-
CA: a Cancer Journal For Clinicians 1968
Topics: Endoscopes; Esophagoscopes; Fiber Optic Technology; Gastrointestinal Diseases; Gastroscopes; Glass; Humans; Laparoscopes; Optics and Photonics; Photography; Proctoscopes
PubMed: 4250266
DOI: 10.3322/canjclin.18.3.129 -
Journal of Vascular Surgery Aug 2015The management of an infected aortic endograft can be challenging both operatively and clinically. Although aortic endograft infection is rare, the incidence is likely...
The management of an infected aortic endograft can be challenging both operatively and clinically. Although aortic endograft infection is rare, the incidence is likely to increase in the coming years because of ever rising numbers of endovascular aneurysm repairs. Definitive management involves the removal of the endograft through laparotomy. Removal of the graft is technically challenging; no manufacturer's device is available to assist in disengagement of barbed hooks that hold the endograft in position. We present a new technique using the disposable proctoscope as a device to facilitate safe removal of the endograft with minimal damage to the aortic wall.
Topics: Aged, 80 and over; Aortic Aneurysm, Abdominal; Axillofemoral Bypass Grafting; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Device Removal; Endovascular Procedures; Humans; Male; Prosthesis Design; Prosthesis-Related Infections; Radionuclide Imaging; Stents; Treatment Outcome; Vascular Surgical Procedures
PubMed: 25937607
DOI: 10.1016/j.jvs.2015.03.033 -
Revista Espanola de Enfermedades... Feb 2005The aim of this study is to clinically test the efficacy of a new approach for patients having symptomatic grade III and IV hemorrhoids. (Clinical Trial)
Clinical Trial
OBJECTIVE
The aim of this study is to clinically test the efficacy of a new approach for patients having symptomatic grade III and IV hemorrhoids.
MATERIAL AND METHOD
32 patients (17 females) complaining of grade III or IV hemorrhoids were included in the study. A specially designed proctoscope coupled with a Doppler transducer on its tip was used to identify the hemorrhoidal arteries, which were afterwards suture ligated. Operating time as well as per- and post-operative complications were analyzed. Follow-up was planned following discharge after 1 week, 1 month, 6 months and 1 year.
RESULTS
Mean operation time was 27 (range 18-43) minutes, and 5 (range 4-7) arteries were located on average. No patient had severe or moderate postoperative pain, with anal discomfort being the main complaint. Rectal bleeding and tenesmus were the commonest post-operative complications. After one year of follow-up, 19 patients were free of symptoms and 6 of them had significant symptom relief. According to grade, the technique failed in just 3 grade III patients, but in as many as 4 grade IV hemorrhoid cases.
CONCLUSIONS
Doppler-guided hemorrhoid artery ligation is an easy-to-perform technique that is well accepted by patients and has good results for grade III hemorrhoids.
Topics: Adult; Aged; Female; Hemorrhoids; Humans; Ligation; Male; Middle Aged; Time Factors; Ultrasonography, Doppler
PubMed: 15801885
DOI: 10.4321/s1130-01082005000200004 -
The American Journal of Gastroenterology Jan 2014High-resolution microendoscopy (HRME) is a low-cost, "optical biopsy" technology that allows for subcellular imaging. The purpose of this study was to determine the in...
OBJECTIVES
High-resolution microendoscopy (HRME) is a low-cost, "optical biopsy" technology that allows for subcellular imaging. The purpose of this study was to determine the in vivo diagnostic accuracy of the HRME for the differentiation of neoplastic from non-neoplastic colorectal polyps and compare it to that of high-definition white-light endoscopy (WLE) with histopathology as the gold standard.
METHODS
Three endoscopists prospectively detected a total of 171 polyps from 94 patients that were then imaged by HRME and classified in real-time as neoplastic (adenomatous, cancer) or non-neoplastic (normal, hyperplastic, inflammatory).
RESULTS
HRME had a significantly higher accuracy (94%), specificity (95%), and positive predictive value (PPV, 87%) for the determination of neoplastic colorectal polyps compared with WLE (65%, 39%, and 55%, respectively). When looking at small colorectal polyps (less than 10 mm), HRME continued to significantly outperform WLE in terms of accuracy (95% vs. 64%), specificity (98% vs. 40%) and PPV (92% vs. 55%). These trends continued when evaluating diminutive polyps (less than 5 mm) as HRME's accuracy (95%), specificity (98%), and PPV (93%) were all significantly greater than their WLE counterparts (62%, 41%, and 53%, respectively).
CONCLUSIONS
In conclusion, this in vivo study demonstrates that HRME can be a very effective modality in the differentiation of neoplastic and non-neoplastic colorectal polyps. A combination of standard white-light colonoscopy for polyp detection and HRME for polyp classification has the potential to truly allow the endoscopist to selectively determine which lesions can be left in situ, which lesions can simply be discarded, and which lesions need formal histopathologic analysis.
Topics: Adenoma; Aged; Colonic Neoplasms; Colonic Polyps; Colonoscopes; Colonoscopy; Comparative Effectiveness Research; Diagnosis, Differential; Fiber Optic Technology; Humans; Image Enhancement; Male; Microscopy; Middle Aged; Precancerous Conditions; Predictive Value of Tests; Proctoscopes; Proctoscopy; Rectal Neoplasms
PubMed: 24296752
DOI: 10.1038/ajg.2013.387 -
Journal of Clinical Microbiology Nov 1982Pseudomonas aeruginosa colonization is found in a high percentage of males with spinal cord injury. The perineum is the body site most frequently colonized, and specific...
Pseudomonas aeruginosa colonization is found in a high percentage of males with spinal cord injury. The perineum is the body site most frequently colonized, and specific serotypes may persist for weeks. We examined patients for the presence of P. aeruginosa and Klebsiella pneumoniae on the perineum and adjacent body sites by using contact plates. P. aeruginosa, K. pneumoniae, or both were cultured from perineal swabs of 22 male patients. Wells (2.5 cm2) containing agar medium selective for these organisms were used to examine samples from 32 sites adjacent to the perineum in each patient. P. aeruginosa was most frequently cultured from samples taken from the perineum, the scrotum, and the penile shaft. K. pneumoniae isolation was more variable; this organism was most commonly found on the perineum and scrotum. Rectal swabs, obtained through a proctoscope, were positive for P. aeruginosa in four of eight patients with this organism on the perineum and positive for K. pneumoniae in eight of nine patients with this organism on the perineum. These studies more clearly define the extent of the colonization of the perineum and adjacent body sites which provides potential reservoirs of P. aeruginosa and K. pneumoniae.
Topics: Humans; Klebsiella pneumoniae; Male; Perineum; Pseudomonas aeruginosa; Rectum; Spinal Cord Injuries
PubMed: 6818252
DOI: 10.1128/jcm.16.5.865-867.1982 -
BMC Public Health Dec 2011Avahan, the India AIDS Initiative, implemented a large HIV prevention programme across six high HIV prevalence states amongst high risk groups consisting of female sex...
BACKGROUND
Avahan, the India AIDS Initiative, implemented a large HIV prevention programme across six high HIV prevalence states amongst high risk groups consisting of female sex workers, high risk men who have sex with men, transgenders and injecting drug users in India. Utilization of the clinical services, health seeking behaviour and trends in syndromic diagnosis of sexually transmitted infections amongst these populations were measured using the individual tracking data.
METHODS
The Avahan clinical monitoring system included individual tracking data pertaining to clinical services amongst high risk groups. All clinic visits were recorded in the routine clinical monitoring system using unique identification numbers at the NGO-level. Visits by individual clinic attendees were tracked from January 2005 to December 2009. An analysis examining the limited variables over time, stratified by risk group, was performed.
RESULTS
A total of 431,434 individuals including 331,533 female sex workers, 10,280 injecting drug users, 82,293 men who have sex with men, and 7,328 transgenders visited the clinics with a total of 2,700,192 visits. Individuals made an average of 6.2 visits to the clinics during the study period. The number of visits per person increased annually from 1.2 in 2005 to 8.3 in 2009. The proportion of attendees visiting clinics more than four times a year increased from 4% in 2005 to 26% in 2009 (p<0.001). The proportion of STI syndromes diagnosed amongst female sex workers decreased from 39% in 2005 to 11% in 2009 (p<0.001) while the proportion of STI syndromes diagnosed amongst high risk men who have sex with men decreased from 12% to 3 % (p<0.001). The proportion of attendees seeking regular STI check-ups increased from 12% to 48% (p<0.001). The proportion of high risk groups accessing clinics within two days of onset of STI-related symptoms and acceptability of speculum and proctoscope examination increased significantly during the programme implementation period.
CONCLUSIONS
The programme demonstrated that acceptable and accessible services with marginalised and often difficult-to-reach populations can be brought to a very large scale using standardized approaches. Utilization of these services can dramatically improve health seeking behaviour and reduce STI prevalence.
Topics: Adult; Cohort Studies; Female; HIV; HIV Infections; Health Promotion; Homosexuality, Male; Humans; India; Male; Medical Records; Patient Acceptance of Health Care; Preventive Health Services; Risk Factors; Sex Workers; Sexually Transmitted Diseases; Substance Abuse, Intravenous; Transsexualism; Young Adult
PubMed: 22970436
DOI: 10.1186/1471-2458-11-s6-s10 -
British Medical Journal (Clinical... Mar 1985Many hospitals now offer barium enema examinations to general practitioners on an open access basis, so bypassing the traditional sequence of first carrying out a...
Many hospitals now offer barium enema examinations to general practitioners on an open access basis, so bypassing the traditional sequence of first carrying out a sigmoidoscopy. An open access sigmoidoscopy/proctoscopy service was therefore opened with requests for a barium enema being denied unless preceded by sigmoidoscopy. During the first three and a half years 1458 patients referred direct from their general practitioners were examined using a rigid sigmoidoscope. Patients were also examined with a proctoscope if thought appropriate. After the first year of the service a subsequent examination with a fibreoptic sigmoidoscope was also carried out if the presenting symptom was bleeding for which no cause could be found with the rigid instruments. A total of 516 abnormalities were found to account for symptoms in 506 patients giving a diagnostic rate of 35%. The most common lesion was piles (307 cases). Other relatively common disorders included inflammatory bowel disease (107 cases), benign tumours (44), and malignant tumours (38). Of 41 patients subsequently undergoing fibreoptic sigmoidoscopy a cause for the bleeding was found in 32, the most common being a malignant tumour (16). Most general practitioners in the district used the service and a questionnaire survey indicated that most found it very helpful. Requests from general practitioners for a barium enema fell substantially over the period.
Topics: Adolescent; Adult; Aged; Barium Sulfate; Child; Enema; England; Family Practice; Health Services Accessibility; Humans; Intestinal Diseases; Middle Aged; Proctoscopy; Rectal Neoplasms; Sigmoidoscopy
PubMed: 3918744
DOI: 10.1136/bmj.290.6470.759 -
Annals of Surgery Jan 1985In a prospective open study of the Proximate ILS circular stapler, the results of 125 intestinal anastomoses in 119 patients were reviewed. Intraoperative leakage was...
In a prospective open study of the Proximate ILS circular stapler, the results of 125 intestinal anastomoses in 119 patients were reviewed. Intraoperative leakage was observed in five instances, after intraluminal povidone instillation, necessitating suture-line reinforcement. In three instances, incomplete tissue rings (donuts) were found. Temporary fecal diversion was used in seven of 84 patients with anastomoses made to the rectum or anal canal. Roentgenographic assessment of 79 of these anastomoses using Gastrografin demonstrated a leak in three (3.8%). There was one clinical leak (0.9%) in the series. Three patients died (2.5%), none from anastomotic complications. Transient anastomotic strictures were found in three of 82 operative survivors where the anastomosis was within range of the proctoscope. There were no instances of significant hemorrhage from the anastomosis. No patient required anastomotic revision, and of the 51 survivors of cancer surgery where proctoscopy could evaluate the anastomosis, there was no evidence of local recurrence in the period of follow up (mean 16.3 months). The authors conclude: that the Proximate ILS is a safe, reliable and effective instrument for construction of intestinal anastomoses.
Topics: Aged; Colostomy; Equipment Design; Evaluation Studies as Topic; Female; Gastrointestinal Hemorrhage; Humans; Intestinal Neoplasms; Intestines; Male; Middle Aged; Neoplasm Recurrence, Local; Postoperative Complications; Prospective Studies; Reoperation; Surgical Staplers; Surgical Wound Dehiscence
PubMed: 3871321
DOI: No ID Found -
Proceedings of the Royal Society of... Mar 1973
Topics: Hemorrhoids; Humans; Ligation; Methods; Proctoscopy
PubMed: 4697991
DOI: No ID Found