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Digital rectal examination

Ronja Fierz, Gian-Piero Ghisu, Daniel Fink
Squamous cell carcinoma (SCC) of the neovagina after genital reconstruction surgery is a rare occurrence with only very few cases published up to the present. We report a case of a 43-year-old transgender woman who developed neovaginal SCC 23 years after vaginoplasty. The patient tested positive for high-risk human papillomavirus (HPV). At the time of diagnosis, radiological investigations revealed already existing lymph node and osseous metastases. The treatment consisted of various cycles of chemotherapy and radiation therapy...
2019: Case Reports in Obstetrics and Gynecology
Anders Dige, Helene Tarri Hougaard, Jørgen Agnholt, Bodil Ginnerup Pedersen, Michaela Tencerova, Moustapha Kassem, Klaus Krogh, Lilli Lundby
BACKGROUND AND AIMS: Perianal fistulas are common in patients with Crohn´s disease (CD). Injections of cultured autologous and allogeneic adipose tissue-derived stem cells have been shown to heal CD-associated fistulas. Unfortunately, this treatment is time-consuming and expensive. We investigated the effects of injecting freshly collected autologous adipose tissue into perianal fistulas in patients with CD. METHODS: In a prospective interventional study freshly collected autologous adipose tissues were injected into complex perianal fistulas of 21 patients with CD, from March 2015 through June 2018...
February 14, 2019: Gastroenterology
Maiko Hongo, Yoko Inaba, Kenjiro Kotake
A 78-year-old man was referred to our hospital with diarrhea, melena, and weight loss. During a digital rectal examination, a protuberant mass located 7-8 cm above the anal verge was palpable. Computed tomography(CT)scans of his chest, abdomen, and pelvis revealed an intestinal obstruction with a target sign in the lower rectum, indicating intussusception due to a sigmoid colon mass. A gastrografin enema examination revealed a typical filling defect with a crab claw sign in the rectum. However, the enema did not reduce the intussusception...
January 2019: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Nigel P Murray, Sócrates Aedo, Eduardo Reyes, Cynthia Fuentealba, Omar Jacob
INTRODUCTION: The limitations of serumPSA as a screening test to detect prostate cancer remainproblematic, especially after an initial negative prostatebiopsy. Detection of primary circulating prostate cells(CPCs) has been reported to be useful in the detectionof prostate cancer in men with a serum PSA>4.0ng/ml.We present a prospective study comparing the detectionof CPCs, total PSA, percent free PSA, digital rectal examination(DRE) and prostate volumen (PV) to establisha predictive model for the detection of prostate cancerin men with an indication for a second prostate biopsy...
January 2019: Archivos Españoles de Urología
Kristian Oien, Håvard Mjørud Forsmo, Cornelia Rösler, Kim Nylund, Jo Erling Waage, Frank Pfeffer
BACKGROUND: Rectal tumor treatment strategies are individually tailored based on tumor stage, and yield different rates of posttreatment morbidity, mortality, and local recurrence. Therefore, the accuracy of pretreatment staging is highly important. Here we investigated the accuracy of staging by magnetic resonance imaging (MRI) and endorectal ultrasound (ERUS) in a clinical setting. MATERIAL AND METHODS: A total of 500 patients were examined at the rectal cancer outpatient clinic at Haukeland University Hospital between October 2014 and January 2018...
February 8, 2019: Acta Oncologica
Peng Liu, Zheng Lou, Zubing Mei, Xianhua Gao, Liqiang Hao, Lianjie Liu, Haifeng Gong, Ronggui Meng, Enda Yu, Hantao Wang, Hao Wang, Wei Zhang
OBJECTIVE: To investigate the surgical efficacy and prognostic factors of T3NxM0 middle-low rectal cancer without neoadjuvant therapy. METHODS: Clinical data of patients with middle-low rectal cancer undergoing TME surgery with T3NxM0 confirmed by postoperative pathology at Colorectal Surgery Department of Changhai Hospital from January 2008 to December 2010 were analyzed retrospectively. INCLUSION CRITERIA: (1)no preoperative neoadjuvant chemoradiotherapy (nCRT); (2) complete preoperative evaluation, including medical history, preoperative colonoscopy or digital examination, blood tumor marker examination, and imaging examination; (3) distance between tumor lower margin and anal verge was ≤ 10 cm; (4) negative circumferential resection margin (CRM-)...
January 25, 2019: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Dae-Ha Kim, Ju Han Lee, Dongwoo Kim, Suhyun Hwang, Kyuho Kang, Ja Seol Koo
A 49-year-old man visited the emergency room of Korea University Ansan Hospital with hematochezia starting the day before the visit. Recently, he was on anti-platelet medication due to hypertension. The patient had no definite symptoms other than hematochezia. Digital rectal exam was positive and laboratory tests showed severe anemia. Sigmoidoscopy was initiated and almost no fecal material was observed in the intestinal tract, allowing insertion into the cecum. Active bleeding from the appendiceal opening was noted...
January 25, 2019: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Pyong Wha Choi
INTRODUCTION: Although vascular anatomy of the rectum is complex, pseudoaneurysm followed by massive hemoperitoneum after rectal impalement injury is extremely rare. CASE PRESENTATION: A 43-year-old man presented with abdominal distension. One day earlier, he had undergone sigmoid loop colostomy for rectal implement injury at a local hospital. After the operation, he had become hemodynamically unstable. Digital rectal examination showed a penny-sized anterior rectal wall defect 6 cm from the anal verge...
January 19, 2019: International Journal of Surgery Case Reports
Jun Zhou, Cheng Yang, Zhaoxiang Lu, Li Zhang, Yu Yin, Sheng Tai, Chaozhao Liang
RATIONALE: Prostatic urothelial carcinoma is a rare disease. Medical misdiagnosis rates remain high because there are no specific clinical symptoms or imaging features, which decreases patient survival. We report a case of prostatic urethral cancer confirmed by transrectal ultrasound-guided prostate biopsy because of an abnormal digital rectal exam. PATIENT CONCERNS: A 55-year-old man was referred to our hospital due to lower urinary tract symptoms that lasted for 5 years...
January 2019: Medicine (Baltimore)
Osman Ergun, Erdem Capar, Yunus Emre Goger, Ayse Gul Ergun
OBJECTIVES: To evaluate the frequency of NIH category IV prostatitis, and the use of expressed prostatic secretions tests in an effort to improve the reliability of prostate specific antigen as an indicator, to avoid unnecessary prostate biopsy. MATERIALS AND METHODS: 178 expressed prostatic secretion positive patients with serum prostate specific antigen levels of ≥ 2.5 ng / mL were included in present prospective study. The diagnostic evaluation included detailed history and physical examination, digital rectal examination, urine analysis, urine culture, and expressed prostatic secretions tests...
December 10, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Athanase Billis, Leandro L L Freitas, Larissa B E Costa, Icleia S Barreto, Luis A Magna, Wagner E Matheus, Ubirajara Ferreira
PURPOSE: The 8th edition of the TNM has been updated and improved in order to ensure a high degree of clinical relevance. A major change in prostate includes pathologically organ - confined disease to be considered pT2 and no longer subclassified by extent of involvement or laterality. The aim of this study was to validate this major change. MATERIALS AND METHODS: Prostates were step - sectioned from 196 patients submitted to radical prostatectomy with organ confined disease (pT2) and negative surgical margins...
November 30, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Jay J Idrees, McKenzie Clapp, Justin T Brady, Sharon L Stein, Harry L Reynolds, Emily Steinhagen
BACKGROUND: A large proportion of patients with anorectal complaints are referred to colorectal surgeons with the label of hemorrhoids. OBJECTIVE: The purpose of this study was to review presenting symptoms and frequency of accurate diagnosis, as well as to analyze determinants of misdiagnosis to guide educational endeavors. DESIGN: This was a retrospective study. SETTINGS: The study was conducted at a tertiary care academic center...
January 8, 2019: Diseases of the Colon and Rectum
Robert Westley Oda, Melissa Agsalda-Garcia, Nicholas Loi, Natalie Kamada, Cris Milne, Jeffrey Killeen, So Yung Choi, Eunjung Lim, Tayro Acosta-Maeda, Anupam Misra, Bruce Shiramizu
HIV-positive individuals are at increased risk for pre-cancerous anal squamous intraepithelial lesions (SILs). Anal cytology and digital rectal examination are performed as screening tools but extensive training and appropriate instruments are required to follow-up on an abnormal anal cytology. Thus novel approaches to SIL evaluation could improve better healthcare follow up by efficient and timely diagnosis to offer treatment options. Recently, Raman-enhanced spectroscopy (RESpect) has emerged as a potential new tool for early identification of SIL...
January 5, 2019: AIDS Research and Human Retroviruses
Yong Ji, Youxin Zhou
RATIONALE: Adenocarcinoma of the anal canal is an uncommon malignancy. Primary adenocarcinoma, in particular, is extremely rare. PATIENT CONCERNS: A 61-year-old man was referred to our institution with complaints of repeated hematochezia. DIAGNOSIS: Digital rectal examination revealed a hard palpable ulcer in the anal canal, measuring 2 cm × 2 cm in size, at the 5 o'clock direction (in the lithotomy position). The pelvic enhanced magnetic resonance imaging revealed anal verge occupying mass...
January 2019: Medicine (Baltimore)
Dudith Pierre-Victor, Paul F Pinsky
Importance: Patient nonadherence to chronic disease prevention guidelines is associated with increased mortality. Nonadherence to offered cancer screening tests may be associated with mortality among middle-aged and older adults. Objective: To evaluate the association between nonadherence to cancer screening tests and mortality in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening trial, excluding mortality from cancers studied in the trial. Design, Setting, and Participants: Randomization at 10 US screening centers occurred from November 8, 1993, to July 2, 2001...
December 28, 2018: JAMA Internal Medicine
Jean-Pierre Gérard, Nicolas Barbet, Jocelyn Gal, Catherine Dejean, Ludovic Evesque, Jérôme Doyen, Régis Coquard, Jean Gugenheim, Emmanuel Benizri, Renaud Schiappa, Guillaume Baudin, Karène Benezery, Eric François
BACKGROUND: Neoadjuvant chemoradiotherapy (nCRT) and watch-and-wait policy as reported by Habr-Gama are references for organ preservation in rectal cancer. To increase the clinical complete response (cCR) and reduce the local recurrence rates, we report a retrospective analysis of a prospective cohort of selected T2-3 tumours treated in three French institutions using contact X-ray brachytherapy (CXB) with nCRT. METHODS: Tumour selection was based on digital rectal examination (DRE), rigid rectoscopy, magnetic resonance imaging (MRI) and/or endorectal ultrasound...
February 2019: European Journal of Cancer
P O Igwe, N A Ibrahim
INTRODUCTION: Spigelian hernia is uncommon and frequently presents with features of intestinal obstruction. Clinical diagnosis is difficult in patients without obvious abdominal mass and a computed tomography scan is very helpful in making diagnosis. We report a patient who presented with a strangulated sliding left sided spigelian hernia who was pre-operatively diagnosed and successfully managed surgically. PRESENTATION OF CASE: A 56-year-old woman was to referred to the surgical emergency unit of our institution with abdominal swelling and pain of three days...
2018: International Journal of Surgery Case Reports
Leslie C Costello, Renty B Franklin
Prostate specific antigen (PSA) does not provide the reliability that is required for the accurate urology screening of prostate cancer (PCa). Consequently, there has been a major focus and search for a simple, rapid, direct, preferably non-invasive, and highly accurate biomarker and procedure for the urology screening for prostate cancer. Virtually all PCa cases exhibit a marked decrease in zinc in prostate tissue and in prostatic fluid. This is a hallmark "signature" clinical characteristic for all prostate cancers, which provides the clinical basis for zinc screening of PCa...
November 2018: Acta scientific cancer biology
Yoshinori Yanai, Takeo Kosaka, Hiroshi Hongo, Kazuhiro Matsumoto, Toshiaki Shinojima, Eiji Kikuchi, Akira Miyajima, Ryuichi Mizuno, Shuji Mikami, Masahiro Jinzaki, Mototsugu Oya
There is an increasing proportion of individuals aged 70 years and older, as well as an increasing life expectancy worldwide. The present study may guide the management of older patients with elevated prostate specific antigen (PSA). The medical records of 241 older men aged >70 years who underwent multiparametric magnetic resonance imaging (mpMRI) before prostate biopsy (PBx) at our institution were reviewed retrospectively. Multiple variables were evaluated as predictors for the diagnosis of prostate cancer (PCa)...
December 2018: Molecular and Clinical Oncology
Abhijit Chandra, Brijesh Mishra, Saket Kumar, Nikhil Chopra, Vivek Gupta, Amit Dangi, Pavan Kumar Gorla, Vishal Gupta
BACKGROUND: Severe fecal incontinence has a significant negative impact on patient well-being. Current surgical methods of total anorectal reconstruction to substitute a colostomy have suboptimal results. A composite graft using antropyloric valve transposition and gracilis wrap has been described with good outcomes. However, this procedure requires extensive training of patients. Gluteus maximus, an accessory muscle for continence, may be better suited for this purpose. OBJECTIVE: The purpose of this study was to evaluate the outcomes of composite antropylorus-gluteus graft for intractable fecal incontinence...
January 2019: Diseases of the Colon and Rectum
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