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At least 1,729 records · Page 96Linked to original sources
PubMed2001

Common anorectal conditions: Part II. Lesions.

Patients with a wide variety of anorectal lesions present to family physicians. Most can be successfully managed in the office setting. A high index of suspicion for cancer should be maintained and all patients should be questioned about relevant family history or other indications for cancer screening. Patients with condylomata acuminata must be examined for human papillomavirus infection elsewhere after treatment of the presenting lesions. Their sexual partners should also be counseled and screened. Both surgical and nonsurgical treatments are available for the pain of anal fissure. Infection in the anorectal area may present as different types of abscesses, cryptitis, fistulae or perineal sepsis. Fistulae may result from localized infection or indicate inflammatory bowel disease. Protrusion of tissue through the anus may be due to hemorrhoids, mucosal prolapse, polyps or other lesions.

Abscess↗
PubMed2001

[Application of ultrasonic investigation in diagnosis of "high" forms of an acute paraproctitis].

Possibilities of ultrasonic investigation (USI) in diagnosis of "high" forms of an acute paraproctitis, ischiorectal and pelviorectal one, were studied. Of 20 patients examined, in 14 the diagnosis difficulties were noted, for correction of which the USI method was applied. The presence of purulent formations in pararectal cellular tissue was confirmed, their localization and spread were determined, permitting to substantiate the rational method of surgical intervention choice.

Acute Disease↗
PubMedDate not supplied

[X-ray study in the examination of patients with perineal fistulas].

The paper discusses whether X-ray study of patients with perineal fistulas is required and justified. The main reason is that there is a diversity of diseases which display the same signs as paraproctitis. Of 426 examinees, perineal fistulas were mainly caused by chronic paraproctitis in 85% and by other various diseases showing the similar symptoms in 15%. The basic studies of these patients included fistulography made in 300 patients with external fistulas and proctofistulography performed in 126 patients with incomplete internal fistulas. Comparing the data of X-ray study with those of clinical and morphological ones showed the sensitivity of the former to be 94.5%. Based on the results of their own observations, the authors defined indications for fistulography or proctofistulography. In addition to the analysis of the findings, they present the main points of differential X-ray diagnosis of different diseases manifested by perineal fistulas.

Adolescent↗
PubMed2001

[Complications in treatment of a patient with total aganglionosis of the large intestine].

The author presents a patient with an congenital malformation, megacolon congenitum, with total agangliosis of the large bowel. Total colectomy was performed preserving part of the rectum with subsequent Duhamel's operation. After four years, at the age of 5.5 years the postoperative course was complicated by an inflammation of the rectum with the subsequent development of multiple fistulae in the perianal, perineal, gluteal and labial area. The condition had a rapid septic course. The patient was subjected to repeated ileostomy. Under general antibiotic treatment and Sulfasalazine the patient's condition improved.

Child, Preschool↗
PubMed1979

Disseminated gonococcal infections (DGI).

Neisseria gonorrhoeae infects superficial membranes of the eyes, oropharynx, genital tract, and rectum prior to dissemination. Gonococcal isolates cultured from patients with disseminated gonococcal infections (DGI) show resistance to serum bacteriolysis, are very sensitive to penicillin, and have characteristic growth requirements for certain amino acids. DGI is characterized by recurrent chills and fever, polyarthralgias and/or polyarthritis (with effusions), and skin lesions. The skin manifestations of DGI include vesicopustules, hemorrhagic bullae, and petechiae. These lesions are found over the juxta-articular areas of the hands (extensor surfaces) or the feet (dorsal aspects). Focal and disseminated gonococcal infections are now treated with several types of penicillin regimens, tetracycline, or spectinomycin.

Anti-Bacterial Agents↗
PubMed2002

Evaluation of morbidity after external radiotherapy and intracavitary brachytherapy in 771 patients with carcinoma of the uterine cervix or endometrium.

PURPOSE: The aim of the present study was to evaluate early and late radiation morbidity and to assess the factors influencing morbidity in patients with cervical or endometrial cancer treated by a combination of external radiotherapy (ERT) and intracavitary brachytherapy (IBRT). MATERIALS AND METHODS: Early and late radiation morbidity were evaluated retrospectively using RTOG/EORTC criteria and Franco-Italian glossary in 771 patients treated between November 1992 and December 1999. RESULTS: Four hundred and seven patients (52.8%) had endometrial carcinoma and 364 (47.2%) had carcinoma of the cervix. One hundred and fifty-four patients with cervical carcinoma were inoperable. In patients with endometrial carcinoma total doses at the vagina, bladder and rectum were 60.36 Gy, 56.2 Gy and 55.6 Gy respectively. Biologically equivalent doses (BED) for the same points were 79.35, 68.63 and 67.37, respectively for early effects and 123.67, 97.65 and 94.85, respectively for late effects. One hundred and sixty-nine patients (41.5%) developed acute morbidity, grade I and II bladder morbidity being the most common type and 85 patients (20.9%) developed late morbidity, grade I and II vaginal morbidity being the most common type. No grade IV morbidity was recorded. Total doses at the vagina, bladder and rectum in operated cervix cancer patients were 60.51 Gy, 56.53 Gy and 55.67 Gy, respectively. BED for the same points were 79.77, 69.36 and 67.52, respectively for early effects and 124.74, 99.3 and 95.17, respectively for late effects. Eighty patients (38.1%) developed early morbidity. Grade I and II bladder morbidity was the most common type. Sixty-five patients (30.9%) developed late morbidity, vaginal morbidity being the most common type. Total doses at the vagina, bladder and rectum in inoperable patients were 70.92 Gy, 66.71 Gy and 62.38 Gy, respectively. BED for the same points were 97.43, 89.64 and 81.63, respectively for early effects and 159.3, 143.16 and 126.56, respectively for late effects. Sixty patients (39%) developed acute morbidity which was grade I or II bladder morbidity in 95%. Ninety-five patients (61.7%) developed late morbidity which was grade I-III vaginal morbidity in 94%. CONCLUSION: Patients with cervical or endometrial cancer can be treated safely by a combination of ERT and IBRT. However the patients should be assessed before, during and after treatment and at every period of follow-up using a standard and well-defined system in order to define and predict the morbidity rate.

Adult↗
PubMed2001

[Hemorrhoidal disease. Current surgical treatment and the place of Whitehead's operation].

In the presented material a review of the current data and comprehensions of the anatomy and physiology of the hemorrhoids is made, as like of the ethiology and pathogenesis of the disease. The new conceptions of the surgical treatment of the disease are pointed out. An attempt was made to differentiate the operative methods in patogenetical principal. The operative results of the General Surgery Clinic by the University Hospital "St. Ann", Sofia for the period 1991-2000 of 157 treated patients with hemorrhoidal disease are presented. Based on these results the authors come to a conclusion, that the Whitehead's operation remains "the golden standard" as a choice of an operative method for the treatment of the hemorrhoidal disease in advanced stages (III-d or IV-th).

Adult↗
PubMed1975

Double contrast examination in disease of the anorectal region.

Patients with symptoms from the anorectal region will not always be rectoscopically examined and sometimes lesions of the ano-rectal region are overlooked by the rectoscopist. In order to increase the overall diagnostic accuracy and make possible an early diagnosis of pathological changes in the ano-rectal region, the radiologist should take responsibility also for this part of the bowel. Minor lesions are often difficult to demonstrate by the conventional barium enema, but they are readily seen on an adequately performed double contrast examination. Of special importance is the diagnosis of small polypoid tumors which may become malignant. An early diagnosis and subsequent surgical removal of these tumors prevent spread and minimizes the surgical procedure.

Air↗
PubMed2002

Sexually transmitted diseases treatment guidelines 2002. Centers for Disease Control and Prevention.

These guidelines for the treatment of patients who have sexually transmitted diseases (STDs) were developed by the Centers for Disease Control and Prevention (CDC) after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on September 26-28, 2000. The information in this report updates the 1998 Guidelines for Treatment of Sexually Transmitted Diseases (MMWR 1998;47 [No. RR-1]). Included in these updated guidelines are new alternative regimens for scabies, bacterial vaginosis, early syphilis, and granuloma inguinale; an expanded section on the diagnosis of genital herpes (including type-specific serologic tests); new recommendations for treatment of recurrent genital herpes among persons infected with human immunodeficiency virus (HIV); a revised approach to the management of victims of sexual assault; expanded regimens for the treatment of urethral meatal warts; and inclusion of hepatitis C as a sexually transmitted infection. In addition, these guidelines emphasize education and counseling for persons infected with human papillomavirus, clarify the diagnostic evaluation of congenital syphilis, and present information regarding the emergence of quinolone-resistant Neisseria gonorrhoeae and implications for treatment. Recommendations also are provided for vaccine-preventable STDs, including hepatitis A and hepatitis B.

Condylomata Acuminata↗
PubMed1975

[Surgical treatment of acute paraproctitis].

Based on the experience with surgical therapy of 1178 patients with acute paraproctitis, a detailed statistic and morphological analysis of the disease is given. The authors have proved the possibility of a one-moment radical operation practically for all forms of acute paraproctitis. The suggested methods are grounded on incision of a pararectal abscess in the intestinal lumen onto the involved Morgan cript. If partial or even complete incision of the anal compressor proves to be necessary during the operation, the authors would apply its suturing or non-tamponade method of the postoperative management.

Abscess↗