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At least 1,675 records · Page 93Linked to original sources
PubMed1978

Two regimes with the same TDF but differing morbidity used in the treatment of stage III carcinoma of the cervix.

As an alternative to five daily fractions per week, one large fraction per week has been used to treat patients with stage III carcinoma of the cervix. This regime was greatly appreciated by our village women who could attend for weekly treatment from their homes. The weekly dose was matched with our previously acceptable daily fractionation using NSD, TDF and CRE values. In 24 patients the early reactions and tumour response were acceptable. Late rectal complications commencing seven months after treatment have, however, developed in all surviving patients with the new regime. The complications have been far more severe than those of a matched group of 24 patients treated with daily fractions and the schedule using one fraction per week has been abandoned. "Iso-effective" doses for the two techniques were selected from the NSD, TDF and CRE tables. This study clearly indicates that for one fraction per week the doses predicted are not "iso-effective" as far as the normal tissues of the pelvis are concerned.

Adult↗
PubMed1981

Medical and surgical risks in handballing: implications of an inadequate socialization process.

Handballing (fist fucking) has long been practiced by male homosexual partners with few evident consequences of a medically serious nature. In recent years, however, medical and surgical risks have risen as handballing has come to be practiced in groups. The potential for physical harm (e.g., rupture of the anal sphincter, perforation of the colon, the spread of anorectal and colon disease, and disturbance of heart rhythms due to vagovagal response), although widely understood, has not been studied statistically. Only three articles in medical journals have commented on the subject and then only as recorded observations. This article describes: (1) how club-sponsored social events function, (2) the medical and surgical risks to those who choose handballing as a sexual life-style, and (3) the precautions to be taken if risks are to be minimized.

Colon↗
PubMed2000

Perineal group A streptococcal disease in a pediatric practice.

OBJECTIVE: This study was designed to document the frequency and define the clinical, epidemiologic, and microbiologic characteristics of perineal disease caused by group A beta-hemolytic streptococci (GAS) in a pediatric practice in which increased numbers of cases had been observed. METHODS: Clinical, epidemiologic, and microbiologic data were collected on all culture-confirmed cases of perineal GAS disease during the calendar year 1997. GAS isolates from clinical cases and a comparison group of children with GAS pharyngitis were analyzed by T typing, emm gene analysis, and pulsed-field gel electrophoresis (PFGE). RESULTS: Twenty-three cases of GAS perineal disease were diagnosed during 4530 office visits in 1997. Thirteen cases had perianal disease, 8 had vulvovaginal infection, and 2 were infected at both sites. No cases of penile disease were identified. Infections peaked in late winter and early spring and affected children with an average age of 5 years with a range of perineal, gastrointestinal, and genitourinary symptoms. Analysis of T and emm types showed the majority (82%) of perineal isolates to be T 28 emm 28, showing 2 closely related PFGE patterns. In contrast, the pharyngeal isolates were distributed among 6 different T and emm types. CONCLUSION: Perineal infection caused by GAS may be a relatively common diagnosis in a pediatric or family practice setting. There may be specific GAS types that have a tropism for perineal tissues but the mechanism of infection is yet to be established.

Child↗
PubMedDate not supplied

Treatment of severe actinic rectitis.

BACKGROUND: The authors report the treatment of three female patients with severe actinic rectitis, with stenosis or perforation, submitted to anterior proctosigmoidectomy and transanal coloanal anastomosis. METHODS: In all cases surgery consisted of total proctosigmoidectomy, mucosectomy of the anal canal, lowering of the left colon through the pelvis and transanal anastomosis performed manually at the level of the pectineal line using separate absorbable sutures. A protective intestinal shunt was performed in all cases. RESULTS: The three patients did not present transoperative or immediate postoperative complications, but the first patient developed deep venous thrombosis of the leg that was submitted to successful clinical treatment. The intestinal shunts were later closed in all three cases. Sphicter function was considered very good in the first case and regular in the remaining two. CONCLUSION: The surgical technique utilized was considered to be adequate for the cases reported and is the first option for the maintenance of transit in patients with severe actinic rectitis since the anastomosis is performed using non-irradiated colon with the pectineal line, practically outside the pelvis.

Aged↗
PubMed1995

Clinical pharmacokinetics and delivery of bovine superoxide dismutase.

Experimentally, superoxide dismutase (SOD) protects against cytotoxological and histotoxological effects of superoxide anions, which play a fundamental role where inflammatory processes are involved. Currently, only bovine copper containing SOD (Cu-SOD) is available for clinical application in the treatment of patients with various arthritic diseases. The intramuscular route is the principal route to administer usual dosages of bovine Cu-SOD 4 to 32mg, 2 or 3 times weekly. A single dose corresponds to an optimal dose ranging from 30 to 200 micrograms/kg, determined from an established dose-response curve. After intramuscular injection of bovine Cu-SOD 8, 16 and 32mg the peak plasma concentration occurs 4 to 8 hours postdose and is 0.05, 0.16 and 0.39 mg/L, respectively. Clinically this metallo-protein is particularly effective for the treatment of inflammation and toxicity resulting from ionising irradiations, ischaemia and tumours. The major advantages of liposomally encapsulated bovine Cu-SOD are its improved pharmacokinetic characteristics, leading to a longer plasma half-life and a slower release of free bovine Cu-SOD. In humans, bovine Cu-SOD (free or liposomal), although a foreign protein, is well tolerated and produces no acute or delayed toxic effects.

Animals↗
PubMed2001

Transperineal and transvaginal sonography of perianal inflammatory disease.

OBJECTIVE: Perianal infection arises in small intersphincteric anal glands predominantly located at the dentate line. Documentation of fluid collections and the relationship of inflammatory tracts to the sphincter mechanism is important for surgical treatment. Transanal sonography for assessment of perianal inflammatory disease is limited because placement of the rigid probe into the anal canal does not allow assessment of disease in the perineal region. The purpose of this study was to validate the use of transperineal sonography in men and both transvaginal and transperineal sonography in women for evaluation of perianal inflammatory disease. SUBJECTS AND METHODS: Fifty-four patients, 28 men and 26 women, were imaged with transperineal and a combination of transperineal and transvaginal sonography, respectively. All patients were examined in the supine lithotomy and left lateral position with a transvaginal 8-to 4-MHz probe or a linear 12- to 7-MHz transducer. All fluid collections, sinus tracts, and fistulas were described by their location in relation to the sphincter mechanism and perineum. RESULTS: Forty-six of 54 patients had perianal fistulas or sinus tracts: 33 transphincteric, seven intersphincteric, and six extrasphincteric. Fifteen patients had an associated abscess. In the eight remaining patients, there were two anovaginal fistulas, one rectovaginal fistula, one prolapsed internal hemorrhoid, two perianal complex masses, and two vascular perianal or perirectal inflammatory masses. Twenty-six patients underwent surgical procedures involving the anorectal canal or perirectal region, and of these, preoperative sonographic findings were confirmed in 22 (85%) of 26 patients. Three patients refused surgery, and six are awaiting surgery at this writing. Fifteen patients were treated conservatively. CONCLUSION: Transperineal and transvaginal sonography are accurate, painless, and cost-effective methods for documenting perianal fluid collections and fistulas or sinus tracts or both.

Abscess↗
PubMed1977

A controlled comparison of corticotropin and hydrocortisone in the treatment of severe proctocolitis.

A randomized controlled trial has been made of corticotropin (ACTH) 80 units given intramuscularly daily and hydrocortisone 400 mg infused intravenously over 24 hours, in the treatment of in-patients with severe proctocolitis. Seven patients were treated with ACTH and nine with hydrocortisone over an initial seven days. Three patients in the ACTH group and six in the hydrocortisone group improved and were discharged on medical treatment. Four patients treated with ACTH and two with hydrocortisone required urgent colectomy during this admission. Plasma cortisol levels were measured, but there was no correlation between these and the observed therapeutic response. Sideeffects were troublesome in both groups but were more marked in those treated with hydrocortisone. It is concluded that ACTH is not intrinsically superior to hydrocortisone in these doses, in the treatment of severe proctocolitis.

Adrenocorticotropic Hormone↗
PubMed1978

A comparison of oral prednisolone given as single or multiple daily doses for active proctocolitis.

Forty mg has been shown to be the optimal daily dosage of prednisone for outpatients requiring oral steroids for active proctocolitis. Although daily doses of oral steroids are commonly divided, a single dose each morning causes less adrenal suppression and is more convenient to take. A randomized controlled trial has been performed on patients with proctocolitis, in which 23 received 40 mg prednisolone each morning as one dose, and 22 received 10 mg four times a day, over two weeks. Physicians unaware of the dosage schedule scored the disease activity and assessed the steroid side-effects when the patient entered the trial, at day 7 and at day 14. Of those taking the divided dose the disease improved in 17 and failed to improve in five. No side-effects were observed in ten patients. Of those receiving a once daily regimen, 17 improved and six did not. Nine patients had no side-effects. Further assessment showed no difference between the two groups either in response rate or side-effects produced. When oral steroids are indicated for active proctocolitis, 40 mg prednisolone, as a single dose each morning can be recommended.

Administration, Oral↗
PubMed1981

A digital quantitative method of estimating inflammation in the rectal mucosa. I. The normal limits in asymptomatic patients.

Histological preparations of the rectal mucosa from 72 rheumatic patients without gastrointestinal symptoms were quantitatively analysed. The variables recorded were the diameter (minor axis) of ten consecutive transversally cut glands, the space of lamina propria between the glands, the number of glands per high-power field, and the number of nuclei in ten consecutive areas (of lamina propria) between the glands. The digitals resulting from the sum of the values in each variable were considered characteristic of the histological state of the rectal mucosa in individual patients. In most biopsies (i.e. 99%) scores of 21 or less were recorded. The data obtained serve as a basis for comparative studies of the histological state of the rectal mucosa from patients with various chronic inflammatory conditions of the rectum.

Adult↗