Abstract:
OBJECTIVES:The clinical significance of hyperplastic polyp-like histologic changes in random biopsy samples ('serrated epithelial change' or SEC) from patients with inflammatory bowel disease (IBD) remains uncertain, with some studies suggesting an increased risk of dysplasia and even carcinoma. Controlled studies are few. We studied the significance of SEC on the development of dysplasia in follow-up surveillance of IBD patients in our system. METHODS:We identified 94 IBD patients with SEC and 187 IBD patients without SEC identified in index biopsy samples, and retrospectively collated results of follow-up surveillance samples in each group, with the development of dysplasia and/or adenocarcinoma as study endpoints. RESULTS:IBD patients with SEC had a 12.8% likelihood of developing dysplasia of any type within IBD-affected areas vs a 4.3% likelihood in non-SEC patients (follow-up in the 1-4 year range for each group). This was significant in univariate analysis (p = 0.013) but not in multivariate analysis, likely due to increased frequency of follow-up sampling in the SEC patients. One cancer developed in each group (p = NS). CONCLUSION:Our data, in the context of other studies, neither prove nor conclusively exclude an increased risk of dysplasia in IBD patients with SEC. But cancer risk appears low and continued surveillance at usual intervals seems reasonable.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Batts KP,Atwaibi M,Weinberg DI,McCabe RPdoi
10.1080/00325481.2020.1802138subject
Has Abstractpub_date
2021-01-01 00:00:00pages
66-70issue
1eissn
0032-5481issn
1941-9260journal_volume
133pub_type
杂志文章abstract:BACKGROUND:Binge eating disorder (BED) is now a formal diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). However, post-DSM-5 patient profiles and viewpoints on BED diagnosis and treatment remain unclear. This study used a focus group methodology to examine demographic and cl...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2014.09.2800
更新日期:2014-09-01 00:00:00
abstract::Primary aldosteronism is a potentially curable cause of hypertension; it occurs in about 1% of hypertensive patients. In the case reported here, persistent hypokalemia developed in a 72-year-old man who had been treated for 13 years for essential hypertension. Investigation revealed elevated aldosterone level and redu...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:
更新日期:1984-08-01 00:00:00
abstract::The fact that the national death rate from carcinoma of the colon and rectum has remained static over the past two decades is strong incentive for future investigation of measures to allow detection in its early and more favorable stage. Although no significant improvements in surgical techniques have afforded improve...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1979.11715249
更新日期:1979-09-01 00:00:00
abstract::The concurrent use of opioids, benzodiazepines (BZDs), and/or alcohol poses a formidable challenge for clinicians who manage chronic pain. While the escalating use of opioid analgesics for the treatment of chronic pain and the concomitant rise in opioid-related abuse and misuse are widely recognized trends, the contri...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2013.07.2684
更新日期:2013-07-01 00:00:00
abstract::To our knowledge, this is the first reported case of primary Pseudomonas maltophilia pneumonia. Presenting symptoms were fever and chills of two days' duration and a density in the right upper lobe. Sputum culture showed normal flora, and multiple blood cultures were negative. Antibiotic therapy initially with penicil...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1979.11715067
更新日期:1979-02-01 00:00:00
abstract::Gallstones are very common, but at least two thirds of detected stones are asymptomatic and a large number undoubtedly go undetected. The presence of symptoms or complications is the indication for surgery. It is important to accurately identify which symptoms are caused by gallstones, because removing the gallbladder...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1991.11701076
更新日期:1991-10-01 00:00:00
abstract::Drug-induced jaundice is relatively uncommon but can be a diagnostic puzzle. Because so many pharmaceutical classes and individual agents can produce jaundice, a thorough history of medications taken should be obtained from a patient presenting with jaundice. Jaundice usually resolves when the offending agent is disco...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1988.11700445
更新日期:1988-10-01 00:00:00
abstract::Self-monitoring of blood glucose (SMBG) levels provides important information regarding glycemic control for patients with diabetes, and is recommended by European and American diabetes organizations as an essential adjunct to periodic glycated hemoglobin (HbA1c) level monitoring. The benefits of SMBG in improving gly...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2013.05.2668
更新日期:2013-05-01 00:00:00
abstract::The traditional cornerstones of analgesic therapy for patients with acute pain have been oral therapies; however, all oral agents exhibit a variety of potentially dose-limiting or intolerable adverse effects in patients. Elderly patients and those with concomitant conditions already being managed with multiple systemi...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2013.1110567011
更新日期:2013-07-01 00:00:00
abstract::Even healthy persons may experience some form of altitude illness when they hike or ski in high mountains. Therefore, it is imperative that those with compromised cardiac or pulmonary function take extra precautions by allowing time for ascent, by recognizing and accepting their limitations, and by descending promptly...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1990.11716360
更新日期:1990-07-01 00:00:00
abstract::Preview The risks associated with diagnostic cardiac catheterization have declined through the years, but the question remains as to which patients should be referred for the procedure. In this article, Drs Walder and Schaller examine present guidelines for different types of heart disease and also review qualificatio...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1995.11945967
更新日期:1995-03-01 00:00:00
abstract::HIT is a common, potentially catastrophic syndrome. Awareness and early diagnosis allow effective therapeutic intervention. Ineffective strategies include stopping heparin only and starting warfarin early. Use of alternative anticoagulants is improving patient outcomes. Lepirudin, argatroban, and danaparoid each have ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2002.09.1307
更新日期:2002-09-01 00:00:00
abstract::Uremic polyneuropathy occurs in about half of patients undergoing dialysis and is characterized by axonal degeneration with secondary segmental demyelination. Hemodialysis or peritoneal dialysis halts the progress of polyneuropathy but usually does not bring improvement. However, improvement invariably occurs with suc...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1997.10.344
更新日期:1997-10-01 00:00:00
abstract::No single therapeutic agent has been found to be universally effective for rheumatoid arthritis, so regimens using combinations of drugs have become the rule. Recently, several new agents with unique mechanisms of action have been introduced and found to produce various degrees of clinical benefit. Among these agents ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.10.1.703
更新日期:1999-10-01 00:00:00
abstract::In a case of rheumatic disease, the patient's history and a careful physical examination should yield most of the information needed to identify the specific disorder present. A convenient classification is based on four differentiating features: number of joints affected, acuteness or chronicity of disease, absence o...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1976.11708414
更新日期:1976-12-01 00:00:00
abstract::Maternal peripartum complications continue to be a significant problem in the United States, even among previously healthy women. The problems include peripartum bleeding, infection, hypertension, and thromboembolic disease. Primary care physicians are often called upon to treat these conditions. An awareness of the a...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-02-01 00:00:00
abstract:INTRODUCTION:With rising health care costs in the United States, trainees will be increasingly challenged in discussing testing stewardship with patients. OBJECTIVE:We piloted a high-value care (HVC) communication skills curriculum utilizing the Four Habits Model for communication. We hoped residents would 1) learn to...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2020.1807728
更新日期:2020-08-22 00:00:00
abstract:OBJECTIVES:There is limited and contradictory information regarding the role of serum ischemia-modified albumin (IMA) in obstructive sleep apnea (OSA). In this study we examine the effects of OSA and obesity on IMA and interleukin-6 (IL-6), and detect whether IMA and IL-6 may be potential biomarkers in OSA. METHODS:Fi...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2016.1203237
更新日期:2016-08-01 00:00:00
abstract::Treatment of congestive heart failure depends on the cause, precipitating factors, and symptoms of the disease in each patient. Dr Kahn outlines the use of the three main types of pharmacologic agents given for heart failure--diuretics, vasodilators, and digoxin. He describes a stepwise regimen, whereby agents are add...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1991.11700920
更新日期:1991-05-01 00:00:00
abstract::Serum electrolyte levels by themselves may be difficult to interpret. For example, an abnormal serum potassium concentration cannot be understood without taking into account the patient's history, other serum electrolyte values, and possibly results of other laboratory tests. Knowledge of the principles of serum elect...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1991.11701146
更新日期:1991-12-01 00:00:00
abstract::Research suggests that depression is a risk factor for the development and progression of cardiovascular disease (CVD) and that there is a strong link between depression and poor outcomes following a cardiovascular event. It has also provided evidence that depressed patients are less likely to follow recommendations t...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.12.2003.suppl32.191
更新日期:2003-12-01 00:00:00
abstract::Combination therapy is a cost-effective and rational approach to treatment of severe hypertension and of mild to moderate hypertension that is refractory to monotherapy. The method has several advantages, most notably improved tolerability and enhanced antihypertensive efficacy. Long-term prospective studies are neede...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1998.09.581
更新日期:1998-09-01 00:00:00
abstract::Peripheral neuropathy may be a minor, even unrecognized, clinical problem, or it may be severe and virtually disabling. As in any chronic disorder, the physician's role is to look for treatable disease and to teach patients about the symptoms and natural history of the dysfunction as well as methods for coping with i...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1980.11715562
更新日期:1980-10-01 00:00:00
abstract::Cecal volvulus is a malrotational abnormality of the intestine that causes obstruction. Diagnosis is difficult and, if delayed, the results may be intestinal ischemia, perforation, sepsis, and even death. Cecal ischemia or gangrene cannot always be determined from physical and laboratory findings. Although not always ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1982.11716164
更新日期:1982-08-01 00:00:00
abstract::The mere presence of uterine fibroids is not, since qua non, an indication for their surgical removal. Knowing when not to operate is probably more important for the physician than knowing when to operate. It is easy to fall into diagnostic and therapeutic traps when uterine fibroids are known to be present, especiall...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:
更新日期:1976-09-01 00:00:00
abstract::As one patient put it after hearing his treatment options for a stage I testicular tumor, "If you're gonna have cancer, this is about as easy a road as you get." With recognition of the importance of orchiectomy, development of the nerve-sparing lymph node dissection procedure, and availability of modern chemotherapy ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.04.699
更新日期:1999-04-01 00:00:00
abstract::A hepatitis B vaccine derived from the plasma of carriers of hepatitis B virus has recently become generally available in the United States. Its use is recommended in groups considered to be at high risk of hepatitis B because of their exposure to potentially infectious blood, saliva, or semen. Experience in more than...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1983.11697828
更新日期:1983-05-01 00:00:00
abstract::Since the sexual revolution of the 1960s, medical complications of sexual activity and sexual side effects related to use of medications have become a significant part of healthcare practice. Specifically, there has been an expanding interest in the treatment of headaches and their relationship to sexual function. Mos...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2001.01.824
更新日期:2001-01-01 00:00:00
abstract::While the cause of multiple sclerosis (MS) remains obscure, epidemiologic investigation suggests that environmental factors encountered years before onset could be responsible. Studies elucidating age-specific onset curves, worldwide distribution, epidemics, clustering, and risk of contraction after migration are cons...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1989.11700620
更新日期:1989-03-01 00:00:00
abstract::A concerted national effort has reduced cardiovascular mortality rates in the general US population. Unfortunately, not all ethnic groups have benefited equally from these improvements in our national health. The author presents insights into social and clinical factors that affect cardiovascular disease among Hispani...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1992.11701252
更新日期:1992-03-01 00:00:00