The Journal of Bucharest College of Physicians and the Romanian Academy of Medical Sciences

Andra Evelin Iacobini

Andra Evelin Iacobini

Particularities of Surgical Treatment for the Neuropathic Diabetic Foot

Diabetic neuropathy is one of the chronic complications of diabetes and along with other complications causes a pathology called diabetic foot. The present study analyzed a group of 164 patients admitted to the surgery department of the Clinical Hospital “Doctor Ioan Cantacuzino” Bucharest, between September and December 2019. The results of the study highlight the potential for contamination of neuropathic lesions and the need for curative surgery, most conservative. The conclusion of the analysis emphasizes that the imbalance of the underlying disease changes, in a negative sense, the prognosis of any complication of it.

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The Dietotherapy of Malignant Degeneration of Small Intestine and Colon, Correlated with the Anticancerous Therapy

The presence of primary or metastatic cancer in small intestine has as a first line treatment the segmental resection. We reach the same therapeutic conduct in case of cancerous patients exposed to abdominal radiation therapy, sometimes severily affecting the small intestine (perforations, strictures, hemorrhages, fistulae). The nutritional implications of intestinal resection are significant, given the role of small intestine in digestion and absorbtion of nutricious principles, and the maintainance of enterohepatic circulation of biliary salts [1].
When we resort to ileal resection, if it does not exceed 100 cm, then a considerable part of biliary salts can not enter the reversed hepatic circuit (the surface for intestinal absorbtion diminishes) and they enter the colon, where they induce a watery diarrhea. It can be avoided if the patient is administered cholestyramine (it binds biliary salts, making them unable to induce diarrhea). Dietary measures alone are not sufficient. We start with 4 grams of cholestyramine per day, dosage after which the diarrhea stops abruptly. Afterwards, the dosage is decreased to half or less. In the mentioned conditions, though a part of the biliary salts loose their capacity to emulsify fats, the absorbtion of fats is not considerably disturbed [2].

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The Dietary Adjustment to the Digestive System's Alterations Induced by the Anticancer Therapy

The nutrition of patients in which the cancerous disease has already spread does not cure the disease [1]. This statement is radically contrary to multiple theories supported by some followers of these cancer specific diets (ex. the shark cartilage diet, the distilled water and wheat seeds diet, etc.). This situation is also encountered in the neoplasm of the digestive system [1].
The objectives of the cancerous disease’s nutrition are represented by the ability to provide the caloric and nutritional requirements which are able to improve the patient’s clinical status, to increase the effort capacity, to extend the survival duration and to amplify the capacity to tolerate chemotherapy and radiation therapy [2].

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