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Biomedical subjects

R G Norfleet

Publications and source records attributed to R G Norfleet.

At least 19 recordsLinked to original sources
PubMed1993

Streptococcus bovis does not selectively colonize colorectal cancer and polyps.

The objective was to determine if Streptococcus bovis selectively colonizes colorectal cancer and polyps. Stools were submitted before colonoscopy; fluid and selected tissue biopsies obtained during colonoscopy were cultured for S. bovis. The setting was a large multispecialty clinic. Outpatients undergoing colonoscopy for suspected colorectal cancer and polyps were the participants. Forty studies on 35 patients were performed. One of 35 stools (2.9%) obtained before colonoscopy yielded S. bovis. S. bovis was cultured from three of 40 fluid aspirations (7.5%), one of 33 adenomas biopsied (3%), none of six adenocarcinomas, none of 14 nonneoplastic polyps, one of 40 (2.5%) biopsies from normal mucosa adjacent to an adenoma, and none of 40 mucosal biopsies remote from any lesion. These data do not support selective colonization of colorectal neoplasms by S. bovis.

Adenocarcinoma↗
PubMed1992

Screening sigmoidoscopy and colorectal cancer mortality.

BACKGROUND: Sigmoidoscopy may reduce colorectal cancer mortality by identifying both cancers and precursor lesions (including polyps) for treatment; however, evidence regarding the efficacy of this technique as a screening procedure is extremely limited. PURPOSE: In the absence of data from randomized controlled trials, we performed a retrospective case-control study to determine if sigmoidoscopy screening is associated with a reduction in colorectal cancer mortality. METHODS: The medical records of 66 members of the Greater Marshfield Community Health Plan (GMCHP) who died of large-bowel cancer from 1979 to 1988 were reviewed for history of screening for colorectal cancer (case subjects). For comparison, the records of 196 GMCHP members of similar gender, age, and enrollment duration were randomly selected for review (control subjects). RESULTS: History of screening sigmoidoscopy was much less common among case subjects (10%) than among control subjects (30%). Risk for death from colorectal cancer was reduced among individuals having had a single examination by screening sigmoidoscopy (odds ratio = 0.21; 95% confidence interval = 0.08-0.52), compared with the risk for those who never had one. The reduction in risk appeared to be limited to tumors in the rectum and distal colon. Neither fecal occult blood testing nor digital rectal examination was associated with a reduction in colorectal cancer mortality. CONCLUSIONS: These results suggest that screening sigmoidoscopy can substantially reduce mortality from cancers of the rectum and distal colon.

Aged↗
PubMed1991

Infectious endocarditis after fiberoptic sigmoidoscopy. With a literature review.

Infectious endocarditis is a feared complication of procedures causing bacteremia. Gastrointestinal procedures cause bacteremia, but are seldom followed by infectious endocarditis. Of nine cases found in the English literature, only five have convincing evidence that endocarditis resulted from the gastrointestinal procedure. I present a new case of endocarditis due to Streptococcus sanguis type II after fiberoptic sigmoidoscopy.

Endocarditis, Bacterial↗
PubMed1990

Mallory-Weiss syndrome after cardiopulmonary resuscitation.

We report hematemesis from Mallory-Weiss tears after successful cardiopulmonary resuscitation (CPR). A computer search of the English language literature disclosed only 3 similar cases, and we review them. This complication of CPR may occur more frequently than recognized and should be prevented by careful technique.

Aged↗
PubMed1989

Strange bedfellows: duodenal ulcer and cancer of the stomach.

We have found only 308 cases of gastric cancer in patients with unoperated duodenal ulcer. We present seven men whose duodenal ulcer disease obscured the diagnosis of gastric cancer. We review the theoretical reasons that those with duodenal ulcer may be protected from gastric cancer, along with the current literature.

Adenocarcinoma↗
PubMed1988

Adenomatous and hyperplastic polyps cannot be reliably distinguished by their appearance through the fiberoptic sigmoidoscope.

This prospective study is designed to determine if experienced sigmoidoscopists can, from gross appearance, differentiate adenomas and hyperplastic polyps. Six hundred eleven polyps discovered at fiberoptic sigmoidoscopy were removed completely or biopsied for histologic examination. The polyp's size, distance from the anal verge, color, and the endoscopist's diagnosis were analyzed. Hyperplastic polyps were significantly smaller, of lighter color, and located closer to the anus than adenomas. The sensitivity of the endoscopic diagnosis for adenomas is 0.80 and the specificity 0.71. We conclude the endoscopic diagnosis of polyps 1.0 cm and smaller is not accurate enough for decision making, and these should be biopsied to guide management. Since 97% of polyps larger than 1.0 cm are adenomas, their removal can be advised without biopsy.

Adenoma↗
PubMed1987

Barrett esophagus.

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Barrett Esophagus↗