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At least 613 records · Page 34Linked to original sources
PubMed2006

Prevalence of perianal intraepithelial neoplasia in HIV-infected patients referred for high-resolution anoscopy.

PURPOSE: This study was designed to describe perianal disease in a cohort of HIV-infected patients referred for high-resolution anoscopy. METHODS: A retrospective chart review was performed on 52 HIV-infected patients referred for high-resolution anoscopy from 2001 to 2005. All patients underwent anal canal and perianal high-resolution anoscopy in the office with biopsy of suspicious areas. Patients with high-grade intraepithelial perianal lesions underwent multiple biopsies under general anesthesia in the operating room to rule out malignancy. RESULTS: Of the 52 patients, 19 (37 percent) had perianal abnormalities noted on high-resolution anoscopy and underwent punch biopsy. The mean duration of known HIV infection in these 19 patients (15 males) was 10.6 years, with 17 on highly active antiretroviral therapy for the last 3-month period. Mean CD4 count was 371 cells/microl. Office perianal biopsies diagnosed two patients with invasive squamous-cell carcinoma and nine with high-grade squamous intraepithelial lesion. Seven of the nine patients with perianal high-grade squamous intraepithelial lesion on office biopsy were submitted to multiple biopsies under general anesthesia. One of these seven had an occult perianal squamous-cell carcinoma. CONCLUSIONS: Perianal disease was common in this group of HIV-infected patients; 11 patients (21 percent of total) were diagnosed with squamous-cell carcinoma or high-grade squamous intraepithelial lesion. Because only 19 patients had clinically suspicious perianal lesions biopsied, this may be an underestimate. Our data suggest that anal canal neoplasia often is accompanied by perianal disease and illustrates the need for biopsy of any suspicious perianal lesions.

Adult↗
PubMed2004

[Anal fissure].

Anal fissures are present in about 10-15% of proctological patients. The cause of the illness is unknown, but is probably multifactorial. Cardinal symptoms are pain during and after defecation, as well as persistent sphincter spasm. In most cases an acute anal fissure heals spontaneously or with adequate conservative therapy. Chronic anal fissures can be cured in some cases by conservative treatment. Where there is treatment resistance, surgical cleansing is necessary.

Fissure in Ano↗
PubMed2004

[Conservative treatment of haemorrhoids].

Haemorrhoidal symptoms have been known from time immemorial; they are considered to be a widespread problem, which is progressive if untreated. Treatment is according to the proctological qualification of the doctor and the degree of the changes. If possible, it should be carried out from the point of view of causal therapy. The most frequently occurring 1st degree haemorrhoids can almost always be treated conservatively, i.e. with sclerotherapy. To prevent recurrence, the life style and defecation habits should be changed. Regular monitoring by specialists aids prevention.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2004

[The diagnosis and treatment of perianal dermatitis].

Perianal dermatitis is one of the most common proctological disorders. The anatomy of the anal region provides suitable conditions for the development of dermatitis. In the diagnostic work-up and the management of patients with perianal dermatitis, three types need to be distinguished: irritant contact dermatitis, atopic dermatitis, and allergic contact dermatitis. Each type has its aetiological and pathogenetic factors, which will provide clues to the diagnosis and subsequent management of the condition. In the differential diagnosis of the condition, consideration should be given to inflammatory diseases of the perianal region which may produce eczema-like patterns.

Dermatitis, Allergic Contact↗
PubMed1976

Idiopathic late-onset immunoglobulin deficiency. Clinical observations in 50 patients.

Fifty patients with late-onset idiopathic immunoglobulin deficiency were studied and the frequency of various clinical associations and complications was observed. Men and women were equally affected, although the age at onset in men peaked in the third decade whereas it was more uniformly distributed in women. Sinobronchopulmonary infections were common and were caused by Haemophilus influenzae. Diplococcus pneumoniae, Streptococcus pyogenes and Staphylococcus aureus: bronchiectasis occurred in 28 per cent. Thirty patients (60 per cent) had diarrhea, which was often associated with steatorrhea, giardiasis, achlorhydria, abnormal Schilling tests and morphologic abnormalities on small bowel biopsy specimens, including nodular lymphoid hyperplasia; three patients had pernicious anemia. In the 20 patients without diarrhea these abnormalities were not observed except for giardiasis in one patient and achlorhydria in two patients. Cholelithiasis occurred in both groups in about a third of the patients tested. A high degree of susceptibility to neoplasia was noted. Thyroid abnormalities, including primary hypothyroidism and Graves' disease, were observed in six patients. Additional occasional findings were vitiligo, keratoconjunctivitis sicca and arthritis. Splenomegaly occurred in 14 (28 per cent) patients. The percentage of B lymphocytes in the blood was determined in 10 patients; it was normal or slightly decreased in eight patients and low in two patients.

Adolescent↗
PubMedDate not supplied

Perforation of the rectum by a Copper-T intra-uterine contraceptive device; a case report.

A case of a rare complication of a Copper-T intra-uterine contraceptive device (IUCD) producing uterine and rectal perforation is reported. The patient presented with the threads of the IUCD protruding through the anus and the device was removed from the rectum using a proctoscope. A review of the literature revealed only seven cases of perforation of the rectosigmoid by an IUCD in which the device was removed per rectum, and this report documents the first of such cases involving a Copper-T. Proctosigmoidoscopic evaluation is recommended whenever perforation of the rectosigmoid by an IUCD is suspected, since it may select those patients for whom rectal recovery of the IUCD is feasible, thus avoiding unnecessary surgical intervention.

Adult↗
PubMed1990

The Dijon clinical staging system for early rectal carcinomas amenable to intracavitary treatment techniques.

The Dijon clinical and endoscopic staging system for intracavitary radiotherapy of rectal cancer takes into account the size and the depth of penetration of the rectal wall. Its prognostic value was evaluated in a series of 72 patients with rectal adenocarcinoma treated at the Centre de Lutte Contre le Cancer G. F. Leclerc in Dijon: 30 presented with a clinical stage (CS) T1A (purely exophytic tumors of less than 3 cm). The 5-year local relapse-free actuarial survival (LRFS) was 97%. Fourteen patients with CS T1B (infiltrative component and less than 3 cm diameter) had a LRFS of 77%. Nine patients with CS T2A tumors (with larger exophytic tumors) has a LRFS of 65%. Nineteen CS T2B cases (larger than 3 cm with an infiltrative component) presented a LRFS of 60%. The size of the tumor and the clinical estimate of the infiltration of the rectal wall both have a significant prognostic value: adenocarcinoma of less than 3 cm (n = 44) had a LRFS of 93% versus 59% in larger ones (n = 39; p = less than 0.01). Free mobile lesions (n = 39) did better (n = 33; LRFS = 86%) than infiltrated tumors (n = 33; LRFS = 66%; p = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1996

Non-surgical repair of rectovaginal fistulae.

Twelve women with recurrent rectovaginal fistulae (RVF) were treated by electrocauterization (EC). Ten fistulae were obstetric and two followed car accidents; they were located in the lower (4 patients), mid (6 patients) and upper (2 patients) third of the vagina. Under anesthesia, a cauterization probe was introduced into the fistulous track and an electric current was switched on for 30-60 s at a frequency of 20,000 cycles/s and a power of 30 W. Two patients required two sessions but all fistulae healed without recurrence (mean follow-up 24 months). No complications were encountered.

Adult↗