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Evaluation of Salvia officinalis in the Treatment of Acetic Acid-Induced Ulcerative Colitis in a Rat Model 评估丹参治疗醋酸诱导的大鼠溃疡性结肠炎模型的效果
Q4 Medicine Pub Date : 2024-07-22 DOI: 10.1055/s-0044-1787141
Reza Shahriarirad, Sarvin Seifbehzad, A. Erfani, Fatemeh Nekouei, S. Ashkani-Esfahani, Masood Hosseinzadeh, Nader Tanideh, O. koohi-Hosseinabadi, Bahador Sarkari
Introduction Ulcerative colitis (UC) is an inflammatory bowel disease that causes long-lasting inflammation and ulcers within the digestive tract. This study aims to determine the histochemical alteration of Salvia officinalis (sage), an anti-inflammatory and antioxidant herbal agent on UC. Materials and Methods The disease was induced in 37 Sprague-Dawley rats with 2 mL of 3% acetic-acid (AA) enema. The rats were divided into five groups: a control group (AA), two 5-aminosalicylic (5-ASA) groups treated either orally (AO) or rectally (AR) with a dose of 100 mg/kg, and two salvia groups treated with 300mg/kg salvia orally (SO) or rectally (SR). Histopathological analyses of the colon were done on day 7, and markers such as C-reactive protein (CRP), superoxide dismutase (SOD), and complete blood count were measured. Result In macroscopic evaluation, the AO group demonstrated the lowest involvement, followed by the SO, SR, AR, and AA groups, respectively (p = 0.01). There was no significant difference between the SO and AO groups (p = 0.10), and the SR and AR groups (p = 0.58). Regarding microscopic histopathological findings, the AO and SO group demonstrated the most satisfactory results, with no significant difference between the AO versus SO, and AR versus SR groups. Inflammation was resolved in all of the AO and SO subjects. Conclusion Salvia can be beneficial in the treatment course of UC by inhibiting inflammatory responses, increasing the growth and viability of intestinal mucosa, and its antioxidant effects. Therefore, we propose the prescription of salvia as an adds-on or alternative therapy in the management of UC.
引言 溃疡性结肠炎(UC)是一种炎症性肠病,会导致消化道内长期炎症和溃疡。本研究旨在确定鼠尾草(一种抗炎和抗氧化草药)对溃疡性结肠炎的组织化学改变。材料与方法 用 2 毫升 3% 乙酸(AA)灌肠诱导 37 只 Sprague-Dawley 大鼠发病。大鼠被分为五组:对照组(AA)、两组 5-氨基水杨酸(5-ASA)组(口服(AO)或直肠(AR),剂量为 100 毫克/千克)和两组丹参组(口服(SO)或直肠(SR),剂量为 300 毫克/千克)。第 7 天对结肠进行组织病理学分析,并测量 C 反应蛋白 (CRP)、超氧化物歧化酶 (SOD) 和全血细胞计数等指标。结果 在宏观评估中,AO 组受累程度最低,其次分别是 SO 组、SR 组、AR 组和 AA 组(P = 0.01)。SO 组和 AO 组(P = 0.10)以及 SR 组和 AR 组(P = 0.58)之间无明显差异。在显微组织病理学结果方面,AO 组和 SO 组的结果最令人满意,AO 组与 SO 组、AR 组与 SR 组之间没有明显差异。所有 AO 组和 SO 组受试者的炎症均已消除。结论 丹参可抑制炎症反应,增加肠粘膜的生长和活力,并具有抗氧化作用,对 UC 的治疗过程有益。因此,我们建议将丹参作为治疗 UC 的附加疗法或替代疗法。
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引用次数: 0
Unusual Case of Colonic Intussusception Caused by Angiolipoma: Case Report and Literature Review 血管脂肪瘤导致结肠肠套叠的罕见病例:病例报告和文献综述
Q4 Medicine Pub Date : 2024-03-15 DOI: 10.1055/s-0043-1777058
Hugo Araujo Lino, Brittany Hubbard, Huy LePhan, Sean Mahoney, Nicholas Harrel
Angiolipomas are benign tumors composed of adipose tissue commonly found in the subcutaneous tissue with vascular proliferation. It is uncommon to find it in the gastrointestinal tract. This report focuses on an angiolipoma found in the sigmoid colon causing intussusception in a young healthy 26-year-old male. We discuss the presentation, workup and surgical management.
血管脂肪瘤是由脂肪组织组成的良性肿瘤,常见于血管增生的皮下组织。在胃肠道中发现血管脂肪瘤的情况并不多见。本报告的重点是在一名 26 岁的健康男性乙状结肠中发现的导致肠套叠的血管脂肪瘤。我们将讨论该病的表现、检查和手术治疗。
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引用次数: 0
Retrospective Study of Patients Submitted to Appendectomy in a Tertiary Hospital: Is There a Difference between the Public and Supplementary Health System? 一家三级医院接受阑尾切除术患者的回顾性研究:公立医疗系统与辅助医疗系统有区别吗?
Q4 Medicine Pub Date : 2024-03-01 DOI: 10.1055/s-0044-1779602
Isaac José Felippe Corrêa Neto, Amanda Gambi Robles, Victor Keniti Gomes Nishiyama, Sany Tomomi de Almeida Rocha Arita, Gabriel Fiorot Cruz Sperandio, Lia Yumi Omori Nishikawa, Rodrigo Ambar Pinto, L. Robles
Introduction Appendicitis is the surgical disease with the highest prevalence in emergency rooms. Its clinical and/or surgical complications are associated with the time course of symptoms, age, comorbidities, and stages of the disease. Objectives To analyze the demographic and clinical data of patients who underwent appendectomy for acute appendicitis in a tertiary referral hospital in the city of São Paulo and compare these data between services provided by the Public and Supplementary Health System. Methodology Retrospective analysis of data from electronic medical records of patients over 14 years old who underwent appendectomy for acute appendicitis at Hospital Santa Marcelina, both in the Public and Supplementary Health Systems from January 2015 to December 2017. Results A total of 536 patients were analyzed, 354 (66%) of whom were male with a general mean age of 29.85 years (14–81 years). The mean time from symptoms to seeking medical care was 53.84 hours. Regarding the phases of acute appendicitis, a greater number of cases of complicated disease was observed in patients operated on in the Public Health System (p < 0.0001), as well as the time course of symptoms (p = 0.0005) and hospitalization (p = 0.0012). On the other hand, the surgical wound infection rate during the hospitalization period was similar between groups (p = 0.2118). Conclusion There was a predominance of male patients undergoing appendectomy for acute appendicitis, with longer time course of symptoms in those operated on in the Public Health System and a predominance of appendicitis in advanced stages (3 and 4) in this group. However, in this group there was no significant increase in the rate of postoperative infection, and the length of stay was shorter than that of patients operated on in the Supplementary Health System.
导言 阑尾炎是急诊室发病率最高的外科疾病。其临床和/或手术并发症与症状出现的时间、年龄、合并症和疾病的阶段有关。目的 分析圣保罗市一家三级转诊医院中因急性阑尾炎而接受阑尾切除术的患者的人口统计学和临床数据,并将这些数据与公共医疗系统和辅助医疗系统提供的服务进行比较。方法 回顾性分析2015年1月至2017年12月期间在公共卫生系统和补充卫生系统的Santa Marcelina医院接受急性阑尾炎阑尾切除术的14岁以上患者的电子病历数据。结果 共分析了 536 名患者,其中 354 名(66%)为男性,平均年龄为 29.85 岁(14-81 岁)。从出现症状到就医的平均时间为 53.84 小时。就急性阑尾炎的不同阶段而言,在公共卫生系统接受手术的患者中,并发症病例的数量较多(p < 0.0001),症状出现的时间(p = 0.0005)和住院时间(p = 0.0012)也较多。另一方面,两组患者在住院期间的手术伤口感染率相似(p = 0.2118)。结论 因急性阑尾炎而接受阑尾切除术的患者以男性居多,在公共卫生系统接受手术的患者症状持续时间较长,且阑尾炎晚期(3 期和 4 期)患者居多。不过,这组病人的术后感染率没有明显增加,住院时间也比在辅助医疗系统接受手术的病人短。
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引用次数: 0
Pilonidal Sinus of the Anal Canal: A Rare Entity - Case Report 肛管乳头窦:罕见病例 - 病例报告
Q4 Medicine Pub Date : 2024-03-01 DOI: 10.1055/s-0044-1779272
Rahul Himmatrao Baviskar, Rita Rahul Baviskar, Kiran Dharma Wagh
Pilonidal sinus is the term first used by Hodges in 1880 to describe a granulomatous lesion containing hairs. It has been previously described as hair extracted from an ulcer and referred to as Jeep's disease, in world war days. Pilonidal sinus is the condition in which a sinus or fistula is situated at a short distance from the anus and generally contains hairs. It is commonly observed in the sacrococcygeal region and a few other sites, such as the axilla, umbilicus, face, etc. Its presence elsewhere is uncommon. Predisposing factors are traumatized, hairy skin, which leads entry of the hair inside the wound, thus forming a sinus. A 31-year-old patient presented with discharging endoanal sinus tract, which, on exploration, turned out to be an endoanal pilonidal sinus containing hair tufts, a rare case. The patient complained of recurrent pus discharge and anal pain for 45 days, reporting history of travelling around 70 km daily in a two-wheeler vehicle.On first physical evaluation, a small endoanal bulge was found. It was located at 1 o'clock in lithotomy position (anterior), with purulent discharge and anterior anal fissure. For confirmation, an endoanal ultrasonography (USG) was performed, which showed a sinus tract containing internal echoes and gas bubbles with a small amount of pus. The sinus was explored, and a wide excision was made and left open for secondary healing.Pilonidal sinus of the anal canal is a rare entity, and it can be found in hairy patients who are used to going on long, daily rides on two wheeled vehicles.
毛囊窦(Pilonidal sinus)是霍奇斯(Hodges)于 1880 年首次使用的术语,用于描述含有毛发的肉芽肿病变。在世界大战期间,它曾被描述为从溃疡中提取的毛发,并被称为吉普病(Jeep's disease)。乳头窦是指位于肛门不远处的窦道或瘘管,通常含有毛发。常见于骶尾部和其他一些部位,如腋窝、脐部、面部等。其他部位则不常见。诱发因素是皮肤受过创伤、多毛,导致毛发进入伤口内部,从而形成窦道。一名 31 岁的患者出现了肛门内窦道分泌物,经检查发现是肛门内含毛发簇的朝天鼻窦,这是一个罕见病例。患者主诉反复出现脓性分泌物和肛门疼痛,已持续 45 天,自述每天驾驶两轮摩托车行驶约 70 公里。第一次身体检查时,发现肛门内有一个小凸起,位于取石位(前方)1 点钟方向,有脓性分泌物,肛门前裂。为确认情况,进行了肛门内超声波检查(USG),结果显示肛窦内有内部回声和气泡,并有少量脓液。肛管乳头状窦道是一种罕见的疾病,多毛、习惯于每天长时间乘坐两轮车的患者也可能患有这种疾病。
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引用次数: 0
Detection of Upper Gastrointestinal Disorders in Patients with Positive Fecal Immunochemical Test (FIT) and Normal Colonoscopy: A Cross-Sectional Study 粪便免疫化学检验 (FIT) 阳性和结肠镜检查正常患者上消化道疾病的检测:一项横断面研究
Q4 Medicine Pub Date : 2024-03-01 DOI: 10.1055/s-0044-1785212
S. Ravanshad, Atefeh Golhasani, Hassan Mehrad‐Majd, Mohammadhossein Taherynejad, Ali Beheshti Namdar
Introduction Colorectal cancer (CRC) is the second most prevalent cancer in the world, and the fecal immunochemical test (FIT) can be mentioned among the CRC screening methods based on the detection of occult blood in the feces, which may indicate upper gastrointestinal (UGI) malignancies; therefore, patients with a positive FIT but normal colonoscopy may be considered for a UGI endoscopy. Materials and Methods The present study was conducted on patients with a positive FIT who were submitted to colonoscopy with normal results. They subsequently underwent endoscopy for the detection of UGI disorders. Results We included 121 patients (64.5% of women and 35.5% of men; average age: 58.85 ± 12.93 years), 72.7% of whom were positive for Helicobacter pylori. The predominant result of the UGI endoscopy was normal, followed by erythema of the gastric mucosa, and anemia and dyspepsia were the most common clinical findings. The most common pathological result was chronic gastritis, followed by acute gastritis. Only one patient presented stomach cancer (adenocarcinoma). Conclusion Considering the small prevalence of cancer in the UGI endoscopies of patients with positive FIT and normal colonoscopy, to the performance of UGI endoscopy in these patients may not be necessary.
导言 大肠癌(CRC)是世界上发病率第二高的癌症,而粪便免疫化学检验(FIT)可以说是 CRC 筛查方法中的一种,其原理是检测粪便中的隐血,隐血可能预示着上消化道(UGI)恶性肿瘤;因此,FIT 阳性但结肠镜检查正常的患者可考虑接受 UGI 内镜检查。材料与方法 本研究的对象是 FIT 阳性且结肠镜检查结果正常的患者。随后,他们接受了内窥镜检查,以发现胃肠道疾病。结果 我们共纳入 121 名患者(女性占 64.5%,男性占 35.5%;平均年龄:58.85 ± 12.93 岁),其中 72.7% 的患者幽门螺杆菌检测呈阳性。消化内镜检查的主要结果是正常,其次是胃黏膜红斑,贫血和消化不良是最常见的临床表现。最常见的病理结果是慢性胃炎,其次是急性胃炎。只有一名患者患有胃癌(腺癌)。结论 考虑到在 FIT 阳性和结肠镜检查正常的患者的消化道内窥镜检查中癌症的发病率较低,对这些患者进行消化道内窥镜检查可能没有必要。
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引用次数: 0
A Health Mobile Application for Self-Care of Colostomy Patients 用于结肠造口术患者自我护理的健康移动应用程序
Q4 Medicine Pub Date : 2024-03-01 DOI: 10.1055/s-0044-1779604
Elahe Jozpoor, Monireh Tahvildarzadeh, Azam Sadat Hoseini, M. Shahmoradi, Mohammad Almasian, Hamid Moghaddasi
Introduction and Objective In most cases, due to the failure of nonsurgical methods in the treatment of diseases related to the colon, it is necessary to perform colostomy as the main treatment method. However, this surgery can cause a wide range of physical, social, and psychological problems in patients. Therefore, in order to prevent and treat the complications of colostomy, it is necessary to adopt measures in the field of self-care and continuous education for patients to control the complications of the disease, seek treatment, and experience improvements in their quality of life . Additionally, considering the role of mobile health (mHealth) applications in facilitating continuous and effective training, and improving self-care for these patients, the aim of the present study was to design and evaluate an mHealth application for self-care of colostomy patients. Materials and Methods In the present applied research, first the functional requirements of the software were determined considering the self-care requirements of colostomy patients. Then, the software was designed based on object-oriented analysis, and according to it, the application was coded in Java and developed in the Android Studio environment. Finally, to evaluate the software, the opinions and comments of 5 gastroenterologists and 10 adult colostomy patients in the age range between 27 and 64 years who had at least a high school diploma were used as the basis of judgment at this stage. The instruments used in the evaluation included a checklist, derived from three standard questionnaires (the System Usability Scale [SUS], the mHealth App Usability Questionnaire [MAUQ], and the User Version of the Mobile Application Rating Scale [uMARS]) to measure the user-friendliness indicator, and a researcher-made checklist to measure the performance indicator of the various services provided. Results The services of the software developed include the provision of medical information and self-care instructions regarding colostomy surgery, as well as alerts for the user to schedule an appointment with a doctor and the time to take medications. Based on the results of the evaluation stage, the users were generally satisfied with the interface, services, and general features of the software. In general, the software was evaluated at the “acceptable” level, with a rate of 85%. Discussion and Conclusion Based on the findings of the current research, the software developed can be significantly effective in facilitating the education of colostomy patients and improving their self-care. Proper and continuous self-care and education for colostomy patients is necessary to prevent and control complications resulting from surgery and to improve their quality of life. Therefore, in addition to patients, all health care staff, organizations, and associations which support colostomy patients can also use this software to educate patients and improve the care provided to them.
导言和目的 在大多数情况下,由于非手术治疗结肠相关疾病的方法无效,必须将结肠造口术作为主要的治疗方法。然而,这种手术会给患者带来一系列生理、社会和心理问题。因此,为了预防和治疗结肠造口术的并发症,有必要在患者自我护理和持续教育方面采取措施,以控制疾病并发症、寻求治疗并提高生活质量。此外,考虑到移动医疗(mHealth)应用在促进持续有效的培训和改善这些患者的自我护理方面所起的作用,本研究旨在设计和评估一种用于结肠造口术患者自我护理的移动医疗应用。材料和方法 在本应用研究中,首先根据结肠造口术患者的自我护理要求确定了软件的功能要求。然后,根据面向对象的分析方法设计软件,并据此在 Android Studio 环境中用 Java 编写和开发应用软件。最后,为了对该软件进行评估,本阶段以 5 名消化科医生和 10 名年龄在 27 至 64 岁之间、至少具有高中学历的成年结肠造口患者的意见和评论作为判断依据。评估中使用的工具包括一份从三份标准问卷(系统可用性量表[SUS]、移动医疗应用可用性问卷[MAUQ]和移动应用用户版评分量表[uMARS])中衍生出来的检查表,用于测量用户友好性指标;以及一份研究人员自制的检查表,用于测量所提供的各种服务的性能指标。结果 所开发软件的服务包括提供有关结肠造口手术的医疗信息和自我护理指导,以及提醒用户预约医生和服药时间。根据评估阶段的结果,用户普遍对软件的界面、服务和一般功能表示满意。总体而言,对软件的评价达到了 "可接受 "水平,满意率为 85%。讨论与结论 根据目前的研究结果,所开发的软件在促进对结肠造口术患者的教育和改善其自我护理方面具有显著效果。为了预防和控制手术引起的并发症,提高患者的生活质量,有必要对结肠造口术患者进行适当和持续的自我护理和教育。因此,除病人外,所有医护人员、支持结肠造口术病人的组织和协会也可以使用该软件来教育病人,改善对他们的护理。
{"title":"A Health Mobile Application for Self-Care of Colostomy Patients","authors":"Elahe Jozpoor, Monireh Tahvildarzadeh, Azam Sadat Hoseini, M. Shahmoradi, Mohammad Almasian, Hamid Moghaddasi","doi":"10.1055/s-0044-1779604","DOIUrl":"https://doi.org/10.1055/s-0044-1779604","url":null,"abstract":"\u0000 Introduction and Objective In most cases, due to the failure of nonsurgical methods in the treatment of diseases related to the colon, it is necessary to perform colostomy as the main treatment method. However, this surgery can cause a wide range of physical, social, and psychological problems in patients. Therefore, in order to prevent and treat the complications of colostomy, it is necessary to adopt measures in the field of self-care and continuous education for patients to control the complications of the disease, seek treatment, and experience improvements in their quality of life . Additionally, considering the role of mobile health (mHealth) applications in facilitating continuous and effective training, and improving self-care for these patients, the aim of the present study was to design and evaluate an mHealth application for self-care of colostomy patients.\u0000 Materials and Methods In the present applied research, first the functional requirements of the software were determined considering the self-care requirements of colostomy patients. Then, the software was designed based on object-oriented analysis, and according to it, the application was coded in Java and developed in the Android Studio environment. Finally, to evaluate the software, the opinions and comments of 5 gastroenterologists and 10 adult colostomy patients in the age range between 27 and 64 years who had at least a high school diploma were used as the basis of judgment at this stage. The instruments used in the evaluation included a checklist, derived from three standard questionnaires (the System Usability Scale [SUS], the mHealth App Usability Questionnaire [MAUQ], and the User Version of the Mobile Application Rating Scale [uMARS]) to measure the user-friendliness indicator, and a researcher-made checklist to measure the performance indicator of the various services provided.\u0000 Results The services of the software developed include the provision of medical information and self-care instructions regarding colostomy surgery, as well as alerts for the user to schedule an appointment with a doctor and the time to take medications. Based on the results of the evaluation stage, the users were generally satisfied with the interface, services, and general features of the software. In general, the software was evaluated at the “acceptable” level, with a rate of 85%.\u0000 Discussion and Conclusion Based on the findings of the current research, the software developed can be significantly effective in facilitating the education of colostomy patients and improving their self-care. Proper and continuous self-care and education for colostomy patients is necessary to prevent and control complications resulting from surgery and to improve their quality of life. Therefore, in addition to patients, all health care staff, organizations, and associations which support colostomy patients can also use this software to educate patients and improve the care provided to them.","PeriodicalId":15408,"journal":{"name":"Journal of Coloproctology","volume":"449 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140281603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Appendiceal Goblet Cell Carcinoma: Comparison of Classification and Staging Systems with Evaluation of the Prognostic Role of Immunohistochemistry Stains 阑尾上皮细胞癌:分类和分期系统的比较以及免疫组化染色的预后作用评估
Q4 Medicine Pub Date : 2024-03-01 DOI: 10.1055/s-0044-1779601
Rachel Masia, Vincent Marcucci, Colton Moore, Xiu Sun, Arthur A. Topilow, Timothy Gelatt, Glenn Parker
Background Goblet cell carcinoma (GCC) of the appendix is a unique lesion that exhibits features of both adenocarcinoma and neuroendocrine tumors. Due to the rarity of this cancer, multiple grading (e.g., Tang, Yozu, and Lee) and staging systems (e.g., tumor, lymph nodes, and metastasis [TNM]) have been developed for classification. This study aimed to compare commonly used classification systems and evaluate the prognostic effectiveness immunohistochemical staining may or may not have for appendiceal GCC. Methods An electronic medical records review of patients who were diagnosed with GCC of the appendix in our hospital system from 2010 to 2020. The data were collected regarding the age at diagnosis, gender, initial diagnosis at presentation, operation(s) performed, final pathology results, current survival status, and year of recurrent disease or death year. Results Ten patients were evaluated. Seventy percent of the patients were above the age of 50 years at diagnosis. Postdischarge survival ranged from 1 month to 109 months postdiagnosis. Two patients expired from GCC at 13- and 54-months following diagnosis. When comparing the classification systems, Lee categorized more patients as high risk than Tang and Yozu. Immunohistochemical staining was analyzed using four staining methods: Ki67, E-cadherin, Beta-catenin, and p53. Tumor, lymph nodes, and metastasis staging has supportive evidence for worsening prognosis and overall survival secondary to the depth of invasion of the tumor. Conclusion Tumor, lymph nodes, and metastasis staging may be superior to the other classification systems in predicting overall mortality. Our study demonstrated that immunohistochemistry staining does not appear to have a significant impact in determining the prognosis for GCC of the appendix.
背景 阑尾胃小管细胞癌(GCC)是一种独特的病变,同时具有腺癌和神经内分泌肿瘤的特征。由于这种癌症的罕见性,目前已开发出多种分级(如 Tang、Yozu 和 Lee)和分期系统(如肿瘤、淋巴结和转移 [TNM])。本研究旨在比较常用的分类系统,并评估免疫组化染色对阑尾 GCC 的预后效果。方法 对 2010 年至 2020 年在我院系统中确诊为阑尾 GCC 的患者进行电子病历回顾。收集的数据包括确诊时的年龄、性别、就诊时的初步诊断、实施的手术、最终病理结果、目前的生存状况以及疾病复发年份或死亡年份。结果 对 10 名患者进行了评估。70%的患者确诊时年龄在 50 岁以上。出院后的生存期从确诊后 1 个月到 109 个月不等。两名患者分别在确诊后 13 个月和 54 个月死于 GCC。在比较两种分类系统时,Lee 将更多患者归为高风险,而 Tang 和 Yozu 则将更多患者归为高风险。免疫组化染色采用四种染色方法进行分析:Ki67、E-cadherin、Beta-catenin 和 p53。肿瘤、淋巴结和转移灶分期有支持性证据表明,肿瘤侵犯深度会导致预后和总生存期恶化。结论 在预测总死亡率方面,肿瘤、淋巴结和转移灶分期可能优于其他分类系统。我们的研究表明,免疫组化染色在判断阑尾 GCC 的预后方面似乎没有显著影响。
{"title":"Appendiceal Goblet Cell Carcinoma: Comparison of Classification and Staging Systems with Evaluation of the Prognostic Role of Immunohistochemistry Stains","authors":"Rachel Masia, Vincent Marcucci, Colton Moore, Xiu Sun, Arthur A. Topilow, Timothy Gelatt, Glenn Parker","doi":"10.1055/s-0044-1779601","DOIUrl":"https://doi.org/10.1055/s-0044-1779601","url":null,"abstract":"\u0000 Background Goblet cell carcinoma (GCC) of the appendix is a unique lesion that exhibits features of both adenocarcinoma and neuroendocrine tumors. Due to the rarity of this cancer, multiple grading (e.g., Tang, Yozu, and Lee) and staging systems (e.g., tumor, lymph nodes, and metastasis [TNM]) have been developed for classification. This study aimed to compare commonly used classification systems and evaluate the prognostic effectiveness immunohistochemical staining may or may not have for appendiceal GCC.\u0000 Methods An electronic medical records review of patients who were diagnosed with GCC of the appendix in our hospital system from 2010 to 2020. The data were collected regarding the age at diagnosis, gender, initial diagnosis at presentation, operation(s) performed, final pathology results, current survival status, and year of recurrent disease or death year.\u0000 Results Ten patients were evaluated. Seventy percent of the patients were above the age of 50 years at diagnosis. Postdischarge survival ranged from 1 month to 109 months postdiagnosis. Two patients expired from GCC at 13- and 54-months following diagnosis. When comparing the classification systems, Lee categorized more patients as high risk than Tang and Yozu. Immunohistochemical staining was analyzed using four staining methods: Ki67, E-cadherin, Beta-catenin, and p53. Tumor, lymph nodes, and metastasis staging has supportive evidence for worsening prognosis and overall survival secondary to the depth of invasion of the tumor.\u0000 Conclusion Tumor, lymph nodes, and metastasis staging may be superior to the other classification systems in predicting overall mortality. Our study demonstrated that immunohistochemistry staining does not appear to have a significant impact in determining the prognosis for GCC of the appendix.","PeriodicalId":15408,"journal":{"name":"Journal of Coloproctology","volume":"616 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140273697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Botulinum-toxin-A Injection Following Conservative Management in Patients with Dyssynergic Defaecation Only Improves Symptoms in the Short Term: A Retrospective Study 排便障碍患者在接受保守治疗后注射肉毒杆菌毒素 A 仅能在短期内改善症状:一项回顾性研究
Q4 Medicine Pub Date : 2024-03-01 DOI: 10.1055/s-0044-1779687
Annabelle G. Ganko, A. Warwick, C. Gillespie
Objective Dyssynergic defaecation (DD) is an important cause of chronic constipation. In patients where conservative treatments fail, injections of botulinum toxin A (BTX-A) into the puborectalis and anal sphincter muscles can be effective. Complications of this procedure are reported to be rare and generally mild. This study aimed to identify the complication rates and short- to medium-term success rates of BTX-A injections as a treatment for DD. Methods A retrospective review was conducted on patients diagnosed with DD who had undergone BTX-A injections at a functional colorectal unit. Patient demographics, manometric assessment, conservative management, and injection technique were collected through a chart review. Subjective patient reports and comparison of pre- and postprocedure symptom scores were used to determine efficacy. Results The 21 patients included (24 procedures, with 3 patients receiving BTX-A on two separate occasions) all received stool modification and dietary advice, and 20 patients underwent pelvic floor physiotherapy, averaging 8 sessions. The injections were universally applied under general anesthetic, primarily targeting the anal sphincter and/or puborectalis muscles. There were 6 reports of faecal urge/incontinence, with all but one being resolved within weeks.The BTX-A injection was subjectively reported as beneficial in 19 cases, averaging 4.7 months (range 1–32) of improvement. Only 2 were sustained beyond 12 months. Despite overall improvements in symptom scores from pre- to postprocedure, none were statistically significant. Conclusion Following a course of conservative management, the BTX-A injection appears to be a safe treatment for DD, but only has short term efficacy.
排便障碍(DD)是导致慢性便秘的一个重要原因。对于保守治疗无效的患者,在耻骨直肠肌和肛门括约肌注射肉毒杆菌毒素 A(BTX-A)可能有效。据报道,这种疗法的并发症很少见,而且一般都很轻微。本研究旨在确定 BTX-A 注射治疗 DD 的并发症发生率和中短期成功率。方法 对在结直肠功能科接受 BTX-A 注射治疗的 DD 患者进行回顾性研究。通过病历审查收集了患者的人口统计学资料、人体测量评估、保守治疗和注射技术。通过患者的主观报告以及术前术后症状评分的比较来确定疗效。结果 纳入的 21 名患者(24 次手术,其中 3 名患者分别接受了两次 BTX-A 治疗)均接受了粪便调整和饮食建议,20 名患者接受了盆底物理治疗,平均 8 次治疗。注射均在全身麻醉下进行,主要针对肛门括约肌和/或耻骨直肠肌。据主观报告,19 例患者在注射 BTX-A 后症状得到改善,平均改善时间为 4.7 个月(1-32 个月)。只有 2 例患者的症状持续了 12 个月以上。尽管从治疗前到治疗后症状评分总体有所改善,但均无统计学意义。结论 在保守治疗后,BTX-A 注射似乎是一种安全的 DD 治疗方法,但只有短期疗效。
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引用次数: 0
Quality of Life and Financial Impacts of Permanent Colostomy for Rectal Cancer 直肠癌永久性结肠造口术的生活质量和经济影响
Q4 Medicine Pub Date : 2024-03-01 DOI: 10.1055/s-0044-1782155
R. Colbran, C. Gillespie, P. Christensen, HØ. Kristensen, A. Warwick
Introduction Returning to work is an important cancer recovery milestone. Permanent colostomy can be required for rectal cancer treatment and can significantly impact well-being. We aimed to evaluate the impact of permanent colostomy on health-related quality of life and return to work in patients with rectal cancer. Methods This was a retrospective cohort study on 23 employed patients receiving curative surgery for rectal cancer requiring permanent colostomy. Demographic and health-related quality-of-life questionnaires (the Colostomy Impact Score (CIS), the EORTC Quality of Life Questionnaire (QLQ)-C30, and the EORTC QLQ-CR29) were posted to eligible patients. Results On average, patients (10 female, 13 male, mean age 61.8 years) were 5.0 ± 3.5 years post-surgery. At the time of questioning, 73.9% had returned to work (21.7% changed their type of work), while 17.4% never returned to work. Of those that returned to work, 11.8% returned within 1 month of surgery, while 23.5% had not returned after 12 months. Comparison of CIS between patients that returned to the same work (14.6 ± 0.93), changed their work (13.0 ± 0.74), and did not return to work (14.3 ± 2.3) revealed no significant differences (p = 0.36). CIS did not correlate with days worked on return, or time to return to work (p > 0.05). Conclusion Returning to work following rectal cancer treatment with permanent colostomy is challenging, with 17.4% never returning to work. Of those who returned to work, 23.5% required more than 12 months. This was not associated with CIS in our study.
导言:重返工作岗位是癌症康复的一个重要里程碑。直肠癌治疗可能需要进行永久性结肠造口术,这会严重影响患者的生活质量。我们旨在评估永久性结肠造口术对直肠癌患者健康相关生活质量和重返工作岗位的影响。方法 这是一项回顾性队列研究,研究对象是 23 名接受直肠癌根治手术并需要永久性结肠造口术的就业患者。向符合条件的患者发放了人口统计学和健康相关生活质量问卷(结肠造口影响评分(CIS)、EORTC 生活质量问卷(QLQ)-C30 和 EORTC QLQ-CR29)。结果 患者(10 名女性,13 名男性,平均年龄 61.8 岁)平均术后 5.0 ± 3.5 年。接受调查时,73.9%的患者已重返工作岗位(21.7%的患者更换了工作类型),17.4%的患者从未重返工作岗位。在重返工作岗位的患者中,11.8% 在手术后 1 个月内重返工作岗位,23.5% 在 12 个月后仍未重返工作岗位。对重返同一工作岗位(14.6 ± 0.93)、更换工作岗位(13.0 ± 0.74)和未重返工作岗位(14.3 ± 2.3)的患者的 CIS 进行比较后发现,他们之间没有显著差异(p = 0.36)。CIS 与重返工作岗位的工作天数或重返工作岗位的时间没有相关性(p > 0.05)。结论 采用永久性结肠造口术治疗直肠癌后重返工作岗位是一项挑战,有 17.4% 的人从未重返工作岗位。在重返工作岗位的患者中,23.5%需要12个月以上的时间。在我们的研究中,这与 CIS 无关。
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引用次数: 0
Profile of Surgeons Who Treat Inflammatory Bowel Diseases in Brazil 巴西治疗炎症性肠病的外科医生简介
Q4 Medicine Pub Date : 2024-03-01 DOI: 10.1055/s-0044-1782153
G. Zabot, O. Cassol, E. Vilela, Antônio José Tibúrcio Alves Junior, Daniel de Castilho da Silva, Rogério Saad-Hossne
Objective To describe the profile of surgeons who treat patients with inflammatory bowel disease as well as the characteristics of inflammatory bowel disease care, unmet demands, and difficulties. Methods The research participants answered a Google Forms questionnaire. Results Of the 99 surgeons who participated in the survey, 84.5% were coloproctologists, 40% were from the southeastern region of Brazil, and 77.7% were male and had been working for more than 19 years. Regarding the healthcare sector, 63.6% of surgeons worked in both public and private clinics, and most clinically cared for up to 50 patients with inflammatory bowel disease and operated on up to 5 cases per year. Conclusion This is the first national study that aimed to identify the profile of surgeons working with inflammatory bowel disease in Brazil. The vast majority are experienced male coloproctologists, located in the southern and southeastern regions, who perform clinical and surgical treatment of these pathologies, with major surgeries being performed in large centers by a small number of surgeons.
目的 描述治疗炎症性肠病患者的外科医生的概况,以及炎症性肠病护理的特点、未满足的需求和困难。方法 研究参与者回答谷歌表格问卷。结果 在参与调查的 99 名外科医生中,84.5% 为结肠直肠科医生,40% 来自巴西东南部地区,77.7% 为男性,工作年限超过 19 年。在医疗行业方面,63.6%的外科医生同时在公立和私立诊所工作,大多数外科医生每年最多为 50 名炎症性肠病患者提供临床护理,最多为 5 例患者实施手术。结论 这是第一项旨在了解巴西炎症性肠病外科医生概况的全国性研究。绝大多数外科医生都是经验丰富的结肠直肠男医生,他们分布在南部和东南部地区,对这些病症进行临床和外科治疗,主要手术由少数外科医生在大型中心进行。
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引用次数: 0
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Journal of Coloproctology
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