scholarly journals Clinicopathological profile of colorectal polyps: retrospective analysis from tertiary care center in Southern India

2019 ◽  
Vol 7 (9) ◽  
pp. 3396
Author(s):  
Prudhvi K. Chandolu ◽  
Venkatakrishnan L. ◽  
Vidhyalakshmi S.
Keyword(s):  
Retrospective Analysis ◽  
Care Center ◽  
Tertiary Care ◽  
Colorectal Polyps ◽  
Tubular Adenoma ◽  
Time Period ◽  
Screening Strategies ◽  
Clinicopathological Profile ◽  
Advanced Adenomas ◽  
The Right

Background: Colorectal Cancer is the fourth most commonly diagnosed and chronological changes in colorectal polyps and cancer is important in efficacy of screening strategies. In this study, we aimed to compare clinicopathological features of colorectal polyps and also aimed to characterise the distribution and the pathological features of polyps during an 18-year period divided in to two groups.Methods: This is retrospective analysis of cases that underwent colonoscopy and found to have colorectal polyps were re-viewed retrospectively for 18 year period are retrieved. 18 year period was divided in to 2001 to 2010 and 2011 to 2018.Results: Among 4230 patients underwent colonoscopy between January 2001 and September 2018, 1356 were excluded; of the remaining 2874, 986 were found to have 1,272 polyps. 306 patients had 412 polyps in 2001 to 2010 group and 680 patients had 860 polyps in 2011 to 2018 group. Adenomas on the left sided colon were significantly higher in the first time period (40.2% vs 30%, p <0.0003). Polyps on the right sided colon were significantly higher in the second time period (37.3% vs 36.9%, p <0.0005). The most common histology in the both periods is tubular adenoma. Histology of adenomas with high grade dysplasia were significantly more in first period (12.4% vs 7.6%, p <0.005).Conclusions: Our data shows shift in polyps from left side to right side colon in recent years. There was no significant change in shift in advanced adenomas from left side to right side of colon.

scholarly journals Types and Patterns of Colonic Polyps Encountered at a Tertiary Care Center in a Developing Country in South Asia

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Dakshitha Praneeth Wickramasinghe ◽  
Sanjeev F. Samaranayaka ◽  
Chamila Lakmal ◽  
Sashi Mathotaarachchi ◽  
Chula Kanishka Lal ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Colonic Polyps ◽  
Colorectal Polyps ◽  
Tubular Adenoma ◽  
Tubulovillous Adenoma ◽  
Chi Square ◽  
Chi Square Test ◽  
Pathology Reports ◽  
Spearman’S Correlation

Purpose. To identify the prevalence, types, and patterns of colonic polyps in a cohort of patients presenting to a tertiary care referral center in Sri Lanka.Methods. Endoscopy and pathology reports of a single unit from 2006 to 2013 were analyzed retrospectively. Spearman’s correlation coefficient and chi-square test were used to identify correlations.Results. There were a total of 158 patients (M : F, 10 : 57) who had polyps encountered on colonoscopy (n=1408) and flexible sigmoidoscopy (n=2402) with an incidence of 4.1%. Mean age was 56.5 years (SD 16.4) and the incidence of polyps increased with age. The majority (81.6%) had one polyp. A total of 188 polyps were assessed and most were seen in the rectum (33.5%) followed by sigmoid colon (22.9%). The commonest histological type was tubulovillous adenoma (33.5%) followed by tubular adenoma (24.5%). Most polyps were benign (91.5%). There was no statistically significant correlation with age or gender with malignancy, site, or histology.Discussion and Conclusion. The incidence of colorectal polyps was lower than the values reported in the west. More polyps were identified in males. There was no statistically significant association between age, gender, or multiplicity and malignant change in the polyps.

scholarly journals Overutilization of surgical resection for benign colorectal polyps: analysis from a tertiary care center

2021 ◽  
Vol 09 (05) ◽  
pp. E706-E712
Author(s):  
Rayan Saade ◽  
Tyler Tsang ◽  
Michel Kmeid ◽  
David Miller ◽  
Zhiyan Fu ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Care Center ◽  
Tertiary Care ◽  
Colorectal Polyps ◽  
Left Colon ◽  
Endoscopic Polypectomy ◽  
Polyp Size ◽  
Colorectal Cancer Prevention ◽  
The Right

Abstract Background and study aims Adequate removal of precancerous polyps is an independent factor in colorectal cancer prevention. Despite advances in polypectomy techniques, there is an increasing rate of surgery for benign polyps. We assessed whether surgical resection is properly utilized for benign colorectal polyps. Patients and methods We identified 144 patients with surgical resection for benign colorectal polyps. Polyp location, size and the indication for and type of surgery were obtained. For the purposes of this analysis, we assumed that gastroenterologists should assess polyp size accurately, endoscopically resect polyps < 2 cm, and treat incompletely excised polyps on follow-up. Results A total of 118 patients (82 %) were referred to surgery without attempted endoscopic removal. In 26 (22 %) of 118, the macroscopic polyp size was < 2 cm (23 in right, 3 in the left colon) and 18 (15 %; 14 in the right, four in the left colon) were found to have had size overestimation during endoscopy. Twenty-two (15 %) of 144 underwent surgical resection for incomplete endoscopic resection of adenomas (16 in the right, 6 in the left colon); 12 (54.5 %) had a residual polyp size of < 2 cm (10 in the right colon; 2 in the left colon). In-hospital mortality was 0.7 % and morbidity was 20.1 %. Conclusions Of the patients, 41 % could have potentially avoided surgical intervention (37 polyps < 2 cm and/or size overestimations precluding endoscopic polypectomy and 22 incomplete resections). When including polyps with size ≥ 2 to < 4 cm, the percentage of patients with avoidable surgery reached 80 %. This confirms the need to develop standardized quality metrics for endoscopic polypectomies and for better overall training of endoscopists performing these procedures. Given the risks of surgery, referral to an experienced gastroenterologist should be considered as a first step.

scholarly journals Colorectal Polyps: A Histopathological Study in Tertiary Care Center

2021 ◽  
Vol 4 (1) ◽  
pp. 414-418
Author(s):  
Dipika Basnet ◽  
Ramesh Makaju ◽  
Ram Bahadur Gurung ◽  
Rachana Dhakal
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Colorectal Polyps ◽  
University Hospital ◽  
Histopathological Study ◽  
Tubular Adenoma ◽  
High Grade ◽  
Age Group ◽  
Male Predominance ◽  
Insight Into

Introduction: Gastrointestinal polyps are commonly encountered in the colorectal region. They can be non-neoplastic or neoplastic. Neoplastic polyps include adenomas which are clinically important because of their premalignant nature. The study was carried out to analyze the histomorphological spectrum of polyps; in our institution with special emphasis on adenomatous polyps.Material and methods: This is a retrospective study done from January 2015 to December 2019 in the Department of Pathology, Dhulikhel Hospital - Kathmandu University Hospital (DH - KUH). Relevant clinical data of the patients were obtained from the histopathological records of the patient from the pathology department and biopsies stained with Haematoxylin and Eosin were studied under the light microscope.Results: A total of 168 cases of polyp were studied from 125 patients. The most common indication for colonoscopy in patients with polyp was per rectal bleeding. The age of the patient ranged from 2 to 83 years. The rectum was the commonest location. 106(63.1%) of polyps were non-neoplastic and 6(36.9%) of polyps were neoplastic. Juvenile polyp(71;42.3%) was the commonest polyp. Tubular adenoma(55;32.7%) was the commonest neoplastic polyp. Themaximum number of neoplastic polyps were seen in the age group of 51-60years (11;29.7%). Male predominance was seen in neoplastic as well as a non-neoplastic polyp. High grade adenoma(4;6.7%) was more commonly seen in adenomatous polyp >2cm(3;75%) followed by 1-2cm(1;25%) and none in <1cm.Conclusions: This study gives a fair insight into the distribution of neoplastic and nonneoplastic polyp in the colorectal region. Adenomatous polyps are premalignant. 

scholarly journals Real-world data on metabolic effects of PCSK9 inhibitors in a tertiary care center in patients with and without diabetes mellitus

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Laurenz T. Fischer ◽  
Daniel A. Hochfellner ◽  
Lisa Knoll ◽  
Tina Pöttler ◽  
Julia K. Mader ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Real World ◽  
Cardiovascular Events ◽  
Care Center ◽  
Tertiary Care ◽  
Lipid Lowering ◽  
Tertiary Care Center ◽  
Pcsk9 Inhibitors ◽  
Real World Data ◽  
Pcsk9 Inhibitor

Abstract Background The lipid-lowering and positive cardiovascular effect of proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors was shown in several studies, hence, they are more widely used in the lipid-lowering management of individuals with high cardiovascular risk. As real-world data are still scarce, specifically in patients with type 2 diabetes (T2D), the aim of this retrospective analysis was to investigate the efficacy of PCSK9 inhibitors in lowering low-density lipoprotein cholesterol (LDL-C) in an outpatient clinic of a tertiary care center in routine care. Methods A retrospective analysis of data extracted from the electronic patient record was performed. Patients who were routinely prescribed with PCSK9 inhibitor therapy (alirocumab or evolocumab) during the years 2016 and 2019 were included in the analysis. Characteristics of the patient population, the effects on LDL-C and HbA1c levels as well as subsequent cardiovascular events were assessed over an observation period of 18 months. Results We identified 237 patients treated with PCSK9 inhibitors between January 2016 and September 2019. Almost all patients (97.5%) received PCSK9 inhibitors for secondary prevention. 26.2% of the population had a concomitant diabetes diagnosis. Intolerance to statins (83.1%), ezetimibe (44.7%) or both agents (42.6%) was reported frequently. Three months after initiation of PCSK9 inhibitor therapy, 61.2% of the patients achieved LDL-C levels < 70 mg/dl, and 44.1% LDL-C levels < 55 mg/dl. The median LDL-C was lowered from 141 mg/dl at baseline, to 60 mg/dl after 3 months and 66 mg/dl after 12 months indicating a reduction of LDL-C as follows: 57.5% after 3 months and 53.6% after 12 months. After 3 months of observation, target achievement of LDL-C was higher in patients with T2D compared to non-diabetes patients; < 55 mg/dl: 51% vs. 41.5%; < 70 mg/dl 69.4 vs. 58.5%. After 12 months even more pronounced target LDL achievement in T2D was demonstrated < 55 mg/dl: 58.8% vs. 30.1%; < 70 mg/dl 70.6 vs. 49.6%. Patients with insufficiently controlled T2D (HbA1c > 54 mmol/mol) had a higher reduction in LDL-C but still were more likely to subsequent cardiovascular events. Conclusions Significant reductions in LDL-C and a high percentage of patients achieving recommended treatment targets were observed. The percentage of patients with T2D meeting recommended LDL-C targets was higher than in those without T2D. Still some patients did not achieve LDL-C levels as recommended in current guidelines. Special attention to the characteristics of these patients is required in the future to enable achievement of treatment goals and avoid adverse cardiovascular outcomes.

Medullary Thyroid Cancer: A Retrospective Analysis of a Cohort Treated at a Single Tertiary Care Center Between 1970 and 2005

Thyroid ◽  
2007 ◽  
Vol 17 (6) ◽  
pp. 549-556 ◽  
Author(s):  
Simona Grozinsky-Glasberg ◽  
Carlos A. Benbassat ◽  
Gloria Tsvetov ◽  
Rafael Feinmesser ◽  
Hava Peretz ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Retrospective Analysis ◽  
Medullary Thyroid Cancer ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Medullary Thyroid

scholarly journals Clinicopathological profile of childhood onset cutaneous mastocytosis from a tertiary care center in South India

2021 ◽  
Vol 12 (5) ◽  
pp. 706
Author(s):  
Dharshini Sathishkumar ◽  
Abyramy Balasundaram ◽  
SuryaMary Mathew ◽  
Lydia Mathew ◽  
Meera Thomas ◽  
...  
Keyword(s):  
South India ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Childhood Onset ◽  
Clinicopathological Profile ◽  
Cutaneous Mastocytosis

Clinicopathological profile of lung cancer at a tertiary care center

2018 ◽  
Vol 55 (3) ◽  
pp. 273
Author(s):  
SatyaPalanki Dattatreya ◽  
Rekha Bansal ◽  
Mohana Vamsy ◽  
Salil Vaniawala ◽  
SS Nirni ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Clinicopathological Profile

scholarly journals Probiotics to Reduce Clostridium difficile Infection: Clinical Experience in a Tertiary Care Center

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S384-S384
Author(s):  
Maggie Box ◽  
Kristine Ortwine ◽  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Primary Outcome ◽  
Care Center ◽  
Tertiary Care ◽  
Concomitant Administration ◽  
Antibiotic Exposure ◽  
Time Period ◽  
Probiotic Preparation ◽  
Hospital Acquired

Abstract Background There is conflicting clinical data regarding the efficacy of probiotics to prevent Clostridium difficile infection (CDI). The goal of this study is to compare rates of hospital acquired Clostridium difficile infection (HA-CDI) among patients receiving antibiotics with or without concomitant administration of probiotics. Methods This retrospective, cohort study compares hospitalized patients who received antibiotics alone vs. antibiotics plus a multi-strain probiotic preparation of lactobacillus over a six month time period. Probiotics were given at the discretion of the physician. The primary outcome was incidence in HA-CDI (defined as onset after hospital day three) between groups. Results A total of 1,576 patients met selection criteria, with 927 patients receiving antibiotics alone and 649 patients receiving antibiotics plus probiotics. HA-CDI rates were 0.9% and 1.8% (P = 0.16), respectively. In a subgroup analysis of patients in the antibiotic only group, patients who received similar antibiotic exposure as the probiotics group (n = 284) had no difference in rates of HA-CDI (1.8% vs. 1.8%; P = 1.0). Conclusion Probiotic administration did not decrease rates of HA-CDI in our institution. We recommend prioritizing resources to other CDI reduction measures such as decreasing antibiotic exposure and preventing transmission. Disclosures All authors: No reported disclosures.

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