scholarly journals Carcinoma of the Colon in an Adult with Intestinal Malrotation

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Michael Donaire ◽  
James Mariadason ◽  
Daniel Stephens ◽  
Sitaram Pillarisetty ◽  
Marc K. Wallack
Keyword(s):  
Colon Cancer ◽  
Incidental Finding ◽  
Case Reports ◽  
Standard Of Care ◽  
Colon Surgery ◽  
Intestinal Malrotation ◽  
Carcinoma Of The Colon ◽  
Common Cancer ◽  
The Usa ◽  
Laparoscopic Colon

Colon cancer is the third most common cancer in the USA. Intestinal malrotation diagnosed in adulthood was, until recently, a very rare phenomenon. While patients may present with intestinal obstruction or abdominal pain, the diagnosis is now often made as an incidental finding by computed tomography (CT). Surprisingly we found only seven case reports of carcinoma of the colon in patients with malrotation; CT failed to make the preoperative diagnosis in a majority. Laparoscopic colon surgery is rapidly becoming standard of care for colon cancer. We present a case of carcinoma of the colon in an adult that thwarted attempts at laparoscopic resection due to failure to recognize malrotation preoperatively. The literature is reviewed, and the implications of malrotation in patients with colon cancer are examined.

scholarly journals Laparoscopic surgery for colon cancer with intestinal malrotation in adults: Two case reports and review of literatures in Japan

2017 ◽  
Vol 38 ◽  
pp. 86-90 ◽  
Author(s):  
Kazuyoshi Nakatani ◽  
Katsuji Tokuhara ◽  
Tatsuma Sakaguchi ◽  
Kazuhiko Yoshioka ◽  
Masanori Kon
Keyword(s):  
Colon Cancer ◽  
Laparoscopic Surgery ◽  
Case Reports ◽  
Intestinal Malrotation

Bedside Cardiac Pocus in Emergency Setting: A Practice Review

2020 ◽  
Vol 15 ◽  
Author(s):  
Christian Zanza ◽  
Yaroslava Longhitano ◽  
Marco Artico ◽  
Gianmaria Cammarota ◽  
Andrea Barbanera ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Core Curriculum ◽  
Case Reports ◽  
Short Review ◽  
Rapid Identification ◽  
Cochrane Library ◽  
Emergency Setting ◽  
Holistic View ◽  
Questions And Answers ◽  
The Usa

Background: in the last years, ultrasound technology has entered in clinical practice as a tank and today, it has also allowed to no-cardiologists to extend and to deep their medical examination without the needing to call the consultant and having a good profile of diagnostic accuracy. The ultrasound bedside does not replace the consultant but it allows not to perform inappropriate consultations with more savings for hospitals. Objective: The aim was to review recently published literature to inform the clinician about the most up to date management of use bedside echography in emergency setting. In this short review we focused on two types of syndromes, no traumatichypotension and dyspnea, common to the three holistic disciplines of medicine, showing the main and basic questions and answers that ultrasound can give us for rapid identification of the problem Methods: We conducted a systematic review using Pubmed/Medline, Ovid/Willey and Cochrane Library, combining key terms such as “cardiac ultrasound, “cardiac diseases”,“emergency medicine”,“pocus”, “dyspnea”,“ hypotension”. We selected the most relevant clinical trials and review articles (excluding case reports) published in the last 19 years and in our opinion 59 publications appeared the best choice according to the PRISMA statement. In additional papers identified from individual article reference lists were also included. Conclusion: Recent studies have shown promise in establishing best practices for evaluation of heart, lung abdomen and deep vessels At the moment bedside US is widely used in an integrated ultrasound vision just like the holistic view have internal medicine, intensive care and emergency medicine and many medical schools in Europe and the USA are inserting ultrasonography into the core curriculum but we still have to find a standard method for the training program for minimum competence acquisition.

Computational Analysis of miRNA and their Gene Targets Significantly Involved in Colorectal Cancer Progression

MicroRNA ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. 68-75 ◽  
Author(s):  
Jeyalakshmi Kandhavelu ◽  
Kumar Subramanian ◽  
Amber Khan ◽  
Aadilah Omar ◽  
Paul Ruff ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Cancer Progression ◽  
Target Prediction ◽  
Computational Prediction ◽  
Initial Step ◽  
Kegg Pathways ◽  
Candidate Mirnas ◽  
Common Cancer ◽  
Colon Cancer Progression

Background:Globally, colorectal cancer (CRC) is the third most common cancer in women and the fourth most common cancer in men. Dysregulation of small non-coding miRNAs have been correlated with colon cancer progression. Since there are increasing reports of candidate miRNAs as potential biomarkers for CRC, this makes it important to explore common miRNA biomarkers for colon cancer. As computational prediction of miRNA targets is a critical initial step in identifying miRNA: mRNA target interactions for validation, we aim here to construct a potential miRNA network and its gene targets for colon cancer from previously reported candidate miRNAs, inclusive of 10 up- and 9 down-regulated miRNAs from tissues; and 10 circulatory miRNAs. </P><P> Methods: The gene targets were predicted using DIANA-microT-CDS and TarBaseV7.0 databases. Each miRNA and its targets were analyzed further for colon cancer hotspot genes, whereupon DAVID analysis and mirPath were used for KEGG pathway analysis.Results:We have predicted 874 and 157 gene targets for tissue and serum specific miRNA candidates, respectively. The enrichment of miRNA revealed that particularly hsa-miR-424-5p, hsa-miR-96-5p, hsa-miR-1290, hsa-miR-224, hsa-miR-133a and has-miR-363-3p present possible targets for colon cancer hallmark genes, including BRAF, KRAS, EGFR, APC, amongst others. DAVID analysis of miRNA and associated gene targets revealed the KEGG pathways most related to cancer and colon cancer. Similar results were observed in mirPath analysis. A new insight gained in the colon cancer network pathway was the association of hsa-mir-133a and hsa-mir-96-5p with the PI3K-AKT signaling pathway. In the present study, target prediction shows that while hsa-mir-424-5p has an association with mostly 10 colon cancer hallmark genes, only their associations with MAP2 and CCND1 have been experimentally validated.These miRNAs and their targets require further evaluation for a better understanding of their associations, ultimately with the potential to develop novel therapeutic targets.

Update: Laparoscopic Colon Surgery

1997 ◽  
Vol 14 (5) ◽  
pp. 444-449 ◽  
Author(s):  
P. Petropoulos ◽  
Chr. Chanson ◽  
P. Kiesler ◽  
K. Nassiopoulos
Keyword(s):  
Colon Surgery ◽  
Laparoscopic Colon Surgery ◽  
Laparoscopic Colon

An Ethicolegal Analysis of Involuntary Treatment for Opioid Use Disorders

2020 ◽  
Vol 48 (4) ◽  
pp. 735-740
Author(s):  
Farhad R. Udwadia ◽  
Judy Illes
Keyword(s):  
Police Officers ◽  
Standard Of Care ◽  
Opioid Use ◽  
Ethical Concerns ◽  
Prescription Drug Monitoring Programs ◽  
The Usa ◽  
The Law ◽  
Court Mandated ◽  
Ethical Critique

Supply-side interventions such as prescription drug monitoring programs, “pill mill” laws, and dispensing limits have done little to quell the burgeoning opioid crisis. An increasingly popular demand-side alternative to these measures – now adopted by 38 jurisdictions in the USA and 7 provinces in Canada — is court-mandated involuntary commitment and treatment. In Massachusetts, for example, Part I, Chapter 123, Section 35 of the state's General Laws allows physicians, spouses, relatives, and police officers to petition a court to involuntarily commit and treat a person whose alcohol or drug abuse poses a likelihood of serious harm. This paper explores the ethical underpinnings of this law as a case study for others. First, we highlight the procedural and substantive standards of Section 35 and evaluate the application of the law in practice, including the frequency with which it has been invoked and outcomes. We then use this background to inform an ethical critique of the law. Specifically, we argue that the infringement of autonomy and privacy associated with involuntary intervention under Section 35 is not currently justified on the grounds of a lack of evidenced benefits and a risk of significant of harm. Further ethical concerns also arise from a lack of standard of care provided under the Section 35 pathway. Based on this analysis, we advance four recommendations for change to mitigate these ethical shortcomings.

scholarly journals Novel operative technique of advancement urethral meatoplasty utilizing buccal mucosa for Vulvar Paget’s disease with urethral invasion: two case reports

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Masaki Nakamura ◽  
Yuji Hakozaki ◽  
Shohei Iwata ◽  
Yusuke Sato ◽  
Katsuhiro Makino ◽  
...  
Keyword(s):  
Urethral Stricture ◽  
Buccal Mucosa ◽  
Case Reports ◽  
Paget’S Disease ◽  
External Genitalia ◽  
Skin Grafting ◽  
Standard Of Care ◽  
Paget's Disease ◽  
Vaginal Mucosa ◽  
Vulvar Paget’S Disease

Abstract Background Vulvar Paget’s disease (VPD) is a rare malignant disorder originating in the external genitalia. It occasionally invades into urethral or vaginal mucosa of female, making surgical treatment more complicating. In case of urethral invasion of Paget’s cells, systematic mapping biopsy of urethral mucosa is the standard of care to determine the range of surgical resection. Resection of urethral mucosa and simple skin grafting often result in urethral stricture after surgery, which severely deteriorates patient’s quality of life. Case presentation We applied a new technique of advancement urethral meatoplasty using buccal mucosa, in two Japanese cases of VPD with urethral invasion. After broad resection of vulvar skin together with the urethral mucosa, buccal mucosa was implanted between advanced urethral mucosa and skin graft. In both cases, we could prevent urethral stricture one year and two years after surgery, respectively. Conclusion This technique prevented urethral stricture after surgery and could be a useful technique as part of urethroplasty for VPD.

scholarly journals Rationing, racism and justice: advancing the debate around ‘colourblind’ COVID-19 ventilator allocation

2021 ◽  
pp. medethics-2020-106856
Author(s):  
Harald Schmidt ◽  
Dorothy E Roberts ◽  
Nwamaka D Eneanya
Keyword(s):  
Medical Knowledge ◽  
State Level ◽  
Standard Of Care ◽  
Black Communities ◽  
Racial Justice ◽  
Life Saving ◽  
Black Patients ◽  
The Usa ◽  
Alternative Measures ◽  
The Way

Withholding or withdrawing life-saving ventilators can become necessary when resources are insufficient. In the USA, such rationing has unique social justice dimensions. Structural elements of dominant allocation frameworks simultaneously advantage white communities, and disadvantage Black communities—who already experience a disproportionate burden of COVID-19-related job losses, hospitalisations and mortality. Using the example of New Jersey’s Crisis Standard of Care policy, we describe how dominant rationing guidance compounds for many Black patients prior unfair structural disadvantage, chiefly due to the way creatinine and life expectancy are typically considered.We outline six possible policy options towards a more just approach: improving diversity in decision processes, adjusting creatinine scores, replacing creatinine, dropping creatinine, finding alternative measures, adding equity weights and rejecting the dominant model altogether. We also contrast these options with making no changes, which is not a neutral default, but in separate need of justification, despite a prominent claim that it is simply based on ‘objective medical knowledge’. In the regrettable absence of fair federal guidance, hospital and state-level policymakers should reflect on which of these, or further options, seem feasible and justifiable.Irrespective of which approach is taken, all guidance should be supplemented with a monitoring and reporting requirement on possible disparate impacts. The hope that we will be able to continue to avoid rationing ventilators must not stand in the way of revising guidance in a way that better promotes health equity and racial justice, both to be prepared, and given the significant expressive value of ventilator guidance.

Ductal and lobular carcinoma in situ arising within an enlarging biopsy proven fibroadenoma

2021 ◽  
Vol 14 (1) ◽  
pp. e237017
Author(s):  
Yara Z Feliciano ◽  
Rochelle Freire ◽  
Jose Net ◽  
Monica Yepes
Keyword(s):  
Needle Biopsy ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Incidental Finding ◽  
Case Reports ◽  
Lobular Carcinoma ◽  
Lobular Carcinoma In Situ ◽  
Current Case ◽  
Malignant Changes

The diagnosis via core needle biopsy of concurrent ductal carcinoma in situ and lobular carcinoma in situ within an enlarging previously biopsied benign fibroadenoma in women in their 40s is rare. Several case reports have described the occurrence of malignant changes within fibroadenomas, usually as an incidental finding following excision, and few reports have documented the transition of a fibroadenoma to malignancy. The current case report emphasises the importance of re-biopsying enlarging fibroadenomas, even with otherwise maintained benign appearing features on imaging, in women in their 40s, in order to exclude the possibility of malignancy.

Intracardiac Self Insertion of a Darning Needle in a Psychiatric Patient

2021 ◽  
Vol 4 (5) ◽  
pp. 01-13
Author(s):  
Avra Laarakker
Keyword(s):  
Left Ventricle ◽  
Psychiatric Patient ◽  
Surgical Intervention ◽  
Case Reports ◽  
Interventricular Septum ◽  
Intravenous Drug User ◽  
Standard Of Care ◽  
Pubmed Search ◽  
Needle Entry ◽  
The Right

Objective: We report a case of self inserted needle into the left ventricle of the heart and a description of our surgical intervention in a psychiatric patient without decision-making capacity. We discuss issues regarding obtaining consent in this patient with a sub-acute presentation, report our operative approach, and summarize a treatment approach based on a review of current literature. Methods: A PubMed search using terms “needle, “heart”, “insertion”, “intracardiac foreign object”, yielded 69 relevant papers. 67 of these were case reports yielding 72 individual cases. Age, gender, cause of the needle entry (Accidental Plus (A+), Intravenous Drug User [IVDU], Self-inflicted (SI)), type of needle, location in heart, neuropsychiatric history, treatment, and outcome were documented. Results: Within the SI category, there were a total of 28 cases, 89.3% had a neuropsychiatric history whereas only there were only 2 such patients in both the IVDU and A+ group. The location of the needle in the heart in all 72 cases was as follows: right ventricle 40.3%, other 20.8%, left ventricle 19.4 %, ventricle and interventricular septum 16.7% and the right and left atrium were each 1.4 %. In all three groups (n=72), 77.8% of patients underwent surgery, with 92.9% having a stable outcome. Conclusion: Our case and review demonstrates that management of such cases, particularly when active mental health issues are present, requires a case-by-case evaluation and treatment as a specific standard of care has not been established. Surgical intervention appears to be the preferred management regardless of presentation with good outcomes. Running Title: Intracardiac Self Insertion of a Darning Needle in a Psychiatric Patient

scholarly journals Gastrocolic Fistula: A Rare Presentation of Colon Cancer

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Chukwunonso Chime ◽  
Madhavi Ravi ◽  
Myrta Daniel ◽  
Harish Patel ◽  
Bhavna Balar
Keyword(s):  
Colon Cancer ◽  
Late Complication ◽  
Survival Rates ◽  
Standard Of Care ◽  
Lymph Node Involvement ◽  
En Bloc ◽  
Rare Presentation ◽  
Additional Advantage ◽  
Node Involvement

Gastrocolic fistulae have been described for benign conditions including penetrating peptic ulcer and complicated pancreatitis. Malignant etiology can arise from gastric or colon cancer and is a rare and late complication with an incidence of 0.3-0.4%. Usual presentation is the classic triad of weight loss, diarrhea, and feculent vomiting. Barium enema has been shown to have the highest diagnostic accuracy but endoscopy offers additional advantage of biopsy to aid in diagnosis of malignant etiology; the role of computed tomography (CT) scan is controversial. Treatment by one-stage en bloc surgical approach is the current acceptable standard of care with variable recurrence and survival rates. Adjuvant chemotherapy would be based on lymph node involvement and patient discussion.

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