scholarly journals Routine Colonoscopy after Diverticulitis Should not be Performed to Rule Out Colorectal Cancer

2019 ◽  
pp. 29-32
Author(s):  
Dijkhorst PJ ◽  
Loffeld RJLF
Keyword(s):  
Colorectal Cancer ◽  
Radiologic Diagnosis ◽  
Uncomplicated Diverticulitis ◽  
Male Patients ◽  
Histological Confirmation ◽  
Endoscopic Investigation ◽  
Ultrasound Investigation ◽  
Study Hospital ◽  
Rule Out ◽  
Sigmoid Cancer

Introduction: Diverticulitis is a clinical diagnosis generally confirmed by a radiological examination. Guidelines recommend routine screening for colorectal cancer after the acute phase. Aim: Patients diagnosed with diverticulitis were studied in order to gain more information on presence of concomitant abnormalities. Material and methods: Inclusion criterion was the radiologic diagnosis of diverticulitis. All consecutive requests for ultrasound and/ or CT-scan of the abdomen in a three year period, with Diverticulitis mentioned in application were included. If diverticulitis was diagnosed, than this specific investigation was included in the present study. Hospital records were searched for the presence of endoscopic investigation. Results: In the three year period 1410 consecutive ultrasound investigation and/or CT-scans of the abdomen were performed. After exclusions 198 patients remained with the radiological confirmed diagnosis of diverticulitis. Of these patients 127 (64%) underwent an additional endoscopy. Seventy one patients (36%) did not undergo a colonoscopy. There was no difference in gender or in age between both groups. Colonoscopy showed additional abnormalities in 22 (17.3%) of the patients. These were hyperplastic polyp(s) in six, adenomatous polyp(s) in nine, polyps without histological confirmation in three and segmental colitis in three. Two male patients were diagnosed with sigmoid cancer. Both had non-subsiding diverticulitis with abscess formation at the location of the tumor. Conclusion: It is safe to omit colonoscopy after an episode of uncomplicated diverticulitis. Only in cases of complications or persistent complaints cancer should be part of the differential diagnosis and a subsequent colonoscopy should be performed.

scholarly journals Colonoscopy after Diverticulitis

2021 ◽  
Author(s):  
Jeremy Meyer ◽  
Frédéric Ris
Keyword(s):  
Colorectal Cancer ◽  
Complicated Diverticulitis ◽  
Uncomplicated Diverticulitis ◽  
Increased Risk ◽  
Case Basis ◽  
Rule Out

Patients suffering from diverticulitis are at increased risk for colorectal cancer and should undergo colonoscopy to rule out colorectal cancer. The prevalence of colorectal cancer in this population was estimated to range between 1.9 and 2.3%. This prevalence is higher in patients with complicated diverticulitis (abscess, perforation) and ranges between 6.1% and 7.9%. Therefore, interval colonoscopy is strongly recommended after an episode of complicated diverticulitis. The prevalence of colorectal cancer is lower in patients with uncomplicated diverticulitis and approaches the prevalence from screened populations. In patients with uncomplicated diverticulitis, the indication for colonoscopy is still a matter of debate and should be done on a case-by-case basis.

Bone Marrow Culture Yield for the Diagnosis of Opportunistic Diseases in Patients with AIDS and Disseminated Kaposi Sarcoma

2020 ◽  
Vol 18 (4) ◽  
pp. 277-282
Author(s):  
P. Cornejo-Juárez ◽  
B. Islas-Muñoz ◽  
A.F. Ramírez-Ibargüen ◽  
G. Rosales-Pedraza ◽  
B. Chávez-Mazari ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Complete Blood Count ◽  
Kaposi Sarcoma ◽  
Opportunistic Pathogens ◽  
Reactive Protein ◽  
Negative Results ◽  
Recent Diagnosis ◽  
Male Patients ◽  
Liver Tests ◽  
Rule Out

Background: Disseminated Kaposi sarcoma (DKS) is present in patients with advanced HIV infection in whom co-infection with other opportunistic pathogens can occur. Bone marrow (BM) aspirate and biopsy comprises a robust diagnostic tool in patients with fever, cytopenias, and abnormal liver tests. However, the yield in patients with DKS has not been determined. Objective: The aim of this study was to evaluate the utility of BM aspirate and biopsy in patients with DKS. Methods: We included 40 male patients with recent diagnosis of DKS. BM aspirate and biopsy was performed as part of the workup to rule out co-infections. Results: In four patients, Mycobacterium avium complex (MAC) was recovered from culture. In another four patients, intracellular yeasts were observed in the Grocott stain, diagnosed as Histoplasma. The yield of BM was calculated in 20%. Only 12 patients (30%) had fever and 11 (27.5%) had pancytopenia. Alkaline phosphatase (ALP) above normal values and C-reactive protein (CRP) were higher in patients with positive results for BM than in those with negative results (63% vs. 21.9%, and 3.0 vs. 1.2 mg/L; p = 0.03 in both comparisons). No differences were found on comparing complete blood-count abnormalities. Conclusion: We recommend performing a BM aspirate for stains, culture, and biopsy in all HIV patients with DKS, as this will permit the early diagnosis of co-infections and prevent further complications in those who receive chemotherapy.

scholarly journals Sigmoid adenocarcinoma with renal metastasis

2011 ◽  
Vol 1 (4) ◽  
pp. 88 ◽  
Author(s):  
Carini Dagnoni ◽  
Luzete Cristina Silva Granero ◽  
Rodrigo Kraft Rovere
Keyword(s):  
Colorectal Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Metastasis ◽  
Partial Cystectomy ◽  
Tubular Adenocarcinoma ◽  
Colovesical Fistula ◽  
Kidney Tumors ◽  
Renal Metastasis ◽  
Therapeutic Challenge ◽  
Sigmoid Cancer

We report a case of a 75-year-old man submitted to a rectosigmoidectomy and partial cystectomy because of a sigmoid cancer and colovesical fistula. Seven months later and after four cycles of adjuvant chemotherapy, a lesion was detected in the kidney. Histology revealed tubular adenocarcinoma, which meant sigmoid cancer metastasis. Kidney metastases are very rare in colorectal cancer (CRC), but may be generally associated with an unfavorable prognosis. Thus, patients with metastatic CRC and kidney tumors are a diagnostic and therapeutic challenge.

scholarly journals Cyclin D1 G870A Variant is Associated with Increased Risk of Microsatellite Instability-Positive Colorectal Cancer in Young Male Patients

2007 ◽  
Vol 10 (2) ◽  
pp. 29-36
Author(s):  
T Josifovski ◽  
N Matevska ◽  
M Hiljadnikova-Bajro ◽  
Z Sterjev ◽  
A Kapedanovska ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Microsatellite Instability ◽  
Cyclin D1 ◽  
Regulatory Protein ◽  
Significant Risk ◽  
Young Male ◽  
Genotype Distribution ◽  
Increased Risk ◽  
Significant Difference ◽  
Male Patients

Cyclin D1 G870A Variant is Associated with Increased Risk of Microsatellite Instability-Positive Colorectal Cancer in Young Male PatientsCyclin D1 (CCND1) is a cell cycle regulatory protein, which is often over expressed in human tumors and is associated with cell proliferation and poor prognosis. A common G870A single nucleotide polymorphism at codon 242 in exon 4 of the CCND1 gene is associated with an altered messenger RNA transcript and increased risk of colorectal cancer (CRC) and adenoma in some studies. Over expression of CCND1 modifies the effect of mutations in mismatch repair (MMR) genes, enhances microsatellite instability (MSI), and influences the age ofonset of hereditary non polyposis colorectal cancer (HNPCC). We have extended our study that indicated that the CCND1 A variant may influence the age of onset of CRC in the Macedonian population only in patients who exhibit MSI tumors by a case control study of 331 randomly selected CRC patients and 101 controls without clinical diagnosis of CRC. We did not observe a significant difference in overall allelic frequencies and genotype distribution of affected and unaffected mutation carriers, but found a statistically significant risk of CRC in carriers of the CCND1 A allele when patients were grouped according to gender, age and MSI status. A higher risk was observed in patients with MSI-positive tumors and particularly in male patients under 60 years of age. The consequences of the above observation were reversed in female patients. These results indicate that the CCND1 A variant may enhance CRC progression through a pathway influenced by estrogens in colonic epithelia.

Prevalence of colorectal cancer in acute uncomplicated diverticulitis and the role of the interval colonoscopy

2018 ◽  
Vol 33 (7) ◽  
pp. 991-994 ◽  
Author(s):  
Nicholas Yock Teck Soh ◽  
Daryl Kai Ann Chia ◽  
Nan Zun Teo ◽  
Calvin Jian Ming Ong ◽  
Ramesh Wijaya
Keyword(s):  
Colorectal Cancer ◽  
Uncomplicated Diverticulitis ◽  
Acute Uncomplicated Diverticulitis

scholarly journals Proteogenomics of Colorectal Cancer Liver Metastases: Complementing Precision Oncology with Phenotypic Data

Cancers ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 1907 ◽  
Author(s):  
Bernhard Blank-Landeshammer ◽  
Vincent R. Richard ◽  
Georgia Mitsa ◽  
Maud Marques ◽  
André LeBlanc ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Precision Oncology ◽  
Kras Mutations ◽  
Phenotypic Data ◽  
Colorectal Cancer Liver Metastases ◽  
Parallel Reaction Monitoring ◽  
Therapeutic Opportunity ◽  
Protein Variants ◽  
Rule Out

Hotspot testing for activating KRAS mutations is used in precision oncology to select colorectal cancer (CRC) patients who are eligible for anti-EGFR treatment. However, even for KRASwildtype tumors anti-EGFR response rates are <30%, while mutated-KRAS does not entirely rule out response, indicating the need for improved patient stratification. We performed proteogenomic phenotyping of KRASwildtype and KRASG12V CRC liver metastases (mCRC). Among >9000 proteins we detected considerable expression changes including numerous proteins involved in progression and resistance in CRC. We identified peptides representing a number of predicted somatic mutations, including KRASG12V. For eight of these, we developed a multiplexed parallel reaction monitoring (PRM) mass spectrometry assay to precisely quantify the mutated and canonical protein variants. This allowed phenotyping of eight mCRC tumors and six paired healthy tissues, by determining mutation rates on the protein level. Total KRAS expression varied between tumors (0.47–1.01 fmol/µg total protein) and healthy tissues (0.13–0.64 fmol/µg). In KRASG12V-mCRC, G12V-mutation levels were 42–100%, while one patient had only 10% KRASG12V but 90% KRASwildtype. This might represent a missed therapeutic opportunity: based on hotspot sequencing, the patient was excluded from anti-EGFR treatment and instead received chemotherapy, while PRM-based tumor-phenotyping indicates the patient might have benefitted from anti-EGFR therapy.

scholarly journals Patient characteristics associated with the level of patient-reported care coordination among male patients with colorectal cancer in the Veterans Affairs health care system

Cancer ◽  
2015 ◽  
Vol 121 (13) ◽  
pp. 2207-2213 ◽  
Author(s):  
George L. Jackson ◽  
Leah L. Zullig ◽  
Sean M. Phelan ◽  
Dawn Provenzale ◽  
Joan M. Griffin ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Health Care System ◽  
Care Coordination ◽  
Patient Characteristics ◽  
Veterans Affairs ◽  
Patient Reported ◽  
Male Patients ◽  
Care System

scholarly journals The role of rebound tenderness in acute appendicitis and appendicular perforation

2017 ◽  
Vol 4 (2) ◽  
pp. 725
Author(s):  
Yashwant R. Lamture ◽  
Varsha P. Gajbhiye
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Study Data ◽  
Rebound Tenderness ◽  
Important Sign ◽  
Male Patients ◽  
Rule Out

Background: Acute appendicitis is the most common surgical emergency. Inspite of sophisticated new investigations mainstay of diagnosis depends on clinical sign and symptoms, rebound tenderness is very important sign with controversial views regarding it in available literature. Hence this study was undertaken to prove its efficacy of it related to rule out appendicular perforations.Methods: This study was conducted in 418 patients with 186 female and 251 male. Patients were of acute appendicitis operated for appendicectomy were included in the study. Data analysis was done by data statistic software.Results: The sensitivity and specificity of rebound tenderness to diagnose acute appendicitis is 65% and 73.6% respectively whereas the sensitivity and specificity of rebound tenderness to diagnose appendicular perforation was 94% and23.3% respectively with positive predictive value is 5 and negative predictive value is 99.Conclusions: Hence it indicates that rebound tenderness is very important to rule out complications like perforation or peritonitis and to support diagnosis of acute appendicitis. It has minimal significance to diagnose perforation of appendix as positive predictive value is less.

scholarly journals PERCEPTIONS OF COLOSTOMY PATIENTS ABOUT NURSING CARE IN ONCOLOGY INPATIENT UNITS

2021 ◽  
Author(s):  
Claudia Bruna Perin ◽  
Andréia Machado Cardoso ◽  
Alessandra Yasmin Hoffmann ◽  
Vanessa Zancanaro ◽  
Vanessa Manfrin
Keyword(s):  
Colorectal Cancer ◽  
Elementary Education ◽  
Nursing Care ◽  
Exploratory Study ◽  
Structured Interview ◽  
Qualitative Approach ◽  
Sociodemographic Data ◽  
Male Patients ◽  
Colorectal Cancer Patients ◽  
Inpatient Units

Objective: To analyze the perceptions of colorectal cancer patients using colostomy on the nursing care of the oncology inpatient units of a hospital in western Santa Catarina. Methods: Descriptive-exploratory study of qualitative approach carried out in the oncology inpatient units of the Hospital Regional do Oeste, in the period from January to August 2020, through a questionnaire containing sociodemographic data and semi-structured interview, applied to 20 patients with colorectal cancer using colostomy. The data were analyzed using Laurence Bardin’s Content Analysis. Results: The results indicated a prevalence of colostomy male patients, with a mean age of 60.25 years, married, retired, and with incomplete elementary education. From the qualitative analysis of the interviews emerged the category: patients’ perceptions of nursing care, which was subdivided into: nursing care with the bag and the stoma and nursing care during hospitalization. Conclusion: At the end of the survey, it is concluded that the colostomy patients perceive that the nursing staff performs the essential care of the bag and the stoma, including its exchange and hygiene during hospitalization, meeting the patients’ needs. In addition, they provide important guidance on the use of the devices, promoting health education.

Sign in / Sign up

Export Citation Format

Share Document