the use of MITT for the treatment of benign thyroid nodules

"Postural Management" to prevent hip dislocation in children with cerebral palsy

Muscolo-skeletal disorders and hip deformity play a key role on future development of motor and adaptive functions in children with cerebral palsy (CP). Lateral migration of the femoral head increases on average 7.7% per year and may progress in association with acetabular dysplasia to hip dislocation. Conservative preservation of muscle length and balance may prevent or reduce femoral head migration and acetabular dysplasia. Equipment for position lying, sitting, and standing is an established method of maintaining muscle length and joint range. French approach (Le M\ue9tayer et al) include the use of customised plaster cast orthoses, for sitting and standing positions, called si\ue8ge moul\ue9 and goutti\ue8re, tailor-made according to the child's muscolo-skeletal characteristics and motor abilities. At our department, hips with clinical and radiological evidence of displacement unresponsive to pharmacological and surgical treatment were treated with postural management. The two cases we show in this paper underwent a physiotherapy programme (neurodevelopment treatment ) twice a week and a seated postural programme 5 hours a day with the si\ue8ge moul\ue9. Hip radiographs were measured with the migration percentage (MP) described by Reimers. The follow-up measurements showed a progressive reduction of MP values of the hip treated, confirming the significant benefit from the combined non surgical approach. The study supports the evidence that conservative management of hip deformity with si\ue8ge moul\ue9 can be successful if implemented before the development of hip dysplasia

Muscle function as an index of nutritional status: Principles, techniques and normal values corrected for age

In the last eight years the use of muscle function tests as indices of nutrition status has become increasingly popular. Indeed, malnourished patients often present symptoms of muscle weakness and fatigue accompanied by ponderal loss. During poor nutritional intake, skeletal muscle mass is reduced as it represents the chief source of glycogenetic amino acids. These changes are also accompanied by biochemical and body compositional alterations. In the light of the present literature, there seems to be a need for normal values corrected for age, particularly for those age groups above 60. The aim of the present study was to investigate the effect of age on muscle function and to obtain normal values for different age groups

Le centrage des hanches au moyen de sigès moulés : Études et résultats

Background: Musculo-skeletal disorders and hip deformity play a key role on future development of motor and adaptive functions in children with cerebral palsy (CP). Lateral migration of the femoral head increases on average of 7.7% per year and may progress to hip dislocation. Conservative preservation of muscle length and balance may prevent or reduce femoral head migration and acetabular dysplasia. A prospective comparative non randomized study was conducted to determine the effect of a sige moul\ue9 postural management, in association with a physiotherapy program, on the progression of hip displacement in children with CP. Thirty-five patients with bilateral CP and so-called hip at risk (migration percentage [MP] of over 10% but less than 40%) were included into the study and evaluated by neurofunctional assessment, Gross Motor Function Classification System (GMFCS), Tardieu scale and radiological measurements (MP by Reimers). Eighteen children were treated with therapeutic education and postural management 4 hours a day, and 17 children (control group) were treated with NDT alone. Results: A significant difference was found between MP values of case group and control group after 1 year (T1) and 2 years of treatment (T2) (p = 0,001). The rate of hip displacement was reduced by 5 % in the treatment group after the first year and by 7 % at second follow-up. Conclusion: Our data show a progressive reduction of MP values measured in the treated group confirming the significant benefit from combined non-surgical approach. The study supports the evidence that conservative management of hip deformity can be successful if implemented before the development of hip dysplasia