MedWorm: Anoscopy

The Ethicon EndoSurgery anoscope retractor for anorectal procedures other than stapled haemorrhoidectomy.

Colorectal Disease — Fri, 20 Jan 2012 20:55:47 +0100

(Source: Colorectal Disease)

MedWorm Sponsor Message: Find the best January Sales in the UK.

Evaluation of the hybrid capture 2 assay for detecting anal high‐grade dysplasia

International Journal of Cancer — Tue, 10 Jan 2012 05:00:00 +0100

AbstractHybrid‐Capture 2 HPV DNA Test® (HC2) is FDA‐ approved and is a proven aid in detecting HPV infections of the cervix and as an aid in diagnosing, with cytology, cervical disease. A prospective feasibility study was conducted to determine if HC2 testing has utility when screening for high‐grade anal dysplasia (AIN2+). We enrolled 298 patients (45% HIV+) who had AIN2+ screening with cytology, histology and HC2 testing for two specimens: a swab into liquid‐based cytology medium and either a swab or brush collection in Specimen Transport Medium (STM). High‐resolution anoscopy was performed on all patients; with biopsy of AIN2+ suspicious lesions. Cytology was benign (42%), ASCUS (30%), LSIL (18%), HSIL (1%), ASC‐H (1.7%) and non‐diagnostic (7%) and 36% had AIN2+histology....

Review of Screening Guidelines for Non-AIDS-Defining Malignancies: Evolving Issues in the Era of Highly Active Antiretroviral Therapy.

AIDS Reviews — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Tyerman Z, Aboulafia DM Abstract HIV-associated morbidity and mortality have declined dramatically in the era of HAART. Through direct and indirect benefits of HAART, people with HIV/AIDS are living longer, developing less AIDS-defining cancers and more cancers commonly seen in the seronegative population. Herein, we review cancer screening strategies for people living with HIV and compare and contrast them with those of the general population. The most noticeable differences occur in anal and cervical cancer screening. Although anal cancer is uncommon in the general population, it is more prevalent in men who have sex with men and people at high risk for human papillomavirus infection, especially those infected with HIV. To address this, we recommend that a digital rectal...

Partial stapled hemorrhoidopexy: a minimally invasive technique for hemorrhoids

Surgery Today — Wed, 07 Dec 2011 10:48:33 +0100

Conclusions Partial stapled hemorrhoidopexy appears to be a safe and effective technique for grade III–IV hemorrhoids. Encouragingly, PSH is associated with mild postoperative pain, few urgency episodes, and no stenosis or anal incontinence. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00595-011-0085-5Authors Hong-Cheng Lin, Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University (Gastrointestinal and Anal Hospital), Guangzhou, 510655 People’s Republic of ChinaQiu-Lan He, Department of Anesthesia, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080 People’s Republic of ChinaDong-Lin Ren, Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University...

A Conversation With High-Resolution Anoscopists: Perspectives From Nurse Practitioner Experts

Journal of the Association of Nurses in AIDS Care — Tue, 01 Nov 2011 04:00:00 +0100

Recent data suggest that persons living with HIV (PLWH) are at significantly greater risk of developing anal cancer than the general population (). The development of anal cancer is associated with infection with human papilloma virus (HPV) (). HPV causes dysregulation at the cellular level in the anal canal leading to dysplastic changes, referred to as anal intraepithelial neoplasia (AIN), or anal dysplasia (). It is hypothesized that identification of anal dysplasia and treatment of dysplastic lesions can reduce the occurrence of anal cancer; however, definitive data are still pending. (Source: Journal of the Association of Nurses in AIDS Care)

Elements of an Anal Dysplasia Screening Program

Journal of the Association of Nurses in AIDS Care — Tue, 01 Nov 2011 04:00:00 +0100

This article discusses the procedures for anal cancer screening including cytology, digital anal rectal examinations, high-resolution anoscopy, and biopsy. (Source: Journal of the Association of Nurses in AIDS Care)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Keratosis Reduces Sensitivity of Anal Cytology in Detecting Anal Intraepithelial Neoplasia.

Gynecologic Oncology — Wed, 19 Oct 2011 04:00:00 +0100

CONCLUSION: Keratosis reduces the sensitivity of anal cytology. Furthermore, anal cytology poorly correlates with anoscopy in the detection of AIN (κ statistic = -0.0213). PMID: 22019527 [PubMed - as supplied by publisher] (Source: Gynecologic Oncology)

Breast cancer metastatic to the rectum: a case report

Techniques in Coloproctology — Mon, 12 Sep 2011 15:50:50 +0100

Conclusions Rectal metastasis from breast cancer is very rare. The presented case emphasizes the need to keep in mind this possibility and at all times associate the emergency condition with the related history of breast cancer. Content Type Journal ArticlePages 1-3DOI 10.1007/s10151-011-0740-2Authors C. Efthimiadis, Department of Surgery, Interbalkan European Medical Center, Asklipiou 10, Pilea, Thessaloniki, GreeceC. Kosmidis, Department of Surgery, Interbalkan European Medical Center, Asklipiou 10, Pilea, Thessaloniki, GreeceP. Fotiadis, Department of Surgery, Interbalkan European Medical Center, Asklipiou 10, Pilea, Thessaloniki, GreeceG. Anthimidis, Department of Surgery, Interbalkan European Medical Center, Asklipiou 10, Pilea, Thessaloniki, GreeceK. Vasiliadou...

High Resolution Anoscopy in a Recurrent Perianal Giant Condyloma Acuminata After Renal Transplantation: Case Report

Colorectal Disease — Mon, 12 Sep 2011 04:00:00 +0100

(Source: Colorectal Disease)

Early Detection of Anal Intraepithelial Neoplasia in High-Risk Patients.

Actas Dermo-Sifiliograficas — Thu, 14 Jul 2011 23:00:00 +0100

Authors: Sendagorta E, Herranz P, Guadalajara H, Zamora FX The incidence of anal squamous cell carcinoma has increased alarmingly, particularly in high-risk groups such as men who have sex with men and immunosuppressed patients. Infection with an oncogenic strain of the human papillomavirus in the anal canal or perianal skin leads to anal intraepithelial neoplasias (AIN), progressive dysplastic intraepithelial lesions that are the precursors of anal squamous cell carcinoma. AIN can be diagnosed through cytological screening and biopsy guided by high-resolution anoscopy and can be treated using a range of procedures in an effort to prevent progression to invasive anal carcinoma. Given the recent advances in the understanding of this disease, and the increasing calls from experts for the...

Hiding Intersphincteric and Transphincteric Sepsis in a Novel Pathological Approach to Chronic Anal Fissure.

Surgical Innovation — Wed, 06 Jul 2011 23:00:00 +0100

Conclusion. The authors assume that chronic fissures may persist because of hiding sepsis in the anal canal and that chronic anal fissure might be the clinical and pathological expression of a coexisting intersphincteric or low transphincteric fistula, and the ultrasonographic findings strongly support this theory. PMID: 21742658 [PubMed - as supplied by publisher] (Source: Surgical Innovation)

MedWorm Sponsor Message: Find the best January Sales in the UK.

The value of high-resolution anoscopy in the diagnosis of anal cancer precursor lesions in hiv-positive patients

Arquivos de Gastroenterologia — Wed, 22 Jun 2011 17:46:13 +0100

CONCLUSION: High-resolution anoscopy demonstrated to be a sensitive, but not specific test for the detection of anal squamous intraepithelial lesions. Risk factors anal receptive sex and anal HPV infection were significantly associated to the presence of anal squamous intraepithelial lesions. Based on high-resolution anoscopy image data, acetowhite lesions relief and surface pattern were prone to distinguish between low-grade squamous intraepithelial lesions and high-grade squamous intraepithelial lesions.CONTEXTO: O câncer anal, muito embora ainda seja uma doença rara, vem sendo observado com frequência ascendente em alguns grupos populacionais considerados sob risco para o desenvolvimento da doença. Infecção pelo vírus do papiloma humano (HPV), imunossupressão e o sexo anorecepti...

Agraffectomy after low rectal stapling procedures for hemorrhoids and rectocele

Techniques in Coloproctology — Tue, 21 Jun 2011 20:54:09 +0100

Conclusions There is no clear evidence that agraffectomy is indicated if not in case of rectal stenosis and hemorrhage caused by the staples. Content Type Journal ArticlePages 1-6DOI 10.1007/s10151-011-0704-6Authors S. Petersen, Department of General and Visceral Surgery, Asklepios Hospital Altona, Paul-Ehrlich-Str. 1, 22763 Hamburg, GermanyJ. Jongen, Department of Coloproctology, Park Hospital Kiel, Kiel, GermanyW. Schwenk, Department of General and Visceral Surgery, Asklepios Hospital Altona, Paul-Ehrlich-Str. 1, 22763 Hamburg, Germany Journal Techniques in ColoproctologyOnline ISSN 1128-045XPrint ISSN 1123-6337 (Source: Techniques in Coloproctology)

Initial Experience with Topical Fluorouracil for Treatment of HIV-Associated Anal Intraepithelial Neoplasia

Journal of the International Association of Physicians in AIDS Care (JIAPAC) — Thu, 24 Mar 2011 00:00:00 +0100

Exposure to high-risk strains of human papillomavirus (HPV) promotes cellular dysplasia of the anal canal epithelium, potentially leading to anal intraepithelial neoplasia (AIN), which is in turn a precursor to invasive squamous cell carcinoma of the anus (SCCA). People with HIV infection who engage in anoreceptive intercourse are at heightened risk for acquiring HPV, AIN, and SCCA. Although intravenous 5-fluorouracil (5-FU) is commonly used for treatment of invasive SCCA, there has been little experience with the use of topical 5-FU as therapy for AIN. We retrospectively reviewed records of the first 11 HIV-positive patients treated with topical 5-FU in our anal dysplasia clinic. Six (55%) patients had clinical improvement with reduction in area of dysplasia seen on high-resolution anosco...

Association between genital intraepithelial lesions and anal squamous intraepithelial lesions in HIV-negative women

American Journal of Obstetrics and Gynecology — Thu, 17 Mar 2011 00:00:00 +0100

Conclusion: There seems to be a strong association between ASIL and multicentric GSIL. Another factor related to ASIL was the practice of unprotected anal intercourse. (Source: American Journal of Obstetrics and Gynecology)

Diagnosis and Treatment of Anal Intraepithelial Neoplasia and Condylomata

Seminars in Colon and Rectal Surgery — Tue, 01 Mar 2011 00:00:00 +0100

Anal human papilloma virus (HPV) infection causes significant pathology, including condylomata as well as low- and high-grade anal intraepithelial lesions, the precursors of invasive cancer. Men who have sex with men, women with concomitant high-grade cervical/vulvar disease, and immunocompromised patients are particularly vulnerable. The incidence of anal cancer is increasing in men and women, but human immunodeficiency virus-infected patients regardless of immune reconstitution are at greatest risk. A critical review of the literature and evidence-based, comparative analysis and discussion of treatment modalities for anal HPV related diseases was undertaken. Anal cytology screening for high-grade dysplasia has been shown to be sensitive and cost-effective in men who have sex with men; an...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Performance of p16INK4a immunocytochemistry as a marker of anal squamous intraepithelial lesions

Cancer Cytopathology — Fri, 25 Feb 2011 00:00:00 +0100

CONCLUSIONS:There was no association between ICCp16 results and histopathological findings nor between ICCp16 and HPV genotyping. ICCp16 showed poor sensitivity and moderate specificity for the diagnosis of ASIL or high‐risk HPV. Cancer (Cancer Cytopathol) 2011. © 2011 American Cancer Society. (Source: Cancer Cytopathology)

Anal cancer precursor lesions in HIV-positive and HIV-negative patients seen at a tertiary health institution in Brazil.

Acta Cirurgica Brasileira — Tue, 01 Feb 2011 00:00:00 +0100

Conclusions: In the patients studied, ASIL (low and/or high-grade) tended to be significantly more prevalent in HIV-positive patients. Nonetheless, HIV-negative anoreceptive patients also presented great probability to have anal cancer precursor lesions, mainly those of the male gender. PMID: 21271206 [PubMed - in process] (Source: Acta Cirurgica Brasileira)

Rectal bleeding due to leech bite: a case report.

Turkish Journal of Trauma and Emergency Surgery : TJTES — Sat, 01 Jan 2011 00:00:00 +0100

We present herein a case with a four-day history of fresh rectal bleeding due to leech bite. The cause was found to be a leech in the rectum by anoscope. This pathological condition is extremely rare in urban areas. Leech endoparasitism, although rare, may cause serious, even lethal, complications. Suspicion of leech infestation should be kept in mind when faced with intermittent or severe rectal bleeding in humans, and should be investigated surgically as with all other foreign bodies. In the current study, we present a patient who admitted with rectal bleeding due to leech bite. The leech was removed by hand examination (by forceps) without requiring any surgical attempt. PMID: 21341141 [PubMed - in process] (Source: Turkish Journal of Trauma and Emergency Surgery : TJTES)

Anal cancer and cervical cancer screening: Key differences

Cancer Cytopathology — Mon, 20 Dec 2010 00:36:33 +0100

This article provides an overview of anal cancer screening while highlighting its differences from cervical cancer screening and the remaining obstacles and controversies to implementation of a successful anal cancer screening program. Cancer (Cancer Cytopathol) 2011;. © 2010 American Cancer Society. (Source: Cancer Cytopathology)

Endoanal Ultrasound: Staging and Follow-Up of Squamous Cell Carcinoma of the Anal Canal

Seminars in Colon and Rectal Surgery — Sat, 27 Nov 2010 05:14:36 +0100

Squamous cell carcinoma is the most common malignancy of the anal canal. Accurate staging is important, both in selecting among treatment modalities and in predicting a patient's response, local recurrence, and survival. The traditional anal cancer tumor-nodes-metastases staging system is defined solely by tumor diameter, as determined via digital and anoscopic examination. As a result, a movement has emerged toward the use of endoanal ultrasound (EAUS). The data to suggest the advantages of anal canal cancer staging via the use of depth of penetration are fairly robust. Many studies, including a large multicenter prospective clinical trial, have shown ultrasound staging to be a more accurate predictor of complete response, local recurrence, and survival. EAUS is a better tool for evaluati...

MedWorm Sponsor Message: Find the best January Sales in the UK.

Anal Intraepithelial Neoplasia in Women With Genital Intraepithelial Neoplasia.

Obstetrics and Gynecology — Fri, 27 Aug 2010 08:59:22 +0100

CONCLUSION:: Patients with cervical, vulvar, and vaginal intraepithelial neoplasia have 12.2% prevalence of anal intraepithelial neoplasia and should be screened with high-resolution anoscopy. In anal intraepithelial neoplasia screening, anoscopy is more sensitive but less specific than anal cytology. LEVEL OF EVIDENCE:: II. PMID: 20733438 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)

Topical 5‐fluorouracil treatment of anal intraepithelial neoplasia in human immunodeficiency virus‐positive men

British Journal of Dermatology — Thu, 12 Aug 2010 00:00:00 +0100

Conclusions A substantial proportion of HIV‐positive MSM with AIN completely cleared their lesions with topical 5‐FU treatment. In those with partial response, pretreatment with topical 5‐FU might facilitate subsequent ablative therapy. (Source: British Journal of Dermatology)

Topical 5-fluorouracil treatment of anal intraepithelial neoplasia in HIV-positive men.

The British Journal of Dermatology — Wed, 11 Aug 2010 23:00:00 +0100

Conclusions A substantial proportion of HIV-positive MSM with AIN completely cleared their lesions with topical 5-FU treatment. In those with partial response, pre-treatment with topical 5-FU might facilitate subsequent ablative therapy. PMID: 20716208 [PubMed - as supplied by publisher] (Source: The British Journal of Dermatology)

The Ferguson Operating Anoscope as a minimally invasive option for the treatment of rectal tumors.

The American Surgeon — Sat, 31 Jul 2010 23:00:00 +0100

Authors: Stanley JD, Bell C, Hinkle N, Moore RA, Burns RP Transanal excision of rectal tumors may be performed using the Ferguson Operating Anoscope (FOA). This retrospective case series evaluates the effectiveness of FOA for the excision of selected benign and malignant rectal tumors. The office records of 97 patients with rectal tumors who underwent FOA transanal excision by a single surgeon from 1999 through 2009 were reviewed. In the 97 patients evaluated, 99 FOA transanal excisions were performed for 39 adenocarcinomas, 55 benign tumors, and five carcinoid tumors. The tumors were 0.5 to 13.5 cm in diameter and located an average of 6.9 cm (range, 1 to 15 cm) from the anal verge. Ninety-one per cent of cases were performed as an outpatient. Postoperative complications occurred in 1...

Sigmoidoscope and anoscope warning issued

Nursing Times Breaking News — Sun, 25 Jul 2010 06:15:01 +0100

The Medicines and Healthcare products Regulatory Agency has issued a warning over sigmoidoscope and anoscope systems and accessories manufactured by Welch Allyn Limited. (Source: Nursing Times Breaking News)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

High-Res Anoscopy Best for Detecting High-Grade Anal Dysplasia in HIV+ Men

Medscape Hematology-Oncology Headlines — Thu, 20 May 2010 16:54:29 +0100

High-grade anal dysplasia is prevalent in HIV-positive gay men and high-resolution anoscopy is the best way to detect it, clinicians from Canada have found. Reuters Health Information (Source: Medscape Hematology-Oncology Headlines)

Evaluation and Management of Anal Intraepithelial Neoplasia in HIV-Negative and HIV-Positive Men Who Have Sex with Men

Current Infectious Disease Reports — Wed, 24 Feb 2010 06:55:52 +0100

Abstract The incidence of human papillomavirus (HPV)–associated anal cancer in men who have sex with men (MSM) is striking and has not been mitigated by the use of highly active antiretroviral therapy. Detection and treatment of high-grade anal intraepithelial neoplasia (HGAIN) may reduce the incidence of anal cancer. Anal cytology is a useful tool to detect HGAIN; annual screening of HIV-positive MSM and biennial screening of HIV-negative MSM appears to be cost-effective. MSM with abnormal cytology should be referred for high-resolution anoscopy and biopsy. Individuals with HGAIN should receive treatment; treatment modalities for HGAIN demonstrate moderate efficacy and are usually well tolerated, but greater study is required to determine which treatment is optimal. Lar...

Anal carcinoma in HIV-positive men: results of a prospective study from Germany.

The British Journal of Dermatology — Mon, 22 Feb 2010 00:00:00 +0100

Conclusions Anal carcinoma and AIN are frequent in HIV-positive men, even in patients participating in anal cancer prevention programs. High-grade dysplasia in these patients can progress to invasive cancer within a short period of time. Anal margin carcinoma and anal canal carcinoma substantially differ in their lesional HPV-spectrum, prognosis, and treatment response. PMID: 20184584 [PubMed - as supplied by publisher] (Source: The British Journal of Dermatology)

A dedicated applicator for light delivery and monitoring of PDT of intra-anal intraepithelial neoplasia

Photodiagnosis and Photodynamic Therapy — Mon, 22 Feb 2010 00:00:00 +0100

The objective of this study was to develop an applicator for delivery of light and monitoring of photodynamic therapy (PDT) in the anal cavity for treatment of anal intraepithelial neoplasia grade III (AIN III), which can progress to invasive anal cancer.Forty-eight hours before treatment, patients participating in the study were injected with 0.03 (n=2) or 0.075 (n=2)mgkg−1 m-THPC. For light delivery and monitoring of PDT, an applicator based on standard anoscopy equipment was developed which facilitates, in addition to a light treatment fiber, fiber optic probes to monitor blood saturation, blood volume, fluorescence and fluence (rate) at two different locations in situ. Patients were given a light dose of 10–17Jcm−2 at a fluence rate of 45–50mWcm−2 based on in situ measured li...

Anal carcinoma in human immunodeficiency virus-positive men: results of a prospective study from Germany

British Journal of Dermatology — Mon, 22 Feb 2010 00:00:00 +0100

Conclusions Anal carcinoma and AIN are frequent in HIV-positive men, even in patients participating in anal cancer prevention programmes. High-grade dysplasia in these patients can progress to invasive cancer within a short period of time. Anal margin carcinoma and anal canal carcinoma differ substantially in their lesional HPV spectrum, prognosis and treatment response. (Source: British Journal of Dermatology)

MedWorm Sponsor Message: Find the best January Sales in the UK.

Rectal duplication in an infant

Surgery — Fri, 04 Dec 2009 00:00:00 +0100

A 5-month-old girl presented to the emergency room with the parents' concern of anal swelling, grunting on defecation, and possible stool coming from the vagina. On rectal examination, her sphincter tone was poor and a tubular structure was palpable along the anterior rectal wall. Computed tomography of the pelvis revealed an elongated, tubular structure anterior to the rectum, running superiorly up to the level of the sigmoid colon. The child was then taken to the operating room for a thorough examination under anesthesia. Cystoscopy and vaginoscopy revealed a normal bladder, vagina, and cervical opening. No rectovaginal fistula was noted. During anoscopy, a small orifice was observed in the anterior rectal wall and was cannulated with a 5-French feeding tube ( A). Water-soluble contrast ...

Comparison of a modified anoscope and the purse-string anoscope in stapled haemorrhoidopexy.

World Journal of Gastroenterology : WJG — Thu, 26 Nov 2009 13:54:32 +0100

CONCLUSION: Operation time decreased and the surgeon's satisfaction increased with use of the modified anoscope, and fewer haemostatic sutures were required if the surgeon waited longer before and after firing the stapler. PMID: 19938197 [PubMed - as supplied by publisher] (Source: World Journal of Gastroenterology : WJG)

Anal-rectal cytology: A review

Diagnostic Cytopathology — Wed, 25 Nov 2009 00:00:00 +0100

The incidence of invasive anal squamous cell carcinoma, a human papilloma virus (HPV) related cancer, is on the rise, especially in HIV positive men who have sex with men (MSM). Like cervical cancer, anal cancer is associated with precursor lesions detectable on exfoliative cytology as squamous intraepithelial lesions and on biopsy as intraepithelial neoplasia. Anal-rectal cytology screening programs, similar to cervical cytology screening programs, have been developed in an effort to detect and to eradicate precursor lesions prior to progression to invasive squamous cell carcinoma. Either conventional or liquid-based anal-rectal cytology specimens are acceptable, but liquid-based specimens are preferred. Specimens may be collected by health care professionals or by patients. A minimum of ...

Anal cytology in patients with AIDS

Diagnostic Cytopathology — Wed, 07 Oct 2009 23:00:00 +0100

The objective of the present study was to study the prevalence of abnormal anal cytology in patients with AIDS. Anal smears, obtained with a cytobrush, of 102 HIV-positive patients of the Emilio Ribas Institute (Sao Paulo, Brazil) were collected, and only after that, the patients were submitted to anoscopy. Thirty-two patients had LSIL and 14 others had HSIL. Squamous intra-epithelial lesions were also observed in 38% of the patients without condyloma (18/47): in 9 of the 33 patients without history of condyloma (27%) and in 9 of the 14 patients who had previously treated condyloma (64%). An invasive squamous cell carcinoma was observed in one patient without history of condyloma. In all 13 patients with HSIL, biopsies guided by high resolution anoscopy confirmed high grade dysplasia. Our ...

Short-term results of DST EEA 33 stapler and neu@ anoscope for stapled haemorrhoidectomy: a prospective study of 1,118 patients from a single centre

Techniques in Coloproctology — Sat, 19 Sep 2009 05:51:51 +0100

Conclusion Stapled haemorrhoidectomy using the DST EEA 33 stapler is safe. The neu@ anoscope provides good visibility and handling, and is a useful tool in this procedure. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s10151-009-0532-0Authors Ming Hian Kam, Singapore General Hospital Department of Colorectal Surgery Outram Road Singapore 169608 SingaporeJit Fong Lim, Singapore General Hospital Department of Colorectal Surgery Outram Road Singapore 169608 SingaporeKok Sun Ho, Singapore General Hospital Department of Colorectal Surgery Outram Road Singapore 169608 SingaporeBoon Swee Ooi, Singapore General Hospital Department of Colorectal Surgery Outram Road Singapore 169608 SingaporeKong Weng Eu, Singapore General Hospital Department of Colorectal Sur...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Anal human papillomavirus infection is associated with HIV acquisition in men who have sex with men

AIDS — Sun, 31 May 2009 23:00:00 +0100

Conclusion: Anal HPV infection is independently associated with HIV acquisition. Studies that incorporate high-resolution anoscopy to more accurately identify HPV-associated disease are needed to determine the relationship between HPV-associated disease and HIV seroconversion. (C) 2009 Lippincott Williams & Wilkins, Inc. (Source: AIDS)

Management of Anal Squamous Intraepithelial Lesions

Clinics in Colon and Rectal Surgery — Thu, 28 May 2009 08:29:49 +0100

Clinics in Colon and Rectal Surgery 2009; 22: 094-101DOI: 10.1055/s-0029-1223840ABSTRACTAnal squamous intraepithelial lesions include both low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) and are caused by chronic infection with the human papillomavirus (HPV). The disease is increasing in both incidence and prevalence, especially among patients with the following risk factors: homosexual men, acquired or iatrogenic immunosuppression, and presence of other HPV-related diseases. Although the natural history of the disease is unknown, there is significant evidence that untreated HSIL progresses to squamous cell carcinoma in 11% of patients and in up to 50% of patients with extensive disease and immunosuppression. Anal cytology and reflex...

High level of HPV 16 and 18 DNA load in anal swabs from male and female HIV-1 infected patients

Journal of Clinical Virology — Wed, 01 Apr 2009 04:00:00 +0100

Conclusions: Longitudinal studies are needed to evaluate the link between high anal HPV DNA load and progression to anal squamous intraepithelial lesions and anal cancer. (Source: Journal of Clinical Virology)

High level of HPV 16 and 18 DNA load in anal swabs from male and female HIV-1 infected patients.

Journal of Clinical Virology — Thu, 05 Mar 2009 05:00:00 +0100

CONCLUSIONS: Longitudinal studies are needed to evaluate the link between high anal HPV DNA load and progression to anal squamous intraepithelial lesions and anal cancer. PMID: 19269245 [PubMed - as supplied by publisher] (Source: Journal of Clinical Virology)

[Anogenital warts: a clinical, pathological and virological study.]

Anales de Pediatria — Mon, 01 Dec 2008 05:00:00 +0100

The objective of this study was to investigate the possible relationship between the presence of anogenital warts (AGW) in children and the sexual abuse as mode of transmission. Our series includes 8 patients with AGW who were treated in our hospital during the year 2007. A complete physical examination was carried out, including colposcopy or anoscopy, and samples were taken for histopathological examination and human papiloma virus (HPV) subtyping. We considered perinatal transmission as a possible route in two cases. Although sexual abuse was definitively confirmed in only one case, we observed some findings in four cases that led us to consider the possibility of sexual abuse. We did not consider the possibility of heteroinoculation or autoinoculation from common warts in any case. Our...

MedWorm Sponsor Message: Find the best January Sales in the UK.

Comparison of patient- and clinician-collected anal cytology samples to screen for human papillomavirus-associated anal intraepithelial neoplasia in men who have sex with men.

Annals of Internal Medicine — Tue, 02 Sep 2008 04:00:00 +0100

CONCLUSION: In a community-based sample, a high proportion of HIV-positive and HIV-negative men who have sex with men have AIN. The sensitivity of cytology to detect AIN is higher for clinician-collected versus self-collected specimens and for HIV-positive versus HIV-negative men. The specificity of cytology to detect AIN is higher in HIV-negative versus HIV-positive men. However, the probability of AIN in a patient with a negative cytology result may not be low enough (23% for HIV-negative men and 45% for HIV-positive men with a patient-collected specimen) for clinicians to be comfortable recommending no anoscopy for those with a negative cytology result if done as a one-time test. These data raise the question of whether the optimal population screening strategy is cytology screening wit...

A simplified method for anal ultrasonography: assessment of patient satisfaction and the simplicity of the procedure

Techniques in Coloproctology — Tue, 05 Aug 2008 07:05:43 +0100

Conclusions This simple and less-costly adaptation of anal ultrasonography allows good quality examinations to be performed with better patient comfort in units with echoendoscopes already available, avoiding the need for a more expensive dedicated probe. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s10151-008-0422-xAuthors D. Castellani, University of Perugia Gastroenterology and Hepatology Section Department of Clinical and Experimental Medicine Perugia ItalyE. Antonelli, University of Perugia Gastroenterology and Hepatology Section Department of Clinical and Experimental Medicine Perugia ItalyG. Sabatino, University of Perugia Gastroenterology and Hepatology Section Department of Clinical and Experimental Medicine Perugia ItalyV. Giuliano, Univer...

Performing Handsewn Coloanal Anastomosis with the Pursestring Suture Anoscope

Diseases of the Colon & Rectum — Thu, 03 Jul 2008 08:05:21 +0100

Abstract The pursestring suture anoscope, originally developed for the procedure for rectal prolapse and hemorrhoids, has been successfully used when performing coloanal anastomosis. The use of this tool for handsewn coloanal anastomosis can achieve relatively atraumatic results to the patient. It is a suitable and handy tool that makes handsewn transanal colonanal anastomosis simple and easy to perform. Content Type Journal ArticleCategory Technical NotesDOI 10.1007/s10350-008-9309-1Authors Chih-Chien Chin, Chang Gung Memorial Hospital Division of Colon and Rectal Surgery, Department of Surgery 6 West, Chia-Pu Rd Putz City, Chiayi County TaiwanWen-Shih Huang, Chang Gung Memorial Hospital Division of Colon and Rectal Surgery, Department of Surgery 6 West, Chia-Pu Rd Putz...

Videoanoscope-assisted stapled haemorrhoidopexy: analysis of 18 patients

Techniques in Coloproctology — Wed, 11 Jun 2008 06:08:59 +0100

Abstract An optimal stapled haemorrhoidopexy requires the purse-string suture to be placed circumferentially at a constant distance from the dentate line and to pass through an appropriate thickness of rectal mucosa. An unsuitable purse-string suture may increase the risk of postoperative complications. We developed a new anoscope (the videoanoscope) to prevent the difficulties during application of the purse-string suture, and we used the videoanoscope in 18 stapled haemorrhoidopexy procedures. The videoanoscope is made up of three pieces. The front part is in the form of an open half-cylinder. The second piece is a sliding lid that covers the front piece. The rear part of the anoscope includes a hollow handle in which a scope can be inserted, and the whole procedure can ...

Management of internal genital warts: do we all agree? A postal survey

International Journal of STD and AIDS — Tue, 20 May 2008 04:00:00 +0100

A postal survey was undertaken to determine whether there was any consensus of opinion regarding the management of internal genital warts in genitourinary medicine clinics in the UK. Overall, 110 forms were returned (57% response). The majority of clinics would refer patients with cervical warts for colposcopy especially if the patient was over the age of 25 or HIV-positive. Proctoscopy or anoscopy was performed in 60% of clinics for patients with perianal warts to determine the presence of warts within the anal canal or rectum. Only 24% of patients with intra-anal warts are referred directly to surgery for biopsy, increasing to 61% if the patient has HIV infection. Cryotherapy is the main treatment for all types of internal warts. Our findings suggest there is no consensus and we recommen...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Hybrid Capture II Detection of Oncogenic Human Papillomavirus: A Useful Tool When Evaluating Men Who Have Sex with Men with Atypical Squamous Cells of Undetermined Significance on Anal Cytology

Diseases of the Colon & Rectum — Thu, 15 May 2008 06:02:16 +0100

Conclusions Hybrid-Capture II testing for high-risk human papillomavirus in men who have sex with men with atypical cells of undetermined significance and referring only those with high-risk human papillomavirus reduces the number who require high-resolution anoscopy by more than half. Five percent with high-grade squamous intraepithelial lesions would be missed. Content Type Journal ArticleCategory Original ContributionDOI 10.1007/s10350-008-9306-4Authors Stephen E. Goldstone, Department of Surgery Mt. Sinai School of Medicine New York New York USAAdam Z. Kawalek, Department of Internal Medicine New York University School of Medicine New York New York USARobert N. Goldstone, Department of Surgery Mt. Sinai School of Medicine New York New York USAAndrew B. Goldstone, ...

A new anoscope for transanal surgery.

American Journal of Surgery — Tue, 06 May 2008 04:00:00 +0100

CONCLUSION: Preliminary histologic studies in the pig suggest that the design of the anoscope prevents inclusion of the muscular layer in the pursestring. PMID: 18466861 [PubMed - as supplied by publisher] (Source: American Journal of Surgery)

[Clinical] Diagnosing chlamydia and managing proctitis in men who have sex with men: current UK practice

Sexually Transmitted Infections — Thu, 27 Mar 2008 04:00:00 +0100

Conclusions: There is a wide variation in the diagnosis and management of chlamydial infection in MSM and there is an urgent need for a more consistent approach. (Source: Sexually Transmitted Infections)

High-Resolution Anoscopy Targeted Surgical Destruction of Anal High-Grade Squamous Intraepithelial Lesions: A Ten-Year Experience

Diseases of the Colon & Rectum — Tue, 25 Mar 2008 07:16:40 +0100

Conclusions High-resolution anoscopy-targeted destruction combined with office-based surveillance and therapy is effective in controlling high-grade squamous intraepithelial lesions and is superior to reports of expectant management or traditional mapping procedures. Content Type Journal ArticleCategory Original ContributionDOI 10.1007/s10350-008-9233-4Authors Carlos E. Pineda, Stanford University School of Medicine Department of General Surgery Stanford California USAJ. Michael Berry, University of California San Francisco Department of Medicine San Francisco California USANaomi Jay, University of California San Francisco Department of Medicine San Francisco California USAJoel M. Palefsky, University of California San Francisco Department of Medicine San Francisco Cal...

Validation set correlates of anogenital injury after sexual assault.

Accident and Emergency Nursing — Fri, 29 Feb 2008 20:09:27 +0100

CONCLUSIONS: Approximately half the patients displayed AGI. This rate is higher than earlier studies, but consistent with current investigations utilizing similar injury detection methods. The correlates of injury found reinforce the findings of prior studies, while prompting questions for future study. PMID: 18304053 [PubMed - in process] (Source: Accident and Emergency Nursing)

MedWorm Sponsor Message: Find the best January Sales in the UK.

High-Resolution Anoscopy in the Diagnosis of Anal Cancer Precursor Lesions in Renal Graft Recipients

Annals of Surgical Oncology — Tue, 26 Feb 2008 15:46:37 +0100

Conclusions With a prevalence of 23.81% of subclinical ASIL-ACU lesions, the studied renal graft recipients had all these lesions detected by high-resolution anoscopy, notwithstanding most anal transition zone acetowhitened biopsied areas did not reveal histopathological aspects of anal cancer precursor lesions or condyloma acuminatum. Therefore, greater experience with the diagnostic tool was felt necessary to enhance its positive predictive value, specificity and diagnostic precision. Content Type Journal ArticleCategory Gastrointestinal OncologyDOI 10.1245/s10434-007-9750-8Authors Ivan Tramujas da Costa e Silva, Federal University of Amazonas Department of Surgery, School of Medicine Rua Afonso Pena, 1053 Manaus Amazonas 69020-160 BrazilLuiz Carlos de Lima Ferreir...

Anal Human Papillomavirus Testing with Digene’s Hybrid Capture 2 Using Two Different Sampling Methods

Diseases of the Colon & Rectum — Wed, 21 Nov 2007 16:41:50 +0100

Conclusions Anal screening for human papillomavirus-DNA by hybrid capture 2 is a useful method for detection of human papillomavirus-associated disease. Sample collection using Dacron swabs identifies more human papillomavirus-positive patients, and yields higher relative light unit values than using the cervical brush. Further studies are needed to determine the exact value of hybrid capture 2 in the screening for (pre)cancerous lesions of the anal canal. Content Type Journal ArticleCategory Original ContributionsDOI 10.1007/s10350-007-9082-6Authors Florian Roka, Medical University Vienna Department of Dermatology, Division of General Dermatology Vienna AustriaJulia Roka, Medical University Vienna Department of Surgery Austria, Waehringer Guertel 18–20 A-1090 Vien...

Perianal squamous cell carcinoma with high-grade anal intraepithelial neoplasia in an HIV-positive patient using highly active antiretroviral therapy: case report.

Sao Paulo Medical Journal — Sat, 01 Sep 2007 04:00:00 +0100

Authors: Nahas SC, Nahas CS, Silva Filho EV, Levi JE, Atui FC, Marques CF CONTEXT: Highly active antiretroviral therapy (HAART) has turned human immunodeficiency virus (HIV) infection into a chronic condition, and this has led to increased incidence of anal dysplasia among HIV-positive patients. Routine anal evaluation including the anal canal and perianal area is recommended for this population, especially for patients infected by oncogenic human papillomavirus (HPV) types. CASE REPORT: A 54-year-old homosexual HIV-positive man presented with a six-year history of recurrent perianal and anal warts. He had previously undergone incomplete surgical excision and fulguration in another institution on two occasions. He had been using HAART over the past two years. He presented some condylom...

High Resolution Anoscopy in the Planned Staged Treatment of Anal Squamous Intraepithelial Lesions in HIV-Negative Patients

Journal of Gastrointestinal Surgery — Tue, 21 Aug 2007 06:47:34 +0100

Abstract Anal dysplasia (low-grade squamous intraepithelial lesions, LSIL; high-grade squamous intraepithelial lesions, HSIL) is a challenging disease for the surgeon. We reviewed 42 patients that underwent high-resolution anoscopy (HRA)-targeted surgical therapy of anal dysplasia in the past 10 years. Patients were followed up in the Anal Neoplasia Clinic with physical examination, cytology, HRA, and biopsy if indicated. Patients with disease amenable to local therapy were treated with office-based HRA-directed therapies. There were 30 men (mean age 39 years, range 21–63) and 12 women (mean age 50 years, range 31–71) included in the study. HSIL was present in 33, with four undergoing planned staged treatment due to circumferential disease. HSIL recurred ...

Combined Colonoscopy and Three-Quadrant Hemorrhoidal Ligation: 500 Consecutive Cases

Diseases of the Colon & Rectum — Tue, 31 Jul 2007 06:45:36 +0100

Conclusions Combining colonoscopy with three-quadrant hemorrhoidal ligation is a safe and effective method of treating symptomatic internal hemorrhoids. The procedure is convenient for both physician and patient and makes more efficient use of time and resources. Content TypeJournal Article JournalDiseases of the Colon & RectumOnline ISSN 1530-0358Print ISSN 0012-3706 (Source: Diseases of the Colon & Rectum)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Local Anesthesia of Upper Anal Canal for Multiple Rubber Band Ligation: Description of Technique and Preliminary Results

Diseases of the Colon & Rectum — Tue, 31 Jul 2007 06:45:35 +0100

Conclusions Local anesthesia of the upper anal canal results in full relaxation and maximal mucosal redundancy of the anal canal simulating the anus in a natural condition during defecation. This gives an excellent exposure of the anal canal, enabling an accurate and multiple applications of rubber bands without pain during and shortly after the procedure. Content TypeJournal Article JournalDiseases of the Colon & RectumOnline ISSN 1530-0358Print ISSN 0012-3706 (Source: Diseases of the Colon & Rectum)

Anal squamous intraepithelial lesions and condyloma in HIV-infected heterosexual men, homosexual men and women: prevalence and associated factors

AIDS — Tue, 10 Jul 2007 23:00:00 +0100

Conclusion: The high rate of condyloma and histological dysplasia seen argues for a systematic screening for these lesions in HIV-infected individuals. (C) 2007 Lippincott Williams & Wilkins, Inc. (Source: AIDS)

Long-term outcome of a multicentre randomized clinical trial of stapled haemorrhoidopexy versus Milligan-Morgan haemorrhoidectomy

British Journal of Surgery — Tue, 22 May 2007 04:00:00 +0100

This study reports the long-term follow-up of a randomized clinical trial comparing the two techniques in 100 patients affected by third- and fourth-degree haemorrhoids.All patients were contacted and invited to attend the clinic to assess long-term functional outcome. The degree of continence and satisfaction were assessed by questionnaire. Anal manometry and anoscopy were performed.Eighty patients were available after a median follow-up of 87 months. No statistically significant differences were found between the two groups in terms of incontinence, stenosis, pain, bleeding, residual skin tags or recurrent prolapse. A tendency towards a higher recurrence rate was reported in patients with fourth-degree haemorrhoids, irrespective of the technique used. No significant changes in anal manom...

Prevalence and Risk Factors for Anal Cytologic Abnormalities and Human Papillomavirus Infection in a Rural Population of HIV-Infected Males

Diseases of the Colon & Rectum — Thu, 12 Apr 2007 06:58:23 +0100

Conclusions Anal squamous intraepithelial lesions and oncogenic human papillomavirus are highly prevalent in males infected with HIV and living in a rural setting. Content TypeJournal Article JournalDiseases of the Colon & RectumOnline ISSN 1530-0358Print ISSN 0012-3706 (Source: Diseases of the Colon & Rectum)

Infrared Coagulator Ablation of High-Grade Anal Squamous Intraepithelial Lesions in HIV-Negative Males Who Have Sex with Males

Diseases of the Colon & Rectum — Fri, 23 Mar 2007 12:14:30 +0100

Conclusions Infrared coagulation is a safe and effective office-based procedure for treating anal high-grade squamous intraepithelial lesions. Although recurrence was high after the first infrared coagulation, repeated treatment led to resolution of high-grade squamous intraepithelial lesions. Treatment success with infrared coagulation is significantly superior in HIV-negative patients compared with HIV-positive patients. Content TypeJournal Article JournalDiseases of the Colon & RectumOnline ISSN 1530-0358Print ISSN 0012-3706 (Source: Diseases of the Colon & Rectum)

MedWorm Sponsor Message: Find the best January Sales in the UK.

Response to "Anoscopy could be beneficial for women with external anogenital condyloma"

European Journal of Obstetrics, Gynecology, and Reproductive Biology — Mon, 05 Mar 2007 05:00:00 +0100

Response to "Anoscopy could be beneficial for women with external anogenital condyloma" Eur J Obstet Gynecol Reprod Biol. 2007 Mar 5; Authors: O'mahony C PMID: 17343975 [PubMed - as supplied by publisher] (Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology)

Anoscopy could be beneficial for women with external anogenital condyloma-A response to the letter by Dr. C. O'Mahony.

European Journal of Obstetrics, Gynecology, and Reproductive Biology — Wed, 21 Feb 2007 05:00:00 +0100

Authors: Mlakar B PMID: 17320265 [PubMed - as supplied by publisher] (Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology)

Anoscopy could be beneficial for women with external anogenital condyloma.

European Journal of Obstetrics, Gynecology, and Reproductive Biology — Mon, 19 Feb 2007 05:00:00 +0100

Authors: Mlakar B PMID: 17314001 [PubMed - as supplied by publisher] (Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology)

Siascopy Sees Stuff In Skin

Medgadget — Fri, 08 Dec 2006 07:00:00 +0100

The good people of Frost & Sullivan have bestowed their European Technology Innovation of the Year award upon UK company Astron Clinica for their SIAscope. Now, we've used scopes of all kinds, from ophthalmoscopes to anoscopes, and had never heard of the SIAscope. But it's real, it's new, and this spectrophotometric intra-cutaneous analysis (SIA, see?) lets doctors see the constituents of skin without hacking it to pieces. "Astron Clinica's SIAscopy utilises both visible and infrared (IR) light to examine skin components such as blood, melanin, dermal melanin and collagen to a depth of 2 mm below the skin's surface, and provides gross living pathological data on skin lesions," notes Frost & Sullivan Research Analyst Sangeetha Prabakar. "This eliminates the need for other more laborious cli...

Prevalence of Perianal Intraepithelial Neoplasia in HIV-Infected Patients Referred for High-Resolution Anoscopy

Diseases of the Colon & Rectum — Fri, 15 Sep 2006 08:06:00 +0100

This study was designed to describe perianal disease in a cohort of HIV-infected patients referred for high-resolution anoscopy. Content TypeJournal Article JournalDiseases of the Colon & RectumOnline ISSN 1530-0358Print ISSN 0012-3706 (Source: Diseases of the Colon & Rectum)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Dna 2.0?

Medgadget — Tue, 25 Jul 2006 17:37:56 +0100

If there is one cardinal truth in the gadget world, it is that products must continually change and improve to become better, faster, and sexier. Plain Xray films have evolved into digital films on my smartphone. Anoscopes have become self-propelling, self navigating, disposable colonoscopes. Now, in an effort to win the techno rat-race, plain boring old DNA has released its newest model which is sure to rock the ribonucleic acid world. Ladies and gentlemen, we introduce to you--DNA 2.0!! Researchers believe they have found a second code in DNA in addition to the genetic code. The genetic code specifies all the proteins that a cell makes. The second code, superimposed on the first, sets the placement of the nucleosomes, miniature protein spools around which the DNA is looped. The spools bo...

Randomized clinical evaluation of self-screening for anal cancer precursors in men who have sex with men

CytoJournal — Mon, 20 Mar 2006 00:00:00 +0100

Conclusion: Self-collection of anorectal swab specimens for cytologic screening in research and possibly clinical settings appears feasible, particularly if specimen adequacy can be further improved. The severity of biopsy-confirmed anorectal disease is seriously underestimated by cytological screening, regardless of collector. (Source: CytoJournal)

Anal screening cytology

CytoJournal — Wed, 16 Feb 2005 00:00:00 +0100

Gladwyn LeimanCytoJournal 2005 2(1):5-5This issue of CytoJournal contains an article on screening for anal intraepithelial neoplasia in high-risk male patients. This accompanying Editorial focuses on current understanding of this relatively new disease entity, with insights as to the potential role of screening cytopathology in the epidemiology, pathophysiology and clinical management of this HIV and HPV related anal lesion, which predominates in male patients living long-term with AIDS. Mention is made of techniques of obtaining samples, methods of preparation, and morphologic classification. Issues of anoscopic confirmation, as well as topical and surgical management are emphasized. The similarity of initial experiences in anal screening to problems encountered early in cervical cancer s...

The Anal Pap smear : Cytomorphology of squamous intraepithelial lesions

CytoJournal — Wed, 16 Feb 2005 00:00:00 +0100

Conclusions: In this study liquid based anal smears had a high sensitivity (98%) for detection of ASIL but a low specificity (50%) for predicting the severity of the abnormality in subsequent biopsy. Patients with cytologic diagnoses of ASC-US and LSIL had a significant risk (46-56%) of HSIL at biopsy. We suggest that all patients with a diagnosis of ASC-US and above be recommended for high resolution anoscopy with biopsy. (Source: CytoJournal)