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Colo rectal

G Cocorullo, R Tutino, N Falco, T Fontana, G Salamone, L Licari, G Gulotta
Rectal bleeding is very common in general population with a prevalence of 10-20 %. Primary care physicians have to stratify patients basing on urgency and on the colo-rectal cancer risk and to conduct a decision making for the correct management. We report a case of a 61-years-old woman, complaining rectal bleeding and an anal mass attended to their family doctor who does a visit but without a digital rectal examination and diagnosed a hemorrhoidal prolapse suggesting medical therapy. For the persistence of symptoms she comes to our service from emergency attention...
May 2016: Il Giornale di Chirurgia
Peter R Shewry, Sandra J Hey
Wheat is the most important staple crop in temperate zones and is in increasing demand in countries undergoing urbanization and industrialization. In addition to being a major source of starch and energy, wheat also provides substantial amounts of a number of components which are essential or beneficial for health, notably protein, vitamins (notably B vitamins), dietary fiber, and phytochemicals. Of these, wheat is a particularly important source of dietary fiber, with bread alone providing 20% of the daily intake in the UK, and well-established relationships between the consumption of cereal dietary fiber and reduced risk of cardio-vascular disease, type 2 diabetes, and forms of cancer (notably colo-rectal cancer)...
October 2015: Food Energy Secur
Alberto Grandi, Alice Santi, Susanna Campagnoli, Matteo Parri, Elisa De Camilli, Chaojun Song, Boquan Jin, Aurelien Lacombe, Serenella Castori-Eppenberger, Paolo Sarmientos, Guido Grandi, Giuseppe Viale, Luigi Terracciano, Paola Chiarugi, Piero Pileri, Renata Grifantini
Endoplasmic reticulum (ER) stress and unfolded protein response (UPR) are highly activated in cancer and involved in tumorigenesis and resistance to anti-cancer therapy. UPR is becoming a promising target of anti-cancer therapies. Thus, the identification of UPR components that are highly expressed in cancer could offer new therapeutic opportunity.In this study, we demonstrate that Endoplasmic Reticulum Metallo Protease 1 (ERMP1) is broadly expressed in a high percentage of breast, colo-rectal, lung, and ovary cancers, regardless of their stage and grade...
August 23, 2016: Oncotarget
Alexander T Hawkins, Sekhar Dharmarajan, Katerina K Wells, Devi Mukkai Krishnamurty, Matthew G Mutch, Sean C Glasgow
BACKGROUND: Anastomotic leak is one of the most feared complications of gastrointestinal surgery. Surgeons routinely perform a diverting loop ileostomy (DLI) to protect high-risk colo-rectal anastomoses. STUDY DESIGN: The NSQIP database was queried from 2012 to 2013 for patients undergoing open ileo-colic resection with and without a DLI. The primary outcome was the development of any anastomotic leak-including those managed operatively and non-operatively. Secondary outcomes included overall complication rate, return to the OR, readmission, and 30-day mortality...
October 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Jeremie Zeitoun, Benjamin Menahem, Audrey Fohlen, Gil Lebreton, Jean Lubrano, Arnaud Alves
A 61-year-old man presented via the emergency department with a few days history of abdominal and colic occlusion symptoms. He presented signs of sepsis, midline lumbar spine tenderness and reduced hip flexion. Computer tomography of the abdomen and pelvis showed a presacral collection contiguous with the posterior part of the colo-rectal anastomosis, and MRI lumbar spine revealed abscess invation into the epidural space. He underwent a laparotomy with washout of the presacral abscess and a colostomy with a prolonged course of intravenous antibiotic therapy...
2016: Journal of Surgical Case Reports
M Demir, M Kurt, A B Akçay
BACKGROUND AND AIM: It has been reported that the fragmented QRS (fQRS) is related to left ventricular systolic dysfunction and diastolic dysfunction. The aim of this study was to determine the frequency of fragmented QRS (fQRS) in patients with decompensated cirrhosis and to evaluate the relationship between the presence of fQRS and systolic and diastolic dysfunction. METHOD: PThe study included consecutive 189 patients with decompensated cirrhosis. fQRS pattern was described as presence of RSR' manifested as existence of additional R wave and notching in either R or S waves in ECG recordings...
April 2016: Acta Gastro-enterologica Belgica
T Suzuki, T Hara, Y Kitagawa, T Yamaguchi
AIM: Endoscopic submucosal dissection (ESD) is currently widely conducted for the treatment of early gastrointestinal -cancers. Due to the characteristic anatomy of the large intestine, needle- tip type devices such as Dual knife are mainly used in colorectal ESD. On the other hand, the non- needle-tip type IT knife is a unique device with an insulated tip, and has been reported to be safe, efficacious and speedy when used in gastric ESD. A new model of IT knife, IT knife nano, anticipated to be useful for esophageal and colorectal ESD has become available, but its usefulness has not been reported...
April 2016: Acta Gastro-enterologica Belgica
Michael Pohl, Wolff Schmiegel
BACKGROUND: Colorectal cancer (CRC) is the third most common cancer type in Western countries. Significant progress has been made in the last decade in the therapy of metastatic CRC (mCRC) with a median overall survival (OS) of patients exceeding 30 months. The integration of biologic targeted therapies and anti-epidermal growth factor receptor (EGFR) monoclonal antibodies (MABs) in the treatment of patients with genomically selected all-RAS wild-type mCRC leads to a significant progress in advanced incurable disease state...
2016: Digestive Diseases
Giacomo Ruffo, Giuliano Barugola, Roberto Rossini, Carlo Augusto Sartori
Improving the quality and effectiveness of care is a key priority of any health policy. The outcomes of health care can be considered as indicators of effectiveness or quality. The scientific literature that evaluates the association between the volume of activity and the outcome of health interventions has greatly developed over the past decade, but, for practical reasons, ethical and social issues, a few randomized controlled studies were made to evaluate this association, although there are numerous observational studies of outcome and systematic reviews of the studies themselves...
June 2016: Updates in Surgery
Melinda E Stack, Konstantin Umanskiy
BACKGROUND: Various methods exist for the treatment of rectovaginal fistulas, with the choice of repair largely dependent on the fistula location. Options include local repair with mucosal advancement flaps, the use of agents like fibrin glue, and an abdominal approach with resection and colo-anal reconstruction. Traditionally, local repair with mucosal advancement flaps is reserved for simple, low rectovaginal fistulas, while high rectal fistulas require a transabdominal approach.1,2 METHODS: Here, we demonstrate an innovative approach for the treatment of a complex, high rectovaginal fistula in a patient with a hostile pelvis via a transanal approach with robotic assistance...
May 24, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
P Loftås, G Arbman, V Fomichov, O Hallböök
BACKGROUND: Pathological complete response (pCR) after neoadjuvant therapy in rectal cancer is correlated with improved survival. There is limited knowledge on the incidence of pCR at a national level with uniform guidelines. The aim of this prospective register-based study was to investigate the incidence and outcome of pCR in relation to neoadjuvant therapy in a national cohort. METHOD: All patients abdominally operated for rectal cancer between 2007 and 2012 (n = 7885) were selected from The Swedish Colo-rectal Cancer Register...
June 2016: European Journal of Surgical Oncology
Pierpaolo Correale, Cirino Botta, Elodia Claudio Martino, Cristina Ulivieri, Giuseppe Battaglia, Tommaso Carfagno, Maria Grazia Rossetti, Antonella Fioravanti, Giacomo Maria Guidelli, Sara Cheleschi, Claudia Gandolfo, Francesco Carbone, Tatiana Cosima Baldari, Pierfrancesco Tassone, Pierosandro Tagliaferri, Luigi Pirtoli, Maria Grazia Cusi
Thymidylate synthase (TS) is a tumor-associated enzyme critical for DNA replication and main 5'-fluorouracil (5'-FU) target. TSPP/VAC1 is a multi-arm trial phase-Ib trial program aimed to investigate the toxicity and biomodulatory activity of a poly-epitope-peptide vaccine to TS (TSPP) in cancer patients (pts). Here, we present the results of the TSPP/VAC1/arm C trial aimed to evaluate TSPP in combination with chemo-immunotherapy in pretreated metastatic colo-rectal cancer (mCRC) pts. Twenty-nine pts, 14 males and 15 females, received poly-chemotherapy with gemcitabine [GEM; 1,000 mg/sqm, day-1], oxaliplatin [OX; 80 mg/sqm, day-2], levofolinate [100 mg/sqm, days 1-2], bolus/infusional 5'-FU [400 mg/800 mg/sqm, days 1-2], sargramostim [50 μg, days 3-7/q30], and interleukin-2 [sc...
April 2016: Oncoimmunology
J Hernández, L Molins, J J Fibla, F Heras, R Embún, J J Rivas
BACKGROUND: Patients with pulmonary metastases from colorectal cancer (CRC) may benefit from aggressive surgical therapy. The objective of this study was to determine the role of major anatomic resection for pulmonary metastasectomy to improve survival when compared with limited pulmonary resection. PATIENTS AND METHODS: Data of 522 patients (64.2% men, mean age 64.5 years) who underwent pulmonary resections with curative intent for CRC metastases over a 2-year period were reviewed...
May 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Cassandra L Miller, Sureshkumar Muthupalani, Zeli Shen, Frauke Drees, Zhongming Ge, Yan Feng, Xiaowei Chen, Guanyu Gong, Karan K Nagar, Timothy C Wang, Frank B Gertler, James G Fox
During a survey of clinical rectal prolapse (RP) cases in the mouse population at MIT animal research facilities, a high incidence of RP in the lamellipodin knock-out strain, C57BL/6-Raph1tm1Fbg (Lpd-/-) was documented. Upon further investigation, the Lpd-/- colony was found to be infected with multiple endemic enterohepatic Helicobacter species (EHS). Lpd-/- mice, a transgenic mouse strain produced at MIT, have not previously shown a distinct immune phenotype and are not highly susceptible to other opportunistic infections...
2016: PloS One
Francesco Bianco, Andrea Belli, Silvia De Franciscis, Armando Falato, Giovanni Maria Romano
Despite recent improvements in surgical technique, low rectal anastomoses for rectal cancer still carry a not negligible incidence of anastomotic leakage and pelvic related morbidity. The Turnball-Cutait delayed colo-anal anastomosis, also referred as pull-through procedure was introduced with the aim to reduce the surgical anastomotic related complications and overcome the need of diverting ileostomy creation. Recently, this technique regained popularity as a viable option not only as salvage procedure after anastomotic failure or in case of hostile pelvis but also as first choice option in case of low rectal cancer...
March 2016: Updates in Surgery
Thomas Kallachil
There are several techniques and variations described for tying a Surgeon's knot, all with the intention of getting a secured and square knot. A new, safe, quick and scientific approach to making a Surgeon's knot is presented here. Three basic techniques have been described in the literature for tying a Surgeon's knot: using the instrument, one-handed technique and two-handed technique. A two-handed technique for putting the initial double throw in a Surgeon's knot is described here. The number of throws can be increased as the situation demands...
December 2015: Indian Journal of Surgery
Raul Embun, Juan J Rivas de Andrés, Sergi Call, Beatriz de Olaiz Navarro, Jorge L Freixinet, Sergio Bolufer, Jose R Jarabo, Nuria Pajuelo, Laureano Molins
BACKGROUND: Although numerous existing studies have analyzed the prognostic factors of patients who have had surgical intervention for lung metastases of colorectal carcinoma (CRC), many of the results obtained until now have been contradictory. As a consequence, there is no established consensus about which group of prognostic factors could have a greater value when considered together. METHODS: This was a multicenter prospective cohort study that included all patients who underwent a first pulmonary metastasectomy of CRC, with radical intent, during a 2-year period (March 2008 to February 2010)...
May 2016: Annals of Thoracic Surgery
Charles J Kahi, C Richard Boland, Jason A Dominitz, Francis M Giardiello, David A Johnson, Tonya Kaltenbach, David Lieberman, Theodore R Levin, Douglas J Robertson, Douglas K Rex
No abstract text is available yet for this article.
March 2016: Gastrointestinal Endoscopy
Marzia Del Re, Marcello Tiseo, Paola Bordi, Armida D'Incecco, Andrea Camerini, Iacopo Petrini, Maurizio Lucchesi, Alessandro Inno, Daniele Spada, Enrico Vasile, Valentina Citi, Giorgio Malpeli, Enrica Testa, Stefania Gori, Alfredo Falcone, Domenico Amoroso, Antonio Chella, Federico Cappuzzo, Andrea Ardizzoni, Aldo Scarpa, Romano Danesi
INTRODUCTION: KRAS oncogene mutations (MUTKRAS) drive resistance to EGFR inhibition by providing alternative signaling as demonstrated in colo-rectal cancer. In non-small cell lung cancer (NSCLC), the efficacy of treatment with EGFR tyrosine kinase inhibitors (EGFR-TKIs) depends on activating EGFR mutations (MUTEGFR). However, inhibition of EGFR may select resistant cells displaying alternative signaling, i.e., KRAS, or restoration of EGFR activity due to additional MUTEGFR, i.e., the c...
January 20, 2016: Oncotarget
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