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At least 433 records · Page 24Linked to original sources
PubMed1995

Protection by endoscopy against death from colorectal cancer. A case-control study among veterans.

BACKGROUND: Although several clinical and epidemiologic studies suggest that timely diagnostic procedures of the large bowel may reduce mortality from colorectal cancer, the evidence for this relationship is primarily circumstantial. METHODS: A case-control study was conducted among hospitalized US military veterans to investigate whether diagnostic procedures of the large bowel were performed in the period preceding the diagnosis of colorectal cancer less frequently in patients dying of colorectal cancer than in control patients. Data files of a total of 4411 veterans dying of colorectal cancer between 1988 and 1992 were extracted from the records of the US Department of Veterans Affairs, Washington, DC. Data of four living control patients and four dead control patients without colorectal cancer were matched by age, sex, and race to each case patient. The case and the two control populations were compared by conditional logistic regression, calculating odds ratios, and their 95% confidence interval. RESULTS: Diagnostic procedures of the large bowel reduced mortality from colorectal cancer, the odds ratio being 0.41 (range, 0.33 to 0.50) for the comparison with living control patients. The protective effects of proctosigmoidoscopy, colonoscopy, and polypectomy lasted for 5 years. The procedures were protective against death from cancer of the colon, as well as cancer of the rectum. The most protective influence was associated with removal of tissue through biopsy, fulguration, and polypectomy. Similar influences were found comparing case patients with dead control patients. CONCLUSION: Removal of tissue represents the most effective means to reduce mortality from cancers of the large bowel. It retains its efficacy over a time period of 5 years.

Aged↗
PubMed1975

Clindamycin. A Trojan horse?

Clindamycin is a widely used antibiotic with a spectrum that includes Gram-positive bacteria, with the exception of enterococci, and Gram-negative anaerobes. Toxicities include clindamycin colitis, a pseudomembranous colitis that can be fatal. The colitis usually is related to dosage and duration of therapy, but can occur after ingestion of only several capsules. Once diarrhea develops in a patient taking clindamycin, the drug should be stopped and diagnostic measures to define colitis initiated. If colitis is present, it should be managed aggressively, probably with corticosteroids and with intensive supportive measures.

Bacteria↗
PubMed1976

Appendicovesical fistula in childhood: a rare complication of ruptured appendix.

The diagnosis of appendicovesical fistula is difficult and usually delayed. This is most unfortunate, since surgery is uniformly successful. The case we report reemphasizes the diagnostic value of the rectal examination, intravenous pyelogram, and foiding cystogram in a child with subacute or chronic abdominal pain. Only an awareness of this condition on the part of the attending physician will lead to prompt diagnosis and definitive therapy.

Appendicitis↗
PubMed1975

Drug-induced colitis mimicking an acute surgical condition of the abdomen.

Pseudomembranous colitis secondary to antibiotic therapy has received increasing recognition. During a one-year period, eight of 42 patients with this entity had findings closely resembling an acute surgical condition of the abdomen manifested by fever, leukocytosis, and severe abdominal pain and tenderness. All eight patients received clindamycin and two were also given lincomycin hydrochloride monohydrate. Differentiation from an acute surgical condition of the abdomen was difficult until the characteristic findings of pseudomembranous colitis were noted on proctoscopic examination. Unnecessary celiotomy was averted in all patients. Seven of eight patients responded to discontinuation of the antibiotic and supportive measures; one required a diverting ileostomy. Drug-induced colitis must be an important consideration in any patient recently receiving antibiotics who develops fever, abdominal pain, and diarrhea.

Abdomen, Acute↗
PubMed1981

Does Peutz-Jeghers syndrome predispose to gastrointestinal malignancy? A later look.

Several reports have recently suggested an association between the development of intestinal carcinoma and the presence of Peutz-Jeghers syndrome. During the 45-year period between 1935 and 1979, 48 patients with Peutz-Jeghers syndrome were seen at the Mayo Clinic, Rochester, Minn, and followed up for a median period of 33 years. Carcinoma of the small or large intestine did not develop in any patient, with possibly one exception. Survival of patients with Peutz-Jeghers syndrome also was found to be similar to that of the general population. Therefore, skepticism continues about the premalignant potential of this rare syndrome, especially in the small intestine, and surgical conservatism should be practiced in its management.

Adult↗
PubMed1975

Pneumatosis cystoides intestinalis. Treatment with oxygen via close-fitting mask.

Four patients with pneumatosis cystoides intestinalis were recently treated with oxygen via a close-fitting mask. They responded initially to this therapy, with cessation of all symptoms and, after seven days of treatment, with return of proctoscopic and barium-contrast roentgenographic findings in the colon to normal. However, the disease recurred in one of the four patients after six months. There is a potential hazard of toxic effects from oxygen, and this may be detected by frequent measurement of pulmonary vital capacity. Our experience corroborates the efficacy of oxygen therapy in the treatment of this disorder but we question its long-term effectiveness in all cases.

Aged↗