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A S Dhadda, A Martin, S Killeen, I A Hunter
AIMS: Contact radiotherapy for early rectal cancer uses 50 kV X-rays to treat rectal cancers under direct vision. We present data of a series of patients treated at a single centre with prospective follow-up and functional assessment. MATERIALS AND METHODS: All patients were treated at the Queen's Centre for Oncology, Hull, UK between September 2011 and October 2015. Patients received a biopsy, magnetic resonance imaging (MRI) of the liver/pelvis, computed tomography of the chest and endorectal ultrasound...
October 7, 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
Avnish Kumar Seth, Pawan Rawal, Ruchika Bagga, Priti Jain
Forty-four-year-old male with ulcerative colitis (UC) for 11 years reported frequent relapse despite daily sulfasalazine 4 g, azathioprine 125 mg, and rectal 5-aminosalicylic acid. Repeated use of corticosteroids led to cataract. At enrollment, he was passing eight stools a day with blood with a Mayo score of 9 (3+1+3+2). Stool was negative for ova/cysts/acid fast bacilli and Clostridium difficile toxin assay. Rectal biopsy showed cryptitis, crypt abscess, and crypt distortion with no inclusion bodies, and cytomegalovirus DNA was negative...
September 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Sanne Jensen Dich, Alaa El-Hussuna
INTRODUCTION: We present a case of a presacral hematoma, which penetrated into the rectum resulting in rectal bleeding. This is an unusual presentation of a presacral hematoma. PRESENTATION OF THE CASE: A 76-year-old woman, using warfarin anticoagulant prophylaxis, presented with a rectal bleed two days after a fall. A sigmoidoscopy revealed that the source of bleeding was a presacral hematoma penetrating into the rectum. A Computed Tomography scan of the pelvis confirmed the presence of a hematoma measuring 10×9...
September 22, 2016: International Journal of Surgery Case Reports
Hans-Christian Pommergaard, Jakob Burcharth, Jacob Rosenberg, Hans Raskov
PURPOSE: Evidence supports an association between certain colorectal adenoma characteristics and predisposition to cancer. The association between anatomical location of colorectal adenoma, age and advanced adenomas needs attention. The objective of this study was to evaluate the possible association between occurrence of sporadic advanced adenomas with location and age. MATERIALS AND METHODS: A cross-sectional study using baseline data from index colonoscopy from a randomized controlled trial evaluating chemopreventive treatment against recurrence of colorectal adenomas was performed...
August 16, 2016: Scandinavian Journal of Gastroenterology
Chyng-Wen Fwu, Paul L Kimmel, Paul W Eggers, Kevin C Abbott
BACKGROUND: Although patients treated with maintenance hemodialysis are at an increased risk of colorectal cancer compared with the general population, national practices for colorectal cancer screening have not been reported in this population. We assessed the performance of colorectal cancer screening in the US end-stage renal disease program in comparison with the US Medicare population. METHODS: We studied the United States Renal Data System for US prevalent hemodialysis patients between 2002 and 2011 who had Medicare as their primary insurer...
October 2016: Clinical Kidney Journal
Abhinav Goyal, Moiz Salahuddin, Yogesh Govil
A 31-year-old female with a history of lupus nephritis on Hydroxychloroquine, Prednisone, and Mycophenolate Mofetil (MMF) for 10 years presented to the hospital for ankle swelling. On day four, she started to have severe, nonbloody, watery diarrhea with abdominal distension and tenderness. Stool PCR was negative for C. difficile. CT abdomen/pelvis showed gaseous distension of the colon without any obstruction. Flexible sigmoidoscopy revealed a normal looking mucosa. Histopathology showed crypt atrophy and increased crypt apoptosis, consistent with MMF colitis...
2016: Case Reports in Gastrointestinal Medicine
Asser Mathiassen Oppfeldt, Jens F Dahlerup, Lisbet A Christensen, Christian L Hvas
Faecal microbiota transplantation (FMT) is increasingly being used to treat refractory and recurring Clostridium difficile infection (CDI). Although FMT appears to be safe and highly effective in patients with a preserved colon and immunocompetence, its use in patients with inflammatory bowel disease (IBD) who are on immunomodulating therapies is controversial. In particular, patients who have undergone colectomy may have different treatment responses to FMT. In this case report, we describe the successful use of FMT in a female patient aged 19 years with Crohn's disease who underwent ileorectal anastomosis following colectomy...
2016: BMJ Case Reports
Elizabeth Sheena John, Ann M John, David R Hansberry, Prashant J Thomas, Prateek Agarwal, Christopher Deitch, Sita Chokhavatia
PURPOSE: Patients screened for colorectal cancer (CRC) frequently turn to the Internet to improve their understanding of tests used for detection, including colonoscopy, flexible sigmoidoscopy, fecal occult blood test (FOBT), and CT colonography. It was of interest to determine the quality and readability levels of online health information. METHODS: The screening tools were googled, and the top 20 results of each test were analyzed for readability, accessibility, usability, and reliability...
September 20, 2016: International Journal of Colorectal Disease
Trevor A Crowell, James Lk Fletcher, Irini Sereti, Suteeraporn Pinyakorn, Robin Dewar, Shelly J Krebs, Nitiya Chomchey, Rungsun Rerknimitr, Alexandra Schuetz, Nelson L Michael, Nittaya Phanuphak, Nicolas Chomont, Jintanat Ananworanich
INTRODUCTION: Colonic infiltration by HIV occurs soon after infection, establishing a persistent viral reservoir and a barrier to cure. We investigated virologic and immunologic correlates of detectable colonic HIV RNA during acute HIV infection (AHI) and their response to antiretroviral treatment (ART). METHODS: From 49,458 samples screened for HIV, 74 participants were enrolled during AHI and 41 consented to optional sigmoidoscopy, HIV RNA was categorized as detectable (≥50 copies/mg) or undetectable in homogenized colon biopsy specimens...
2016: Journal of the International AIDS Society
Börje Jonefjäll, Lena Öhman, Magnus Simrén, Hans Strid
BACKGROUND: Gastrointestinal symptoms (GI) compatible with irritable bowel syndrome (IBS) are common in patients with ulcerative colitis (UC) in remission. The causes of these symptoms remain to be clarified. Our aim was to investigate prevalence and factors associated with IBS-like symptoms in patients with UC in deep remission. METHODS: We included 298 patients with UC and used Mayo score, sigmoidoscopy, and fecal calprotectin to define deep remission versus active disease...
November 2016: Inflammatory Bowel Diseases
Jieun Lee, In-Ho Kim, Jin Su Kim, Sang Woo Kim, Jun Gi Kim, Seung Tack Oh, Won Kyung Kang, Myung Ah Lee
The incidence of colorectal cancer (CRC) is increasing in young-age patients, but the clinical history is not established. Authors analyzed the clinical characteristics of young-age onset CRC to support basic information for setting treatment policies.Between January 2006 to January 2014, 100 CRC patients diagnosed at the age of 10 to 39 were analyzed. The clinicopathologic characteristics were reviewed based on medical records. Survival outcomes including overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS) were analyzed...
September 2016: Medicine (Baltimore)
Chien-Hsin Chen, Po-Li Wei, Mao-Chih Hsieh, En-Kwang Lin, Jeng-Fong Chiou, Yen-Jung Lu, Szu-Yuan Wu
To investigate the outcomes of the selective neoadjuvant concurrent chemoradiotherapy (CCRT) in lower 3rd rectal cancer patients in different groups (with or without neoadjuvant CCRT), especially in survival rate, local recurrence rate, and sphincter preservation rate.From January 1999 to December 2012, 69 consecutive patients who had histologically proven adenocarcinoma of lower 3rd rectum, defined preoperatively as lower tumor margin within 7 cm from the anal verge as measured by rigid sigmoidoscopy, received total mesorectum excision (TME)...
September 2016: Medicine (Baltimore)
Bernardette Bonello, Alex Ghanouni, Harriet L Bowyer, Eilidh MacRae, Wendy Atkin, Stephen P Halloran, Jane Wardle, Christian von Wagner
BACKGROUND: To assess public preferences for colorectal cancer (CRC) surveillance tests for intermediate-risk adenomas, using a hypothetical scenario. METHODS: Adults aged 45-54 years without CRC were identified from three General Practices in England (two in Cumbria, one in London). A postal survey was carried out during a separate study on preferences for different first-line CRC screening modalities (non- or full-laxative computed tomographic colonography, flexible sigmoidoscopy, or colonoscopy)...
2016: BMC Gastroenterology
Vibhakorn Permpoon, Krit Pongpirul, Sinn Anuras
AIM: To investigate the clinical characteristics, treatment, medication use, and treatment response in patients with ulcerative colitis (UC) across ethnic groups. METHODS: This study retrospectively analyzed medical records of all 268465 patients who visited the Bumrungrad International Digestive Disease Center during 2005-2010. The demographics, clinical characteristics, medication use, results of investigations, and medical and surgical management for patients with UC were evaluated...
August 6, 2016: World Journal of Gastrointestinal Pharmacology and Therapeutics
Jill Tinmouth, Emily T Vella, Nancy N Baxter, Catherine Dubé, Michael Gould, Amanda Hey, Nofisat Ismaila, Bronwen R McCurdy, Lawrence Paszat
Introduction. The objectives of this systematic review were to evaluate the evidence for different CRC screening tests and to determine the most appropriate ages of initiation and cessation for CRC screening and the most appropriate screening intervals for selected CRC screening tests in people at average risk for CRC. Methods. Electronic databases were searched for studies that addressed the research objectives. Meta-analyses were conducted with clinically homogenous trials. A working group reviewed the evidence to develop conclusions...
2016: Canadian Journal of Gastroenterology & Hepatology
Mark Katory, Ross McLean, Khalid Osman, Mukhtar Ahmad, Tracey Hughes, Mike Newby, Christopher Dennison, Paul O'Loughlin
PURPOSE: Interpretation of water-soluble contrast enema following laparoscopic low anterior resection can be very challenging for both radiologists and colorectal surgeons. Discriminating the radiological appearances secondary to anastomotic configuration from those caused by actual anastomotic dehiscence is a common problem and may be made worse with the advent of laparoscopic surgery. The aim of this study is to identify potential novel appearances of the water-soluble contrast enema (WSCE) images of rectal anastomosis following laparoscopic low anterior resection to radiologists and surgeons...
September 6, 2016: Abdominal Radiology
Zibing Woodward, J Lucas Williams, Amnon Sonnenberg
BACKGROUND: The number of procedures utilized in the general management of gastrointestinal bleeding (GIB) has not been investigated previously. We used the National Endoscopic Database of the Clinical Outcomes Research Initiative for an observational study to analyze the average length of workup in GIB. METHODS: The electronic database was queried for all patients aged 18 years and older who underwent an endoscopic evaluation for any bleeding indication between 2000 and 2014...
October 2016: European Journal of Gastroenterology & Hepatology
Lapo Sali, Daniele Regge
CT colonography (CTC) is a minimally invasive radiological investigation of the colon. Robust evidence indicates that CTC is safe, well tolerated and highly accurate for the detection of colorectal cancer (CRC) and large polyps, which are the targets of screening. Randomised controlled trials were carried out in Europe to evaluate CTC as primary test for population screening of CRC in comparison with faecal immunochemical test (FIT), sigmoidoscopy and colonoscopy. Main outcomes were participation rate and detection rate...
August 19, 2016: British Journal of Radiology
Diana Sarfati, Caroline Shaw, Melissa McLeod, Tony Blakely, Ian Bissett
There are many different potential screening strategies for colorectal cancer (CRC) that vary both in the likely magnitude of their benefits on CRC mortality and their impact on health services. Many approaches to CRC screening are cost-effective, but there is substantial uncertainty about the optimal approach. Decision models using Markov or microsimulation modelling that compare the cost-effectiveness of different screening strategies are useful in this regard. We have reviewed recent decision models that compare the cost-effectiveness of one-off flexible sigmoidoscopy screening with immunochemical faecal occult blood (FIT) based screening...
2016: New Zealand Medical Journal
Javier R Lama, Shelly T Karuna, Shannon P Grant, Edith M Swann, Carmela Ganoza, Patricia Segura, Silvia M Montano, Martin Lacherre, Stephen C De Rosa, Susan Buchbinder, Jorge Sanchez, M Juliana McElrath, Maria P Lemos
BACKGROUND: Rectal and genital sampling in HIV prevention trials permits assessments at the site of HIV entry. Yet the safety and acceptability of circumcision and sigmoidoscopy (and associated abstinence recommendations) are unknown in uncircumcised men who have sex with men (MSM) at high risk of HIV infection. METHODS: Twenty-nine HIV-seronegative high-risk Peruvian MSM agreed to elective sigmoidoscopy biopsy collections (weeks 2 and 27) and circumcision (week 4) in a 28-week cohort study designed to mimic an HIV vaccine study mucosal collection protocol...
2016: PloS One
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