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Edgar L Leclaire, Jennifer Duong, Rachel M Wykes, Kevin E Miller, Tessa L Winterton, Milan Bimali
BACKGROUND: Intravesical injection with onabotulinum toxin A (BTX-A) injection can be performed in-office under local anesthesia. Rectally administered pain medication presents a potentially feasible and previously uninvestigated adjunct to office-based anesthesia protocols. OBJECTIVES: The primary aim of this study was to determine whether adding a belladonna and opiate (BO) suppository to standard lidocaine instillation resulted in reduction of bladder injection pain during BTX-A injection procedure...
June 11, 2018: American Journal of Obstetrics and Gynecology
Vladimir Mouraviev, Michael McDonald
INTRODUCTION: The changing face of current infection phenotypes from planktonic to biofilm type has been developed implicating bacterial biofilms in recurrent infection. To date, no specific medical treatment exists to specifically target biofilms in the human host. Similarly, the identification of a biofilm has relied upon the analysis of tissue samples with electron microscopy or DNA identification with polymerase chain reaction (PCR) and sequencing. Standard culture and sensitivity test is not able to detect a presence of biofilms...
June 2018: Canadian Journal of Urology
Evan Luther, Timur Urakov, Steven Vanni
BACKGROUND AND STUDY OBJECTIVE:  Complex traumatic lumbar spine fractures are difficult to manage and typically occur in younger patients. Surgical immobilization for unstable fractures is an accepted treatment but can lead to future adjacent-level disease. Furthermore, large variations in fracture morphology create significant difficulties when attempting fixation. Therefore, a surgical approach that considers both long-term outcomes and fracture type is of utmost importance. We present a novel technique for percutaneous fixation without interbody or posterolateral fusion in a young patient with bilateral pedicle dissociations and an acute-onset incomplete neurologic deficit...
June 11, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Amel Benatallah, Faissal Ghozlane, Michel Marie
Objective: This study was conducted to evaluate the effect of water restriction (WR) on physiological and blood parameters on lactating dairy cows reared under Mediterranean climate. Methods: The trial lasted 16 days preceded by two weeks of adaptation to the experimental condition in spring 2014 on 6 dairy cows in mid-lactation. These cows were watered at will for 4 days (W100) (hydration period), then split into 2 groups, one group has received 25% and the other 50% of water compared to their mean water consumption during the hydration period; then rehydrated for 4 days...
May 31, 2018: Asian-Australasian Journal of Animal Sciences
Jonas F Schiemer, Lennart Zimniak, Edin Hadzijusufovic, Hauke Lang, Werner Kneist
BACKGROUND: Pelvic intraoperative neuromonitoring during nerve-sparing robot-assisted total mesorectal excision (RTME) is feasible. However, visual separation of the neuromonitoring process from the surgeon console interrupts the workflow and limits the usefulness of available information as the procedure progresses. Since the robotic surgical system provides multi-image views in the surgeon console, the aim of this study was to integrate cystomanometry and internal anal sphincter electromyography signals to aid the robotic surgeon in his/her nerve-sparing technique...
June 4, 2018: Techniques in Coloproctology
Ryosuke Okamura, Koya Hida, Tomohiro Yamaguchi, Tomonori Akagi, Tsuyoshi Konishi, Michio Yamamoto, Mitsuyoshi Ota, Shuichiro Matoba, Hiroyuki Bando, Saori Goto, Yoshiharu Sakai, Masahiko Watanabe, Kazuteru Watanabe, Koki Otsuka, Ichiro Takemasa, Keitaro Tanaka, Masataka Ikeda, Chu Matsuda, Meiki Fukuda, Junichi Hasegawa, Shintaro Akamoto, Manabu Shiozawa, Atsushi Tsuruta, Takashi Akiyoshi, Takeshi Kato, Shunsuke Tsukamoto, Masaaki Ito, Masaki Naito, Akiyoshi Kanazawa, Takao Takahashi, Takashi Ueki, Yuri Hayashi, Satoshi Morita, Takashi Yamaguchi, Masayoshi Nakanishi, Hirotoshi Hasegawa, Ken Okamoto, Fuminori Teraishi, Yasuo Sumi, Jo Tashiro, Toshimasa Yatsuoka, Yoji Nishimura, Kenji Okita, Takaya Kobatake, Hisanaga Horie, Yasuyuki Miyakura, Hisashi Ro, Kunihiko Nagakari, Eiji Hidaka, Takehiro Umemoto, Hideaki Nishigori, Kohei Murata, Fuminori Wakayama, Ryoji Makizumi, Shoichi Fujii, Eiji Sunami, Hirotoshi Kobayashi, Ryosuke Nakagawa, Toshiyuki Enomoto, Shinobu Ohnuma, Jun Higashijima, Heita Ozawa, Keigo Ashida, Fumihiko Fujita, Keisuke Uehara, Satoshi Maruyama, Masato Ohyama, Seiichiro Yamamoto, Takao Hinoi, Masanori Yoshimitsu, Masazumi Okajima, Shu Tanimura, Masayasu Kawasaki, Yoshihito Ide, Shoichi Hazama, Jun Watanabe, Daisuke Inagaki, Akihiro Toyokawa
Sphincter-preserving procedures (SPPs) for surgical treatment of low-lying rectal tumors have advanced considerably. However, their oncological safety for locally advanced low rectal cancer compared with abdominoperineal resection (APR) is contentious. We retrospectively analyzed cohort data of 1500 consecutive patients who underwent elective resection for stage II-III rectal cancer between 2010 and 2011. Patients with tumors 2-5 cm from the anal verge and clinical stage T3-4 were eligible. Primary outcome was 3-year local recurrence rate, and confounding effects were minimized by propensity score matching...
September 2017: Annals of gastroenterological surgery
Nicola de'Angelis, Frederic Pigneur, Aleix Martínez-Pérez, Giulio Cesare Vitali, Filippo Landi, Teresa Torres-Sánchez, Victor Rodrigues, Riccardo Memeo, Giorgio Bianchi, Francesco Brunetti, Eloy Espin, Frederic Ris, Alain Luciani
Background: Locally advanced rectal cancer (LARC) requires a multimodal therapy tailored to the patient and tumor characteristics. Pretreatment magnetic resonance imaging (MRI) is necessary to stage the primary tumor, while restaging MRI, which is not systematically performed, may be of interest to identify poor responders to neoadjuvant chemoradiation therapy (NCRT), and redefine therapeutic approach. The EuMaRCS study group aimed to investigate the role and accuracy of pretreatment (including pelvimetry) and restaging MRIs in predicting surgical difficulties and surgical outcomes in LARC therapy...
May 18, 2018: Oncotarget
J S Munday, A A Cullum, N A Thomson, M Bestbier, T McCormack, A F Julian
CASE HISTORY: Anal warts were observed in heifers in two unrelated groups of animals. Heifers in one group developed visible warts 4 months after manual rectal examination and heifers in the other group developed warts 5 months after examination using a hand-held rectal ultrasound probe. CLINICAL FINDINGS: Large exophytic proliferative anal masses were observed in 5/15 (33%) heifers in one group and 13/149 (9%) heifers in the second group. Heifers in the second group were also noted to have similar masses on the underside of the tail at sites previously used for venepuncture and some of the heifers had skin warts...
May 23, 2018: New Zealand Veterinary Journal
M Pakianathan, W Whittaker, M J Lee, J Avery, S Green, B Nathan, A Hegazi
OBJECTIVES: The aim of the study was to analyse associations between chemsex and new HIV and sexually transmitted infection (STI) diagnoses among gay, bisexual and other men who have sex with men (GBMSM) accessing sexual health clinics. METHODS: A retrospective case note review was carried out for all GBMSM attending two London sexual health clinics between 1 June 2014 and 31 July 2015. RESULTS: Chemsex status was documented for 1734 of 1840 patients...
May 22, 2018: HIV Medicine
M Pobijakova, D Scepanovic, M Paluga, M Fekete, J Mardiak
Cervical cancer is the third most common cancer in women worldwide. Standard of care for patients with node positive or locally advanced tumors >4 cm is definitive radiotherapy and concurrent chemotherapy. Brachytherapy is an integral part of definitive radiotherapy for cervical cancer. The aim of the study was to show a dynamics of High Risk Clinical Target Volume (HR-CTV) reduction during Brachytherapy (BT) as a part of definitive treatment (External Beam Radiotherapy /EBRT/ +/- Chemotherapy /ChT/) depending on the initial Gross Tumor Volume (GTV) and its impact on HR-CTV coverage in patients with inoperable cervical cancer...
March 14, 2018: Neoplasma
Marc J Gollub, Supreeta Arya, Regina Gh Beets-Tan, Gregory dePrisco, Mithat Gonen, Kartik Jhaveri, Zahra Kassam, Harmeet Kaur, David Kim, Andrea Knezevic, Elena Korngold, Chandana Lall, Neeraj Lalwani, D Blair Macdonald, Courtney Moreno, Stephanie Nougaret, Perry Pickhardt, Shannon Sheedy, Mukesh Harisinghani
PURPOSE: To propose guidelines based on an expert-panel-derived unified approach to the technical performance, interpretation, and reporting of MRI for baseline and post-treatment staging of rectal carcinoma. METHODS: A consensus-based questionnaire adopted with permission and modified from the European Society of Gastrointestinal and Abdominal Radiologists was sent to a 17-member expert panel from the Rectal Cancer Disease-Focused Panel of the Society of Abdominal Radiology containing 268 question parts...
May 21, 2018: Abdominal Radiology
Kamran A Ahmed, Jacob G Scott, John A Arrington, Arash O Naghavi, G Daniel Grass, Bradford A Perez, Jimmy J Caudell, Anders E Berglund, Eric A Welsh, Steven A Eschrich, Thomas J Dilling, Javier F Torres-Roca
INTRODUCTION: We assessed the radiosensitivity of lung metastases based on primary histology using a validated gene signature and model lung metastases for the genomically adjusted radiation dose (GARD). METHODS: Tissue samples were identified from our prospective observational protocol. The radiosensitivity index (RSI) 10 gene assay was run on samples and calculated alongside GARD using the previously published algorithms. A cohort of 105 patients with 137 lung metastases treated with SBRT at our institution was used for clinical correlation...
May 4, 2018: Journal of Thoracic Oncology
William Tzu-Liang Chen, Saurabh Bansal, Tao-Wei Ke, Sheng-Chi Chang, Yu-Chun Huang, Takashi Kato, Hwei-Ming Wang, Abe Fingerhut
BACKGROUND: Few clear recommendations exist for the management of colorectal anastomotic leaks, often based on surgeon preferences or institutional protocols. The primary goal was to evaluate the feasibility and safety of the combined laparoscopic and transanal (hybrid) approach to treat postoperative colorectal anastomotic leaks. The secondary goals included comparison of outcomes following early (< 5 days after initial resection) versus late (≥ 5 days) detection of leaks...
May 1, 2018: Surgical Endoscopy
Sue M Evans, Declan G Murphy, Ian D Davis, Shomik Sengupta, Ehsan Zare Borzeshi, Fanny Sampurno, Jeremy L Millar
AIM: This study aims to assess characteristics of patients with prostate cancer for whom clinical T stage category (cT) was not documented in the medical record and assess whether specialists had concordant conclusions regarding cT based on digital rectal examination (DRE) notes. METHODS: Data from the Prostate Cancer Outcome Registry - Victoria (PCOR-Vic) were interrogated. Four specialists independently assigned cT to DRE notes. Words, or part thereof, associated with agreement between clinicians were identified...
April 27, 2018: Asia-Pacific Journal of Clinical Oncology
Chun-Nan Kuo, Jen-Jung Pan, Ya-Wen Huang, Hui-Ju Tsai, Wei-Chiao Chang
BACKGROUND: Cyclooxygenes-2 overexpression may contribute to colorectal cancer (CRC) occurrence. Aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) can reduce CRC recurrence, but the efficacy of primary prevention in Asian populations is still elusive. Thus, we examined the primary preventive efficacy of aspirin and NSAIDs on CRC incidence in Taiwan. METHODS: A nested case-control study was conducted using the National Health Insurance Research Database in Taiwan...
April 25, 2018: Cancer Epidemiology, Biomarkers & Prevention
D Mege, E Hain, Z Lakkis, L Maggiori, J Prost À la Denise, Y Panis
AIM: To compare the learning curve for trans-anal total mesorectal excision (TATME) with laparoscopic TME started by a perineal approach (LTME). METHOD: The first 34 consecutive patients who underwent TATME for low rectal cancer were matched with LTME (performed by the same surgeon) for gender, body mass index and chemoradiation. RESULTS: Thirty-four patients undergoing TATME (23 men; 58 ± 14 years) were matched with 34 undergoing LTME (23 men; 59 ± 13 years)...
June 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
M Pezzella, B Brogna, A Romano, F Torelli, G Esposito, M Petrillo, F M Romano, N Di Martino, A Reginelli, R Grassi
INTRODUCTION: Diagnosing lymphoma continues to prove challenging in the clinical practice. Composite lymphoma (CL) is defined by the coexistence of different lymphoma subtypes in the same anatomical location. This condition has seldom been witnessed in the gastrointestinal (GI) tract. We weren't able to find previous cases in the literature about small bowel CL with follicular lymphoma (FL) and classical Hodgkin lymphoma (CHL). Surgery is the treatment of choice to obtain accurate histology, to manage and prevent acute complications...
2018: International Journal of Surgery Case Reports
Jun Li, Yongbo An, Guocong Wu, Xiaomu Zhao, Yingchi Yang, Jin Wang, Lan Jin, Hongwei Wu, Na Zeng, Fuxiao Xie, Jie Dong, Anlong Yuan, Wuqing Sun, Ruiqing Zhou, Hongwei Yao, Zhongtao Zhang
OBJECTIVE: To assess the incidence and independent risk factors for clinical anastomotic leakage (AL) in patients undergoing anterior resection(AR) or low anterior resection, (LAR) for rectal cancer. METHODS: This was a retrospective case-control study of 550 patients with rectal cancer who underwent AR or LAR from April 2007 to March 2017 in Beijing Friendship Hospital, Capital Medical University. The relationship between the incidence of AL and clinicopathological manifestations was analyzed by Chi-squared test and Fisher exact test, and the independent risk factors of AL were analyzed using logistic regression analysis...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
T G Mullaney, A L Lightner, M Johnston, S R Kelley, D W Larson, E J Dozois
Retrorectal tumors are rare tumors that require resection for symptoms, malignancy and potential malignant transformation. Traditional approaches have included laparotomy, perineal excision or a combination. Multiple minimally invasive techniques are available which have the potential to minimize morbidity and enhance recovery. We performed a systematic review of the literature to determine the feasibility and surgical outcomes of retrorectal tumors approached using minimally invasive surgical techniques. Publications in which adult patients (≥ 18 years) had a minimally invasive approach (laparoscopic or robotic) for resection of a primary retrorectal tumor were included...
April 2018: Techniques in Coloproctology
Saartje Van de Vondel, Filip Baert, Christine Reenaers, Stijn Vanden Branden, Leila Amininejad, Pieter Dewint, Wouter Van Moerkercke, Jean-François Rahier, Pieter Hindryckx, Peter Bossuyt, Marc Ferrante
Background: Adalimumab (ADM) has been shown efficacious in ulcerative colitis (UC). In randomized controlled trials, dose escalation from 40 mg ADM every other week to 40 mg every week was required in 20%-25% of patients within 1 year. Real-life data suggest higher escalation rates. Attempts for dose de-escalation have not been studied yet. We assessed the need for, outcome of, and predictors of dose escalation and de-escalation in a large retrospective cohort of UC patients treated with ADM...
April 23, 2018: Inflammatory Bowel Diseases
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