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Biomedical subjects

H Aste

Publications and source records attributed to H Aste.

At least 55 records · Page 3Linked to original sources
PubMed1984

Outcome of follow-up programs in patients previously resected for colorectal cancer.

The survival of a group of 115 patients (group A) who entered a follow-up program after apparently "curative" surgery for colorectal cancer was compared with that of 62 similar patients (group B) who did not join such a program. No significant difference was found. Clinical benefits to single patients in group A, in terms of anticipated diagnosis and effective treatment of recurrences and of metachronous neoplasias, appeared to be, if any, extremely limited. In light of the high costs of intensive follow-up programs, it is concluded that their use can be justified only within controlled perspective trials aimed to evaluate their usefulness.

Actuarial Analysis↗
PubMed1984

Adenomatous polyps and familial incidence of colorectal cancer.

The frequency of colonic adenomatous polyps and the incidence of colorectal cancer in close relatives were evaluated in a prospective study performed in 100 consecutive patients operated on for colorectal cancer. One hundred patients matched for age and sex, in whom double contrast enema and colonoscopy failed to show cancer, served as control group. Colorectal carcinomas in first-degree relatives were found in 11% of the surgically treated patients and 6% of the control group (the difference is not statistically significant). Solitary or discrete adenomas in patients operated on for colorectal carcinomas were significantly more frequent (32%) than in the control group (18%) (P less than 0.05). This difference is also statistically significant when considering only those patients without relatives suffering from carcinoma; however, the same cannot be statistically proven with the small group of patients with a positive family history. Present findings do not indicate that single or discrete adenomas synchronous with colorectal cancer are significantly associated with a familial history of large bowel malignancy. These findings are consistent with the hypothesis of environmental factors being involved in adenoma pathogenesis.

Aged↗
PubMed1984

Blind pan-esophageal brush cytology. Diagnostic accuracy.

A non-endoscopic abrasive panesophageal method of detecting malignant cells is described. This method showed a high specificity and an acceptable sensitivity as compared with endoscopic abrasive guided cytology, and is suitable for screening patients at risk of developing esophageal malignancy, and in the follow-up of patients who have undergone radical surgery.

Adult↗
PubMed1984

Occult blood testing in asymptomatic patients previously resected for colorectal cancer.

Hemoccult testing was carried out in 100 patients who had previously undergone surgical resection for colorectal cancer. Of the 15 Hemoccult-positive patients detected, endoscopic examination revealed polypoid formations in six (one with invasive carcinoma) and local recurrent tumors in three. Eighteen polypoid lesions were endoscopically detected in 10 Hemoccult-negative patients. Patient acceptance was good (above 90%) for Hemoccult testing especially when compared to the significantly lower compliance to endoscopic examination (66% in Hemoccult-negative patients). The results suggest that a significant number of lesions may be missed if the Hemoccult test is heavily relied upon exclusively for follow-up of patients previously resected for colorectal cancer.

Adult↗
PubMed1983

Left-sided stenosing lesions in colonoscopy.

Of 2625 consecutive colonoscopic examinations, 122 stenotic lesions interfered with endoscopy. The sigmoid was the most frequent site of stenosis (64%). Of the two types of endoscopic patterns, type A, in which there is an intraluminal protruding mass, is the most frequent, and type B, in which a segment of colon gradually narrows, has intact mucosa. Adenocarcinoma was the most frequent cause of type A (83%), and complications related to diverticular disease (32%) and adenocarcinoma (27%) were most often associated with type B. Colonoscopy, guided multiple biopsies, and brushing cytology gave high diagnostic accuracy for type A lesions. In type B cases, brushings were usually negative.

Adenocarcinoma↗
PubMed1983

"Splitting" and stretching dilation of esophageal strictures.

The "Splitting" action of metal olives, and the stretching effect of tapering Neoplex tubes of increasing diameter on dysphagia in a group of 55 consecutive patients with esophageal strictures are compared. Dilators were passed over a fibreoptic endoscopically positioned guide wire. Greater relief of dysphagic symptoms was obtained with the stretching procedure, mainly in postanastomotic and peptic strictures. Both procedures were safe, but the stretching technique was easier and resulted in wider dilations in most patients. Consecutive dilations using stretching procedures in malignant strictures appear to be an appropriate easy and safe alternative to endoprosthesis insertion.

Adult↗
PubMed1982

Left-sided colonoscopy in screening programs. What preparation?

In order to limit patients' refusal to undergoing colorectal cancer endoscopic screening procedures, traditional cleansing enemas were compared with a new simpler oral cleansing preparation by means of a randomized controlled trial. Ninety-three patients were evaluated both for compliance and effectiveness of the two modalities tested. No difference in acceptability or effectiveness was detected. The authors discuss more rigorous cleansing techniques routinely used in diagnostic schedules which cannot be considered for preparation for colonoscopy in screening programs.

Administration, Oral↗
PubMed1981

Value of multiple forceps biopsies in assessing the malignant potential of colonic polyps.

Fifty-nine colo-rectal polyps were detected at endoscopy and repeatedly biopsied before removal by endoscopic snare polypectomy. The aim of the present paper was to evaluate the reliability of multiple forceps biopsies in assessing both the malignant potential and the presence or absence of invasive cancer (IC) in colo-rectal adenomas (CRA). In order to achieve the first objective, the histologic types and the degree of dysplasia have been defined. The data obtained by means of multiple biopsies examination, compared with those of polyp in toto study, show that fractional biopsies were of value in the histologic classification of only the smallest 41 polyps (agreement 88.09%), whilst no reliability of biopsies was demonstrated in the 18 largest polyps (agreement 27.68%). In the field of dysplasia grading, the agreement was 55% and 61% for the smallest and the largest CRA respectively. These last figures are hardly acceptable. Biopsies examination gave also under- and overestimation of the histologic severity and of dysplasia as well as a significant incidence of false negative results in IC detection. It is concluded that polypectomy is the only method which provides adequate material for precise diagnosis, no matter how large a polyp. Therefore it should be performed whenever possible. Finally the authors discuss the management of small sessile adenomas.

Biopsy↗
PubMed1981

Endoscopy in asymptomatics previously submitted to anterior resection for colorectal cancer.

Eighty-two colonoscopies were performed in 58 asymptomatic subjects previously submitted to anterior resection for colorectal cancer. In 6 patients endoscopy disclosed recurrent cancer at the anastomosis; in 1, a cancer synchronous to the primary neoplasia was detected 6 months from resection. Twenty-four polyps were detected in 19 patients. Severe epithelial dysplasia was present in two adenomatous polyps, and invasive cancer in another. From these findings, it appears that an endoscopic periodic surveillance of this high risk group is strongly advisable.

Colonic Neoplasms↗
PubMed1980

Gastric carcinoma: preliminary data of a cooperative program for early diagnosis.

The results of a program of early gastric cancer detection, carried out in the Oncologic Institutes of Genoa, Forlì and Florence, are evaluated. General practitioners screened subjects, according to possible anamnestic and clinical risk indicators (age, family history, previous gastric lesions, digestive complaints, etc.). The diagnostic consisted of medical examinations, endoscopy with cytology and/or directed biopsy, and possibly air contrast barium X-ray. Of 3,180 subjects examined, 224 had gastric cancers (7 %), 29 of which were early cancers, and 688 had high risk lesions; 1,478 cases of other pathology were detected. The authors stress that the proportion of early cancer is clearly higher than that found in routine diagnosis, yet still lower compared to the results of screening programs carried on the general population. Moreover, the high diagnostic sensitivity of each method in early gastric cancer detection and, on the other hand, the difficulties in the detection of high risk lesions, which require systematic multiple biopsies, are emphasized.

Adult↗
PubMed1980

Atrophic gastritis and intestinal metaplasia in asymptomatic Hungarian and Italian populations.

The histological patterns of the gastric mucosa obtained by endoscopic biopsy were evaluated in two different ethnic groups, each containing one hundred patients without gastro-intestinal diseases. The incidence of atrophic gastritis and intestinal metaplasia increased with age in both groups, revealing a statistically significant difference above 60 years. The comparative study of gastric cancer death rates in the two population groups showed a significant prevalence in the Hungarians above 50 years. This fact seems to support the hypothesis that an ethnic group with high gastric cancer rate has a higher prevalence of atrophic gastritis and intestinal metaplasia in the older age groups, and offers additional evidence for the association of chronic inflammatory changes of the gastric mucosa with malignant gastric cancer.

Adult↗
PubMed1979

Prolonged endoscopic and manometric observations of the pylorus.

Functional aspects of the antral-pyloric segment were evaluated in 30 patients without gastroduodenal disorders by means of prolonged endoscopic observations. Patients were examined in standardized conditions. Pressure measurements of the antrum, pylorus and duodenal bulb were assessed by means of water-perfused polyvinyl tubes in 7 patients of the same group a few days after the endoscopy. The pylorus appeared open in above 80% of the total endoscopic observation time. Pyloric closure was observed only for few seconds at the end of 30-40% of antral peristaltic waves. The antrum and pylorus appeared to contract in sequence. Antral peristaltic waves moved at a mean rate of 2.4 per minute and duodenal reflux was observed at a mean rate of 0.96 per minute usually in the form of bubbles. The manometric measurements by means of pull through in 7 patients and immediately after by means of prolonged registration carried out in a fixed position in 4 patients failed to show a high pressure zone in the gastroduodenal junction. In some cases it was possible to observe a peculiar phasic activity in the pyloric tract. The endoscopic and manometric observations suggest that human pylorus does not act as a true physiological sphincter. These findings confirm the functional aspects described by radiology and manometry in other studies. In this way, endoscopy appears to be a useful procedure to evaluate some functional aspect of the gastroduodenal tract.

Adult↗
PubMed1976

Gastric reflux measurements during duodenal infusion with saline, acid and fat.

Duodeno-gastric reflux measured in 18 patients without gastrointestinal complaints showed a wide variation of regurgitation rates. Duodeno-gastric reflux was significantly diminished during duodenal acidification. The effect was more intense and lasted longer after olive oil infused intraduodenally, leading practically to a closed pylorus.

Adult↗