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Biomedical subjects

M L Borum

Publications and source records attributed to M L Borum.

At least 37 records · Page 2Linked to original sources
PubMed1999

Colorectal cancer surveillance in African-American and white patients at an urban university medical center.

Colorectal cancer causes significant morbidity and mortality in the United States. Recommendations for colorectal cancer screening have been developed. This study evaluated the colorectal cancer screening practices of African-American and white patients by internal medicine resident physicians. A retrospective chart review was conducted during 1989-1994. The performance of rectal examination, fecal occult blood testing, and flexible sigmoidoscopy among patients > 50 years was evaluated. The medical records of 200 patients (90 men and 110 women) were reviewed. Ninety-one rectal examinations, 26 fecal occult blood testing, and 30 flexible sigmoidoscopies were performed. There were 129 African-American (54 men and 75 women) and 52 white (26 men and 27 women) patients. Of the African-American patients, 57 underwent a rectal examination, 17 had fecal occult blood testing, and 26 underwent flexible sigmoidoscopy. Of the white patients, 24 had a rectal examination, 8 had fecal occult blood testing, and 12 underwent flexible sigmoidoscopy. These results demonstrate that resident physicians adhered poorly to colorectal cancer screening recommendations. There was no statistically significant difference in the screening of African-American and white patients. Increased efforts should be made to improve colorectal cancer screening practices by resident physicians.

Academic Medical Centers↗
PubMed1998

Gastrointestinal diseases in women.

Gastrointestinal disorders are among the most common disorders for which women seek medical attention. Most gastrointestinal diseases in women are not inherently different from those that occur in men. There are several disorders, however, that occur more frequently or manifest themselves differently in women. This article reviews common gastrointestinal disorders affecting women. The pathophysiology, clinical manifestations, management, and gender-specific issues of gastroesophageal reflux disease, peptic ulcer disease, irritable bowel syndrome (IBS), and inflammatory bowel disease (IBD) are discussed.

Contraceptives, Oral↗
PubMed1998

Hepatobiliary diseases in women.

Most diseases of the hepatic and biliary systems affect both women and men. There are several disorders, however, that affect women differently than they affect men. Gallstones, primary biliary cirrhosis (PBC), and autoimmune liver disease occur more often in women. The impact of alcohol on the liver is worse in women. Chronic liver disease from any cause can affect fertility. In addition, oral contraceptive use and pregnancy can have specific effects on the liver.

Biliary Tract Diseases↗
PubMed1998

Domestic violence in women.

Domestic violence is a significant public health issue affecting women. Numerous medical organizations have recommended that routine screening of women be conducted to assist in the prevention, identification, and care for victims of violence. This article examines the scope of domestic violence in women, reviews ways to recognize abuse, examines the potential impact of abuse upon health and discusses the management of victims.

Female↗
PubMed1998

Does age influence screening for colorectal cancer?

OBJECTIVE: To evaluate whether patients' age influenced colorectal cancer screening by internal medicine resident physicians in an ambulatory care clinic. METHODS: A retrospective chart review of 200 patients aged >50 years to assess the performance of rectal examinations, faecal occult blood testing and flexible sigmoidoscopy. RESULTS: Physicians performed rectal examinations in 21 patients 10.5%, faecal occult blood testing in 85 (42.5%) and flexible sigmoidoscopies in 95 (47.5%). Significantly more rectal examinations were performed in patients aged 50-60 years than in patients aged 61-70 years (P < 0.005) or > or = 71 years (P < 0.00002). There was significantly more faecal occult blood testing in patients aged 50-60 years than in those aged > or = 71 years (P < 0.02). In women, there were more rectal examinations in those aged 50-60 years than in those aged 61-70 years (P < 0.05) or > or = 71 years (P < 0.008). Men aged 61-70 years had more rectal examinations than men aged > or = 71 years (P < 0.04). CONCLUSIONS: Colorectal cancer screening is performed less often in older patients attending a hospital for health maintenance evaluation. Chronological age alone should not determine whether physicians screen for colorectal cancer.

Age Factors↗
PubMed1998

Hereditary angioedema. Complex symptoms can make diagnosis difficult.

Although rare, hereditary angioedema is a potentially life-threatening disorder that can be difficult to diagnose. It is characterized by a deficiency in C1 esterase inhibitor (C1 INH). Manifestations include gastrointestinal, subcutaneous, and respiratory edema. Factors that trigger episodes vary. Symptoms typically last 48 to 72 hours, but they can last 4 hours to 1 week. Treatment includes prophylactic therapy with attenuated androgens or antifibrinolytic agents. Acute episodes can be medical emergencies, and airway management is a major concern. The treatment of choice in an acute episode is administration of plasma concentrate of C1 INH.

Abdominal Pain↗
PubMed1998

Hereditary angioedema: an unusual case in an African-American woman.

Hereditary angioedema is a rare disorder characterized by a localized subepithelial edema and swelling of the gastrointestinal and upper respiratory tract. The disorder is estimated to occur in 1 in 50,000 to 150,000 individuals. However, the prevalence of the disorder among the African-American population is uncertain. This is a case report of hereditary angioedema occurring in an African-American woman whose symptoms persisted for more than a decade prior to diagnosis.

Abdominal Pain↗
PubMed1997

Medical residents' colorectal cancer screening may be dependent on ambulatory care education.

Colorectal cancer results in significant morbidity and mortality in the United States. Screening is a critical component of cancer prevention. However, research has suggested that physicians may inconsistently adhere to surveillance guidelines. Since residency training can significantly impact upon future practice patterns, assessment of postgraduate colorectal cancer education is important. This retrospective chart review of patients > or = 50 years of age compared screening performed by resident physicians' in different internal medicine residency programs at The George Washington University Medical Center. Resident physicians who received multiple lectures in colorectal cancer surveillance or were required to document performance of screening on a medical record preventive care summary form performed significantly more rectal examinations (P < 0.0004), fecal occult blood testing (P < 0.00001), and flexible sigmoidoscopies (P < 0.00001) when compared to other resident physicians. Postgraduate education should employ multiple education techniques and reinforcement procedures to increase physician compliance with cancer screening.

Ambulatory Care↗
PubMed1997

Cancer screening in women by internal medicine resident physicians.

BACKGROUND: Research suggests that women may not have consistent cancer surveillance. METHODS: We conducted a retrospective review of internal medicine resident physicians' screening methods for breast, cervical, and colorectal cancer of women aged 50 or older. RESULTS: Resident physicians did breast examinations in 39.1%, mammography in 37.3%, Pap smears in 32.7%, rectal examinations in 37.3%, fecal occult blood testing in 39.1%, and flexible sigmoidoscopy in 11.8% of the women. They instructed 3.6% to do breast self-examination. There was no statistically significant difference in the breast or cervical cancer screening based on patient race, insurance type, or sex of physician. Female physicians did more rectal examinations and fecal occult blood testing than male physicians. There was no statistically significant difference in colorectal cancer surveillance based on physician race or insurance status. CONCLUSIONS: We need to increase cancer screening in women. Assessment of the impact of the sex of the physician on cancer surveillance needs to be further evaluated.

Aged↗