Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Proctoscopy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 793 records · Page 44Linked to original sources
PubMed1984

Procedural skills training in the internal medicine residency.

To determine whether there was agreement on a core of procedural skills that all internal medicine residents should be able to perform, faculty members and residents at the University of Pennsylvania and the University of Nebraska were surveyed regarding 72 procedures. Nineteen procedures were indicated by 90 percent or more of the respondents as those that should be learned by the graduates. In response to a second survey, many senior residents said they did not feel competent to perform these 19 procedures, and many did not recall that their performance on procedures had been evaluated. Thus, despite any regional or institutional influences, there was agreement on a core of procedural skills that should be required of all physicians completing the general internal medicine residency. It is important that training programs assess whether or not the procedures they consider essential are being mastered by their residents.

Clinical Competence↗
PubMedDate not supplied

Endoscopic MRI using 3D-spoiled GRASS (SPGR) sequence for local staging of rectal carcinoma.

OBJECTIVE: Magnetic resonance imaging was performed with an MR endoscope to evaluate the depth of invasion of rectal carcinomas. MATERIALS AND METHODS: Twenty-two patients with rectal carcinomas were studied prior to surgery with MRI using a 3D-fast spoiled GRASS (SPGR) sequence, a nonmagnetic endoscope and an antenna probe. RESULTS: The MR images on 3D-fast SPGR sequence showed that the normal bowel mucosa had a high signal intensity, the submucosal layer had a low signal intensity, and the muscularis propria had moderate signal intensity. Small tumors had moderate signal intensity similar to the muscularis propria. Advanced tumors with considerable volume revealed heterogeneous findings with intermediate and low signal intensities. The depth of wall invasion by rectal carcinoma was correctly staged with endoscopic MRI in 16 of 22 patients. CONCLUSION: This technique may be useful for the accurate staging of the depth of invasion by rectal carcinomas.

Carcinoma↗
PubMed1981

Resolution of radiographic-endoscopic discrepancies in colon neoplasms.

Fifty-one colon neoplasms larger than 1 cm were diagnosed by double-contrast barium enema (DC), but were not confirmed by initial endoscopy. Seventeen lesions were shown to be radiographic false-positive diagnoses by careful review of the original radiographs (10 cases) or repeat DC (7 cases). The presence of a neoplasm was confirmed in 21 cases (41%) by repeat endoscopy or surgery (15 cases) or by repeat DC alone (6 cases). Seven (47%) of 15 resected lesions were malignant. The results emphasize the complementary nature of the DC and endoscopy in detection of colon neoplasms. When discrepancies between the radiographic and endoscopic diagnoses cannot be explained by careful review of the DC, repeat radiographic or endoscopic examination should be performed.

Adenocarcinoma↗
PubMed1986

A prospective comparison of anoscopy and fiberendoscopy in detecting anal lesions.

With the increase in rectal and perianal disease, thorough examination of this area is necessary in every patient with colorectal complaints. We compared the current fibersigmoidoscope and colonoscope with routine anoscopy in the detection rate of perianal pathology in 115 consecutive patients. Straight withdrawal and retroflexion in the rectum of the fiberoptic instruments led to lesion detection rates of 78% and 54%, respectively. The anoscope showed 99% of lesions. Anoscopy was easily learned and required less than a minute to perform. We conclude that anoscopy should be performed in every patient undergoing fibersigmoidoscopy or colonoscopy. Instructions in this procedure should be provided in all training programs.

Adult↗
PubMedDate not supplied

Argon plasma coagulation of hemorrhagic solitary rectal ulcer syndrome.

Solitary ulcer syndrome (SUS) is a rare disorder that may provoke hematochezia. Argon plasma coagulation (APC) is used in a wide range of gastrointestinal bleeding. We experienced APC in a patient with a bleeding gigantic SUS: a 64-year-old woman who developed a SUS at 60. After 3 years, recurrent hematochezia, secondary anemia, and rectal pain occurred. Endoscopy revealed a large rectal bleeding ulcer. Moreover, the pain led the patient to assume analgesics. These conditions stimulated us to treat this ulcer with APC within 4 sessions; each session spaced out at 30-day intervals. The patient experienced and maintained the following benefits: (1) resolution of bleeding and secondary anemia after the first session, (2) reduction of ulcer depth, disappearance of pain and analgesic withdrawal at the end of the cycle, (3) almost complete endoscopic healing of the ulcer after 9 months of follow-up. This experience suggests that APC may represent a therapeutic approach for bleeding SUS even if controlled studies are necessary before recommending it as acceptable treatment.

Argon↗
PubMed2001

Stab wounds to the gluteal region: a management strategy.

OBJECTIVE: To examine the utility of a protocol for treating stab wounds to the gluteal region. These are uncommon and potentially lethal, and the location of injury influences the rate and severity of associated injuries. This was a retrospective, uncontrolled study. METHODS: Patients who sustained gluteal stab wounds and were treated according to our predetermined protocol that classifies injuries as upper or lower zone were reviewed, and associated injuries and outcome were measured. RESULTS: Of 27 gluteal stab wounds in 17 patients, 53% were classified as upper zone and 47% as lower zone injuries. Sixty-six percent of the upper zone injuries had associated neurologic, vascular, or visceral injuries that required invasive procedures or surgery, compared with 12.5% for lower zone injuries (p < 0.05). CONCLUSION: Upper zone gluteal stab wounds require prompt multisystem evaluation with mandatory angiography and aggressive management. Lower zone wounds need observation and repeated evaluations.

Adolescent↗
PubMed1998

Type of health care coverage and the likelihood of being screened for cancer.

OBJECTIVES: This study explored whether type of outpatient health coverage affected the likelihood of men and women aged 20 to 64 years receiving recommended cancer screening procedures. METHODS: Data from the 1989 and 1990 California Behavioral Risk Factor Surveillance Surveys were used to compare Pap smear, mammogram, fecal occult blood test, and proctoscopic examination rates for adults with three different types of private health care coverage (Group/staff model health maintenance organization, Independent Practice Association Model health maintenance organization, indemnity plan) and no outpatient health insurance. Logistic regression models were used to control for sociodemographic and health characteristics and whether individuals had a usual health care provider. RESULTS: Individuals with Group Model health maintenance organization coverage were significantly more likely than those with indemnity plans to have had recent cervical, breast, and colorectal cancer screening, whereas screening likelihood for those with Independent Practice Association model health maintenance organization coverage did not differ substantially from those with indemnity plans. Individuals with no outpatient coverage were less likely to be screened than those with outpatient coverage. The most consistently significant predictor across cancer screening procedures for both men and women was having a usual doctor who knew their medical history. CONCLUSIONS: Adults who had private outpatient insurance were more likely to undergo recommended cancer detection procedures than those who did not. Adults who belonged to a health maintenance organization, which emphasizes and pays for a broader spectrum preventive care, were more likely to receive Pap smears, mammograms, and fecal occult blood tests than those covered by indemnity plans. Receiving care primarily from one doctor significantly increased the likelihood of having screening procedures, irrespective of type of health plan.

Adult↗
PubMed1980

Fiberoptic colonoscopic examination in surgical patients with colorectal cancer.

A diagnostic and surveillance program using colonscopy in patients with colorectal cancer was established at North Carolina Memorial Hospital. The records of all patients who had preoperative or postoperative colonoscopic examination between 1976 and 1979 were reviewed. Fifty-five patients had colonscopic examination preoperatively. No additional disease was found in 39. In 15 patients, unsuspected additional disease was detected, and one patient had a suspected polyp ruled out by colonoscopic examination. One of these patients was found to have a synchronous primary cancer, not demonstrated by barium enema. Surgical treatment was modified in nine (16%) of these 55 patients by the preoperative colonoscopic findings. Sixty patients had colonoscopy six months to six years postoperatively. No additional disease was found in 47. Adenomatous polyps were found in eight. Two patients had recurrent cancer proved by colonoscopy, and three had a second primary cancer detected only by colonoscopy. Treatment was directly influenced by colonoscopy in eight (13.3%) of these 60 patients. These studies had a favorable cost/benefit ratio in patients with colorectal cancer and support a program of preoperative colonoscopy in patients with colorectal cancer and reexamination within two to three years after operation.

Colonic Neoplasms↗
PubMed1988

Penetrating trauma to the buttock.

Penetrating trauma to the buttock is an injury with potential impact on multiple body systems. The purpose of this study was to review our experience with penetrating trauma to the buttock, to establish the frequency of system injury and related morbidity and mortality, and to make recommendations for the evaluation and management of these injuries. Among the 56 system injuries, soft tissue injuries predominated. Of the 25 operative procedures done, eight were for wound care and debridement and seven for rectal injuries; three were orthopedic, two vascular, three genitourinary, and one neurosurgical. One patient had examination under anesthesia, and one had laparotomy for missile trajectory. There were no deaths in this series. Morbidity consisted of nerve injury/defect in three patients, stroke in one patient, and impotence in one. An understanding of the systems at risk in penetrating buttock trauma is necessary for prompt multisystem work-up.

Adult↗