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Animals : An Open Access Journal From... Jan 2023The presence of androgen (AR) and estrogen (ER) receptors has been demonstrated both in normal perianal (hepatoid) glands and in perianal tumors. The aim of this study...
The presence of androgen (AR) and estrogen (ER) receptors has been demonstrated both in normal perianal (hepatoid) glands and in perianal tumors. The aim of this study was to demonstrate the relationship between the expression of AR and ER in perianal gland tumors and the effectiveness of antihormonal treatment. The study was performed on 41 male dogs with neoplastic lesions of the anal region. Histopathological evaluation of the lesions revealed 24 adenomas, 12 epitheliomas, and five carcinomas. Treatment was administered orally with tamoxifen at a dose of 1 mg/kg BW and cyproterone acetate at a dose of 5 mg/kg. Tumor diameters were measured regularly with calipers and recorded in millimeters starting with the measurement before treatment, and then after 1, 2, 3, 6, 12, 18, and 24 months of therapy. The results show that hepatoid adenomas that are characterized by high expression of AR and ER receptors respond positively to antihormonal therapy, resulting in complete tumor regression. For locally malignant hepatoid epitheliomas and carcinomas with low expression of AR and ER receptors, antihormonal therapy makes it possible to reduce the size of the tumor, but does not make it possible to cure it completely.
PubMed: 36766353
DOI: 10.3390/ani13030463 -
Frontiers in Pediatrics 2023Complications of Crohn's disease (CD) often impair patients' quality of life. It is necessary to predict and prevent these complications (surgery, stricturing...
BACKGROUND
Complications of Crohn's disease (CD) often impair patients' quality of life. It is necessary to predict and prevent these complications (surgery, stricturing [B2]/penetrating [B3] disease behavior, perianal disease, growth retardation and hospitalization). Our study investigated previously suggested and additional predictors by analyzing data of the CEDATA-GPGE registry.
METHODS
Pediatric patients (< 18 years) diagnosed with CD with follow up data in the registry were included in the study. Potential risk factors for the selected complications were evaluated by performing Kaplan-Meier survival curves and cox regression models.
RESULTS
For the complication surgery, the potential risk factors older age, B3 disease, severe perianal disease and initial therapy with corticosteroids at the time of diagnosis were identified. Older age, initial therapy with corticosteroids, low weight-for-age, anemia and emesis predict B2 disease. Low weight-for-age and severe perianal disease were risk factors for B3 disease. Low weight-for-age, growth retardation, older age, nutritional therapy, and extraintestinal manifestations (EIM) of the skin were identified as risk factors for growth retardation during the disease course. High disease activity and treatment with biologicals were predictors for hospitalization. As risk factors for perianal disease, the factors male sex, corticosteroids, B3 disease, a positive family history and EIM of liver and skin were identified.
CONCLUSION
We confirmed previously suggested predictors of CD course and identified new ones in one of the largest registries of pediatric CD patients. This may help to better stratify patients' according to their individual risk profile and choose appropriate treatment strategies.
PubMed: 36873644
DOI: 10.3389/fped.2023.1043067 -
JPMA. the Journal of the Pakistan... May 2022Perianal tuberculosis (TB) is an extremely rare form of mycobacterial infection, in which the anal mucocutaneous junction becomes infected by autoinoculation from an...
Perianal tuberculosis (TB) is an extremely rare form of mycobacterial infection, in which the anal mucocutaneous junction becomes infected by autoinoculation from an active draining gastrointestinal tract infection. The case of a 73-year-old immunocompetent male patient, who came in with a refractory perianal ulcer is presented. The patient had no history of TB and his lab tests for TB were all negative. A chest X-ray showed streak and nodular opacities in both upper lungs. The ulcer was biopsied twice and a diagnosis of TB was finally rendered by histological examination with confirmatory Polymerase chain reaction (PCR). The lesion was finally cured by intensive anti-TB treatment. Perianal TB needs to be excluded in patients with a refractory perianal ulcer, including immunocompetent cases without TB history. Biopsies and microbiological tests should be performed for any suspicious lesion and repeated if there is high clinical concern. Consideration of differential diagnoses, especially inflammatory bowel disease, is essential. Early and sufficient antitubercular treatment should be initiated to minimize morbidity.
Topics: Aged; Antitubercular Agents; Humans; Male; Tuberculosis; Ulcer
PubMed: 35713070
DOI: 10.47391/JPMA.4019 -
Case Reports in Dermatology 2015Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer. Exposure to ultraviolet light is an important risk factor for BCC development and the disorder...
Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer. Exposure to ultraviolet light is an important risk factor for BCC development and the disorder therefore develops commonly on body areas that are more exposed to sunlight, such as the face and neck. It is uncommon in the closed area of the body and quite rare in the perianal and genital regions. Herein, we report a 34-year-old patient with perianal BCC who had no additional risk factors.
PubMed: 25848349
DOI: 10.1159/000380847 -
Middle East Journal of Digestive... Jul 2022: Hemorrhoidectomy is commonly associated with post-operative perianal pain. Local botulinum toxin injection by relaxing the smooth muscles of the perianal sphincter and...
: Hemorrhoidectomy is commonly associated with post-operative perianal pain. Local botulinum toxin injection by relaxing the smooth muscles of the perianal sphincter and reducing anal pressure can be effective in decreasing post-operative pain. This study evaluates the effectiveness of local botulinum toxin injection in controlling pain after hemorrhoidectomy. : This study was a double-blind, randomized clinical trial. A total of 40 patients undergoing hemorrhoidectomy who were referred to Shariati Hospital in 2019- 2020 were enrolled as participants and divided into two groups. In one group, injection of botulinum toxin was done in intersphincteric area, and in the other group, there was no intervention after hemorrhoidectomy. SPSS software version 24 was used to analyze the data. : Local botulinum toxin injection (MASPORT® 500) significantly reduced post-operative perianal pain on the first, third, fifth, and seventh days after the operation compared with the second group (<0.05). The mean pain scores in the first, third, fifth, and seventh days in the first and second groups were 7.60 (±0.88) versus 8.25 (±1.16), 40.5 (±0.88) versus 6.05 (±0.99), 2.45 (±0.51) versus 3.05 (±0.68), and 2.05 (±0.39) versus 1.70 (±0.57), respectively. Furthermore, pain during defecation was significantly lower for the experimental group (<0.05). : Local botulinum toxin injection effectively improves post-operative pain after hemorrhoidectomy. Further studies are needed to prove the clinical value of local botulinum toxin injection.
PubMed: 36619264
DOI: 10.34172/mejdd.2022.291 -
Journal of Clinical Microbiology Jul 2022Stool specimens are frequently used to detect gastrointestinal tract colonization with antimicrobial-resistant enteric bacteria, but they cannot be rapidly collected....
Stool specimens are frequently used to detect gastrointestinal tract colonization with antimicrobial-resistant enteric bacteria, but they cannot be rapidly collected. Perianal swab specimens can be collected more quickly and efficiently, but data evaluating their suitability as a specimen type for this purpose are sparse. We performed selective culture for extended-spectrum β-lactamase-producing (ESBL-E) and fluoroquinolone-resistant (FQRE) using paired perianal swab and stool specimens that were collected within 1 day of each other from hematopoietic cell transplant recipients and patients with acute leukemia. Nineteen (7.6%) of 251 stool specimens yielded ESBL-E and 64 (26%) of 246 stool specimens yielded FQRE. The positive percent agreement of perianal swab specimens compared to stool specimens was 95% (18/19; 95% confidence interval [CI], 74% to 100%) for detecting ESBL-E and 95% (61/64; 95% CI, 87% to 99%) for detecting FQRE. The concordance between specimen types was 98% (95% CI, 97% to 100%). Perianal swabs are a reliable specimen type for surveillance of the gastrointestinal tract for ESBL-E and FQRE.
Topics: Anti-Bacterial Agents; Enterobacteriaceae; Fluoroquinolones; Gastrointestinal Tract; Hematopoietic Stem Cell Transplantation; Humans; beta-Lactamases
PubMed: 35695506
DOI: 10.1128/jcm.00234-22 -
Journal of Crohn's & Colitis May 2023Local injection of adipose tissue-derived mesenchymal stem cells [MSCs] is effective in fistulizing perianal Crohn's disease [CD]. Less is known about bone... (Clinical Trial)
Clinical Trial
Clinical and MRI Evolution After Local Injection of Bone Marrow-Derived Mesenchymal Stem Cells in Perianal Fistulae in Crohn's Disease: Results From a Prospective Monocentric Study.
BACKGROUND
Local injection of adipose tissue-derived mesenchymal stem cells [MSCs] is effective in fistulizing perianal Crohn's disease [CD]. Less is known about bone marrow-derived MSCs and little is known about predictive factors of response and magnetic resonance imaging [MRI] evolution of the fistulae after MSC injection. Our aims were to evaluate the safety and clinical outcome of bone marrow-derived MSC injection for perianal fistulizing CD, to evaluate the MRI evolution of the fistulae and to identify factors associated with fistula closure.
PATIENTS AND METHODS
All CD patients with perianal fistula and appropriate drainage with a seton without abscess at MRI were eligible. Clinical examination, biomarkers and pelvic MRI were performed at weeks 0, 12 and 48. The clinical outcome was assessed by closure of the treated external openings at clinical examination and MRI exploration.
RESULTS
Sixteen patients with a median age of 49 years and a median duration of perianal CD of 8 months were included. No unexpected safety event occurred. At weeks 12 and 48, 9/16 and 8/16 patients had complete fistula[e] closure, respectively, whereas 11/16 patients had at least partial closure. At MRI, the degree of fibrosis increased significantly after MSC injection. In total, 86% of patients with >80% of fibrosis of the fistula tract at week 48 had fistula closure. Fistula closure at week 12 was predictive of fistula closure at week 48. The MAGNIFI-CD did not change significantly over time.
CONCLUSION
Open-label injection of bone marrow-derived MSCs was safe and was effective in half of the patients in fistulizing perianal CD and induced significant MRI changes associated with favourable clinical outcome.
Topics: Humans; Middle Aged; Bone Marrow; Crohn Disease; Magnetic Resonance Imaging; Mesenchymal Stem Cells; Prospective Studies; Rectal Fistula; Treatment Outcome
PubMed: 36733215
DOI: 10.1093/ecco-jcc/jjac192 -
Journal of Surgical Case Reports Dec 2023Perianal Paget's disease (PPD) is a rare intraepidermal neoplastic disease, presenting with nonspecific symptoms, such as pruritis ani or eczema. Perianal Paget's...
Perianal Paget's disease (PPD) is a rare intraepidermal neoplastic disease, presenting with nonspecific symptoms, such as pruritis ani or eczema. Perianal Paget's disease may present as a primary lesion or as a paramalignant phenomenon. Uniform evidence-based treatment strategies have not been defined for this rare condition, and currently, different treatment methods are suggested. This case report presents three cases of perianal Paget's disease with three different treatments and outcomes. Pathogenesis, treatment, and the importance of a strict follow-up program are discussed.
PubMed: 38163059
DOI: 10.1093/jscr/rjad684 -
Diagnostic and Interventional Radiology... Jan 2019Anal and perianal region is a commonly affected area in the course of several inflammatory, infectious, and neoplastic diseases. Several imaging modalities may be used...
Anal and perianal region is a commonly affected area in the course of several inflammatory, infectious, and neoplastic diseases. Several imaging modalities may be used in imaging evaluation of this area and magnetic resonance imaging (MRI) emerges as the imaging modality of choice due to its superb soft tissue resolution. MRI is not only useful for initial detection of anal/perianal pathologies but also in the follow-up of these disorders. In this article, we aimed to illustrate MRI findings of several diseases affecting this area including perianal fistula as well as anal fissure, hypertrophic myopathy of internal anal sphincter, hidradenitis suppurativa, pilonidal sinus, rectovaginal/anovaginal fistula and anal canal carcinoma. We think that this article will serve to familiarize the imaging specialists to the MRI findings of these diseases.
Topics: Anal Canal; Anus Diseases; Anus Neoplasms; Female; Fissure in Ano; Hidradenitis Suppurativa; Humans; Magnetic Resonance Imaging; Pilonidal Sinus; Preoperative Care; Rectal Fistula; Rectovaginal Fistula
PubMed: 30582572
DOI: 10.5152/dir.2018.17499 -
Cancers Dec 2023Distinction between anal canal and perianal squamous cell carcinomas (pSCCs) is essential, as these two subgroups have different anatomical, histological, and lymphatic... (Review)
Review
Nodal Elective Volume Selection and Definition during Radiation Therapy for Early Stage (T1-T2 N0 M0) Perianal Squamous Cell Carcinoma: A Narrative Clinical Review and Critical Appraisal.
Distinction between anal canal and perianal squamous cell carcinomas (pSCCs) is essential, as these two subgroups have different anatomical, histological, and lymphatic drainage features. Early-stage true perianal tumors are very uncommon and have been rarely included in clinical trials. Perianal skin cancers and aCCs are included in the same tumor classification, even though they have different lymphatic drainage features. Furthermore, pSCCs are treated similarly to carcinomas originating from the anal canal. Radiation therapy (RT) is an essential treatment for anal canal tumors. Guidelines do not differentiate between treatment volumes for perianal tumors and anal cancers. So far, in pSCC, no study has considered modulating treatment volume selection according to the stage of the disease. We conducted a narrative literature review to describe the sites at higher risk for microscopic disease in patients with early-stage perianal cancers (T1-T2 N0 M0) to propose a well-thought selection of RT elective volumes.
PubMed: 38136378
DOI: 10.3390/cancers15245833