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1. Lin OS, Schembre DB, McCormick SE, Gluck M, Patterson DJ, Jiranek GC, Soon MS, Kozarek RA: Risk of proximal colorectal neoplasia among asymptomatic patients with distal hyperplastic polyps. Am J Med; 2005 Oct;118(10):1113-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Risk of proximal colorectal neoplasia among asymptomatic patients with distal hyperplastic polyps.
  • PURPOSE: Many guidelines on colorectal cancer screening do not consider distal hyperplastic polyps to be a marker for proximal neoplasia.
  • However, 11 of 17 published studies have shown an increased risk of proximal neoplasia in patients with distal hyperplastic polyps.
  • Our goal is to assess the risk of proximal neoplasia in asymptomatic patients with distal hyperplastic polyps, compared to those with distal tubular adenomas or no distal polyps.
  • METHODS: We assessed proximal (cecum, ascending, transverse colon and splenic flexure) and distal polyps in patients undergoing screening colonoscopy, classifying them into 3 groups: distal hyperplastic polyps only; distal adenomas with or without hyperplastic polyps; no distal polyps.
  • The prevalence of proximal neoplasia and advanced neoplasia (polyps > or =1 cm, villous adenomas, or cancer) was compared among these groups.
  • Proximal neoplasia occurred in 175 (9%) of 1896 patients with no distal polyps, compared with 28 (12%) of 237 with distal hyperplastic polyps (P = 0.20) and 64 (29%) of 224 with distal adenomas (P <0.0001).
  • Proximal advanced neoplasia occurred in 39 (2%) patients with no distal polyps, compared with 4 (2%) with distal hyperplastic polyps (P = 0.70) and 9 (4%) with distal adenomas (P = 0.13).
  • CONCLUSIONS: Patients with distal hyperplastic polyps, unlike those with distal adenomas, do not exhibit an increased risk for proximal neoplasia or proximal advanced neoplasia compared to those with no distal polyps.
  • [MeSH-major] Adenoma / epidemiology. Colon / pathology. Colorectal Neoplasms / epidemiology. Intestinal Polyps / epidemiology. Precancerous Conditions / epidemiology. Rectum / pathology

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  • (PMID = 16194642.001).
  • [ISSN] 0002-9343
  • [Journal-full-title] The American journal of medicine
  • [ISO-abbreviation] Am. J. Med.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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2. Reichart M, Busch OR, Bruno MJ, Van Lanschot JJ: Black esophagus: a view in the dark. Dis Esophagus; 2000;13(4):311-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • A 73-year-old man had a low anterior resection for a villous adenoma in the rectosigmoid.
  • On the 4th day after surgery, he suddenly developed severe interscapular pain.
  • With conservative treatment, including proton pump inhibition, he recovered completely.

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  • (PMID = 11284980.001).
  • [ISSN] 1120-8694
  • [Journal-full-title] Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
  • [ISO-abbreviation] Dis. Esophagus
  • [Language] ENG
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anti-Ulcer Agents; 0 / Proton Pump Inhibitors; 54182-58-0 / Sucralfate; KG60484QX9 / Omeprazole
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3. Emrich J, Niemeyer C: [The secreting villous adenoma as a rare cause of acute renal failure]. Med Klin (Munich); 2002 Oct 15;97(10):619-23
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [The secreting villous adenoma as a rare cause of acute renal failure].
  • [Transliterated title] Das sezernierende villöse Adenom als seltene Ursache einer akuten Niereninsuffizienz.
  • BACKGROUND: Using a typical case the symptomatology, the clinical course, the diagnostics with its difficulties as well as the therapy of the rare secreting villous adenoma with severe electrolyte and fluid depletion syndrome are described.
  • By an increase of the mucous volume together with an exhaustion of the physiological compensation mechanisms a life-threatening condition with severe electrolyte and fluid loss as well as acute prerenal failure develops, which can lead to difficulties in the diagnosis finding.
  • Therefore, especially in case of a triade of prerenal failure, electrolyte disorder and chronic diarrhea, the existence of an intestinal villous adenoma should be considered.
  • TREATMENT: After restoration of the homeostasis, the surgical removal of the infested intestine section should be the first aim, in order to eliminate the chronic electrolyte and fluid loss and detect or prevent a malignant degeneration.
  • Only in exempt cases an endoscopic treatment or a drug therapy with indometacin can alternatively be considered.
  • An untreated secreting villous adenoma on the other side shows a mortality of 100%.
  • [MeSH-major] Acute Kidney Injury / etiology. Adenoma, Villous / secretion. Colonic Neoplasms / secretion

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  • (PMID = 12386796.001).
  • [ISSN] 0723-5003
  • [Journal-full-title] Medizinische Klinik (Munich, Germany : 1983)
  • [ISO-abbreviation] Med. Klin. (Munich)
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Germany
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4. Cruz-Correa M, Hylind LM, Romans KE, Booker SV, Giardiello FM: Long-term treatment with sulindac in familial adenomatous polyposis: a prospective cohort study. Gastroenterology; 2002 Mar;122(3):641-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term treatment with sulindac in familial adenomatous polyposis: a prospective cohort study.
  • Sulindac, a nonsteroidal anti-inflammatory drug, causes regression of colorectal adenomas in the retained rectal segment of FAP patients, although long-term use of this therapy has not been studied.
  • We evaluated the long-term effectiveness and toxicity of sulindac in attempting to maintain retained rectal segments free of adenomas.
  • Number, size, and histologic grade of polyps, side effects, and medication compliance were assessed every 4 months.
  • Prevention of recurrence of higher-grade adenomas (tubulovillous, villous adenomas) was also observed (P = 0.004).
  • At 35 months of follow-up, 1 patient developed stage III cancer in the rectal stump.
  • CONCLUSIONS: Long-term use of sulindac seems to be effective in reducing polyp number and preventing recurrence of higher-grade adenomas in the retained rectal segment of most FAP patients.
  • [MeSH-major] Adenomatous Polyposis Coli / drug therapy. Anti-Inflammatory Agents, Non-Steroidal / administration & dosage. Sulindac / administration & dosage
  • [MeSH-minor] Adult. Disease-Free Survival. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / prevention & control. Prospective Studies. Rectum / pathology

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  • (PMID = 11874996.001).
  • [ISSN] 0016-5085
  • [Journal-full-title] Gastroenterology
  • [ISO-abbreviation] Gastroenterology
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anti-Inflammatory Agents, Non-Steroidal; 184SNS8VUH / Sulindac
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5. Ortega Carnicer J, Ambrós Checa A, Diarte De Miguel J: [Acute pancreatitis, acute kidney failure, metformin intoxication and villous rectal adenoma]. Med Intensiva; 2006 Nov;30(8):409-10
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Acute pancreatitis, acute kidney failure, metformin intoxication and villous rectal adenoma].
  • [Transliterated title] Pancreatitis aguda, insuficiencia renal aguda, intoxicación por metformina y adenoma velloso rectal.

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  • (PMID = 17129542.001).
  • [ISSN] 0210-5691
  • [Journal-full-title] Medicina intensiva
  • [ISO-abbreviation] Med Intensiva
  • [Language] SPA
  • [Publication-type] Case Reports; Letter
  • [Publication-country] Spain
  • [Chemical-registry-number] 0 / Hypoglycemic Agents; 9100L32L2N / Metformin
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6. Farraye FA, Wallace M: Clinical significance of small polyps found during screening with flexible sigmoidoscopy. Gastrointest Endosc Clin N Am; 2002 Jan;12(1):41-51
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • In deciding how to interpret the significance and management of small distal adenomatous polyps found on FS, one must first decide on the goal of a screening program.
  • Unfortunately cost and cost-effectiveness are important considerations when administering a screening program with a fixed budget.
  • Multiple studies support the recommendation that villous polyps regardless of size and adenomatous polyps greater than 1 cm found on FS are important markers for the presence of advanced polyps and cancer in the proximal colon.
  • If one assumes that a sigmoidoscopy-based approach is reasonable, and accepts that such an approach always misses a small number of proximal lesions, how should one manage patients with a small adenomatous polyp on FS?
  • In aggregate, the studies discussed previously suggest that patients with no distal polyps, distal hyperplastic polyps, or a single small distal tubular adenoma have a similar and low risk of advanced proximal adenomas of the colon.
  • The study by Read et al also included patients with distal villous adenomas in their low-risk group.
  • Given these caveats, what can one conclude about the predictive value of a small tubular adenoma found on FS?
  • These studies suggest that the risk of proximal advanced polyps is similar or slightly increased in patients with a distal adenoma than those with a negative FS.
  • The risk of finding an advanced adenoma seems to be 0% to 4% regardless of the findings of no polyps, hyperplastic polyps, or small tubular adenomatous polyps on FS in low-risk patients.
  • A small portion of patients with hyperplastic polyps found on FS have advanced proximal adenomas.
  • If a hyperplastic polyp on FS is not an indication for colonoscopy and the risk of proximal advanced adenomas is similar in patients with only a small distal adenoma, it is inconsistent to recommend colonoscopy for a small distal tubular adenoma and not a hyperplastic polyp.
  • Based on the studies of asymptomatic patients with no family history and negative FOBT, the authors believe it is reasonable to defer colonoscopy if no polyp, a hyperplastic, or a small tubular adenoma is found at sigmoidoscopy in low-risk patients.
  • It remains to be seen if the increase in costs and risks justifies the improved detection rate of colonic polyps.
  • Given manpower issues that face us today, and examining the question from a population perspective, reserving colonoscopy for only those patients with an advanced distal polyp on FS gives the biggest yield.

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  • (PMID = 11916160.001).
  • [ISSN] 1052-5157
  • [Journal-full-title] Gastrointestinal endoscopy clinics of North America
  • [ISO-abbreviation] Gastrointest. Endosc. Clin. N. Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 45
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7. Cascón Fonseca LF, Guerrero Gallego J, Balongo de la Vega A: [Three cases of villous adenoma of the Vater papilla]. Gastroenterol Hepatol; 2000 Apr;23(4):174-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Three cases of villous adenoma of the Vater papilla].
  • [Transliterated title] Tres casos de adenoma velloso de papila de Vater.
  • A series of three cases of villous adenoma of the papilla of Vater is reported.
  • In two cases, the pathological diagnosis made before, during and after surgery was of benign villous adenoma.
  • In the third case, the diagnosis made before and during surgery was of adenoma but in the postsurgical examination a macro-invading carcinoma was found.
  • Further endoscopic exploration revealed a recurrent villous adenoma and further surgery was carried out.
  • Total resection, rather than a duodenopancreatectomy, was performed due to the length of time from detection of the recurrence until the second operation as well as to the small size of the recurrent tumor in the surgical examination.
  • [MeSH-major] Adenoma, Villous / pathology. Ampulla of Vater. Common Bile Duct Neoplasms / pathology

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  • (PMID = 10863858.001).
  • [ISSN] 0210-5705
  • [Journal-full-title] Gastroenterología y hepatología
  • [ISO-abbreviation] Gastroenterol Hepatol
  • [Language] spa
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] SPAIN
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8. Riojas MA, Guo M, Glöckner SC, Machida EO, Baylin SB, Ahuja N: Methylation-induced silencing of ASC/TMS1, a pro-apoptotic gene, is a late-stage event in colorectal cancer. Cancer Biol Ther; 2007 Nov;6(11):1710-6
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  • The methylation status of ASC/TMS1 was analyzed in a series of colorectal cancer (CRC) cell lines, adenomas and primary colorectal cancers and normal colorectal tissue samples using methylation-specific PCR (MSP).
  • RT-PCR showed absence of mRNA expression in these same cell lines, and expression was restored after treatment with the demethylating drug 5-aza-2'-deoxyazacytidine.
  • The two unmethylated cell lines showed ASC/TMS1 mRNA expression both before and after treatment with 5-aza-2'-deoxyazacytidine.
  • Methylation was seen in 20 of 115 (17%) of primary colorectal cancer specimens, but no methylation was seen in 30 colorectal adenomas and 11 normal colorectal tissue samples.
  • Methylation status of ASC/TMS1 was correlated with a series of clinicopathological variables using multivariate analysis.
  • Methylation of ASC/TMS1 was more common in right-sided tumors (p = 0.02), concordant with hMLH1 methylation (p = 0.03) and is a late stage event, occurring in 0 of 18 tubular adenomas, 0 of 12 villous adenomas, 2 of 44 (5%) Stage 1 cancers, 8 of 31 (26%) Stage 2 cancers, 8 of 21 (38%) Stage 3 cancers and 2 of 19 (11%) Stage 4 cancers.
  • Methylation of ASC/TMS1 appears to be a late-stage event in colorectal carcinogenesis associated with invasive carcinomas but not with normal colorectal tissue or colorectal adenomas.

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  • (PMID = 17986858.001).
  • [ISSN] 1555-8576
  • [Journal-full-title] Cancer biology & therapy
  • [ISO-abbreviation] Cancer Biol. Ther.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Cytoskeletal Proteins; 0 / PYCARD protein, human; 0 / RNA, Messenger; 0 / Tumor Necrosis Factor-alpha
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9. Franklin ME Jr, Díaz-E JA, Abrego D, Parra-Dávila E, Glass JL: Laparoscopic-assisted colonoscopic polypectomy: the Texas Endosurgery Institute experience. Dis Colon Rectum; 2000 Sep;43(9):1246-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • METHODS: From May 1990 to September 1999 laparoscopic-monitored colonic polypectomies were performed in 47 patients, with a total of 60 polyps being removed.
  • If the pathologic evaluation indicates malignancy then a segmental resection may be performed, otherwise the patients are decompressed and fed within a short time before discharge.
  • The most common histopathologic diagnosis was tubulovillous adenoma in 28 polyps followed by villous adenoma in 11 polyps.
  • This less invasive procedure yields recovery times similar to that of colonoscopy alone, and the potential complications of a segmental resection are avoided.
  • [MeSH-minor] Acetaminophen / therapeutic use. Adenoma, Villous / surgery. Aged. Analgesics, Non-Narcotic / therapeutic use. Colonic Neoplasms / surgery. Female. Humans. Male. Pain, Postoperative / drug therapy

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  • (PMID = 11005491.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Analgesics, Non-Narcotic; 362O9ITL9D / Acetaminophen
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