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https://www.readbyqxmd.com/read/28719012/the-impact-of-immunoglobulin-in-acute-hiv-infection-on-the-hiv-reservoir-a-randomized-controlled-trial
#1
J Tiraboschi, S Ray, K Patel, A Teague, M Pace, P Phalora, N Robinson, E Hopkins, J Meyerowitz, Y Wang, J Cason, S Kaye, J Sanderson, P Klenerman, S Fidler, J Frater, J Fox
OBJECTIVES: Antiretroviral therapy (ART) during acute HIV infection (AHI) restricts the HIV reservoir, but additional interventions are necessary to induce a cure. Intravenous immunoglobulin (IVIG) is not HIV-specific but is safe and temporarily reduces the HIV reservoir in chronic HIV infection. We present a randomized controlled trial to investigate whether IVIG plus ART in AHI reduces the HIV reservoir and immune activation compared with ART alone. METHODS: Ten men with AHI (Fiebig II-IV) initiated ART (tenofovir, entricitabine, ritonavir boosted darunavir and raltegravir) at HIV-1 diagnosis and were randomized to ART alone or ART plus 5 days of IVIG, once virally suppressed (week 19)...
July 18, 2017: HIV Medicine
https://www.readbyqxmd.com/read/28689518/colon-cancer-screening-is-it-time-yet
#2
EDITORIAL
Hadi Bhurgri, Sami Samiullah
The month of March is dedicated to Colon Cancer Awareness. Worldwide, colorectal cancer (CRC) incidence has been on the rise. It is currently the third most common cancer in men (746,000 cases, 10.0% of the total) and the second in women (614,000 cases, 9.2% of the total).1 Arecent meta-analysis reported a 61% risk reduction in CRC incidence with colonoscopy.2 Unlike screening programs for breast and prostate cancers, not only has CRC screening reduced mortality from colon cancer and detected early CRC, it has also decreased the incidence of CRC through detection and removal of pre-cancerous lesions...
June 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28687458/effectiveness-of-screening-modalities-in-colorectal-cancer-a-network-meta-analysis
#3
REVIEW
Jianping Zhang, Zhiyuan Cheng, Yubao Ma, Caili He, Yongbin Lu, Yaxue Zhao, Xiaoyu Chang, Yawei Zhang, Yana Bai, Ning Cheng
The aim of the study was to evaluate on the effectiveness of screening modalities in the prevention of colorectal cancer (CRC) occurrence and deaths. General meta-analysis was performed to produce pooled estimates of the effect of CRC incidence and mortality using a search of PubMed, Web of Science, and the Cochrane Library for eligible studies from January 1992 to March 2016. A network meta-analysis was performed to synthetically compare the effectiveness of 5 frequently used screening modalities. A total of 44 studies with a focus on mortality from CRC using different screening methods were included...
April 4, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/28685889/correlates-of-community-based-colorectal-cancer-screening-in-a-rural-population-the-role-of-fatalism
#4
Richard A Crosby, Tom Collins
One largely unexplored barrier to colorectal cancer (CRC) screening is fatalistic beliefs about cancer. The purpose of this study was to identify correlates of ever having endoscopy screenings for CRC and to determine whether fatalism plays a unique role. Because evidence suggests that cancer-associated fatalistic beliefs may be particularly common among rural Americans, the study was conducted in a medically underserved area of rural Appalachia.  METHODS: Rural residents (N = 260) between 51 and 75 years of age, from a medically underserved area of Appalachia, Kentucky, were recruited for a cross-sectional study...
July 7, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28667446/diagnostic-performance-of-flexible-sigmoidoscopy-combined-with-fecal-immunochemical-test-in-colorectal-cancer-screening-meta-analysis-and-modeling
#5
Tobias Niedermaier, Korbinian Weigl, Michael Hoffmeister, Hermann Brenner
Once-only flexible sigmoidoscopy (FS), which reliably detects neoplasms in the distal colon and rectum but not in the proximal colon, has been shown to reduce incidence and mortality of distal colorectal cancer (CRC). Fecal immunochemical tests (FITs) detect the majority of CRCs and some proportion of adenomas also in the proximal colon. We assessed the expected diagnostic performance of combined application of FS and FIT. We systematically reviewed screening studies conducted in an average risk population that reported specificities and site-specific sensitivities of FITs for detection of CRC or advanced adenoma (AA)...
June 30, 2017: European Journal of Epidemiology
https://www.readbyqxmd.com/read/28630239/an-unusual-case-of-escherichia-coli-o157-h7-infection-with-pseudomembranous-colitis-like-lesions-associated-with-haemolytic-uraemic-syndrome-and-neurological-sequelae
#6
James Kennedy, Lauren Simmonds, Robert Orme, Warren Doherty
A 75-year-old man was admitted with abdominal pain and fresh rectal bleeding. Significantly, he had no risk factors for Clostridium difficile infection. An abdominal CT demonstrated colonic thickening, and flexible sigmoidoscopy identified pseudomembranous colitis-like lesions. After initial treatment as C. difficile colitis, a stool sample revealed Escherichia coli O157:H7 infection. Antibiotic therapy was stopped due to the risk of lysis-mediated toxin release, but unfortunately, the patient continued to deteriorate...
June 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28626069/how-many-deaths-from-colorectal-cancer-can-be-prevented-by-2030-a-scenario-based-quantification-of-risk-factor-modification-screening-and-treatment-in-norway
#7
Katrine Damgaard Skyrud, Tor Age Myklebust, Freddie Bray, Morten Tandberg Eriksen, Thomas de Lange, Inger Kristin Larsen, Bjørn Møller
BACKGROUND: Colorectal cancer (CRC) mortality can be reduced through risk factor modification (adherence to lifestyle recommendations), screening, and improved treatment. This study estimated the potential of these three strategies to modify CRC mortality rates in Norway. METHODS: The potential reduction in CRC mortality due to risk factor modification was estimated using the software Prevent, assuming that 50% of the population in Norway-who do not adhere to the various recommendations concerning prevention of smoking, physical activity, body weight, and intake of alcohol, red/processed meat, and fiber-started to follow the recommendations...
June 16, 2017: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/28623248/dieulafoy-s-lesion-of-the-anal-canal-a-rare-cause-of-lower-gastrointestinal-bleeding
#8
Ahmed Khalid, Husham Abdelrahman, Syed Muhammad Ali, Ejaz Ahmed Latif, Hassan Al-Thani, Ayman El-Menyar
BACKGROUND Dieulafoy's lesion of the anal canal is an uncommon cause of lower gastrointestinal bleeding due to rupture of a submucosal artery. This could be an under-recognized cause of hemorrhagic shock in rare cases. CASE REPORT We present 2 cases admitted with bleeding per rectum and hemorrhagic shock, and both were diagnosed as Dieulafoy's lesion of the anal canal on sigmoidoscopy. One case was treated surgically and the second was managed endoscopically. CONCLUSIONS Dieulafoy's lesion of the anal canal can be a source of massive lower gastrointestinal bleeding...
June 17, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28614168/glove-port-transanal-excision-of-rectal-tumors-an-alternative-method-for-rectal-tumor-excision-single-center-experience
#9
Sridhar Dharamavaram, Dimple Sapre, Ahmed M A Mohammed, Krishnamurthy Badrinath
AIM: Transanal minimal invasive surgery has been practiced for several years for excision of rectal tumors however there is no standard consensus about its applications. This minimally invasive approach helps in avoiding major rectal resections and its associated risk of mortality and morbidity.The aim of this study is to describe a single center experience with transanal glove port excision of rectal tumors which are not amenable to colonoscopic excision. MATERIALS AND METHODS: Between the years 2011 and 2014, 9 patients underwent glove port excision of rectal tumors located within 15 cm from the anal verge...
June 13, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28600072/colorectal-cancer-screening-recommendations-for-physicians-and-patients-from-the-u-s-multi-society-task-force-on-colorectal-cancer
#10
Douglas K Rex, C Richard Boland, Jason A Dominitz, Francis M Giardiello, David A Johnson, Tonya Kaltenbach, Theodore R Levin, David Lieberman, Douglas J Robertson
This document updates the colorectal cancer (CRC) screening recommendations of the U.S. Multi-Society Task Force of Colorectal Cancer (MSTF), which represents the American College of Gastroenterology, the American Gastroenterological Association, and The American Society for Gastrointestinal Endoscopy. CRC screening tests are ranked in 3 tiers based on performance features, costs, and practical considerations. The first-tier tests are colonoscopy every 10 years and annual fecal immunochemical test (FIT). Colonoscopy and FIT are recommended as the cornerstones of screening regardless of how screening is offered...
June 2, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28572877/does-music-reduce-anxiety-and-discomfort-during-flexible-sigmoidoscopy-a-systematic-review-and-meta-analysis
#11
Arun P Shanmuganandan, Muhammad R Sameem Siddiqui, Nicholas Farkas, Kiran Sran, Rhys Thomas, Said Mohamed, Robert I Swift, Al Mutaz Abulafi
AIM: To investigate the role of music in reducing anxiety and discomfort during flexible sigmoidoscopy. METHODS: A systematic review of all comparative studies up to November 2016, without language restriction that were identified from MEDLINE and the Cochrane Controlled Trials Register (1960-2016), and EMBASE (1991-2016). Further searches were performed using the bibliographies of articles and abstracts from major conferences such as the ESCP, NCRI, ASGBI and ASCRS...
May 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28562114/macroscopic-findings-incidence-and-characteristics-of-microscopic-colitis-in-a-large-cohort-of-patients-from-the-united-kingdom
#12
John S Kane, Olorunda Rotimi, Alexander C Ford
OBJECTIVE: Microscopic colitis (MC) is classically associated with normal or near-normal endoscopic appearances. However, non-specific macroscopic findings have been described, the importance of biopsy location for confirming a diagnosis of MC is unclear, and reported incidence data from the United Kingdom are limited. This study was designed to assess macroscopic features, incidence, demographics, and location and positivity of biopsy samples in MC. MATERIALS AND METHODS: Retrospective, cross-sectional study of individuals with newly diagnosed MC...
September 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28561198/risk-of-infection-following-colonoscopy-and-sigmoidoscopy-in-symptomatic-patients
#13
Jiun-Nong Lin, Chang-Bi Wang, Chih-Hui Yang, Chung-Hsu Lai, Hsi-Hsun Lin
Background and study aims Previous studies describing the incidence of infection after colonoscopy and sigmoidoscopy are limited. The aim of this study was to determine the incidence of infection, and to propose a nomogram to predict the probability of infection following colonoscopy and sigmoidoscopy in symptomatic patients. Patients and methods A nationwide retrospective study was conducted by analyzing the National Health Insurance Research Database of Taiwan. The incidence of infection within 30 days after colonoscopy and sigmoidoscopy was assessed and compared with a control group matched at a ratio of 1:1 based on age, sex, and the date of examination...
May 24, 2017: Endoscopy
https://www.readbyqxmd.com/read/28555635/the-association-between-distal-findings-and-proximal-colorectal-neoplasia-a-systematic-review-and-meta-analysis
#14
REVIEW
Jason L W Huang, Y H Wang, Johnny Y Jiang, C P Yu, Y L Wu, P Chen, X Q Yuan, Harry H X Wang, Martin C S Wong
OBJECTIVES: Whether screening participants with distal hyperplastic polyps (HPs) detected by flexible sigmoidoscopy (FS) should be followed by subsequent colonoscopy is controversial. We evaluated the association between distal HPs and proximal neoplasia (PN)/advanced proximal neoplasia (APN) in asymptomatic, average-risk patients. METHODS: We searched Ovid Medline, EMBASE, and the Cochrane Library from inception to 30 June 2016 and included all screening studies that examined the relationship between different distal findings and PN/APN...
May 30, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28555631/the-conversion-of-planned-colonoscopy-to-sigmoidoscopy-and-the-effect-of-this-practice-on-the-measurement-of-quality-indicators
#15
Sabina Beg, Stefano Sansone, Francesco Manguso, John Schembri, Jay Patel, Mo Thoufeeq, Gareth Corbett, Krish Ragunath
OBJECTIVES: A cecal intubation rate (CIR) of >90% is a well-accepted quality indicator of colonoscopy and is consequently monitored within endoscopy units. Endoscopists' desire to meet this target may mean that incomplete colonoscopies are recorded as flexible sigmoidoscopies. The aim of this study was to examine whether the conversion of requested colonoscopies is a clinically significant phenomenon and whether this impacts upon the measurement of quality indicators. METHODS: A retrospective review of all flexible sigmoidoscopies performed between 1 January 2015 and 31 December 2015 at Nottingham University Hospitals, Sheffield Teaching Hospitals, and Cambridge University Hospitals was performed...
May 30, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28555630/colorectal-cancer-screening-recommendations-for-physicians-and-patients-from-the-u-s-multi-society-task-force-on-colorectal-cancer
#16
Douglas K Rex, C Richard Boland, Jason A Dominitz, Francis M Giardiello, David A Johnson, Tonya Kaltenbach, Theodore R Levin, David Lieberman, Douglas J Robertson
This document updates the colorectal cancer (CRC) screening recommendations of the U.S. Multi-Society Task Force of Colorectal Cancer (MSTF), which represents the American College of Gastroenterology, the American Gastroenterological Association, and The American Society for Gastrointestinal Endoscopy. CRC screening tests are ranked in 3 tiers based on performance features, costs, and practical considerations. The first-tier tests are colonoscopy every 10 years and annual fecal immunochemical test (FIT). Colonoscopy and FIT are recommended as the cornerstones of screening regardless of how screening is offered...
June 6, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28551972/sigmoidoscopy-and-faecal-occult-blood-test-a-comparative-screening-trial
#17
Thomas de Lange, Kristin Ranheim Randel, Anna Lisa Schult, Markus Dines Knudsen, Benedicte Kirkøen, Edoardo Botteri, Paula Berstad, Anita Jørgensen, Giske Ursin, Michael Bretthauer, Geir Hoff
No abstract text is available yet for this article.
May 2017: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
https://www.readbyqxmd.com/read/28550146/does-painless-rectal-bleeding-equate-to-a-colonic-polyp
#18
Alison Morag Campbell, Ian Sugarman
BACKGROUND: It is often stated that if a patient presents with 'painless rectal bleeding' then a rectal polyp is the probable diagnosis. The aim of this study is to review our experience of children undergoing endoscopy to assess if the above statement is correct. METHODS: The senior author keeps a prospective database of every child undergoing flexible sigmoidoscopy or colonoscopy. As part of this database, the symptoms and signs that the patient presents with, specifically abdominal pain, diarrhoea, mucous per rectum and rectal bleeding, are recorded...
May 26, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28547857/confocal-endomicroscopy-in-diagnosis-of-intestinal-chronic-graft-versus-host-disease
#19
Kathrin Rieger, Ute Günther, Ulrike Erben, Anja Kühl, Christoph Loddenkemper, Antonio Pezzutto, Britta Siegmund, Christian Bojarski
Graft-versus-host disease (GvHD) is a major complication of allogeneic stem cell transplantation. High-resolution in vivo histology of the intestine by confocal endomicroscopy (CEM) detects acute GvHD (aGvHD) with high sensitivity. This pilot study aims to evaluate the diagnostic value of CEM for intestinal chronic GvHD (cGvHD). The study included 20 patients with gastrointestinal symptoms and confirmed cGvHD in other organs as well as 20 patients with clinically suspected acute GvHD for control. Confocal endomicroscopy was performed as gastroscopy followed by sigmoidoscopy after intravenous injection of fluorescein (10%) and topical application of acriflavine (0...
May 25, 2017: Hematological Oncology
https://www.readbyqxmd.com/read/28536232/native-valve-endocarditis-caused-by-lactococcus-garvieae-an-emerging-human-pathogen
#20
Felicia H Lim, David R Jenkins
A 57-year-old man presented with native mitral valve endocarditis caused by Lactococcus garvieae, a known animal pathogen that is increasingly being reported as a cause of human infections. The organism was cultured in four sets of blood cultures and identification was initially made by matrix-assisted laser desorption/ionisation-time of flight mass spectrometry and confirmed by 16S rDNA PCR of the blood culture isolate. He was successfully treated with 6 weeks of both amoxicillin and gentamicin and underwent valve replacement surgery after 4 weeks of antimicrobial treatment...
May 22, 2017: BMJ Case Reports
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