Should Screening for Colorectal Neoplasm Be Recommended in Patients at High Risk for Coronary Heart Disease: A Cross-Sectional Study

Colorectal neoplasm (CRN) and coronary heart disease (CHD) share common risk factors. We aimed to assess the risk for CRN in patients who are at high risk for developing CHD determined by measurements, which are independent from the risk factors for CRN.This study was conducted on individuals who underwent total colonoscopic examination and were without history of CHD. Two-hundred thirty-five subjects (82 with CRN and 153 with normal colonoscopic findings) participated in the study. Colorectal carcinoma (CRC) was defined as the presence of adenocarcinoma. We measured carotid intima media thickness (CIMT), flow-mediated dilation (FMD), and calculated Framingham risk score (FRS) for all participants. An increased CIMT (≥1.0 mm), a decreased FMD (<10%), and a high FRS (>20%) were defined as high risks for developing CHD. The risk and the prevalence of CRN were analyzed in relation to the risk for developing CHD.The ratio of the patients with overall-CRN and CRC was significantly higher in individuals who are at high risk for developing CHD compared with individuals who are at low risk for developing CHD by each 3 risk estimation method (P < 0.05 for all). An increased CIMT, a decreased FMD, and a high FRS score were significantly associated with the high risk for the presence of CRC (odds ratio [OR]: 6.018, OR: 3.699, and OR: 4.120, respectively). An increased CIMT, a decreased FMD, and an intermediate FRS were significantly associated with the risk for the presence of overall-CRN (OR: 3.607, OR: 1.866 and OR: 2.889, respectively).The risk for CRN increases as the risk for developing CHD increases. It can be suggested that screening for CRN can be recommended for individuals who are at high risk for developing CHD.     

Influenza-associated pneumonia in a Turkish area with endemic avian influenza

Background and objective:   The aim of the study was to describe the effects of influenza associated with community-acquired pneumonia (CAP) on the outcome of patients in an area characterized by endemic avian influenza.
Methods:   Sixty patients diagnosed with CAP and requiring hospitalization were studied for the presence of influenza. Based on the presence or absence of influenza, patients were divided into two groups: group 1 were CAP patients positive for influenza and group 2 included CAP patients negative for influenza. Laboratory investigations, CXR findings and prognosis were compared.
Results:   Nasopharyngeal swabs or deep tracheal aspirates were tested for viral aetiology, and seven patients were positive for influenza AH3; one was positive for influenza AH1; seven were positive for influenza B; and one was positive for parainfluenza. Group 1 patients ( n  = 16) had a mean age of 56 years and group 2 patients ( n  = 45) had a mean age of 55 years. Significant increases in creatinine kinase and lymphopaenia were seen in group 1 patients. On CXR, interstitial infiltration was more marked in group 1. There was significantly higher mortality in group 1 than in group 2.
Conclusion:   CAP associated with influenza had a different clinical picture and outcome compared with patients without evidence of influenza.     

The clinical presentations of ectopic biliary drainage into duodenal bulbus and stomach with a thorough review of the current literature

Background

Inflammatory Bowel Diseases (IBD) remain significant health problems in the US and worldwide. IBD is most often associated with eastern European ancestry, and is less frequently reported in other populations of African origin e.g. African Americans ('AAs'). Whether AAs represent an important population with IBD in the US remains unclear since few studies have investigated IBD in communities with a majority representation of AA patients. The Louisiana State University Health Sciences Center in Shreveport (LSUHSC-S) is a tertiary care medical center, with a patient base composed of 58% AA and 39% Caucasian (W), ideal for evaluating racial (AA vs. W) as well and gender (M vs. F) influences on IBD.

Methods

In this retrospective study, we evaluated 951 visits to LSUHSC-S for IBD (between 2000 to 2008) using non-identified patient information based on ICD-9 medical record coding (Crohn's disease 'CD'-555.0- 555.9 and ulcerative colitis 'UC'-556.0-556.9).

Results

Overall, there were more cases of CD seen than UC. UC and CD affected similar ratios of AA and Caucasian males (M) and females (F) with a rank order of WF > WM > AAF > AAM. Interestingly, in CD, we found that annual visits per person was the highest in AA M (10.7 ± 1.7); significantly higher (* -p < 0.05) than in WM (6.3 ± 1.0). Further, in CD, the female to male (F: M) ratio in AA was significantly higher (*- p < 0.05) (1.9 ± 0.2) than in Caucasians (F:M = 1.3 ± 0.1) suggesting a female dominance in AACD; no differences were seen in UC F: M ratios.

Conclusion

Although Caucasians still represent the greatest fraction of IBD (~64%), AAs with IBD made up >1/3 (36.4%) of annual IBD cases from 2000-2008 at LSUHSC-S. Further studies on genetic and environments risks for IBD risk in AAs are needed to understand differences in presentation and progression in AAs and other 'non-traditional' populations.     

Right-sided lateralisation of ovarian cancer and right bias asymmetry for involved pelvic lymph nodes by ovarian cancer cells

The aim of the present study was to investigate if there is a possible lateralisation for ovarian cancers, to re-examine left-right asymmetry in pelvic lymph nodes distribution in patients with ovarian cancer, and to investigate if pelvic lymph node involvement by metastatic invasion of ovarian cancer cells is ipsilateral or contralateral. There was right-sided lateralisation for ovarian cancer. The numbers of external iliac and hypogastric+obturator lymph nodes were higher on the right side in patients with ovarian cancer on the right side; but they were about equal for right and left sides in patients with ovarian cancer in their left side. The numbers of external iliac and hypogastric+obturator lymph nodes involved by metastatic cancer cells were higher on the right side in patients with ovarian cancer on the both right and left sides. This case may result from the stronger cell-mediated immune activity in the left sides of humans.     

Knowledge and Attitudes on Organ Donation From the Perspective of Liver Transplant Patients

PurposeThis study was performed to investigate the knowledge and attitudes about organ donation from the perspective of liver transplant patients.Design and MethodsThe study was conducted at the organ transplantation clinics. The data were collected by the researchers from 129 participants using in-person interviews.FindingsIn this study, 83% of patients received the organ from live donors, 36% received liver transplants in the previous 1 year, more than 70% agreed to donate their organs, and 80% thought awareness should be raised in society about organ donation.ConclusionIt was found that the participants in the sample needed information on the issue, although the sample consisted of individuals who had experienced organ donation. It is important that nurses and nurse managers understand the level of knowledge and the attitudes of organ donation patients who have undergone liver transplantation. Worldwide, organ donation is not at the desired level. This study aims to enhance in nurses and nurse managers the foresight regarding and awareness about behaviors of transplantation patients.