WorldWideScience

Sample records for teorijske analize nuklearnih

  1. Teorijske i praktične osnove TIG postupka zavarivanja

    OpenAIRE

    Horvat, Marko; Kondić, Veljko; Brezovački, Dražen

    2014-01-01

    TIG/GTAW postupak zavarivanja je elektrolučni postupak zavarivanja netaljivom elektrodom u zaštitnoj atmosferi inertnih plinova ili smjesa plinova. U radu je prikazana kratka povijest i teorijske osnove postupka, prednosti i nedostaci te osvrt na praktične osnove primjene postupka.

  2. Problems of space-time behaviour of nuclear reactors; Problemi prostorno-vremenskog ponasanja nuklearnih reaktora

    Energy Technology Data Exchange (ETDEWEB)

    Obradovic, D [Institut za nuklearne nauke ' Boris Kidric' , Vinca, Belgrade (Yugoslavia)

    1966-07-01

    This paper covers a review of literature and mathematical methods applied for space-time behaviour of nuclear reactors. The review of literature is limited to unresolved problems and trends of actual research in the field of reactor physics. Dat je pregled literature i matematickih metoda koje se koriste prilikom tretiranja prostorno-vremenskog ponasanja nuklearnih reaktora. Pregled literature ogranicen je na jos neresene probleme i pravce u kojima su danas usmerena istrazivanja u ovoj oblasti fizike nuklearnih reaktora (author)

  3. Research in nuclear reactor theory and experimental reactors; Istrazivanja u teoriji nuklearnih reaktora i ekspeimentalni reaktori

    Energy Technology Data Exchange (ETDEWEB)

    Pop-Jordanov, J [Elektrotehnicki fakultet, Beograd (Yugoslavia)

    1978-05-15

    The paper is devoted to the possibilities of using experimental reactors for scientific research in nuclear power with a stress on problems in nuclear reactor theory. The stationary and nonstationary neutron fields, burnup prediction and analyses as well as fuel element development and the corresponding role of test-reactors were dealt with. It was shown that the investigations in nuclear reactor theory in Yugoslavia were developing continuously and in a useful interaction with experiments on research reactors. The needs for continuing the work on fundamental problems in neutron transport theory and on improving the calculation methods for thermal power reactors, together with the improvement of performances of existing research systems, were pointed out. A new quality in scientific work could be obtained dealing with the problems connected to a possible introduction of test-reactors, and fast systems later on. It was also pleaded for the corresponding orientations in fundamental sciences. (author) Rad je posvecen mogucnostima koriscenja eksperimentalnih reaktora za naucna istrazivanja u nuklearnoj energetici, sa akcentom na probleme teorije nuklearnih reaktora. Obradjena su stacionarna i nestacionarna neutronska polja, predikcija i analize sagorevanja, kao i razvoj gorivnih elemenata te uloga test-reaktora u osvajanju njihove tehnologije. Pokazano je da su se istrazivanja u teoriji nuklearnih reaktora u nas odvijala kontinualno i u korisnoj interakciji sa eksperimentima na istrazivackim reaktorima. Istaknuta je potreba nastavljanja rada na fundamentalnim problemima transportne teorije neutrona i na usavrsavanju metoda proracuna termalnih enerrgetskih reaktora, uz poboljsanje performansi postojecih istrazivackih sistema. Novi kvalitet u naucnom radu bi predstavljala orijentacija na probleme vezane sa eventualnim uvodjenjem test-reaktora, a zatim i brzih sistema. Pledirano je i za odgovarajuca usmeravanja u fundamentalnim naukama. (author)

  4. Purification of cooling water for nuclear reactors using ion exchangers; Preciscavanje vode za hladjenje nuklearnih reaktora pomocu neorganskih jonoizmenjivaca

    Energy Technology Data Exchange (ETDEWEB)

    Ruvarac, A [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1969-07-01

    Zirconiumphosphate, zirconiumoxide and natural magnetite as inorganic substances with favourable adsorption properties were the subject of investigations dealing with problems of water purification for nuclear rector cooling. Study on adsorption of impurities form reactor water to 300 deg C and 100 Atm was done by specially constructed autoclaves. On the other hand, a pre-project covering a laboratory plant for investigation of inorganic ion exchangers under real dynamic conditions is given. In order to obtain necessary data on the basis of which techno-economical analyses regarding utilization of zirconiumphosphate, zirconiumoxide and magnetite for water purification is cooling the reactors types BWR and PWR, could be performed, systematic investigations of physical and chemical properties of these substances were commenced. Equilibrium constants have been determined for adsorption processes at different pH values, as well as under various temperatures. Obtained equilibrium constants were used for calculation of thermodynamic quantities {delta}H, {delta}G and {delta}S (author) [Serbo-Croat] Cirkonijumfosfat, cirkonijumoksid i prirodni magnet, kao neorganski materijali sa pogodnim adsorpcionim osobinama, bili su predmet istrazivanja vezanih za probleme preciscavanja vode za hladjenje nuklearnih reaktora. Izucavanje adsorpcije necistoca iz reaktorske vode do 300 deg C i 100 Atm vrseno je pomocu specijalno konstruisanog autoklava, a za ispitivanje neorganskih jonoizmenjivaca pri realnim dinamickim uslovima dat je idejni projekt jednog laboratorijskog postrojenja. Za dobijanje potrebnih podataka, na osnovu kojih se mogu napraviti tehno-ekonomske analize o koriscenju cirkonijumfosfata, cirkoijumoksida i magnetita za preciscavanje vode za hladjenje reaktora tipa BWR i PWR, zapoceto je sa sistematskim proucavanjima fizickih i hemijskih osobina pomenutih materijala, odredjivane su konstante ravnoteze za procese adsorpcije pri razlicitim pH vrednostima, kao i na razlicitim

  5. Twenty years of chemistry associated with the needs and utilization of nuclear reactors at the 'Boris Kidric' Institute of nuclear sciences, Vinca, Yugoslavia; Dvadeset godina hemije vezane za potrebe i koriscenje nuklearnih reaktora u Institutu za nuklearne nauke 'Boris kidric' i Vinci

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1969-07-01

    This publication covers nine review papers on the following topics related to the needs and utilization of nuclear reactors in the Boris Kidric Institute of nuclear sciences during previous twenty years: radiochemistry, hot atom chemistry, isotope production, spent nuclear fuel reprocessing, chemistry of transuranium elements; liquid radioactive waste processing, purification of reactor coolant water by inorganic ion exchangers, research related to deuterium concentration processes, and chemical dosimetry at the RA reactor. [Serbo-Croat] Ova publikacija obuhvata devet radova, po sledecim naslovima, a odnose se na potrebe i uslove nuklearnih reaktora u Institutu za nuklearne nauke 'Boris Kidric' tokom prethodnih dvadeset godina: radiohemija, hemija vruceg atoma, proizvodnja radioaktivnih izotopa, prerada isluzenog nuklearnog goriva, hemija transuranskih elemenata, obrada radioaktivnih otpadnih voda, preciscavanje vode za hladjenje nuklearnih reaktora pomocu neorganskih jonoizmenjivaca, istrazivanje procesa za koncentrovanje deuterijuma i hemijska dozimetrija reaktora RA.

  6. The training of the staff for work with radioactive materials and work on nuclear reactor in the Institute; Obuka kadrova za rukovanje radioizotopima i pogon nuklearnih reaktora u Institutu 'Boris Kidric' - Vinca

    Energy Technology Data Exchange (ETDEWEB)

    Milosevic, M; Mladjenovic, O; Sotic, O [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Yugoslavia)

    1978-05-15

    A short informational review of the activities in the 'Boris Kidric' Institute on the training courses for the use of radioactive materials and for operating nuclear reactors including power reactors. The survey of the courses is given in the enclosures. (author) Kratak informativni pregled delatnosti u IBK na kursevima za obuku kadrova u rukovanju readioaktivnim materijalima i pogonu nuklearnih reaktora, ukljucujuci reaktore snage. pregled kurseva i materijala za njih dati su u prilozima. (author)

  7. Theoretical analysis of nuclear reactors (Phase III), I-V, Part III, Reactor poisoning; Razrada metoda teorijske analize nuklearnih reaktora (III faza) I-IV, III Deo, Zatrovanje reaktora

    Energy Technology Data Exchange (ETDEWEB)

    Pop-Jordanov, J [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1963-01-15

    Report on calculation of poisoning in experimental and power reactor includes four parts. Part one describes the influence of poisoning on the physical parameters of a reactor. part two includes transformation of differential equations for iodine and xenon. It was needed for easier solution of of differential equation using the analog computer. This calculation was done for RA reactor operating at 5 MW power. The RA reactor was used an example of calculation by the proposed method. Part four shows the application of the method for calculating the Calder Hall power reactor.

  8. Anal acoustic reflectometry

    DEFF Research Database (Denmark)

    Mitchell, Peter J; Klarskov, Niels; Telford, Karen J

    2011-01-01

    Anal acoustic reflectometry is a new technique of assessing anal sphincter function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, the opening and closing elastance, and hysteresis.......Anal acoustic reflectometry is a new technique of assessing anal sphincter function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, the opening and closing elastance, and hysteresis....

  9. Keratosis reduces sensitivity of anal cytology in detecting anal intraepithelial neoplasia.

    Science.gov (United States)

    ElNaggar, Adam C; Santoso, Joseph T; Xie, Huiwen Bill

    2012-02-01

    To identify factors that may contribute to poor sensitivity of anal cytology in contrast to the sensitivity of anoscopy in heterosexual women. We analyzed 324 patients with biopsy confirmed diagnosis of genital intraepithelial neoplasia (either vulva, vaginal, or cervical) from 2006 to 2011 who underwent both anal cytology and anoscopy. Cytology, anoscopy, and biopsy results were recorded. Biopsy specimens underwent independent analysis for quality of specimen. Also, biopsy specimens were analyzed for characteristics that may contribute to correlation, or lack thereof, between anal cytology and anoscopic directed biopsy. 133 (41%) patients had abnormal anoscopy and underwent directed biopsy. 120 patients with normal anal cytology had anoscopy directed biopsies, resulting in 58 cases of AIN (sensitivity 9.4%; 0.039-0.199). This cohort was noted to have extensive keratosis covering the entire dysplastic anal lesion. 18 patients yielded abnormal anal cytology. Of these patients, 13 had anoscopic directed biopsies revealing 6 with AIN and absent keratosis (specificity 88.6%; 0.78-0.95). The κ statistic for anal cytology and anoscopy was -0.0213 (95% CI=-0.128-0.086). Keratosis reduces the sensitivity of anal cytology. Furthermore, anal cytology poorly correlates with anoscopy in the detection of AIN (κ statistic=-0.0213). Copyright © 2011 Elsevier Inc. All rights reserved.

  10. Anal fissure - series (image)

    Science.gov (United States)

    Anal fissures are tears in the skin overlying the anal sphincter, usually due to increased tone of the anal sphincter muscles, and a failure of these muscle to relax. Anal fissures cause pain during defecation and bleeding from the anus.

  11. Theoretical analysis of nuclear reactors (Phase I), I-V, Part III, Reactor poisoning; Razrada metoda teorijske analize nuklearnih reaktora (I faza) I-V, III Deo, Zatrovanje reaktora, I faza

    Energy Technology Data Exchange (ETDEWEB)

    Pop-Jordanov, J [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1962-07-15

    Method was developed for calculation of Xe{sup 135} static effect and kinetic effects of Xe{sup 135} and Sm{sup 149} with separate treatment of iodine effect and influence of reactor poisoning during power increase. Mentioned effects are treated first for uranium fuel and then the basic formulae were generalized for a mixture of fissile material. The annex contains a table with data needed for calculations and the Xe{sup 135} microscopic capture cross section dependent on temperature. Razradjen je metod proracuna statickog efekta Xe{sup 135} zatim kinetickog efekta Xe{sup 135} i Sm{sup 149} sa posebnim tretiranjem jodne jame i promene zatrovanja pri prelazu sa jedne snage na drugu. Navedeni efekti su tretirani prvo za uransko gorivo, a zatim su glavni obrasci uopsteni za smesu fisibilnih materijala. U prilogu su dati u vidu tabele, podaci potrebni za proracun i grafik zavisnosti mikroskopskog preseka zahvata Xe{sup 135} od temperature.

  12. Theoretical analysis of nuclear reactors (Phase II), I-V, Part III, Reactor poisoning; Razrada metoda teorijske analize nuklearnih reaktora (II faza) I-V, III Deo, Zatrovanje reaktora, II faza

    Energy Technology Data Exchange (ETDEWEB)

    Pop-Jordanov, J [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1962-10-15

    This phase is dealing with influence of all the fission products except Xe{sup 135} on the reactivity of a reactor, usually named as reactor poisoning. The first part of the report is a review of methods for calculation of reactor poisoning. The second part shows the most frequently used method for calculation of cross sections and yields of pseudo products (for thermal neutrons). The system of equations was adopted dependent on the conditions of the available computer system. It is described in part three. Detailed method for their application is described in part four and results obtained are presented in part five.

  13. HIV-associated anal cancer

    OpenAIRE

    Newsom-Davis, T; Bower, M

    2010-01-01

    HIV-associated anal carcinoma, a non-AIDS-defining cancer, is a human papillomavirus-associated malignancy with a spectrum of preinvasive changes. The standardized incidence ratio for anal cancer in patients with HIV/AIDS is 20-50. Algorithms for anal cancer screening include anal cytology followed by high-resolution anoscopy for those with abnormal findings. Outpatient topical treatments for anal intraepithelial neoplasia include infrared coagulation therapy, trichloroacetic acid, and imiqui...

  14. IMPORTANCE OF THE ANAL MANOMETRY IN THE JUDICIALMEDICAL EXPERTISE OF THE ANAL PENETRATION

    Directory of Open Access Journals (Sweden)

    Jelica Miljkovic

    2001-11-01

    Full Text Available The forceful anal penetration can leave as a consequence a lasting damage ofthe anal sphincter function. The anal manometry is one of the methods that, in anindirect way, by measuring the pressure in the anal channel, may determine theexistence of the anus-closing muscles' function damage. The importance of the analmanometry application as an objective indicator of a possible damage of the analsphincter function is presented in the cases of the judicial-medical expertise of theanal penetration. Three cases of criminal acts of sexual abuse and rape in which thejudicial-medical expertise by the anal manometry method was applied are analyzed.The anal manometry method is reliable in determining the functional stote of theexternal and the internal anal sphincter and it should be accepted as obligatory indiagnostics and verification of the anal penetration.

  15. Experimental study of space dependent nuclear reactor kinetics - Progress report; Eksperimentalno proucavanje prostorno zavisne kinetike nuklearnih reaktora - Izvestaj o napredovanju

    Energy Technology Data Exchange (ETDEWEB)

    Obradovic, D; Petrovic, M [Institute of nuclear sciences Boris Kidric, Vinca, Beograd (Yugoslavia)

    1966-11-15

    This paper describes experimental study of space-time behaviour of nuclear reactors by local complex-periodic perturbation of the absorption cross section and by measuring the local reactor response to this perturbation. Perturbation was done by BOR-1 fast oscillator. Cross correlation between the response and the perturbation was done numerically after completing the measurement by using digital computer. Obtained experimental results are preliminary and are measured with significant errors which were analysed in this paper. Results show qualitative agreement with those obtained by theoretical model. This paper is the first progress report in this field in our country. U radu je opisan eksperimentalni prilaz proucavanju prostorno-vremenskog ponasanja nuklearnih reaktora, vrseci lokalnu slozeno-periodicnu perturbaciju apsorpcionog preseka i mereci lokalni odziv reaktora na tu perturbaciju. Perturbacija je vrsena brzim oscilatorom BOR-1. Kroskorelacija izmedju odziva i perturbacije vrsena je numericki posle obavljenog merenja upotrebom digitalne racunske masine. Dobijeni eksperimentalni rezultati imaju preliminarni karakter i odredjeni su sa znatnim eksperimentalnim greskama koje su, u radu analizirane. Izlozeni rezultati pokazuju kvalitativna slaganja sa teorijski dobijenim modelom. Ovaj rad predstavlja prvi izvestaj o napredovanju na ovoj problematici kod nas (author)

  16. Anal incontinence after two vaginal deliveries without obstetric anal sphincter rupture

    DEFF Research Database (Denmark)

    Persson, Lisa K G; Sakse, Abelone; Langhoff-Roos, Jens

    2017-01-01

    PURPOSE: To evaluate prevalence and risk factors for long-term anal incontinence in women with two prior vaginal deliveries without obstetric anal sphincter injury (OASIS) and to assess the impact of anal incontinence-related symptoms on quality of life. METHODS: This is a nation-wide cross......-sectional survey study. One thousand women who had a first vaginal delivery and a subsequent delivery, both without OASIS, between 1997 and 2008 in Denmark were identified in the Danish Medical Birth Registry. Women with more than two deliveries in total till 2012 were excluded at this stage. Of the 1000 women...... affected their quality of life. No maternal or obstetric factors including episiotomy and vacuum extraction were consistently associated with altered risk of anal incontinence in the multivariable analyses. CONCLUSIONS: Anal incontinence and fecal urgency is reported by one fifth of women with two vaginal...

  17. HPV infection, anal intra-epithelial neoplasia (AIN and anal cancer: current issues

    Directory of Open Access Journals (Sweden)

    Stanley Margaret A

    2012-09-01

    Full Text Available Abstract Background Human papillomavirus (HPV is well known as the major etiological agent for ano-genital cancer. In contrast to cervical cancer, anal cancer is uncommon, but is increasing steadily in the community over the last few decades. However, it has undergone an exponential rise in the men who have sex with men (MSM and HIV + groups. HIV + MSM in particular, have anal cancer incidences about three times that of the highest worldwide reported cervical cancer incidences. Discussion There has therefore traditionally been a lack of data from studies focused on heterosexual men and non-HIV + women. There is also less evidence reporting on the putative precursor lesion to anal cancer (AIN – anal intraepithelial neoplasia, when compared to cervical cancer and CIN (cervical intraepithelial neoplasia. This review summarises the available biological and epidemiological evidence for HPV in the anal site and the pathogenesis of AIN and anal cancer amongst traditionally non-high risk groups. Summary There is strong evidence to conclude that high-grade AIN is a precursor to anal cancer, and some data on the progression of AIN to invasive cancer.

  18. Anal Cancer—Patient Version

    Science.gov (United States)

    Anal cancer cases have been increasing over several decades. Infection with human papillomavirus (HPV) is the major risk factor for anal cancer. Start here to find information on anal cancer treatment, causes and prevention, research, and statistics.

  19. Theoretical analysis of nuclear reactors (Phase I), I-V, Part IV, Nuclear fuel depletion; Razrada metoda teorijske analize nuklearnih reaktora (I faza) I-V, IV Deo, Promena izotopnog sastava goriva

    Energy Technology Data Exchange (ETDEWEB)

    Pop-Jordanov, J [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1962-07-15

    Nuclear fuel depletion is analyzed in order to estimate the qualitative and quantitative fuel property changes during irradiation and the influence of changes on the reactivity during long-term reactor operation. The changes of fuel properties are described by changes of neutron absorption and fission cross sections. Part one of this report covers the economic significance of fuel burnup and the review of fuel isotopic changes during depletion. Pat two contains the analysis of the U{sup 235} chain, analytical expressions for the concentrations of U{sup 235}, U{sup 236} and Np{sup 237} as a function of burnup. Part three contains the analysis of neutron spectrum influence on the Westcott method for calculating the cross sections. Part four contains the calculation method applied on Calder Hall type reactor. The results were obtained by applying ZUSE-22 R digital computer.

  20. Anal Cancer—Health Professional Version

    Science.gov (United States)

    Anal cancer is a rare malignancy and accounts for a small percentage of cancers of the lower alimentary tract. The most common type of anal cancer is squamous cell carcinoma in the anal canal. Find evidence-based information on anal cancer treatment, causes and prevention, research, and statistics.

  1. Anal incontinence in women with recurrent obstetric anal sphincter rupture

    DEFF Research Database (Denmark)

    Bøgeskov, Reneé; Nickelsen, Carsten Nahne Amtoft; Secher, Niels Jørgen

    2015-01-01

    UNLABELLED: Abstract Objectives: To determine the risk of recurrent anal sphincter rupture (ASR), and compare the risk of anal incontinence (AI) after recurrent ASR, with that seen in women with previous ASR who deliver by caesarean section or vaginally without sustaining a recurrent ASR. METHODS...

  2. [Acute anal pain].

    Science.gov (United States)

    Pittet, Olivier; Demartines, Nicolas; Hahnloser, Dieter

    2013-07-01

    Acute anal pain is a common proctological problem. A detailed history together with the clinical examination are crucial for the diagnosis. An acute perianal vein thrombosis can be successfully excised within the first 72 hours. Acute anal fissures are best treated conservatively using stool regulation and topical medications reducing the sphincter spasm. A chronic anal fissure needs surgery. Perianal abscesses can very often be incised and drained in local anesthesia. Proctalgia fugax and the levator ani syndrome are exclusion diagnoses and are treated symptomatically.

  3. Endosonographic and manometric assessment of the anal sphincters after ileal pouch-anal anastomosis

    International Nuclear Information System (INIS)

    Sudol-Szopinska, I.; Jakubowski, W.; Ciesielski, A.; Bielecki, K.; Baczuk, L.; Tarnowski, W.

    2003-01-01

    Background. The aim of this study was to compare endosonography and manometry of the anal sphincters in patients after ileal pouch-anal anastomosis (IPAA). Patients and methods. Ten patients aged between 23 and 50 years with IPAA performed for ulcerative colitis were examined with anal endosonography (AES) and manometry. Results. AES visualised abnormal image of the internal anal sphincter (IAS) in 9 patients (90%). Defects of the external anal sphincter (EAS) and puborectalis muscle (PR) were shown in 4 patients (40%). In 5 patients (50%) correlation between endosonographic and manometric assessment for the all analysed muscles: IAS, EAS and PR was found. In 4 cases (40%) both methods correlated with the evaluation of the EAS only and in 1 patient (10%) no correlation was found. Correlation between both methods for the IAS was found in half of the patients (50%) while in the evaluation of the EAS and PR dynamic activity, it was found in 9 cases (90%). Conclusions. Anal endosonography and manometry allow us to assess the morphology as well as the function of the anal sphincters in patients with IPAA. The methods mentioned above show high correlation in the assessment of the EAS function (9 cases; 90%) whereas in the case of IAS, manometry frequently (5 patients; 50%) does not confirm endosonografically detected defects. (author)

  4. Chronic anal fissure: morphometric analysis of the anal canal at 3.0 Tesla MR imaging.

    Science.gov (United States)

    Erden, Ayşe; Peker, Elif; Gençtürk, Zeynep Bıyıklı

    2017-02-01

    OBJECTıVE: To compare the morphometric data relating to the muscular structures of the anal canal, in patients with chronic anal fissure and in control group, examined at a 3.0 Tesla MR system. Forty-seven consecutive patients with chronic anal fissure and randomly selected 40 patients who had no claims for perianal disease during their life time were included in the study. T2-weighted sagittal, high-resolution (HR) T2-weighted, and contrast-enhanced fat-suppressed T1-weighted oblique axial and oblique coronal images were retrospectively analyzed by two observers in consensus. Thickness of sphincteric muscles, anal canal length, anorectal angle, thickness of anococcygeal ligament, depth of Minor triangle, width between subcutaneous sphincters, vascularity of posterior commissure, visibility of posterosuperior projection of external sphincter, and angle between the distal anal canal and posterosuperior projection of external sphincter (H angle) in patients and in controls were compared and analyzed using t test, Mann-Whitney U test, and Spearman correlation. The patients with chronic anal fissure had longer anal canal (51.50 mm ± 0.91 vs. 44.11 mm ± 0.71; p = 0.000), thicker internal anal sphincter muscle at mid-anal level (4.18 ± 0.15 vs. 3.39 ± 0.07; p = 0.007), and wider space between subcutaneous external sphincters (11.39 ± 0.50 vs. 6.89 ± 0.22; p = 0.000). In patients, there was a positive correlation between H angle and external sphincter thickness at proximal (r = 0.347; p = 0.021), middle (r = 0427; p = 0.000), and distal (r = 0.518; p = 0.000)) levels of the anal canal. CONCLUSıON: 3.0 Tesla MR imaging provides detailed information about the morphometric changes in the anal sphincter muscles in patients with chronic anal fissure.

  5. [Surgical treatment of anal fistula].

    Science.gov (United States)

    Zeng, Xiandong; Zhang, Yong

    2014-12-01

    Anal fistula is a common disease. It is also quite difficult to be solved without recurrence or damage to the anal sphincter. Several techniques have been described for the management of anal fistula, but there is no final conclusion of their application in the treatment. This article summarizes the history of anal fistula management, the current techniques available, and describes new technologies. Internet online searches were performed from the CNKI and Wanfang databases to identify articles about anal fistula management including seton, fistulotomy, fistulectomy, LIFT operation, biomaterial treatment and new technology application. Every fistula surgery technique has its own place, so it is reasonable to give comprehensive individualized treatment to different patients, which may lead to reduced recurrence and avoidance of damage to the anal sphincter. New technologies provide promising alternatives to traditional methods of management. Surgeons still need to focus on the invention and improvement of the minimally invasive techniques. Besides, a new therapeutic idea is worth to explore that the focus of surgical treatment should be transferred to prevention of the formation of anal fistula after perianal abscess.

  6. Theoretical analysis of nuclear reactors (Phase II), I-V, Part IV, Depletion of nuclear fuel; Razrada metoda teorijske analize nuklearnih reaktora (II faza) I-V, IV Deo, Promena izotopnog sastava goriva

    Energy Technology Data Exchange (ETDEWEB)

    Pop-Jordanov, J [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1962-10-15

    This phase of the project deals with the U{sup 238} isotope chain with the analysis of Pu{sup 239} build-up. Part one of the report shows two theoretical approaches, one leading to a system of differential equations which could be solved by using a computer, and the second Machinari-Goto method which gives analytical expressions for approximations for certain isotopes. Part two includes the results obtained by using digital computer ZUSE-Z22-R.

  7. Anal Sphincter Augmentation Using Biological Material.

    Science.gov (United States)

    Alam, Nasra N; Narang, Sunil K; Köckerling, Ferdinand; Daniels, Ian R; Smart, Neil J

    2015-01-01

    The aim of this review is to provide an overview of the use of biological materials in the augmentation of the anal sphincter either as part of an overlapping sphincter repair (OSR) or anal bulking procedure. A systematic search of PubMed was conducted using the search terms "anal bulking agents," "anal sphincter repair," or "overlapping sphincter repair." Five studies using biological material as part of an overlapping sphincter repair (OSR) or as an anal bulking agent were identified. 122 patients underwent anal bulking with a biological material. Anorectal physiology was conducted in 27 patients and demonstrated deterioration in maximum resting pressure, and no significant change in maximum squeeze increment. Quality of life scores (QoLs) demonstrated improvements at 6 weeks and 6 months, but this had deteriorated at 12 months of follow up. Biological material was used in 23 patients to carry out an anal encirclement procedure. Improvements in QoLs were observed in patients undergoing OSR as well as anal encirclement using biological material. Incontinence episodes decreased to an average of one per week from 8 to 10 preoperatively. Sphincter encirclement with biological material has demonstrated improvements in continence and QoLs in the short term compared to traditional repair alone. Long-term studies are necessary to determine if this effect is sustained. As an anal bulking agent the benefits are short-term.

  8. Measurement of the effective resonance integral of natural uranium; Merenje efektivnog rezonantnog integrala prirodnog urana

    Energy Technology Data Exchange (ETDEWEB)

    Markovic, V; Kocic, A [Institute of nuclear sciences Boris Kidric, Vinca, Beograd (Yugoslavia)

    1965-12-15

    Good understanding of the nuclear properties of the materials in the reactor core is essential for reactor operation. One of the fundamental properties is the resonance absorption of the fuel, which is directly included in the reactor calculation through resonance escape probability and influences the choice of the materials quality in the core. This paper describes the measurement of resonance absorption integral of the natural uranium as a function of the S/M ratio. Improved experiment planning and analysis of results, as well as improvement of the ROB-1 reactor oscillator device related to the interpretation of results and decrease of reactor drift variations during measurement enabled higher precision of results compared to previous experiments. Poznavanje osobina nuklearnih karakteristika materijala koji ulaze u jezgro nuklearnog reaktora predstavlja bitan faktor u njegovom rezimu rada. Jedna od osnovnih je svakako rezonantna apsorpcija goriva, cija velicina - preko faktora rezonantnog izbegavanja - direktno ulazi u proracun nuklearnih reaktora i utice na izbor kvaliteta materijala koji ga sacinjavaju. U radu se opisuje merenje rezonantnog apsorpcionog integrala prirodnog urana u funkciji odnosa S/M. Bolja postavka eksperimenta i interpretacija rezultata, s jedne strane, i poboljsanje uredjaja reaktorskog oscilatora ROB-1 /1/ u pogledu analize podataka i smanjenja promene drifta reaktora u toku merenja, s druge strane, daju znacaj ovom radu u pogledu dobijanja preciznijih rezultata u odnosu na ranije /2/ (author)

  9. Trends in incidence of anal cancer and high-grade anal intraepithelial neoplasia in Denmark, 1978-2008

    DEFF Research Database (Denmark)

    Nielsen, Ann; Plum, Christian Edinger Munk; Kjaer, Susanne K

    2012-01-01

    The aim of the study was to determine the incidences of anal cancer and high-grade anal intraepithelial neoplasia (AIN2/3) over time in Danish women and men. Describing the burden of anal cancer and AIN may be valuable in future evaluations of the human papillomavirus (HPV) vaccine. We included all...... anal cancers in the Danish Cancer Register in the period 1978-2008 and all cases of AIN2/3 in the Danish Registry of Pathology. Overall and age-, period- and histology-specific incidence rates were estimated. During the 30-year period, 2187 anal cancers were identified, two thirds of which were...... in women. Between 1978-1982 and 2003-2008, the age-standardized incidence rate of anal cancer increased from 0.68 to 1.48 per 100 000 person-years in women and from 0.45 to 0.80 per 100 000 person-years in men. Although there is no systematic screening for AIN in Denmark, we nevertheless identified 608...

  10. HIV/AIDS, HPV and Anal Cancer

    Science.gov (United States)

    Wang, Chia-ching J.; Sparano, Joseph; Palefsky, Joel M.

    2016-01-01

    SYNOPSIS Anal cancer is an increasingly common non-AIDS-defining cancer among HIV-infected individuals. It is associated with human papillomavirus (HPV), the most common sexually transmitted infectious agent. The 14 oncogenic types of HPV are causally associated with 5–10% of all cancers, notably anogenital cancers. HPV16 is the most common genotype detected in about 70% of anal cancers. The HPV types detected in anal cancer are included in the 9-valent vaccine. HPV vaccines have demonstrated efficacy in reducing anal precancerous lesions in HIV-infected individuals. The standard treatment for anal cancer has been fluorouracil (5-FU) and mitomycin (or cisplatin) as chemotherapy agents plus radiation, which can also be effectively used for the HIV-infected patients. Continued studies will be needed to test new treatment strategies in HIV-infected patients with anal cancer to determine which treatment protocols provide the best therapeutic index. PMID:27889034

  11. Theoretical analysis of nuclear reactors (Phase I), I-V, Part V, Determining the fine flux distribution; Razrada metoda teorijske analize nuklearnih reaktora (I faza) I-V, V Deo, Odredjivanje fine raspodele fluksa

    Energy Technology Data Exchange (ETDEWEB)

    Pop-Jordanov, J [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1962-07-15

    Mono energetic neutron transport equation was solved by Carlson numerical method in cylindrical geometry. S{sub n} code was developed for the digital computer ZUSE Z23. Neutron flux distribution was determined for the RA reactor cell by applying S{sub 4} approximation. Reactor cell was treated as D{sub 2}O-U-D{sub 2}O system. Time of iteration was 185 s. Resena je transportna monoenergetska jednacina numerickom metodom Carlsona u cilindricnoj geometriji. Razvijanje S{sub n} kod za digitalnu masinu ZUSE-Z 23. Odredjena je raspodela fluksa u celiji reaktora RA S{sub 4} aproksimacijom. Celija je tretirana kao D{sub 2}O-U-D{sub 2}O. Vreme iteracije je 185 sec (author)

  12. ANAL SPHINCTER INJURIES (OASIS AT DELIVERY

    Directory of Open Access Journals (Sweden)

    Katja Jakopič

    2018-02-01

    Full Text Available Background: Anal incontinence severely impairs quality of life. It affects 4 to 19 % of women and is statistically related to number of vaginal deliveries. It is grossly underreported and most patients that do seek help are referred to gastroenterologists or colorectal surgeons. Incidence of recognized sphincter injuries at time of delivery is 1 to 2 %. However studies with anal ultrasound showed incidence of anal sphincter injuries at 28 to 41 %. Depending on the degree of injury symptoms range from partial to complete inability to control passing of winds, liquid or solid stools. About three thirds of patients are asymp- tomatic in puerperium, however half of them are at risk of developing anal incontinence in later life. Hypoestrogenisem, additional perineal trauma during consequent deliveries and sphincter atrophy can unmask anal sphincter damage years later. Timely recognition and treatment are vital for good long term results and quality of life, if possible immediately after delivery. Good knowledge of perineal anatomy, recognition of risk factors, intense search and appropriate treatment and follow-up are essential to management of anal sphincter injuries. All secondary sphincter repair is less effective. Content: Updated overview of current opinion and guidelines on anal sphincter injuries are pre- sented. Anal sphincter is composed of external anal sphincter (EAS and internal anal sphincter (IAS. Striated EAS is divided into three parts – subcutaneous, superficial, deep, and con- nected to puborectalis muscle posteriorly. Smooth-muscled IAS is a continuation of a cir- cular smooth-muscle layer of rectum. In between there is a thin longitudinal muscle layer. IAS constitutes 70 % of resting tone and is under constant contraction. EAS contributes to 30 % of resting tone and almost all pressure during active contraction. EAS injury leads to insufficient contraction after rectal sampling and filling which causes urgency – patient can

  13. Encopresis and anal masturbation.

    Science.gov (United States)

    Aruffo, R N; Ibarra, S; Strupp, K R

    2000-01-01

    Current pediatric and psychiatric studies on encopresis and its treatment are heavily influenced by mechanical, physiological, and behavioral considerations. Although psychodynamic treatment has generally been considered to be of little benefit, and its findings suspect, the authors suggest that a psychodynamic approach adds substantially to the understanding of some cases of encopresis; that the anal sensations and anal erotic feelings reported by a number of encopretic children are intense, and that the encopretic symptom, soiling, in these children is the result of a conscious form of anal masturbation in which the fecal mass is used for stimulation; and that any study of encopresis is incomplete that does not include what encopretic children, engaged in a sound therapeutic relationship, know and say about their soiling. The authors further suggest that physical treatments of those children whose encopresis is psychologically driven may be contraindicated. The presence of a large stool does not in itself substantiate a physical illness. Further research is needed to elucidate the prevalence of anal masturbation in encopretic children.

  14. Internal anal sphincter: Clinical perspective.

    Science.gov (United States)

    Kumar, Lalit; Emmanuel, Anton

    2017-08-01

    To summarise current knowledge of Internal anal sphincter. The internal anal sphincter (IAS) is the involuntary ring of smooth muscle in the anal canal and is the major contributor to the resting pressure in the anus. Structural injury or functional weakness of the muscle results in passive incontinence of faeces and flatus. With advent of new assessment and treatment modalities IAS has become an important topic for surgeons. This review was undertaken to summarise our current knowledge of internal anal sphincter and highlight the areas that need further research. The PubMed database was used to identify relevant studies relating to internal anal sphincter. The available evidence has been summarised and advantages and limitations highlighted for the different diagnostic and therapeutic techniques. Our understanding of the physiology and pharmacology of IAS has increased greatly in the last three decades. Additionally, there has been a rise in diagnostic and therapeutic techniques specifically targeting the IAS. Although these are promising, future research is required before these can be incorporated into the management algorithm. Copyright © 2016 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  15. Development of methods for theoretical analysis of nuclear reactors (Phase II), I-V, Part IV, Fuel depletion; Razrada metoda teorijske analize nuklearnih reaktora (II faza), I-V, IV Deo, Promena izotopnog sastava goriva

    Energy Technology Data Exchange (ETDEWEB)

    Pop-Jordanov, J [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1962-10-15

    This report includes the analysis of plutonium isotopes from U{sup 238} depletion chain. Two theoretical approaches for solving the depletion of fuel are shown. One results in the system of differential equations that can be solved only by using electronic calculators and the second, Machinari-Goto method enables obtaining analytical equations for approximative values of particular nuclei. In addition, differential equations are given for different approximation levels in calculating Pu {sup 239}, as well as relations between the released energy and irradiation. Ova faza obuhvata analizu stvaranja izotopa plutonijuma u lancu U{sup 238}. Prikazana su dva teorijska pristupa resavanju problema 'konverzije goriva', jedan dovodi do sistema diferecijalnih jednacina za cije je resavanje neophodno koriscenje elektronskih racunskih masina, i drugi, Machinari-Goto metod koji omogucava da se dobiju analiticki izrazi vrednosti aproksimacije pojedinih jezgara. Osim toga date su diferencijalne jednacine raznih stepena aproksimacije u racunanju Pu {sup 239}, kao i veze izmedju oslobodjene energije i ozracivanja.

  16. [Effectiveness of human papillomavirus genotyping for detection of high-grade anal intraepithelial neoplasia compared to anal cytology].

    Science.gov (United States)

    Padilla-España, Laura; Repiso-Jiménez, Juan Bosco; Fernández-Sánchez, Fernando; Pereda, Teresa; Rivas-Ruiz, Francisco; Fernández-Morano, Teresa; de la Torre-Lima, Javier; Palma, Fermín; Redondo, Maximino; de Troya-Martín, Magdalena

    2016-01-01

    The incidence of high-grade anal intraepithelial neoplasia (HGAIN) -with an aetiological based on high-risk types of human papillomavirus- is increasing in some high-risk groups. Screening for HGAIN includes routine anal cytology and, more recently, HPV genotyping. The main objective of this study was to determine the sensitivity and specificity of anal cytology and HPV genotyping for the detection of HGAIN. This is a study to determine the correlation of cytological and microbiological findings with anal biopsy findings in a cohort of patients at high risk of developing AIN referred to the department of sexually transmitted infections of the Hospital Costa del Sol, Spain, between January 2008 and December 2014. Of the 151 patients subjected to screening, a total of 92 patients, all of them with the result of three screening test (anal cytology, genotyping and biopsy) were included in the study. Just under two-thirds (62%) of them were HIV-positive. The sensitivity and specificity of anal cytology to detect HGAIN were 52.8 and 85.7%, respectively (k: 0.328), and 78 and 62.8% to detect two or more HPV oncogenic genotypes (k: 0.417). The detection of oncogenic HPV genotypes allowed the identification of 23 new cases of HGAIN that had been underdiagnosed with anal cytology, with 14 cases containing at least three high-risk genotypes. Anal cytology did not show enough sensitivity in HGAIN screening. HPV genotyping has shown to be a useful tool to detect HGAIN cases, although it could lead to an over-diagnosis as a solitary screening procedure. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  17. Anal squamous intraepithelial lesions in HIV+ MSM

    NARCIS (Netherlands)

    Siegenbeek van Heukelom, M.L.

    2018-01-01

    In this thesis we report on several aspects of high-grade anal squamous intraepithelial lesions (HSIL) in HIV+ men who have sex with men (MSM). It is estimated that 10% of HIV+ MSM with anal HSIL will develop anal squamous cell carcinoma (ASCC) over 30 years time. Screening programs similar to

  18. The importance of ultrasound findings in the study of anal pain Importancia de los hallazgos ecográficos en el dolor anal

    Directory of Open Access Journals (Sweden)

    A. M. Vieira

    2010-05-01

    Full Text Available Objective: endoanal ultrasonography can detect organic causes of anal pain without pathology on physical examination. The aim of this study is to evaluate the importance of endoanal ultrasonography in the diagnosis and therapeutic management of idiopathic and functional anal pain. Material and methods: retrospective study, between 15 March 2005 and 15 June 2008, of all patients with proctalgia and normal examination or with alterations not responsible for anal pain at proctologic exam that have undergone an endoanal ultrasonography. Results: a total of 90 patients were analyzed, with a mean age of 50.5 years, 58% were female. Twenty-three patients had functional anal pain clinic criteria. Endoanal ultrasonography revealed alterations in 49% of patients. The primary findings were changes in sphincters in 14 patients, followed by anal sepsis in 12 patients, anal fissure in 10 patients, perirectal lesions in 6 patients and ulcer of the anal canal in 2 patients. Of the patients with sphincter defects, 5 patients had criteria of chronic anal pain. In this group of patients, no differences were found in manometric and defecographic results between the different ultrasound abnormalities. Conclusions: the endoanal ultrasonography detected occult organic lesions to proctologic examination, in half the patients with anal pain. Ultrasound abnormalities were found in 22% of patients with functional anal pain. However, there was no correlation between ultrasound findings and physiological studies, and therefore could not find etiological or pathogenic factors of functional anal pain.Objetivo: la ecografía endoanal puede detectar causas orgánicas en el dolor anal sin patología en la exploración física. El objetivo de este estudio es evaluar la importancia de la ecografía endoanal en el diagnóstico y en el abordaje terapéutico del dolor anal idiopática y funcional. Material y métodos: estudio retrospectivo realizado entre el 15 de marzo de 2005 y el

  19. A Mouse Model for Human Anal Cancer

    Science.gov (United States)

    Stelzer, Marie K.; Pitot, Henry C.; Liem, Amy; Schweizer, Johannes; Mahoney, Charles; Lambert, Paul F.

    2010-01-01

    Human anal cancers are associated with high-risk human papillomaviruses (HPVs) that cause other anogenital cancers and head and neck cancers. As with other cancers, HPV16 is the most common high-risk HPV in anal cancers. We describe the generation and characterization of a mouse model for human anal cancer. This model makes use of K14E6 and K14E7 transgenic mice in which the HPV16 E6 and E7 genes are directed in their expression to stratified squamous epithelia. HPV16 E6 and E7 possess oncogenic properties including but not limited to their capacity to inactivate the cellular tumor suppressors p53 and pRb, respectively. Both E6 and E7 were found to be functionally expressed in the anal epithelia of K14E6/K14E7 transgenic mice. To assess the susceptibility of these mice to anal cancer, mice were treated topically with dimethylbenz[a]anthracene (DMBA), a chemical carcinogen that is known to induce squamous cell carcinomas in other sites. Nearly 50% of DMBA-treated HPV16 E6/E7 transgenic mice showed overt signs of tumors; whereas, none of the like treated non-transgenic mice showed tumors. Histopathological analyses confirmed that the HPV16 transgenic mice were increased in their susceptibility to anal cancers and precancerous lesions. Biomarker analyses demonstrated that these mouse anal cancers exhibit properties that are similar to those observed in HPV-positive precursors to human anal cancer. This is the first mouse model for investigating the contributions of viral and cellular factors in anal carcinogenesis, and should provide a platform for assessing new therapeutic modalities for treating and/or preventing this type of cancer. PMID:20947489

  20. Anal high-risk human papillomavirus infection and high-grade anal intraepithelial neoplasia detected in women and heterosexual men infected with human immunodeficiency virus

    Directory of Open Access Journals (Sweden)

    Gandra S

    2015-01-01

    Full Text Available Sumanth Gandra, Aline Azar, Mireya WessolosskyDivision of Infectious Disease and Immunology, University of Massachusetts Medical School, Worcester, MA, USABackground: Although anal high-risk human papillomavirus (HR-HPV infection and anal cytological abnormalities are highly prevalent among human immunodeficiency virus (HIV-infected men who have sex with men (MSM, there are insufficient data on these abnormalities among HIV-infected heterosexual men (HSM and women. In this study, we evaluated the prevalence of anal HR-HPV, cytological abnormalities, and performance of these screening tests in detecting high-grade anal intraepithelial neoplasia (AIN2+ among our cohort of HIV-infected MSM and non-MSM (HSM and women.Methods: A single-center, retrospective cohort study was conducted with HIV-infected individuals who underwent anal cancer screening with anal cytology and HR-HPV testing from January 2011 to January 31, 2013.Results: Screening of 221 HIV-infected individuals for both HR-HPV and anal cytology showed the presence of HR-HPV in 54% (abnormal anal cytology 48% of MSM, 28% (abnormal anal cytology 28% of HSM, and 27% (abnormal anal cytology 34% of women. Among 117 (53% individuals with abnormal results (HR-HPV-positive and/or cytology was atypical squamous cells of undetermined significance or above, 67 underwent high resolution anoscopy. Of these 67 individuals, 22 individuals had AIN2+ (17 MSM, four women, and one HSM. HR-HPV correlated better with AIN2+ than with anal cytology on biopsy in both MSM (r=0.29 versus r=0.10; P=0.05 versus P=0.49 and non-MSM (r=0.36 versus r=-0.34; P=0.08 versus P=0.09.Conclusion: Given the presence of AIN2+ in screened HIV-infected HSM and women, routine anal cancer screening in all HIV-infected individuals should be considered. HR-HPV merits further evaluation for anal cancer screening among non-MSM.Keywords: human immunodeficiency virus, anal human papillomavirus, heterosexual men, women, anal cancer

  1. Anal Itching

    Science.gov (United States)

    ... has many possible causes, such as skin problems, hemorrhoids, and washing too much or not enough. If ... dermatitis. Other medical conditions. These include chronic diarrhea, hemorrhoids, anal tumors and diseases that affect the whole ...

  2. Early discharge after external anal sphincter repair

    DEFF Research Database (Denmark)

    Rosenberg, J; Kehlet, H

    1999-01-01

    PURPOSE: The aim of this study was to describe an accelerated-stay program for repair of the external anal sphincter. METHODS: Twenty consecutive patients undergoing overlapping repair of the external anal sphincter were included in the study. Effect parameters were length of hospitalization....... CONCLUSION: We have described a safe accelerated-stay program (24 to 48 hours) for overlapping repair of external anal sphincter....

  3. Mode of delivery after obstetric anal sphincter injury.

    Science.gov (United States)

    Karmarkar, Roopali; Bhide, Alka; Digesu, Alex; Khullar, Vik; Fernando, Ruwan

    2015-11-01

    To assess the effect of vaginal delivery and caesarean section on faecal symptoms and structure and function of anal sphincter in women who sustained obstetric anal sphincter injuries (OASIS) in their previous pregnancy and were advised about the mode of delivery based on faecal incontinence symptoms, anal manometry and endoanal ultrasound. It is a descriptive study on a cohort of women who had OASIS from 2006 to 2013. They were assessed after OASIS and during subsequent pregnancy with a questionnaire, endoanal ultrasound and anal manometry. Vaginal delivery was recommended to asymptomatic women with normal investigations. Elective caesarean section was recommended to women with faecal symptoms, anal sphincter defects of more than 30° or low resting or incremental anal pressures. All women were reassessed after subsequent delivery. Fifty women who had pregnancies after OASIS, were seen after OASIS, during subsequent pregnancy and after the second delivery. 15 women had faecal symptoms after OASIS. The external, internal and combined anal sphincter defects were seen in 13, 11 and 9 women respectively. Low resting and incremental pressure were seen in 15 and 11 women respectively. Caesarean section was done in 22 women and 28 women delivered vaginally. Worsening of faecal symptoms and reduction in anal pressures were not observed in planned vaginal delivery or elective caesarean section groups. Faecal symptoms were worse with reduced anal pressures in three women from the planned caesarean section group. One of the women had a vaginal delivery and two women had emergency caesarean section at 7cm and 10cm dilatation. There were no new sphincter defects or recurrent OASIS in any of the women in the study group. Decision about the mode of delivery of pregnancy after OASIS based on symptoms, anal manometry and endoanal ultrasound helps in preserving the anal sphincter function and avoiding unnecessary caesarean sections. Further follow-up of these patients is essential

  4. Diagnóstico de HPV anal em mulheres com NIC: prevenção de câncer do ânus? Anal HPV diagnosis in women with NIC: anal cancer prevention?

    Directory of Open Access Journals (Sweden)

    Alice Capobiango

    2009-12-01

    Full Text Available Os objetivos deste estudo foram avaliar a frequência de HPV anal em pacientes com neoplasia intraepitelial cervical (NIC, verificar a concordância entre os subtipos encontrados nos dois locais e investigar os fatores que influenciaram a ocorrência de HPV anal em mulheres com NIC sem evidências clínicas de imunodepressão. Foram avaliadas 52 mulheres com idades entre 16 e 72 anos e diagnóstico de neoplasia intraepitelial cervical graus I, II e III. A identificação do DNA (ácido desoxirribonucleico do HPV e de sete subtipos dos vírus foi realizada por meio da reação em cadeia da polimerase (PCR em material colhido no ânus e colo uterino. Foram pesquisados fatores que poderiam contribuir para a infecção anal, como paridade, número de parceiros, tabagismo, manipulação e coito anal e o tipo de doença ginecológica. Das 52 mulheres, foi diagnosticado HPV na região anal em 25 (48%, das quais 23 (44% também apresentavam HPV no colo uterino - resultado significativo para existência do HPV em portadoras de NIC. Em 16 (31% o HPV foi diagnosticado somente no colo uterino e em 11 (21% não foi identificado em colo ou ânus. Houve associação significativa nas variáveis paridade (p=0,02 e número de parceiros (p=0,04. Concluiu-se que: as mulheres com HPV genital têm mais probabilidade de serem acometidas por HPV anal; não há concordância unânime entre os subtipos do HPV do colo do útero e do ânus e a paridade e o número de parceiros contribuem para aumentar a incidência de HPV anal nas mulheres sem imunodeficiência e com HPV cervical.This study aims were to assess the frequency of HPV anal infection in patients with cervical intra-epithelial neoplasia (CIN, to find out the relation between the found subtypes, when present in both regions, and investigate factors that influenced the occurrence of anal HPV in women with CIN. Fifty two women with age between 16 and 72 years and cervical intra-epithelial neoplasia (CIN diagnosis

  5. Botulinum toxin A injection for chronic anal fissures and anal sphincter spasm improves quality of life in recessive dystrophic epidermolysis bullosa

    Directory of Open Access Journals (Sweden)

    Cassandra Chaptini, MBBS

    2015-12-01

    Full Text Available We report a 20-year-old female with generalized, severe, recessive dystrophic epidermolysis bullosa who developed secondary chronic anal fissures. This resulted in anal sphincter spasm and severe, disabling pain. She was treated with five botulinum toxin A injections into the internal anal sphincter over a period of 2 years and gained marked improvement in her symptoms. This case demonstrates the successful use of botulinum toxin A injections to relieve anal sphincter spasm and fissuring, with long-term improvement.

  6. Anal intraepithelial neoplasia in HIV+ men

    NARCIS (Netherlands)

    Richel, O.

    2014-01-01

    In this thesis we investigated several aspects of anal intraepithelial neoplasia (AIN) in HIV+ men who have sex with men (MSM). This condition has gained clinical interest because of the impressive increase of the anal cancer incidence in HIV+ MSM since the introduction of combination antiretroviral

  7. Electrocautery Superior to Topical Treatments for Precancerous Anal Lesions

    Science.gov (United States)

    ... Professional Anal Cancer Treatment Anal Cancer Prevention Research Electrocautery Superior to Topical Treatments for Precancerous Anal Lesions ... randomized clinical trial conducted in Amsterdam suggest that electrocautery is better than topical imiquimod or fluorouracil at ...

  8. Neuronal hyperplasia in the anal canal

    DEFF Research Database (Denmark)

    Fenger, C; Schrøder, H D

    1990-01-01

    In a consecutive series of minor surgical specimens from the anal canal, neuronal hyperplasia was found in nine of 56 haemorrhoidectomy specimens and in four of 23 fibrous polyps. In an additional series of 14 resections of the anal canal, neuronal hyperplasia was present in six cases, of which f...

  9. Anal Cancer Treatment (PDQ®)—Patient Version

    Science.gov (United States)

    Anal cancer is uncommon, but often curable with treatment. Treatments include radiation therapy, chemotherapy, and surgery. Get detailed information about anal cancer including risk factors, symptoms, diagnosis, prognosis, and treatment in this expert-reviewed summary.

  10. Diagnostic methods for prevention of anal cancer and characteristics of anal lesions caused by HPV in men with HIV/AIDS

    Directory of Open Access Journals (Sweden)

    Araiz Cajueiro Carneiro Pereira

    Full Text Available Abnormalities found with anuscopy under colposcopic vision, anal cytology and anal biopsy were evaluated in 21 men with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS at the Federal University of Pernambuco Hospital in Brazil. Mean age was 38.4 ± 6.0 years, and mean time of HIV infection was 8.3 ± 5.1 years; 95.2% of the patients had been on highly active antiretroviral therapy (HAART for an average of 6.6 ± 4.5 years. Mean CD4+ cell count was 482.2 ± 173.75 cells/mm³, and 80.9% presented a HIV viral load of < 5,000 copies/mL. Reported sexual preference was 52.4% homosexuals, 28.6% bisexuals, and 19.0%heterosexuals; 81% reported having had receptive anal intercourse and 61.9% reported more than 10 sexual partners of the same sex. Results of anuscopy under colposcopic vision revealed 17 (81.0% low-grade lesions and/or condylomata or micropapillae and four (19.0% high-grade lesions with or without condylomata. Among the 21 anal cytology examinations, seven (33.3% revealed low-grade squamous intraepithelial lesions (LSIL; three (14.3% presented atypical squamous cells of undetermined significance (ASCUS and 11 (52.4% were normal. Seventeen patients were submitted to anal biopsy with the following findings: three patients (17.6% with normal epithelium, one (5.9% with infection by HPV, three (17.6% with condylomatas, two (11.8% with AIN 1, four (23.6% with AIN 2, three (17.6% with AIN 3, and one (5.9% with PAIN 2. Anuscopy under colposcopic vision was found to be useful for detecting anal lesions and for guiding anal biopsies. Anal cytology was less useful, as it underestimated the frequency of lesions.

  11. Ettevõtte konkurentsieelis inimeste analüüsi abil / Mait Raava

    Index Scriptorium Estoniae

    Raava, Mait

    2015-01-01

    Ettevõtte töötajate analüüsimisest, analüütika tulemuste rakendamisest juhtivates ettevõttes. Viiest sambast, millel põhineb inimeste analüüsi edukas rakendamine, analüütika rakendamise etapid

  12. Detection of tritium in the air surrounding the heavy water reactors; Elementi detekcije tricijuma u vazduhu kod teskovodnih nuklearnih reaktora

    Energy Technology Data Exchange (ETDEWEB)

    Ninkovic, M; Matic-Vukmirovic, Z; Hadzisehovic, M [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1967-03-15

    This paper contains the study of the literature concerned with physical properties of the tritium, problems of detection control of the tritium level in the atmosphere in the vicinity of heavy water reactors. It is stated that a complete and efficient control of tritium activity, from radiation protection point of view can be achieved only by simultaneous triple measurements: direct measurement of tritium in the air by stationary or movable instruments; air sampling and measurement of activity by laboratory instrumentation; and measurement of tritium in the bio-material of the personnel who have inhaled air contaminated with tritium. Laboratory equipment was adapted for tritium detection in air samples. A method for measuring the specific tritium activity was developed and implemented. The tritium level and distribution in the air were measured during exchange of the fuel channel in the RA reactor. The obtained results indicate that tritium could be dangerous for the staff involved. Proucena je literatura u kojoj se tretiraju osnovne fizicke karakteristike tricijuma, kao i problemi detekcije i kontrole u vazduhu kod teskovodnih nuklearnih reaktora. Utvrdjeno je da kompletna i efikasna kontrola aktivnosti tricijuma, sa aspekta zastite od zracenja, moze biti ostvarena samo ako se vrse istovremeno trostruka merenja: merenje aktivnosti tricijuma u vazduhu direktno, prenosnim ili stacioniranim instrumentima; uzimanje uzoraka vazduha i merenje aktivnosti na laboratorijskoj aparaturi; i merenje aktivnosti tricijuma u biomaterijalu osoblja koje je udisalo vazduh kontaminiran tricijumom. Izvrsena je adaptacija laboratorijske aparature za potrebe detekcije tricijuma u uzorcima vazduha. Razradjen je i uhodan postupak merenja koncentracije aktivnosti tricijuma u uzorcima vazduha. Izvrsena su merenja i dobijeni su rezultati o nivou i raspodeli tricijuma u vazduhu pri operaciji zamene kanala sa gorivom na reaktoru RA u Vinci. Dobijeni rezultati ukazuju na opasnost koju po radno

  13. Nocturnal faecal soiling and anal masturbation.

    Science.gov (United States)

    Clark, A F; Tayler, P J; Bhate, S R

    1990-01-01

    Two cases of late onset faecal soiling as a result of anal masturbation in children who were neither mentally handicapped nor psychotic were studied. The role of soiling in aiding the young person and his family to avoid separating and maturing is highlighted. We suggest that the association of anal masturbation and resistant nocturnal soiling may be unrecognised. PMID:2270946

  14. Complex anal fistulas: plug or flap?

    Science.gov (United States)

    Muhlmann, Mark D; Hayes, Julian L; Merrie, Arend E H; Parry, Bryan R; Bissett, Ian P

    2011-10-01

    Rectal mucosal advancement flaps (RMAF) and fistula plugs (FP) are techniques used to manage complex anal fistulas. The purpose of this study was to review and compare the results of these methods of repair. A retrospective review of all complex anal fistulas treated by either a RMAF or a FP at Auckland City Hospital from 2004 to 2008. Comparisons were made in terms of successful healing rates, time to failure and the use of magnetic resonance imaging. Overall, 70 operations were performed on 55 patients (55.7% male). The mean age was 44.9 years. Twenty-one patients (30%) had had at least one previous unsuccessful repair. Indications for repair included 57 high cryptoglandular anal (81%), 4 Crohn's anal (6%), 7 rectovaginal (10%), 1 rectourethral (1%) and 1 pouch-vaginal fistula (1%). All patients were followed up with a mean of 4.5 months. Forty-eight RMAFs (69% of total) were performed with 16 successful repairs (33%). Twenty-two FPs (31% of total) were performed with 7 successful repairs (32%, P = 0.9). In failed repairs, there was no difference in terms of mean time to failure (RMAF 4.8 months versus FP 4.1 months, P = 0.62). Magnetic resonance imaging was performed in 21 patients (37%) before the repair. The success rate in these patients was 20%. The results of treatment of complex anal fistulas are disappointing. The choice of operation of either a RMAF or a FP did not alter the poor healing rates of about one third of patients in each group.

  15. Environmental scan of anal cancer screening practices: worldwide survey results

    International Nuclear Information System (INIS)

    Patel, Jigisha; Salit, Irving E; Berry, Michael J; Pokomandy, Alexandra de; Nathan, Mayura; Fishman, Fred; Palefsky, Joel; Tinmouth, Jill

    2014-01-01

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey via email and/or fax. Information was collected on populations screened, services and treatments offered, and personnel. Over 300 invitations were sent; 82 providers from 80 clinics around the world completed the survey. Fourteen clinics have each examined more than 1000 patients. Over a third of clinics do not restrict access to screening; in the rest, eligibility is most commonly based on HIV status and abnormal anal cytology results. Fifty-three percent of clinics require abnormal anal cytology prior to performing high-resolution anoscopy (HRA) in asymptomatic patients. Almost all clinics offer both anal cytology and HRA. Internal high-grade anal intraepithelial neoplasia (AIN) is most often treated with infrared coagulation (61%), whereas external high-grade AIN is most commonly treated with imiquimod (49%). Most procedures are performed by physicians, followed by nurse practitioners. Our study is the first description of global anal cancer screening practices. Our findings may be used to inform practice and health policy in jurisdictions considering anal cancer screening

  16. Vascularized anal autotransplantation model in rats: preliminary report.

    Science.gov (United States)

    Araki, J; Mihara, M; Narushima, M; Iida, T; Sato, T; Koshima, I

    2011-11-01

    Ostomy has served as an effective surgery for various anorectal disfunctions. However, it must also be noted that those patients suffered greatly from stresses caused by their stoma. Many alternative therapies have been developed, but none have solved this critical issue. Meanwhile, due to the improvements in operative methods and immunosuppressive therapy, allotranplantation has gained great popularity in recent years. Therefore, we began development of an anal transplantation model. The operation was performed in six adult Wistar rats that were divided into two groups. Group 1 underwent vascular anastomoses, while group 2 did not Group 1 grafts survived, fully recovering anal function. However, many of the group 2 grafts did not survive; those that did survive showed major defects in their anus, never recovering anal function. We succeeded in establishing the rat anal transplantation model utilizing super-microsurgery. While research in anal transplantation was behind compared to that in other fields, we hope that this model will bring significant possibilities for the future. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. Rastreamento e seguimento dos portadores das lesões anais induzidas pelo papilomavírus humano como prevenção do carcinoma anal Screening and follow-up of patients with anal HPV induced lesions for anal carcinoma prevention

    Directory of Open Access Journals (Sweden)

    Sidney Roberto Nadal

    2009-06-01

    Full Text Available O Papilomavírus humano (HPV é o agente sexualmente transmissível mais comum na região perianal. O vírus provoca lesões clínicas e subclínicas que podem evoluir para carcinoma anal. É descrito o aumento da incidência desse tipo de tumor naqueles que praticam sexo anal; nos portadores, de ambos os sexos, de lesões genitais HPV induzidas; nas pessoas com neoplasias intraepiteliais anais de alto grau, o precursor do carcinoma, com maior incidência nos infectados pelo vírus da imunodeficiência humana (HIV, e com outras causas de supressão imunológica. Outra característica das lesões HPV induzidas é a elevada incidência de recidivas. Daí, a importância do seguimento por longo prazo e da pesquisa de meios terapêuticos para reduzir essa ocorrência. A possibilidade da detecção das lesões precursoras indica que programas padronizados de rastreamento para a prevenção do câncer anal deveriam ser instituídos. Os esfregaços anais para citologia vêm sendo realizados, com eficácia semelhante a das coletas cervicais e a colposcopia anal tem sido indicada para biópsias dirigidas quando a citologia mostrou-se alterada, embora muitos recomendam-na, também, como método de rastreamento. Nesse artigo, descrevemos a padronização da coleta de material para citologia anal e o método de realização da colposcopia anal, bem como a periodicidade com que devem ser repetidos.The human papillomavirus is the most frequent sexually transmitted agent in anorectal area. This virus provokes clinical and sub-clinical lesions that can evolve to anal carcinoma. Its incidence is increasing among those who practice anal receptive sex; in both gender patients with genital HPV induced lesions; in those with high grade anal intra-epithelial neoplasia, anal carcinoma precursor, mainly among HIV infected persons or with other causes of immunodeficiency. Another HPV induced lesions characteristic is their elevated incidence of recurrences. Therefore

  18. Prevalence of anal cytological abnormalities in women with positive cervical cytology.

    Science.gov (United States)

    Calore, Edenilson E; Giaccio, Claudia Maria Serafim; Nadal, Sidney R

    2011-05-01

    The objective of this study was to estimate the prevalence of cytological abnormalities of the anal mucosa in women with positive cervical cytology, but without macroscopic anal lesion. Ultimately we postulated if the anal mucosa may be a reservoir of HPV, which would allow the reinfection of cervix. Forty-nine patients with abnormal cervical cytology were selected for this work. In a period not exceeding one week of collecting cervix cytology, two swab specimens of the anal canal were also collected. Women diagnosed with cervical HSIL by Pap smear were referred for colposcopy with biopsy of the lesions, to confirm the cytologic diagnosis and ablation of the lesion. We demonstrated a high prevalence of anal squamous intraepithelial lesions in patients with cervical squamous intraepithelial lesions (29 of the total of 49 patients = 59.2%). Of the 20 cases of cervical LSIL, 11 (55%) had abnormal anal cytology. Of the 26 cases with cervical HSIL, 16 (61.5%) had abnormal anal cytology. So, there was a discrete higher prevalence of abnormal anal cytology in cases of high-grade cervical squamous lesions (cervical HSIL). These results help to support the hypothesis that the anal mucosa is a reservoir of HPV, which can be a source of re-infection for the cervix. However, there was no significant association between the practice of anal sex and the prevalence of anal cytological abnormalities. These facts are epidemiologically important for future programs for population eradication of cervical lesions related to HPV. Diagn. Cytopathol. 2011;39:323-327. © 2010 Wiley-Liss, Inc. Copyright © 2010 Wiley-Liss, Inc.

  19. Early effect of external beam radiation therapy on the anal sphincter: A study using anal manometry and transrectal ultrasound

    International Nuclear Information System (INIS)

    Birnbaum, E.H.; Dreznik, Z.; Myerson, R.J.; Lacey, D.L.; Fry, R.D.; Kodner, I.J.; Fleshman, J.W.

    1992-01-01

    The early of pelvic irradiation on the anal sphincter has not been previously investigated. This study prospectively evaluated the acute effect of preoperative radiation on anal function. Twenty patients with rectal carcinoma received 4,500 cGy of preoperative external beam radiation. The field of radiation included the sphincter in 10 patients and was delivered above the anorectal ring in 10 patients. Anal manometry and transrectal ultrasound were performed before and four weeks after radiotherapy. No significant difference in mean maximal squeeze or resting pressure was found after radiation therapy. An increase in mean minimal sensory threshold was significant. Histologic examination revealed minimal radiation changes at the distal margin in 8 of 10 patients who underwent low anterior resection and in 1 of 3 patients who underwent abdominoperineal resection. The authors conclude that preoperative radiation therapy has minimal immediate effect on the anal sphincter and is not a major contributing factor to postoperative incontinence in patients after sphincter-saving operations for rectal cancer

  20. Diagnostic imaging features of normal anal sacs in dogs and cats.

    Science.gov (United States)

    Jung, Yechan; Jeong, Eunseok; Park, Sangjun; Jeong, Jimo; Choi, Ul Soo; Kim, Min-Su; Kim, Namsoo; Lee, Kichang

    2016-09-30

    This study was conducted to provide normal reference features for canine and feline anal sacs using ultrasound, low-field magnetic resonance imaging (MRI) and radiograph contrast as diagnostic imaging tools. A total of ten clinically normal beagle dogs and eight clinically normally cats were included. General radiography with contrast, ultrasonography and low-field MRI scans were performed. The visualization of anal sacs, which are located at distinct sites in dogs and cats, is possible with a contrast study on radiography. Most surfaces of the anal sacs tissue, occasionally appearing as a hyperechoic thin line, were surrounded by the hypoechoic external sphincter muscle on ultrasonography. The normal anal sac contents of dogs and cats had variable echogenicity. Signals of anal sac contents on low-field MRI varied in cats and dogs, and contrast medium using T1-weighted images enhanced the anal sac walls more obviously than that on ultrasonography. In conclusion, this study provides the normal features of anal sacs from dogs and cats on diagnostic imaging. Further studies including anal sac evaluation are expected to investigate disease conditions.

  1. HAART slows progression to anal cancer in HIV-infected MSM.

    Science.gov (United States)

    Duncan, Katrina C; Chan, Keith J; Chiu, Connie G; Montaner, Julio S G; Coldman, Andy J; Cescon, Angela; Au-Yeung, Christopher G; Wiseman, Sam M; Hogg, Robert S; Press, Natasha M

    2015-01-28

    Antiretrovirals do not prevent anal intraepithelial neoplasia. However, the influence of antiretrovirals in the natural history of invasive anal cancer is less clear. The objective is to investigate the impact of antiretrovirals in the time to the development of anal cancer in HIV-positive MSM. A retrospective analysis of cases of anal cancer in a cohort of HIV-positive MSM receiving antiretrovirals between 1988 and 2008. Time from first CD4 cell count or HIV RNA viral load test to anal cancer diagnosis was analysed using Cox regression and Kaplan-Meier curves. Anal cancer cases treated in the era prior to HAART (cancer cases (n = 37) were compared with a cohort of 1654 HIV-positive MSM on antiretrovirals. Antiretrovirals were started in the pre-HAART era by 70% of cancer cases, and median CD4 cell count nadir was 70 cells/μl (10-130). Time to development of anal cancer was shorter for cases treated during the pre-HAART era [adjusted hazard ratio (AHR) 3.04, 95% confidence interval (95% CI) 1.48-6.24, P = 0.002], with a CD4 cell count nadir less than 100 cells/μl (AHR 2.21, 95% CI 1.06-4.62, P = 0.035) and longer duration of CD4 cell count less than 100 cells/μl (AHR 1.33, 95% CI 1.11-1.58, P = 0.002). Results show that severe immunosuppression and starting therapy pre-HAART are associated with an increased risk of anal cancer. HIV-positive MSM initiating antiretrovirals during the HAART era (1996-2008) had a longer time to the development of anal cancer than those treated pre-HAART. Our results suggest that early use of HAART may delay progression to anal cancer.

  2. Anal metastasis originating from colorectal cancer: Report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Min; Lim, Joon Seok; Choi, Jin Young; Park, Mi Suk; Kim, Myeong Jin [Dept. of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of); Chung, Taek; Kim, Ho Guen [Dept. of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-12-15

    Anal metastasis from colorectal cancer rarely occurs, but it severely impairs the patient's quality of life, often requiring wide resection including the anal sphincter with permanent colostomy. This lesion can be misdiagnosed as a perianal fistula or an abscess, and it can be overlooked at the time of surgery because it is not included in the routine surgical extent of low anterior resection. We report two rare cases of anal metastasis from colorectal cancer. In both cases, perianal nodules with an internal solid portion were detected on preoperative rectal magnetic resonance imaging and additional local excisions of the anal lesions were performed during the process of treatment. Anal metastasis was pathologically confirmed by histology and immunohistochemical staining.

  3. Avaliação manométrica anal de crianças com encoprese Anal manometric evaluation of children with encopresis

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora Prolungatti Cesar

    2010-12-01

    Full Text Available INTRODUÇÃO: A constipação crônica é doença comum na infância, ocorrendo em 5 a 10% dos pacientes pediátricos, considerada a segunda maior causa de procura nos consultórios de pediatria, sendo a encoprese decorrente de constipação grave associada à impactação fecal no reto. Dentre os exames diagnósticos, a manometria anal é utilizada para a avaliação de pacientes com distúrbios funcionais, como a constipação intestinal e a incontinência fecal, em alguns serviços para a avaliação de pacientes com encoprese, pois pode trazer informações sobre o mecanismo evacuatório e possíveis lesões esfincterianas anais. OBJETIVO: Verificar alterações manométricas em pacientes com encoprese. MÉTODOS: Foi realizado estudo de 40 manometrias anais de crianças constipadas com encoprese (G1 e 12 crianças constipados sem encoprese (G2. Foram obtidos os seguintes dados: pressões de repouso, contração e evacuação do canal anal e ampola retal, ponto de maior pressão, reflexo inibitório anal e sensibilidade retal. As manometrias foram realizadas com o aparelho Alacer de perfusão com 8 canais. RESULTADOS: Não foram encontradas diferenças nas pressões de repouso, contração e evacuação do canal anal entre os grupos. Chamou-nos a atenção a ausência de necessidade de maior volume retal para desencadear o reflexo inibitório anal. Não houve diferença da incidência de anismus entre os dois grupos, demonstrando que não se trata de fator importante na manutenção da encoprese, mas sim da constipação. CONCLUSÃO: Não houve necessidade de maior volume para desencadear o reflexo inibitório anal. O anismus não foi diferente entre os dois grupos, não sendo importante na manutenção da encoprese.INTRODUCTION: Chronic constipation is a common childhood disorder that affects 5 to 10% of pediatric patients, being the second most common cause for seeking medical help, with the encopresis arising out of severe constipation

  4. Sotsiaalvõrgustike analüüs / Innar Liiv

    Index Scriptorium Estoniae

    Liiv, Innar, 1982-

    2005-01-01

    Sotsiaalvõrgustike analüüs (social network analys - SNA) on tehnikate, meetodite ning vahendite kogum, mis aitab avastada mustreid sotsiaalsetes struktuurides. Analüüsi kasutamisest energeetikaettevõtte Enron ja kohalike ettevõtete võrgustike näitel. Skeemid

  5. Anal Cancer Treatment (PDQ®)—Health Professional Version

    Science.gov (United States)

    Anal cancer is often curable with treatment. Major prognostic factors are site, size, and nodal status. Treatments include radiation therapy, chemotherapy, and surgery. Get detailed information for anal cancer risk factors, classification, staging, prognosis, and treatment in this summary for clinicians.

  6. KRAS and BRAF mutations in anal carcinoma

    DEFF Research Database (Denmark)

    Serup-Hansen, Eva; Linnemann, Dorte; Høgdall, Estrid

    2015-01-01

    the frequency and the prognostic value of KRAS and BRAF mutations in a large cohort of patients with anal cancer. One hundred and ninety-three patients with T1-4N0-3M0-1 anal carcinoma were included in the study. Patients were treated with curative (92%) or palliative intent (8%) between January 2000...

  7. Recent Advances in the Pharmacotherapy of Chronic Anal Fissure: An Update

    Directory of Open Access Journals (Sweden)

    Bikash Medhi

    2008-07-01

    Full Text Available Surgical sphincterotomy reduces anal tone and sphincter spasm and promotes ulcer healing. Because the surgery is associated with the side effect of faecal incontinence, pharmacological agents to treat chronic anal fissure have been explored recently. Glyceryl trinitrate (GTN ointment (0.2% has an efficacy of up to 68% in healing chronic anal fissure, but it is associated with headache as the major and most common side effect. Though botulinum toxin injected into the anal sphincter healed over 80% of chronic anal fis-sures, it is more invasive and expensive than GTN therapy. Diltiazem ointment achieved healing of chronic anal fissure comparable to 0.2% GTN ointment but was associated with fewer side effects. Other drugs that have been tried are lidocaine, the alpha-adrenergic antagonist indoramin, and the potassium channel opener minoxidil.

  8. Abnormal anal cytology risk in women with known genital squamous intraepithelial lesion

    Directory of Open Access Journals (Sweden)

    Maria do Socorro Nobre

    2016-05-01

    Full Text Available The purpose of this study was to assess the risk of abnormal anal cytology in women with known genital squamous intraepithelial lesion. This study evaluated 200 women with and without genital squamous intraepithelial lesion who were recruited for anal Pap smears. Women who had abnormal results on equally or over atypical squamous cells of undetermined significance were classified as having abnormal anal cytology. A multiple logistic regression analysis (stepwise was performed to identify the risk for developing abnormal anal cytology. Data were analyzed using the SPSS 20.0 program. The average age was 41.09 (±12.64. Of the total participants, 75.5% did not practice anal sex, 91% did not have HPV-infected partners, 92% did not have any anal pathology, and 68.5% did not have anal bleeding. More than half (57.5% had genital SIL and a significant number developed abnormal anal cytology: 13% in the total sample and 17.4% in women with genital SIL. A significant association was observed between genital squamous intraepithelial lesion and anal squamous intraepithelial lesion (PR = 2.46; p = 0.03. In the logistic regression model, women having genital intraepithelial lesion were more likely to have abnormal anal Pap smear (aPR = 2.81; p = 0.02. This report shows that women with genital squamous intraepithelial lesion must be more closely screened for anal cancer.

  9. Using of thermoradiotherapy on treatment of cancerous growths of anal canal

    International Nuclear Information System (INIS)

    Timofeev, Yu.M.; Zikiryakhodjaev, D.Z.

    1997-01-01

    In this chapter of book authors investigated using of thermoradiotherapy on treatment of cancerous growths of anal canal, methods of using of thermoradiotherapy at morbid with anal cancer, methods of irradiation, the characteristic of clinical observations, using of thermoradiotherapy at treatment of epidermoid cancer of anal zone, using of thermoradiotherapy at treatment of non epithelial cancer of anal zone and using thermoradiotherapy at others types of cancerous growths

  10. The impact of anaemia on treatment outcome in patients with squamous cell carcinoma of anal canal and anal margin

    Directory of Open Access Journals (Sweden)

    Oblak Irena

    2016-03-01

    Full Text Available Radiochemotherapy is the main treatment for patients with squamous cell carcinoma of the anal canal. Anaemia is reported to have adverse effect on survival in cancer patients. The aim of the study was to evaluate the influence of anaemia on radiochemotherapy treatment outcome in patients with squamous cell carcinoma of the anal canal.

  11. Seoseid loov kunstiteose analüüs / Anneli Porri

    Index Scriptorium Estoniae

    Porri, Anneli, 1980-

    2013-01-01

    Kunstiteose analüüsi seosest riikliku õppekavaga, ülevaade kunstiteose analüüsimeetoditest kunstiteaduses ning metoodilistest tähelepanekutest kunsti ja visuaalkultuuri kujutiste vaatamise kohta gümnaasiumi kunstitunnis

  12. Patients with newly diagnosed cervical cancer should be screened for anal human papilloma virus and anal dysplasia: Results of a pilot study using a STELLA computer simulation and economic model

    OpenAIRE

    Eli D. Ehrenpreis; Dylan G. Smith

    2018-01-01

    Background: Women with cervical cancer often have anal human papillomavirus (HPV) infection and anal dysplasia. However, effectiveness of anal HPV screening is unknown. Methods: A dynamic model was constructed using STELLA. Populations are represented as ''stocks'' that change according to model rates. Initial anal cytology in new cervical cancer patients, dysplasia progression and regression, cost of treating high-grade squamous intraepithelial lesions (HSIL), and lifetime costs for anal can...

  13. Utilidade da citologia anal no rastreamento dos homens heterossexuais portadores do HPV genital Anal cytology for screening heterosexual men harboring genital HPV infection

    Directory of Open Access Journals (Sweden)

    Raphael Marianelli

    2010-09-01

    Full Text Available Os papilomavírus humanos (HPV de alto risco estão fortemente relacionados à etiologia do carcinoma espinocelular (CEC anogenital e suas lesões precursoras. O HPV-16 é o tipo mais freqüente, estando presente em até 87% dos CEC do canal anal HPV-positivo. Apesar de ser relativamente raro, vem sendo cada vez mais diagnosticado, nas últimas décadas, sobretudo em indivíduos do sexo masculino. A incidência é ainda mais elevada nos grupos considerados de risco, particularmente, os homens e as mulheres HIV-positivo e os homens que fazem sexo com homens (HSH. Grande parte das pesquisas direcionadas à infecção anal pelo HPV e sua relação com neoplasia intraepitelial-anal (NIA e com o carcinoma esteve focada nos grupos de risco. Pouco interesse vem sendo destinado à investigação dos homens heterossexuais. Estudos epidemiológicos da prevalência da infecção pelo HPV em homens, mostraram que os heterossexuais masculinos apresentavam infecção anal pelo HPV em até 12%. As Sociedades médicas e os especialistas recomendam o rastreamento dos portadores de imunodepressão e dos HSH com citologia do raspado do canal anal. Entretanto, até o momento, não há recomendação de rastreamento para homens que fazem sexo com mulheres.The oncogenic human papillomaviruses (HPV are straightly associated with anogenital cancer and dysplasia. The HPV-16 is the most common type, isolated in 87% of the HPV-positive anal squamous cell carcinoma (SCC. Despite being a rare tumor, the incidence of SCC has increased in the last decades, especially in males. Incidence is particularly high amongst men who have sex with men (MSM and among HIV infected men and women. For decades anogenital HPV researches have largely focused risk groups. Poor interest was intended to men who have sex with women (MSW. Prevalence studies of HPV infection in MSW have demonstrated that anal infection was identified in as far as 12%. Medical societies and specialists recommend anal

  14. Anal squamous carcinoma: a new AIDS-defining cancer? Case report and literature review

    Directory of Open Access Journals (Sweden)

    Marcelo Corti

    2012-12-01

    Full Text Available Squamous anal cell carcinoma is a rare malignancy that represents the 1.5% to 2% of all the lower digestive tract cancers. However, an increased incidence of invasive anal carcinoma is observed in HIV-seropositive population since the widespread of highly active antiretroviral therapy. Human papillomavirus is strongly associated with the pathogenesis of anal cancer. Anal intercourse and a high number of sexual partners appear to be risk factors to develop anal cancer in both sexes. Anal pain, bleeding and a palpable lesion in the anal canal are the most common clinical features. Endo-anal ultrasound is the best diagnosis method to evaluate the tumor size, the tumor extension and the infiltration of the sphincter muscle complex. Chemoradiotherapy plus antiretroviral therapy are the recommended treatments for all stages of localized squamous cell carcinoma of the anal canal in HIV-seropositive patients because of its high rate of cure. Here we present an HIV patient who developed a carcinoma of the anal canal after a long time of HIV infection under highly active antiretroviral therapy with a good virological and immunological response.

  15. Dysregulation of Autophagy Contributes to Anal Carcinogenesis.

    Directory of Open Access Journals (Sweden)

    Evie H Carchman

    Full Text Available Autophagy is an intracellular catabolic process that removes and recycles unnecessary/dysfunctional cellular components, contributing to cellular health and survival. Autophagy is a highly regulated cellular process that responds to several intracellular signals, many of which are deregulated by human papillomavirus (HPV infection through the expression of HPV-encoded oncoproteins. This adaptive inhibitory response helps prevent viral clearance. A strong correlation remains between HPV infection and the development of squamous cell carcinoma (SCC of the anus, particularly in HIV positive and other immunosuppressed patients. We hypothesize that autophagy is inhibited by HPV-encoded oncoproteins thereby promoting anal carcinogenesis (Fig 1.HPV16 transgenic mice (K14E6/E7 and non-transgenic mice (FVB/N, both of which do not spontaneously develop anal tumors, were treated topically with the chemical carcinogen, 7,12-Dimethylbenz[a]anthracene (DMBA, to induce anal cancer. The anuses at different time points of treatment (5, 10, 15 and 20 weeks were analyzed using immunofluorescence (IF for two key autophagy marker proteins (LC3β and p62 in addition to histological grading. The anuses from the K14E6/E7 mice were also analyzed for visual evidence of autophagic activity by electron microscopy (EM. To see if there was a correlation to humans, archival anal specimens were assessed histologically for grade of dysplasia and then analyzed for LC3β and p62 protein content. To more directly examine the effect of autophagic inhibition on anal carcinogenesis, nontransgenic mice that do not develop anal cancer with DMBA treatment were treated with a known pharmacologic inhibitor of autophagy, chloroquine, and examined for tumor development and analyzed by IF for autophagic proteins.Histologically, we observed the progression of normal anoderm to invasive SCC with DMBA treatment in K14E6/E7 mice but not in nontransgenic, syngeneic FVB/N background control mice

  16. Anal Human Papillomavirus Infection among HIV-Infected Men in Korea.

    Directory of Open Access Journals (Sweden)

    Chang Hun Lee

    Full Text Available Little is known about the epidemiology on human papillomavirus (HPV infection among HIV-infected men in Korea. The objective of this study was to determine the prevalence, genotype distribution and risk factors associated with anal HPV infection among HIV-infected men in Korea.A single-center cross-sectional study was conducted with HIV-infected men in Korea. Participants completed a detailed sexual behavior risk factor questionnaire. Anal samples were collected for cytology and HPV genotyping. Factors associated with anal HPV infection were assessed using multivariable logistic regression, stratifying by sexual behaviour.A total of 201 HIV-infected men were included in the study: 133 were from men who have sex with men (MSM and 68 from men who have sex with women (MSW. Any anal HPV infection was detected in 82.7% of HIV-infected MSM and in 51.5% of HIV- infected MSW (P < 0.001. High-risk HPV (HR-HPV prevalence was higher among MSM (47.4% than MSW (25.0%; P = 0.002. The HR-HPV types identified most frequently were HPV 16 (11%, HPV 18 (9.9%, and HPV 58 (5% in MSM, and HPV 58(11% and HPV 16 (8.9% in MSW. Prevalence of any HPV types in 9-valent vaccine types was higher among MSM than MSW (47.4% vs 22.1%. P = 0.001. Abnormal anal cytology was more commonly detected in MSM than MSW (42.9% vs.19.1%, P < 0.001. In HIV-infected MSM, higher number of lifetime male sex partners was significantly associated with any anal HPV infection, but age was a significant risk factor associated with anal HR-HPV infection.Anal HPV infection was highly prevalent in HIV-infected MSM in Korea, and also commonly found in HIV-infected MSW. In HIV-infected MSM, the significant risk factor for being infected with any HPV infection was lifetime number of male sexual partners, and with anal oncogenic HPV infection was age.

  17. Anal endosonography and manometry: comparison in patients with defecation problems.

    Science.gov (United States)

    Schäfer, R; Heyer, T; Gantke, B; Schäfer, A; Frieling, T; Häussinger, D; Enck, P

    1997-03-01

    Correlations between anal sphincter function as assessed by anorectal manometry and anal sphincter anatomy measured by endoluminal ultrasound have been reported in the literature both for patients and for healthy individuals but have not been confirmed by other authors. For a larger series of patients (152 consecutive patients, mean age 54.1 +/- 15.5 years; female:male ratio, 111:41) with anorectal dysfunctions such as incontinence (n = 92), constipation (n = 37), and other symptoms (n = 23), diagnostic work-up included conventional multilumen anorectal manometry to evaluate internal sphincter pressure at rest, maximum external sphincter squeeze pressure during contraction, and endoanal sonography to determine anal sphincter integrity and to measure dorsal, left lateral, and right lateral diameter of the internal anal sphincter (IAS) and external anal sphincter (EAS) muscles. Maximum squeeze pressure was significantly correlated to muscle thickness of the EAS (P = 0.001). No association was found between resting pressure and IAS diameter. Women had significantly lower resting and squeeze pressures than men (P = 0.008 and P = 0.003, respectively), but age-related changes of function were only found for resting pressure. Endosonographic values of IAS and EAS did not differ between genders but were significantly correlated with age (P = 0.008 and P = 0.02, respectively). Because all correlations were rather weak, they only can explain a small portion of data variance. Anal manometry and anal ultrasound, therefore, are of complementary value and are both indicated in adequate clinical problems.

  18. Vaccine-preventable anal human papillomavirus in Australian gay and bisexual men

    Directory of Open Access Journals (Sweden)

    I. Mary Poynten

    2017-06-01

    Full Text Available Objective: HPV causes ~90% of anal cancer and HPV16 is the type most commonly associated with anal cancer. Gay and bisexual men (GBM are at greatly increased risk. We investigated patterns of vaccine-preventable anal HPV in older GBM. Methods: The Study of the Prevention of Anal Cancer (SPANC is an ongoing, prospective cohort study of HIV-positive and HIV-negative Australian GBM. Participants completed questionnaires and underwent an anal swab for HPV genotyping using Roche Linear Array. We analysed baseline data from SPANC by HPV type, mean number of types, stratified by age and HIV status. Results: Anal HPV results from 606 (98.2% of 617 participants (median age 49 years, 35.7% HIV-positive showed 525 (86.7% had ≥1 HPV type and 178 (29.4% had HPV16. Over one third of participants (214, 35.3% had no nonavalent vaccine-preventable types detected. Two (0.3% participants had all quadrivalent types and none had all nonavalent vaccine types. HIV-positive participants (p<0.001 and younger participants (p=0.059 were more likely to have more vaccine-preventable HPV types detected. Conclusion: Anal HPV was highly prevalent in this largely community-based GBM cohort. Vaccine-preventable HPV16 was detected in approximately one third of participants. These findings suggest that the potential efficacy of HPV vaccination of older GBM should be explored. Keywords: Human papillomavirus, HPV, Anal, Vaccine, Prevalence, Gay and bisexual men, MSM, HIV

  19. [Caesarean section and anal incontinence].

    Science.gov (United States)

    Kalis, V; Stipán, J; Chaloupka, P; Karbanová, J; Rokyta, Z

    2008-04-01

    Summary of the impact of Caesarean section on anal incontinence. Review. Department of Gynaecology and Obstetrics, Charles University and University Hospital Plzen. Review of the current international literature. Currently, Caesarean section is not considered to reduce symptoms of anal incontinence. If there is any reduction of symptoms, that remains only for a short term (40% in 3 months after the delivery in the largest trial). In a long term, virtually in no trial has been observed any difference, and others, non-obstetrical factors (particularly aging) prevail. Current knowledge does not allow to assess sufficiently pros and cons of Caesarean compared to vaginal delivery. High risk groups, that would profit from elective Ceasarean, have not been clearly identified yet.

  20. Carcinoma of the anal canal: radiation or radiation plus chemotherapy

    International Nuclear Information System (INIS)

    Cummings, B.J.

    1983-01-01

    An editorial is presented which discusses the treatment of carcinoma of the anal canal. Following the initial report of the successful preoperative use of combined chemotherapy and radiation by Nigro in 1974, several centers have confirmed the effectiveness of such combinations either as preoperative or as definitive treatment of anal carcinomas, and many patients are now being referred for radiation therapy. The article by Cantril in this issue describe the successful treatment of anal carcinomas by radiation alone, and raises the important issue of whether radiation plus chemotherapy is more effective treatment than radiation alone for squamous or cloacogenic carcinomas arising in the anal canal or perianal area. Several studies are cited

  1. Regenerative medicine provides alternative strategies for the treatment of anal incontinence

    DEFF Research Database (Denmark)

    Gräs, Søren; Tolstrup, Cæcilie Krogsgaard; Lose, Gunnar

    2017-01-01

    of culture-expanded skeletal myogenic cells stimulates repair of both acute and 2 - 4-week-old anal sphincter injuries. The results from a small clinical trial with ten patients and a case report support the preclinical findings. Animal studies have also demonstrated that local injections of mesenchymal stem...... cells stimulate repair of sphincter injuries, and a complex bioengineering strategy for creation and implantation of an intrinsically innervated internal anal sphincter construct has been successfully developed in a series of animal studies. CONCLUSION: Cellular therapies with myogenic cells...... and mesenchymal stem cells and the use of bioengineering technology to create an anal sphincter are new potential strategies to treat anal incontinence caused by anal sphincter defects, but the clinical evidence is extremely limited. The use of culture-expanded autologous skeletal myogenic cells has been most...

  2. Exploring dynamics of anal sex among female sex workers in Andhra Pradesh.

    Science.gov (United States)

    Tucker, Saroj; Krishna, Rama; Prabhakar, Parimi; Panyam, Swarup; Anand, Pankaj

    2012-01-01

    The anal sex among heterosexual couples is on the rise as reported in many scientific studies. Considering that unprotected anal sex has higher risk of human immunodeficiency virus (HIV) transmission than the vaginal sex, we undertook a study to understand the anal sex practices among Female Sex Workers (FSW). The study was conducted among FSW attending 11 randomly selected sexually transmitted infection (STI) clinics in Bill and Melinda Gates supported targeted interventions in Andhra Pradesh. A structured questionnaire was administered to the 555 FSW attending these clinics by project clinic counselors. Informed consent was obtained from all the study participants. Engaging in anal sex was self reported by 22% of sex workers, though demand from clients was reported to be much higher (40%). The reasons for anal sex practices included more money (61%), clout/influence of the client (45%), risk of losing client (27%), and forced sex (1.2%). Factors associated with anal sex were higher number of clients, higher duration of sex work, higher income, and older age group. Associated risks perceived by FSW were bleeding and injury to anal canal (98%) while only 28% associated it with higher HIV transmission risk. Reported Condom and lubricant use was about 88% and 39% respectively. The study shows that there is frequent anal sex, inconsistent condom and infrequent lubricant usage, economic and physical coercion, and low awareness of STI/HIV transmission risk among FSW, which have serious implications for HIV prevention programmes. There is a need to focus on anal sex education and use of lubricants along with condoms during anal sex in FSW-targeted interventions in AP.

  3. Anal intraepitelial neoplasia: a narrative review

    Directory of Open Access Journals (Sweden)

    Garazi Elorza

    2016-01-01

    Full Text Available Anal intraepitelial neoplasia (AIN constitutes a major health problem in certain risk groups, such as patients with immunosuppression of varied origin, males who have sexual relations with other males, and females with a previous history of vaginal or cervical abnormalities in cytology. Its relationship with the human papillomavirus (HPV infection has been well documented; however, many of the factors involved in the progression and regression of the viral infection to dysplasia and anal carcinoma are unknown. AIN can be diagnosed through cytology of the anal canal or biopsy guided by high-resolution anoscopy. However, the need for these techniques in high-risk groups remains controversial. Treatment depends on the risk factors and given the high morbidity and high recurrence rates the utility of the different local treatments is still a subject of debate. Surgical biopsy is justified only in the case of progression suggesting lesions. The role of the vaccination in high-risk patients as primary prevention has been debated by different groups. However, there is no general consensus on its use or on the need for screening this population.

  4. HPV infection and intraepithelial lesions from the anal region: how to diagnose?

    Directory of Open Access Journals (Sweden)

    Newton Sérgio de Carvalho

    Full Text Available In the last years, the prevalence of HPV infection in the anal region has increased, especially in some groups like homosexual and HIV-positive people. Since this infection can be associated with the development of squamous anal cancer due to its progression from HPV infection to anal intraepithelial neoplasia (AIN and finally to cancer, the screening and evaluation of these conditions are important. Anal cytology and high resolution anoscopy are good methods that are available and can be used. Although useful, these methods should be performed correctly and not indiscriminately in all patients. Patients for whom anal cytology screening is recommended are: HIV-infected patients, homosexuals, women who present with high-grade vulvar squamous intraepithelial neoplasia, vulvar cancer or cervical cancer. An abnormal anal cytology should be further evaluated with high resolution anoscopy.

  5. Magnetic resonance imaging anatomy of the anal canal

    International Nuclear Information System (INIS)

    Kashyap, P.; Bates, N.

    2004-01-01

    The anatomy of the anal canal is complex but well demonstrated by MRI. Understanding the anatomy is a prerequisite for determining the true site and the extent of pathology, especially for surgical workup. In this article, the MRI anatomy of the anal canal has been displayed using highlighted MRI images and line diagrams. Copyright (2004) Blackwell Science Pty Ltd

  6. Fiber types in the striated urethral and anal sphincters

    DEFF Research Database (Denmark)

    Schrøder, H D; Reske-Nielsen, E

    1983-01-01

    Seven normal human striated urethral and anal sphincters obtained by autopsy were examined using histochemical techniques. In both the urethral sphincter and the subcutaneous (s.c.) and superficial part of the anal sphincter a characteristic pattern with two populations of muscle fibers, abundant...

  7. Regenerative medicine provides alternative strategies for the treatment of anal incontinence.

    Science.gov (United States)

    Gräs, Søren; Tolstrup, Cæcilie Krogsgaard; Lose, Gunnar

    2017-03-01

    Anal incontinence is a common disorder but current treatment modalities are not ideal and the development of new treatments is needed. The aim of this review was to identify the existing knowledge of regenerative medicine strategies in the form of cellular therapies or bioengineering as a treatment for anal incontinence caused by anal sphincter defects. PubMed was searched for preclinical and clinical studies in English published from January 2005 to January 2016. Animal studies have demonstrated that cellular therapy in the form of local injections of culture-expanded skeletal myogenic cells stimulates repair of both acute and 2 - 4-week-old anal sphincter injuries. The results from a small clinical trial with ten patients and a case report support the preclinical findings. Animal studies have also demonstrated that local injections of mesenchymal stem cells stimulate repair of sphincter injuries, and a complex bioengineering strategy for creation and implantation of an intrinsically innervated internal anal sphincter construct has been successfully developed in a series of animal studies. Cellular therapies with myogenic cells and mesenchymal stem cells and the use of bioengineering technology to create an anal sphincter are new potential strategies to treat anal incontinence caused by anal sphincter defects, but the clinical evidence is extremely limited. The use of culture-expanded autologous skeletal myogenic cells has been most intensively investigated and several clinical trials were ongoing at the time of this report. The cost-effectiveness of such a therapy is an issue and muscle fragmentation is suggested as a simple alternative.

  8. Retalhos de avanço no tratamento da fissura anal crônica: experiência inicial Advancement flap in the treatment of chronic anal fissure: inicial experience

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora Prolungatti Cesar

    2009-12-01

    Full Text Available A fissura anal é uma laceração do canal anal relacionada ao trauma, hipertonia esfincteriana e isquemia. A maioria cicatriza espontaneamente ou com tratamento conservador, e poucas requerem tratamento cirúrgico. O objetivo deste trabalho é verificar os resultados clínicos e alterações manométricas de pacientes submetidos ao tratamento cirúrgico da fissura anal com avançamento de retalhos em v-y. Métodos: Estudo prospectivo, realizado nos anos de 2007, 2008 e 2009, que abrangeu nove pacientes portadores de fissura anal crônica submetidos ao avançamento de retalho anal. Foram avaliadas as pressões do canal anal ao repouso, contração e esforço evacuatório; no pré e pós-operatório. Resultados: Na amostra, todos os pacientes apresentaram hipertonia esfincteriana prévia. seis (66,6% obtiveram resolução total dos sintomas e das lesões. Um (11,11% sofreu deiscência parcial do retalho, sem sintomas clínicos; e outros dois (22,22%, infecção com perda dos mesmos e persistência da fissura. A análise manométrica das pressões de repouso, contração e evacuação nos grupos não mostrou alteração estatisticamente significativa (p>0,05, o que comprova que a cirurgia não incluiu manipulação dos esfíncteres. Conclusão: Os retalhos anais mostraram-se efetivos no tratamento da fissura anal, com cicatrização da lesão, sem que ocorram alterações nas pressões anais desses pacientes.The anal fissure is a laceration of the anal canal related to trauma, hypertonic sphincter and ischemia. The majority heals spontaneously or with conservative treatment and only a few requires surgical treatment. The objective of this study is to verify the clinical results and manometric alterations of patients submitted to the surgical treatment of the anal fissure with advance of v-y skin flaps. Methods: Prospective study, accomplished in 2007,2008 and 2009, in witch nine patients with chronic anal fissure were submitted to v-y advance. The

  9. The Danish anal sphincter rupture questionnaire: Validity and reliability

    DEFF Research Database (Denmark)

    Due, Ulla; Ottesen, Marianne

    2008-01-01

    Objective. To revise, validate and test for reliability an anal sphincter rupture questionnaire in relation to construct, content and face validity. Setting and background. Since 1996 women with anal sphincter rupture (ASR) at one of the public university hospitals in Copenhagen, Denmark have bee...

  10. Dominant Role of HPV16 E7 in Anal Carcinogenesis

    Science.gov (United States)

    Thomas, Marie K.; Pitot, Henry C.; Liem, Amy; Lambert, Paul F.

    2011-01-01

    Ninety percent of anal cancer is associated with human papilloma viruses (HPVs). Using our previously established HPV transgenic mouse model for anal cancer, we tested the role of the individual oncogenes E6 and E7. K14E6 and K14E7 transgenic mice were treated with dimethylbenz[a]anthracene (DMBA) to the anal canal and compared to matched nontransgenic and doubly transgenic K14E6/E7 mice. K14E7 and K14E6/E7 transgenic mice developed anal tumors (papillomas, atypias and carcinomas combined) at significantly higher rates (88% and 100%, respectively) than either K14E6 or NTG mice (18% and 19%, respectively). Likewise, K14E7 and K14E6/E7 transgenic mice developed frank cancer (carcinomas) at significantly higher rates (85% and 85%, respectively) than either K14E6 or NTG mice (18% and 10%, respectively). These findings indicate that E7 is the more potent oncogene in anal cancer caused by HPVs. PMID:21999991

  11. Cancer of the anal canal: Diagnosis, staging and follow-up with MRI

    Energy Technology Data Exchange (ETDEWEB)

    Durot, Carole; Hoeffel, Christine [Dept. of Radiology, Centre Hospitalo-Universitaire de Reims, Reims (France); Dohan, Anthony; Boudiaf, Mourad; Soyer, Philippe [Dept. of Abdominal Imaging, Hopital Lariboisiere-APHP, Paris(France); Servois, Vincent [Dept. of Radiology and Nuclear Medicine, Institut Curie, Paris (France)

    2017-11-15

    Although a rare disease, anal cancer is increasingly being diagnosed in patients with risk factors, mainly anal infection with the human papilloma virus. Magnetic resonance imaging (MRI) with external phased-array coils is recommended as the imaging modality of choice to grade anal cancers and to evaluate the response assessment after chemoradiotherapy, with a high contrast and good anatomic resolution of the anal canal. MRI provides a performance evaluation of size, extent and signal characteristics of the anal tumor before and after treatment, as well as lymph node involvement and extension to the adjacent organs. MRI is also particularly helpful in the assessment of complications after treatment, and in the diagnosis for relapse of the diseases.

  12. Cancer of the anal canal: Diagnosis, staging and follow-up with MRI

    International Nuclear Information System (INIS)

    Durot, Carole; Hoeffel, Christine; Dohan, Anthony; Boudiaf, Mourad; Soyer, Philippe; Servois, Vincent

    2017-01-01

    Although a rare disease, anal cancer is increasingly being diagnosed in patients with risk factors, mainly anal infection with the human papilloma virus. Magnetic resonance imaging (MRI) with external phased-array coils is recommended as the imaging modality of choice to grade anal cancers and to evaluate the response assessment after chemoradiotherapy, with a high contrast and good anatomic resolution of the anal canal. MRI provides a performance evaluation of size, extent and signal characteristics of the anal tumor before and after treatment, as well as lymph node involvement and extension to the adjacent organs. MRI is also particularly helpful in the assessment of complications after treatment, and in the diagnosis for relapse of the diseases

  13. Use of Anal Acoustic Reflectometry in the Evaluation of Men With Passive Fecal Leakage

    DEFF Research Database (Denmark)

    Hornung, Benjamin R; Telford, Karen J; Carlson, Gordon L

    2017-01-01

    with greater sensitivity and discriminatory ability than conventional anal manometry. OBJECTIVE: The aim of this study was to determine whether men with fecal leakage have an abnormality in anal sphincter function that is detectable by anal acoustic reflectometry. DESIGN: This was an age-matched study......BACKGROUND: Men with passive fecal leakage represent a distinct clinical entity in which the pathophysiology remains unclear. Standard anorectal investigations fail to demonstrate consistent abnormalities in this group. Anal acoustic reflectometry is a new test of anal sphincter function...... of continent and incontinent men. SETTINGS: The study was conducted at a university teaching hospital. PATIENTS: Male patients with isolated symptoms of fecal leakage were recruited. Anal acoustic reflectometry, followed by conventional anal manometry, was performed. Results were then compared with those from...

  14. The anal verge: localization with multi-slice spiral CT

    International Nuclear Information System (INIS)

    Wang Wei; Tang Guangjian

    2010-01-01

    Objective: To determine and evaluate the method of localization of anal verge by multislice spiral CT. To provide an imaging reference for operative guidance of low-rectal cancer. Methods Forty eight consecutive adult patients suspected of abnormalities other than rectal disease were evaluated with abdominal and pelvic CT scans since August, 2009. They were divided into two groups based on sex and age. There were 23 men and 25 women. The ages of young group were 28 to 50 years and the average age was 41 years. The ages of elderly group were 52 to 81 years and the average age was 64 years. A small cotton ball dipped with contrast media was put at the anal verge as a marker and CT scans were performed with 64-slice spiral CT scanner. The distances between the cotton balls and the lower margin of the pubis combination (La), the lower margin of the Sth sacral vertebra (Lb), the inferior aperture of minor pelvis (Lc) and the lower margin of the basement of external anal sphincter (Ld) were measured on the mid- sagittal images obtained by MPR. The averages, the standard deviations (s), the 95% and 80% confidence intervals of La, Lb, Lc and Ld were calculated. We took the intervals of ±1.96 s or ±1.28 s 0.05) between two different sex groups [male group, (10.0±1.2) mm], female group, (9.6±1.2) mm and between two age groups [young group, (9.6±1.2) mm, elderly group, (9.9±1.3) mm]. Conclusions: The lower margin of the basement of external anal sphincter was a useful anatomic landmark for localizing the anal verge, and could be definitely identified on the middle sagittal pelvic CT image. The distance between the structure and anal verge is constant enough and can be used in measuring distance from low rectal lesion to the anal verge. (authors)

  15. Value of conventional cytology in the presence of macroscopic lesions of the anal canal

    Directory of Open Access Journals (Sweden)

    Lêda Pereira de Barcellos

    2014-01-01

    Full Text Available Objectives: To verify the value of conventional cytology for the diagnosis of macroscopic le- sions of the anal canal and to describe the limitations of the samples. Method: We evaluated 395 conventional cytology samples obtained by brushing the anal canal of patients (predominantly male, HIV-positive and compared them to the presence of macroscopic lesions of the anal canal observed under anorectal examination. Results: Of the total, 91.6% of samples were classified as adequate. Cellular elements repre- sentative of the anal transformation zone were observed in 63.5% of samples. Sensitivity in the presence or absence of cellularity was 80% and 31%, respectively. Conclusion: The study demonstrates the feasibility of using conventional anal cytology in outpatients. Resumo: Objetivo: verificar o valor da citologia convencional no diagnóstico de lesões macroscópicas do canal anal e descrever as limitações das amostras obtidas. Método: avaliamos 395 exames citológicos convencionais obtidos por escovado do canal anal de pacientes predominantemente do sexo masculino, soropositivos para HIV, e com- paramos com a presença de lesões macroscópicas do canal anal constatadas ao exame proctológico. Resultado: o percentual de amostras adequadas foi de 91,6%, e os elementos celulares re- presentativos da zona de transformação anal foram observados em 63,5% das amostras. Encontramos sensibilidade de 80% e 31% na presença ou ausência desta celularidade, res- pectivamente. Conclusão: O estudo demonstra a possibilidade de utilização da citologia anal convencional no rastreio de lesões macroscópicas do canal anal em pacientes ambulatoriais. Keywords: HPV Prevention of anal neoplasia Conventional cytology, Palavras-chave: HPV Prevenção de neoplasia anal Citologia convencional

  16. Anal sphincter complex: endoanal MR imaging of normal anatomy

    NARCIS (Netherlands)

    Hussain, S. M.; Stoker, J.; Laméris, J. S.

    1995-01-01

    To determine the normal anatomy of the anal sphincter complex on magnetic resonance (MR) images. Ten healthy volunteers (four men, six women; age range, 21-26 years) underwent MR imaging with an endoanal coil. The lower part of the anal canal contained the internal sphincter, the longitudinal muscle

  17. Development of a pulse height analizer

    International Nuclear Information System (INIS)

    Moreira, E.S.

    1984-01-01

    The development of a Pulse Height Analizer is described. This equipment is essential to analize data coming from detectors producing information codified in pulse amplitudes. The system developed consist of a Signal Input Module connected to a Controller Module based on a 8085A microprocessor capable to memorize pulses up to 1 uS in 256 channels with a resolution better than 20 mV. A Communication Module with a serial interface is used for data transfer to a host computer using RS232c protocol. The Monitoring and Operation Module consist of a hexadecimal Keybord, a 6 digit 7-segment display and a XY analog output enabling real time visualization of data on a XY monitor. The hardware and the software designed for this low cost system were optimized to obtain a typical dead time of approximately 100 uS. As application, this device was used to adquire curves at the Small Angle X-ray Scattering Laboratory in this Department. The apparatus performance was tested by comparing its data with a Northern Pulse Height Analizer model NS633 output, with favorable results. (Author) [pt

  18. Leiomyoma of the anal canal: report of two cases.

    Science.gov (United States)

    Witz, M; Bernheim, J; Griffel, B; Dinbar, A

    1986-10-01

    Leiomyoma of the rectum and anal canal is an unusual clinical entity. Generally, it does not produce any clinical signs and in most cases it is discovered incidentally in the course of routine rectal examination. The clinical presentation, diagnosis, and surgical treatment are described in two presented cases of anal canal leiomyoma.

  19. Squamous intraepithelial lesions of the anal squamocolumnar junction: Histopathological classification and HPV genotyping

    Directory of Open Access Journals (Sweden)

    Omar Clavero

    2017-06-01

    Full Text Available Background: Human papillomavirus (HPV-related anal cancer lesions are often found adjacent to the squamocolumnar junction (SCJ. We have assessed the histopathology and associated HPV genotypes in anal SCJ lesions in surgically excised anal warts in HIV-negative and –positive patients. Methods: Histopathology identified 47 squamous intraepithelial lesions (SILs adjacent to the SCJ amongst a total of 145 cases of clinically diagnosed anal condylomata. The anal SCJ lesions were further analyzed with p16, CK7 and p63 immunohistochemistry and HPV genotyping. Results: Sixteen (16/47 of the excised anal wart lesions contained HSIL; Three were HSIL and exclusively associated with oncogenic HPVs. A further thirteen (13/47 were mixed lesions. Of these eight were HSILs with LSIL and six were HSILs with papillary immature metaplasia (PIM; Ten of the mixed lesions were associated with one or more oncogenic HPVs, while three cases were exclusively associated with HPV6. Conclusions: Clinically diagnosed anal warts cannot be assumed to be limited to low-grade lesions as anal warts of the SCJ often show heterogeneous lesions, with coexistence of LSIL, PIM, and HSIL. Lesions showing PIM, however, may mimic HSIL, because they are hypercellular, but lack the nuclear atypia and conspicuous mitotic activity of HSIL; and are p16 negative. Keywords: Anal squamocolumnar junction, Low-grade squamous intraepithelial lesion (LSIL, High-grade squamous intraepithelial lesion (HSIL, Papillary immature metaplasia (PIM, HPV, HIV

  20. An integrative review of guidelines for anal cancer screening in HIV-infected persons.

    Science.gov (United States)

    Wells, Jessica S; Holstad, Marcia M; Thomas, Tami; Bruner, Deborah Watkins

    2014-07-01

    HIV-infected individuals are 28 times more likely than the general population to be diagnosed with anal cancer. An integrative review of recommendations and guidelines for anal cancer screening was performed to provide a succinct guide to inform healthcare clinicians. The review excluded studies that were of non-HIV populations, redundant articles or publications, non-English manuscripts, or nonclinical trials. The review found no formal national or international guidelines exist for routine screening of anal cancer for HIV-infected individuals. To date, no randomized control trial provides strong evidence supporting efficaciousness and effectiveness of an anal cancer screening program. The screening recommendations from seven international-, national-, and state-based reports were reviewed and synthesized in this review. These guidelines suggest anal cancer screening, albeit unproven, may be beneficial at decreasing the incidence of anal cancer. This review highlights the paucity of screening-related research and is an area of need to provide clear direction and to define standard of care for anal cancer screening in HIV-infected persons.

  1. Surgical Treatment of Anal Stenosis with Diamond Flap Anoplasty Performed in a Calibrated Fashion.

    Science.gov (United States)

    Gülen, Merter; Leventoğlu, Sezai; Ege, Bahadir; Menteş, B Bülent

    2016-03-01

    Regarding anoplasty for anal stenosis, it is not clear to what extent the final anal caliber should be targeted. The aim of this study was to investigate the results of diamond-flap anoplasty performed in a calibrated manner for the treatment of severe anal stenosis due to a previous hemorrhoidectomy. Prospectively prepared standard forms were evaluated retrospectively. Anoplasty with unilateral or bilateral diamond flaps was performed for moderate or severe anal stenosis, targeting a final anal caliber of 25 to 26 mm. The demographic characteristics, causes of anal stenosis, number of previous surgeries, anal stenosis staging (Milsom and Mazier), anal calibers (millimeter), the Cleveland Clinic Incontinence Score, and the modified obstructed defecation syndrome Longo score were recorded on pre-prepared standard forms, as well as postoperative complications and the time of return to work. From January 2011 to July 2013, 18 patients (12 males, 67%) with a median age of 39 years (range, 27-70) were treated. All of the patients had a history of previous hemorrhoidectomy. The number of previous corrective interventions was 2.1 ± 1.8 (range, 0-4), and 2 patients had a history of failed anoplasty. Five patients (28%) had moderate anal stenosis and 13 (72%) had severe anal stenosis. Preoperative, intraoperative, and 12-month postoperative anal calibration values were 9 ± 3 mm (range, 5-15), 25 ± 0.75 mm (range, 24-26), and 25 ± 1 mm (range, 23-27) (p < 0.0001, for immediate postoperative and 12-month postoperative anal calibers compared with the intraoperative). Preoperative and 12-month postoperative Cleveland Clinic Incontinence Scores were 0.83 ± 1.15 (range, 0-4) and 0.39 ± 0.70 (range, 0-2) (p = 1.0). The clinical success rate was 88.9%. No severe postoperative complications were observed. This study was limited because it was a single-armed, retrospective analysis of prospectively designed data. Diamond-flap anoplasty performed in a standardized and calibrated

  2. A trial of radiofrequency ablation for anal intraepithelial neoplasia.

    Science.gov (United States)

    Goldstone, Robert N; Hasan, Shirin R; Drury, Steven; Darragh, Teresa M; van Zante, Annemieke; Goldstone, Stephen E

    2017-03-01

    Radiofrequency ablation (RFA) effectively treats esophageal high-grade dysplasia, but its efficacy in treating anal canal high-grade squamous intraepithelial lesions (HSILs) is unsubstantiated. This prospective study assessed the safety and efficacy of applying hemi-circumferential RFA to anal canal HSIL. Twenty-one HIV-negative participants with HSIL occupying ≤ half the anal canal circumference were treated with hemi-circumferential anal canal RFA. Participants were assessed every 3 months for 12 months with high-resolution anoscopy; recurrence in the treatment zone was re-treated with focal RFA. Twenty-one participants with a mean of 1.7 lesions (range 1-4) enrolled and completed the trial. Six (29 %) participants had recurrent HSIL within the treated hemi-circumference within 1 year. Four participants (19 %) had persistence of an index lesion at 3 months. One (2.9 %) index HSIL persisted again at 12 months. No participants had more than two RFA treatments. KM curve-predicted HSIL-free survival within the treatment zone at 1 year was 76 % (95 % CI 52-89 %). Comparing the first 7 and last 14 participants, the predicted 1-year HSIL-free survivals are 43 % (95 % CI 10-73 %) and 93 % (95 % CI 59-99 %), respectively (p = 0.008), suggesting a learning curve with the treating physician. Multivariable analysis showed decreased recurrence in the last 14 participants (HR 0.02; 95 % CI 0.001-0.63) while increasing BMI increased recurrence (HR 1.43, 95 % CI 1.01-2.01). No participants had device or procedure-related serious adverse events, anal stricture, or heavy bleeding. Hemi-circumferential RFA yielded a high rate of anal HSIL eradication in HIV-negative patients at 1 year with minimal adverse events. Lesion persistence was probably related to incomplete initial ablation.

  3. Overdiagnosis and rising rate of obstetric anal sphincter injuries (OASIS): time for reappraisal.

    Science.gov (United States)

    Sioutis, D; Thakar, R; Sultan, A H

    2017-11-01

    To determine the accuracy of clinical diagnosis of obstetric anal sphincter injuries (OASIS) using three-dimensional (3D) endoanal ultrasound (EA-US) and to compare symptoms and anal manometry measurements between women with anal sphincters adequately repaired and those with persistent anal sphincter defects. The EA-US images of women with clinically diagnosed and repaired OASIS, defined as third- or fourth-degree perineal tear, who attended the perineal clinic at Croydon University Hospital over a 10-year period (2003-2013) were reanalyzed by a single expert blind to symptoms and the results of clinical examination. St Mark's Incontinence Scores (SMIS) and anal manometry measurements were obtained and compared between women with an intact anal sphincter and those with an anal sphincter scar and between those with an intact anal sphincter and those with a defect. Anal manometry measurements were compared between women with an external anal sphincter (EAS) defect and those with an internal anal sphincter (IAS) defect. The images of 908 women were reanalyzed. No evidence of OASIS was found in 64 (7.0%) women, an EAS scar alone was detected in 520 (57.3%) and an anal sphincter defect in 324 (35.7%). Of the 324 women with a defect, 112 had an EAS defect, 90 had an IAS defect and 122 had a combined IAS and EAS defect. SMIS results were significantly higher in women with an anal sphincter defect compared with those with no evidence of OASIS (P = 0.018), but there was no significant difference in scores between women with an intact sphincter and those with an EAS scar only. Women with a defect had a significantly lower maximum resting pressure (median (range), 44 (8-106) vs 55 (29-86) mmHg; P 40) vs 25 (10-40) mm; P = 0.003). Seven percent of women with a clinical diagnosis of OASIS were wrongly diagnosed. We believe that this rate may differ from that of other units but training methods and competency assessment tools for the diagnosis and repair of OASIS need

  4. Viscoelastic assessment of anal canal function using acoustic reflectometry: a clinically useful technique.

    Science.gov (United States)

    Mitchell, Peter J; Klarskov, Niels; Telford, Karen J; Hosker, Gordon L; Lose, Gunnar; Kiff, Edward S

    2012-02-01

    Anal acoustic reflectometry is a new reproducible technique that allows a viscoelastic assessment of anal canal function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, opening and closing elastance, and hysteresis. The aim of this study was to assess whether the parameters measured in anal acoustic reflectometry are clinically valid between continent and fecally incontinent subjects. This was an age- and sex-matched study of continent and incontinent women. The study was conducted at a university teaching hospital. One hundred women (50 with fecal incontinence and 50 with normal bowel control) were included in the study. Subjects were age matched to within 5 years. Parameters measured with anal acoustic reflectometry and manometry were compared between incontinent and continent groups using a paired t test. Diagnostic accuracy was assessed by the use of receiver operator characteristic curves. Four of the 5 anal acoustic reflectometry parameters at rest were significantly different between continent and incontinent women (eg, opening pressure in fecally incontinent subjects was 31.6 vs 51.5 cm H2O in continent subjects, p = 0.0001). Both anal acoustic reflectometry parameters of squeeze opening pressure and squeeze opening elastance were significantly reduced in the incontinent women compared with continent women (50 vs 99.1 cm H2O, p = 0.0001 and 1.48 vs 1.83 cm H2O/mm, p = 0.012). In terms of diagnostic accuracy, opening pressure at rest measured by reflectometry was significantly superior in discriminating between continent and incontinent women in comparison with resting pressure measured with manometry (p = 0.009). Anal acoustic reflectometry is a new, clinically valid technique in the assessment of continent and incontinent subjects. This technique, which assesses the response of the anal canal to distension and relaxation, provides a detailed viscoelastic assessment of anal canal function. This technique

  5. Cytological Anal Squamous Intraepithelial Lesions Associated with Anal High-Risk Human Papillomavirus Infections among Men Who Have Sex with Men in Northern Thailand.

    Directory of Open Access Journals (Sweden)

    Darin Ruanpeng

    Full Text Available Anal cancer, one of human papillomavirus (HPV related malignancies, has increased in recent decades, particularly among men who have sex with men (MSM and HIV-infected (HIV+ persons. We aimed to explore the prevalence of anal squamous intraepithelial lesions (ASIL using Papanicolau (Pap screening among MSM in northern Thailand and its associated factors.Two hundreds MSM aged ≥18 years reporting receptive anal intercourse in the prior 6 months were recruited from July 2012 through January 2013. Medical history and behavioral data were collected by staff interview and computer-assisted self interview. Anal Pap smear, HPV genotyping, and HIV testing were performed. Two pathologists blinded to HPV and HIV status reported cytologic results by Bethesda classification.Mean age was 27.2 years (range 18-54. Overall, 86 (43.0% had ASIL: 28 (14.2% with atypical cells of undetermined significance (ASCUS, 1 (0.5% with atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H, 56 (28.4% with low-grade squamous intraepithelial lesion (LSIL, and 1 (0.5% with high-grade squamous intraepithelial lesion (HSIL. ASIL was associated by univariate analysis (p ≤0.05 with older age, gender identity other than bisexual (i.e., gay men and transgender women, rectal douching, anal symptoms, genital warts, HIV positivity, and high-risk-HPV infection. However, on multiple logistic regression ASIL was associated only with high-risk HPV type (p = 0.002 and HIV infection (p = 0.01.ASIL is quite common in high-risk MSM in northern Thailand and is associated with high-risk HPV types and HIV infection. Routine anal Pap screening should be considered, given the high frequency of ASIL, particularly in the HIV+. High resolution anoscopy (HRA, not done here, should be to confirm PAP smears whose sensitivity and specificity are quite variable. Timely HPV vaccination should be considered for this population.

  6. Cytological Anal Squamous Intraepithelial Lesions Associated with Anal High-Risk Human Papillomavirus Infections among Men Who Have Sex with Men in Northern Thailand.

    Science.gov (United States)

    Ruanpeng, Darin; Chariyalertsak, Suwat; Kaewpoowat, Quanhathai; Supindham, Taweewat; Settakorn, Jongkolnee; Sukpan, Kornkanok; Utaipat, Utaiwan; Miura, Toshiyuki; Kosashunhanan, Natthapol; Saokhieo, Pongpun; Songsupa, Radchanok; Wongthanee, Antika

    2016-01-01

    Anal cancer, one of human papillomavirus (HPV) related malignancies, has increased in recent decades, particularly among men who have sex with men (MSM) and HIV-infected (HIV+) persons. We aimed to explore the prevalence of anal squamous intraepithelial lesions (ASIL) using Papanicolau (Pap) screening among MSM in northern Thailand and its associated factors. Two hundreds MSM aged ≥18 years reporting receptive anal intercourse in the prior 6 months were recruited from July 2012 through January 2013. Medical history and behavioral data were collected by staff interview and computer-assisted self interview. Anal Pap smear, HPV genotyping, and HIV testing were performed. Two pathologists blinded to HPV and HIV status reported cytologic results by Bethesda classification. Mean age was 27.2 years (range 18-54). Overall, 86 (43.0%) had ASIL: 28 (14.2%) with atypical cells of undetermined significance (ASCUS), 1 (0.5%) with atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H), 56 (28.4%) with low-grade squamous intraepithelial lesion (LSIL), and 1 (0.5%) with high-grade squamous intraepithelial lesion (HSIL). ASIL was associated by univariate analysis (p ≤0.05) with older age, gender identity other than bisexual (i.e., gay men and transgender women), rectal douching, anal symptoms, genital warts, HIV positivity, and high-risk-HPV infection. However, on multiple logistic regression ASIL was associated only with high-risk HPV type (p = 0.002) and HIV infection (p = 0.01). ASIL is quite common in high-risk MSM in northern Thailand and is associated with high-risk HPV types and HIV infection. Routine anal Pap screening should be considered, given the high frequency of ASIL, particularly in the HIV+. High resolution anoscopy (HRA), not done here, should be to confirm PAP smears whose sensitivity and specificity are quite variable. Timely HPV vaccination should be considered for this population.

  7. Radiation therapy of recurrent anal squamous cell carcinoma in-situ: a case report

    Directory of Open Access Journals (Sweden)

    Noone Robert

    2010-02-01

    Full Text Available Abstract Introduction High-grade anal intraepithelial neoplasia, also referred to as anal squamous carcinoma in-situ, or Bowen's disease of the anus, make up less than 1% of all digestive system cancers in the United States. The treatment of choice is surgical resection with anal mapping. However, this disease often recurs or persists, requiring additional surgery for these patients. This can compromise the anal sphincter leading to leakage. In this case report, we discuss the efficacy of radiation therapy as a modality to treat post-excisional recurrent Bowen's disease, which may prevent sphincter compromise, leading to improved quality of life. Case presentation An 84-year-old Caucasian woman presented with post-excisional persistent/recurrent squamous cell carcinoma in-situ. The initial lesion measured 3 cm in diameter on the right lateral side of the anal margin. A standard surgery consisting of wide local excision with anal mapping was performed. The margins were clear and our patient was followed up. Our patient recurred with a 1.2 × 0.8 cm lesion on the left anal verge extending to the anal canal. A biopsy along with mapping was done, and 2 of the 17 mapping specimens were positive for carcinoma in-situ, one in the anal canal. Due to the location of the positive anal mapping, and in order to prevent sphincter compromise on re-excision, our patient was offered definitive radiation therapy. Two years after radiation therapy, our patient showed no signs of recurrent disease and had good sphincter control. Conclusion Although the main treatment modality for treating persistent/recurrent Bowen's disease is surgery, an alternative approach using external beam radiation for CIS may be enough to provide a cure for some patients with recurrent disease.

  8. Relation between anal electrosensitivity and rectal filling sensation and the influence of age

    NARCIS (Netherlands)

    Broens, PMA; Penninckx, FM

    PURPOSE: The aim of this study was to assess the effect of age and sex on the rectal filling sensation and anal electrosensitivity and to explore the relation between anal electrosensitivity and the parameters of the rectal filling sensation. METHODS: Anal mucosal electrosensitivity and anorectal

  9. The identification of specialized pacemaking cells in the anal sphincters.

    Science.gov (United States)

    Shafik, Ahmed; El Sibai, Olfat; Ahmed, Ismail

    2006-07-01

    Interstitial cells of Cajal (ICC) are claimed to generate the electrical activity in the colon and stomach. As the external (EAS) and internal (IAS) anal sphincters exhibit resting electrical activity, we hypothesized the presence of ICC in these sphincters. This hypothesis was investigated in the current study. Specimens from the EAS and IAS were taken from normal areas of the anorectum which had been surgically excised by abdominoperineal operation for rectal cancer of 28 patients (16 men, 12 women, mean age 42.2+/-4.8 years). The specimens were subjected to c-kit immunohistochemistry. Controls for the specificity of the antisera consisted of tissue incubation with normal rabbit serum substituted for the primary antiserum. Fusiform, c-kit positive, ICC-like cells were detected in the anal sphincters; they had dendritic processes. They were clearly distinguishable from the non-branching, c-kit negative smooth and striated muscle cells of the anal sphincters. The specimens contained also c-kit positive mast cells, but they had a rounded body with no dendritic processes. Immunoreactivity was absent in negative controls in which the primary antibody was omitted. We have identified, for the first time, cells in EAS and IAS with morphological and immunological phenotypes similar to ICCs of the gut. These cells appear to be responsible for initiating the slow waves recorded from the anal sphincters and for controlling their activity. A deficiency or absence of these cells may affect the anal motile activity. Studies are needed to explore the role of these cells in anal motility disorders.

  10. The impact of anaemia on treatment outcome in patients with squamous cell carcinoma of anal canal and anal margin.

    Science.gov (United States)

    Oblak, Irena; Cesnjevar, Monika; Anzic, Mitja; Hadzic, Jasna But; Ermenc, Ajra Secerov; Anderluh, Franc; Velenik, Vaneja; Jeromen, Ana; Korosec, Peter

    2016-03-01

    Radiochemotherapy is the main treatment for patients with squamous cell carcinoma of the anal canal. Anaemia is reported to have adverse effect on survival in cancer patients. The aim of the study was to evaluate the influence of anaemia on radiochemotherapy treatment outcome in patients with squamous cell carcinoma of the anal canal. One hundred consecutive patients with histologically confirmed squamous cell carcinoma of the anal canal were treated radically with 3-dimensional conformal or intensity-modulated radiation therapy followed by brachytherapy or external beam radiotherapy boost and with concurrent mitomycin C and 5-fluorouracil. The influence on survival of pre-treatment, mean on-treatment and end-of-treatment haemoglobin (Hb) concentrations was studied. The 5-year locoregional control, disease free survival, disease specific survival and overall survival rates for all patients were 72%, 71%, 77% and 62%, respectively. In univariate analysis, patients with pre-treatment and end-of-treatment Hb > 120 g/L survived statistically significantly better compared to patients with Hb ≤ 120 g/L. Patients with mean on-treatment Hb > 120 g/L only had statistically significant better locoregional control and overall survival than patients with Hb ≤ 120 g/L. In multivariate analysis, independent prognostic factors were pre-treatment Hb (> 120 g/L vs. ≤ 120 g/L) for overall survival (hazard ratio [HR] = 0.419, 95% confidence interval [CI] = 0.190-0.927, p = 0.032) and stage (I & II vs. III) for disease specific (HR = 3.523, 95% CI = 1.375-9.026, p = 0.009) and overall survival (HR = 2.230, 95% CI = 1.167-4.264, p = 0.015). The pre-treatment, mean on-treatment and end-of-treatment Hb concentration > 120 g/L carried better prognosis for patients for with squamous cell carcinoma of the anal canal treated with radiochemotherapy. The pre-treatment Hb > 120 g/L was an independent prognostic factor for overall survival of patients with anal canal cancer.

  11. The impact of anaemia on treatment outcome in patients with squamous cell carcinoma of anal canal and anal margin

    International Nuclear Information System (INIS)

    Oblak, Irena; Cesnjevar, Monika; Anzic, Mitja; Hadzic, Jasna But; Ermenc, Ajra Secerov; Anderluh, Franc; Velenik, Vaneja; Jeromen, Ana; Korosec, Peter

    2016-01-01

    Radiochemotherapy is the main treatment for patients with squamous cell carcinoma of the anal canal. Anaemia is reported to have adverse effect on survival in cancer patients. The aim of the study was to evaluate the influence of anaemia on radiochemotherapy treatment outcome in patients with squamous cell carcinoma of the anal canal. One hundred consecutive patients with histologically confirmed squamous cell carcinoma of the anal canal were treated radically with 3-dimensional conformal or intensity-modulated radiation therapy followed by brachytherapy or external beam radiotherapy boost and with concurrent mitomycin C and 5-fluorouracil. The influence on survival of pre-treatment, mean on-treatment and end-of-treatment haemoglobin (Hb) concentrations was studied. The 5-year locoregional control, disease free survival, disease specific survival and overall survival rates for all patients were 72%, 71%, 77% and 62%, respectively. In univariate analysis, patients with pre-treatment and end-of-treatment Hb > 120 g/L survived statistically significantly better compared to patients with Hb ≤ 120 g/L. Patients with mean on-treatment Hb > 120 g/L only had statistically significant better locoregional control and overall survival than patients with Hb ≤ 120 g/L. In multivariate analysis, independent prognostic factors were pre-treatment Hb (> 120 g/L vs. ≤ 120 g/L) for overall survival (hazard ratio [HR] = 0.419, 95% confidence interval [CI] = 0.190–0.927, p = 0.032) and stage (I & II vs. III) for disease specific (HR = 3.523, 95% CI = 1.375–9.026, p = 0.009) and overall survival (HR = 2.230, 95% CI = 1.167–4.264, p = 0.015). The pre-treatment, mean on-treatment and end-of-treatment Hb concentration > 120 g/L carried better prognosis for patients for with squamous cell carcinoma of the anal canal treated with radiochemotherapy. The pre-treatment Hb > 120 g/L was an independent prognostic factor for overall survival of patients with anal canal cancer

  12. Early Squamous Cell Carcinoma of the Anal Canal Resected by Endoscopic Submucosal Dissection

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    Yuzuru Tamaru

    2015-04-01

    Full Text Available The standard treatment approach for squamous cell carcinoma (SCC of the anal canal includes abdominoperineal resection and chemoradiotherapy. However, there are currently very few reports of early SCC of the anal canal resected by endoscopic submucosal dissection (ESD. We report 2 rare cases of SCC of the anal canal resected by ESD. In case 1, a 66-year-old woman underwent a colonoscopy due to blood in her stool, and an elevated lesion, 15 mm in size, was identified from the rectum to the dentate line of the anal canal on internal hemorrhoids. The lesion was diagnosed as an early SCC of the anal canal, and ESD was successfully performed. The histopathological diagnosis was SCC in situ. In case 2, a 71-year-old woman underwent a colonoscopy due to constipation, and an elevated lesion, 25 mm in size, was identified from the dentate line to the anal canal. The lesion was diagnosed as early-stage SCC of the anal canal, and ESD was successfully performed. The histopathological diagnosis was SCC in situ. No complications or recurrence after ESD occurred in either case.

  13. Clinicopathological aspects and prevalence of human papillomavirus in anal cancer

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    Marina Tayla Mesquita Aguiar

    2014-04-01

    Full Text Available Anal cancer is relatively rare; however, its incidence has increased in recent years. Several risk factors are associated with the development of anal cancer, including age older than 50 years, low-fiber diet, chronic anal fistulas, smoking, multiple partners, anal intercourse practice, Human Immunodeficiency Virus infection and immunosuppression. However, the presence of human papillomavirus represents the main risk factor for the development of anal cancer. The aim of this study was to evaluate the clinicopathological aspects of a series of patients with anal carcinomas diagnosed in Hospital Araújo Jorge, Goiânia-Goiás, as well as the prevalence of human papillomavirus genome in these tumors. Clinical, pathological and socio-demographic data were collected from the respective medical files and paraffin blocks containing anal carcinomas specimens were used for DNA extraction and detection of human papillomavirus, by means of polymerase chain reaction, using short PCR fragment primers. Forty-three cases were selected and had the data analyzed, while 38 cases were tested for human papillomavirus genome detection. Among the evaluated patients, 62.8% were women; 53.4% of tumors were squamous cell carcinoma and 46.5% of the patients were aged between 60 and 75 years. Risk factors, such as smoking (39.5% and alcoholism (20.9% were recorded in the studied group. Lymph node metastases were detected in 30.2% of cases and 7.0% had distant metastasis. The detection of human papillomavirus DNA was positive in 76% of cases assessed and this was significantly associated with squamous cell carcinomas. Aggressive behavior and advanced stage of anal cancer described in this study highlight the need for preventive measures that contemplate these tumors, including vaccination against human papillomavirus. Resumo: O câncer anal é relativamente raro, entretanto, sua incidência aumentou nos últimos anos. Vários fatores de risco são associados ao

  14. Incertidumbre en métodos analíticos de rutina.

    OpenAIRE

    Maroto Sánchez, Maria Alicia

    2002-01-01

    Para que los laboratorios de análisis puedan acreditarse según la norma ISO 17025, es necesario que los resultados analíticos vayan acompañados de dos parámetros de calidadbásicos: su trazabilidad y su incertidumbre. Esto ha hecho que, hoy en día, la verificaciónde la trazabilidad y el cálculo de la incertidumbre de los resultados analíticos sea cada vezmás importante. En esta tesis doctoral hemos propuesto diversas metodologías para calcularla incertidumbre en métodos analíticos que se utili...

  15. Endosonographic and manometric evaluation of internal anal sphincter in patients with chronic anal fissure and its correlation with clinical outcome after topical glyceryl trinitrate therapy.

    Science.gov (United States)

    Pascual, Marta; Pera, Miguel; Courtier, Ricard; Gil, Mariá José; Parés, David; Puig, Sonia; Andreu, Montserrat; Grande, Luis

    2007-08-01

    Anorectal pressure studies have demonstrated internal anal sphincter (IAS) hypertonia in patients with chronic anal fissure. It is unknown however, if these changes in IAS function are associated with any abnormality in sphincter morphology. The first aim was to investigate the clinical characteristics and the manometric and endosonographic findings of the IAS in a cohort of patients with chronic anal fissure. The second aim was to investigate the association between these findings and the outcome with topical Glyceryl trinitrate (GTN) therapy. All patients who presented with chronic anal fissure from November 1999 to May 2004 were included after failure of conservative therapy. Anorectal manometry and anal endosonography were performed before treatment with 0.2% GTN ointment twice daily was initiated. Patients were evaluated after 8 weeks. One hundred and twenty-four patients (66 women, mean age, 45.2 +/- 14.8 years) were included. Hypertonia of the IAS was found in 84 (68%) patients. The mean maximum IAS thickness was 3.6 +/- 0.76 mm (1.6-5.5). An abnormally thick IAS, adjusted by age, was observed in 113 (91.1%) patients. We found no correlation between resting pressure and IAS thickness (r = 0.074; p = 0.41). At 8 weeks, 52 patients (42%) had healed with complete symptoms resolution. No statistically significant differences were observed when clinical features and manometric and endosonographic findings were compared between healing and no-healing fissures. The majority of patients with chronic anal fissure present an abnormally thick IAS. Clinical, manometric and endosonographic features had no association with outcome after GTN treatment.

  16. A presença de retocele interfere nos resultados de exames de fisiologia anal? Rectocele influences results of anal physiological examinations?

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora Prolungatti Cesar

    2008-09-01

    Full Text Available INTRODUÇÃO: A retocele é causa comum de constipação por defecação obstruída. Freqüentemente está relacionada com outras causas de defecação obstruída, e os exames de fisiologia anal são importantes para o diagnóstico preciso da causa de constipação intestinal. OBJETIVO: observar a influência da retocele nos exames de fisiologia anal, e a necessidade da realização desses após o diagnóstico da retocele. MÉTODO: Para este trabalho foram estudados 40 pacientes com diagnóstico de defecação obstruída. Todos os pacientes foram submetidos aos exames de manometria, sensibilidade retal, eletromiografia, latência do nervo pudendo e proctografia, e foram separados em 2 grupos: portadores e não portadores de retocele . Foram encontrados 18 pacientes com retocele, e o diagnóstico mais freqüentemente associado foi o anismus . Em relação aos exames foi encontrada diferença significante apenas na proctografia no ângulo ano retal, demonstrando que a presença de retocele não interferiu nos resultados de exames de fisiologia anal quando comparados com outros constipados, mas esteve associada a outras causas de constipação, como anismus que necessita de outro tipo de tratamento. CONCLUSÃO: A retocele não interferiu nos valores dos exames de fisiologia anal, mas esteve associada a outros diagnósticos, sendo importante a realização dos mesmos.INTRODUCTION: Rectocele is a common cause of constipation for obstructed defecation. It often is related with other causes of outlet obstruction and the examinations of anal physiology tests are important for necessary diagnosis of the constipation cause. OBJECTIVE: To observe the influence of rectocele in the anal physiology tests and the necessity of its accomplishment to the diagnosis of rectocele. METHOD: In this study, 40 patients with diagnosis of outlet obstruction had been analyzed. All the patients had been submitted to manometry, rectal sensitivity, electromyography, pudendal

  17. Anal canal plasmacytoma - An uncommon presentation site

    International Nuclear Information System (INIS)

    Antunes, M. I.; Bujor, L.; Grillo, I. M.

    2011-01-01

    Background: Extramedullary plasmacytomas (EMP) are rare plasma cell tumors that arise outside the bone marrow. They are most often located in the head and neck region, but may also occur in the other locations. The lower gastrointestinal EMP represents less than 5% of all cases, and location in the anal canal is exceedingly rare. Aim: We present an exceedingly rare case of anal canal plasmacytoma, aiming to achieve a better understanding of this rare entity. Methods: We report a case of a 61-year-old man with a bulky mass in the anal canal. The lesion measured about 6 cm and invaded in all layers of the anal canal wall. The biopsy was performed and revealed a round and plasmocitoid cell population with a solid growth pattern and necrosis. The tumoral cells have express CD79a and CD138 with lambda chains. There was no evidence of disease in other locations and these features were consistent with the diagnosis of an extra-osseous plasmacytoma. The patient was submitted to conformal radiotherapy 50.4 Gy total dose, 1.8 Gy per fraction. After 24 months, the patient is asymptomatic and the lesion has completely disappeared. Conclusions: EMP accounts for approximately 3% of plasma cell malignancies. The median age is about 60 years, and the majority of patients are male. The treatment of choice for extramedullary plasmacytoma is radiation therapy in a dosage of about 50 Gy. Patients should be followed-up for life with repeated bone marrow aspiration and protein studies to detect the development of multiple myeloma. (authors)

  18. Initial prevalence of anal human papilloma virus infection in liver transplant recipients.

    Science.gov (United States)

    Grąt, Michał; Grąt, Karolina; Hołówko, Wacław; Malejczyk, Magdalena; Walter de Walthoffen, Szymon; Lewandowski, Zbigniew; Kobryń, Konrad; Patkowski, Waldemar; Majewski, Sławomir; Młynarczyk, Grażyna; Krawczyk, Marek

    2014-08-01

    Although liver transplant recipients are at increased risk of human papilloma virus (HPV)-related anal cancer, limited data are available regarding the initial prevalence of anal HPV infection in this population. Anal swabs collected from 50 liver transplant recipients within the first three postoperative weeks were subjected to real-time polymerase chain reaction for detection of the four HPV genotypes: 6, 11, 16, and 18. Predictors of any, low-risk, and high-risk anal HPV infection were evaluated. Overall, the prevalence of any anal HPV infection was 18.0%, with the corresponding rates for high- and low-risk HPV genotypes being 8.0% and 10.0%, respectively. Infection with any type of anal HPV was higher in patients with hepatitis B virus (HBV) infection (P = 0.027), ≥3 sexual partners (P = 0.031), and alcoholic liver disease (P = 0.063). HBV infection was the only factor significantly associated with high-risk HPV infection (P = 0.038). Male sex (P = 0.050), age ≥52 years (P = 0.016), ≥30 sexual partners (P = 0.003), age at first intercourse ≤18 years (P = 0.045), and time since first intercourse ≥38 years (P = 0.012) were identified as predictors of low-risk HPV infection. These results indicate that HPV vaccination of liver transplant candidates and screening for anal HPV infection in high-risk groups should be considered. © 2014 Steunstichting ESOT.

  19. Anal endosonographic findings in women after vaginal delivery

    Energy Technology Data Exchange (ETDEWEB)

    Kolodziejczak, Malgorzata [Department of Proctology, Hospital at Solec, Warsaw (Poland); Sudol-Szopinska, Iwona, E-mail: iwsud@ciop.pl [Department of Proctology, Hospital at Solec, Warsaw (Poland); Department of Diagnostic Imaging, Second Faculty of Warsaw Medical University, Warsaw (Poland); Stefanski, Robert [Department of Proctology, Hospital at Solec, Warsaw (Poland); Department of Diagnostic Imaging, Second Faculty of Warsaw Medical University, Warsaw (Poland); Panorska, Anna K. [Department of Mathematics and Statistics, University of Nevada, Reno (United States); Gardyszewska, Agnieszka [Second Clinic of Obstetrics and Gynecology, Warsaw (Poland); Krasnodebski, Ireneusz [Department of General and Gastroenterological Surgery and Nutrition, Medical University, Warsaw (Poland)

    2011-04-15

    Objective: To estimate a frequency of obstetric anal sphincters defects in women after vaginal delivery. Methods: The study included 102 women, aged from 16 to 40 years (mean age 28.6 years). 28 women had perineal lacerations of 3rd and 4th degree. 22 women had instrumental delivery. Anal endosonography was performed on all participants using BK Medical scanner Pro focus with a 3D endoprobe during the first week after delivery. Starck's classification was used to score sphincters defects. Results: The endosonographic images were abnormal in 8 out of 102 women (7.8%). Follow-up examinations after 6 weeks confirmed defects in 6 out of 102 women (5.8%). Five women had external anal sphincter torn, and 1 woman had both sphincters, internal and external, defected. Discordance between endosonographic diagnosis of defect and clinical assessment of sphincters continuity was demonstrated in 6 (5.9%) out of 8 initially found, including 2 (1.9%) false endosonographic results and 4 (3.9%) false clinical diagnosis (occult sphincter defects). The endosonography sensitivity and accuracy in sphincter defect diagnostic amounted to 100% and 98%, respectively. Conclusions: (1) Anal sphincters' tears in symptomatic women are not as frequent as it was believed. (2) The defect diagnosis in the first week after delivery should be verified by a follow-up endosonography in 6 weeks, after regression of the edema and hematoma.

  20. Anal sexual experience and HIV risk awareness among female sex workers in Dire Dawa, eastern Ethiopia.

    Science.gov (United States)

    Mazeingia, Yohannes Teka; Olijjira, Lemessa; Dessie, Yadeta

    2017-01-01

    Female sex workers have been disproportionately affected with HIV and anal sexual experience elevate their vulnerability. Anal intercourse has more risk of HIV transmission than vaginal intercourse for receptors that coupled with low condom and proper lubricant use behavior during anal sex. Besides majority of them did not understand HIV transmission risk of anal intercourse. In Ethiopia, studies on anal sexual experience is almost none existent, so the purpose of this study is to explored anal sexual experience and HIV transmission risk awareness among female sex worker in Dire Dawa, Eastern Ethiopia. Qualitative study with thematic analysis approach was conducted among 18 female sex workers and recruitment of study participants performed until saturation of information. The principal investigator conducted in-depth interviews using local language (Amharic) and it was recorded on audio recorder. Tape recorded data was transcribed and translated to English and entered into open code version 3.4 for coding and theme identification. Data collection conducted simultaneously with data analysis. Female sex workers practiced anal sex for different themes like financial influence, coercion, intentionally, peer pressure and as a sign of intimacy and love. Coercion, negative attitudes, poor awareness about HIV transmission risks of anal sex and protection capacity of condom and proper lubricants are the identified themes for not using condom and proper lubricants during anal sex by female sex workers. Inaccessibility and unavailability of health services for issues related to anal sex was the core reason for female sex workers' misperception and risk anal sexual experience. Female sex workers practiced anal sex without risk reduction approaches and they did not understand exacerbated risk of anal sex to HIV transmission. Stakeholders including ministry of health need to incorporate potential awareness raising tasks and programs about risk of anal sex and methods of risk

  1. Oral and anal sex practices among high school youth in Addis Ababa, Ethiopia

    Directory of Open Access Journals (Sweden)

    Cherie Amsale

    2012-01-01

    Full Text Available Abstract Background Understanding the full range of sexual behaviors of young people is crucial in developing appropriate interventions to prevent and control sexually transmitted infections including HIV. However, such information is meager in developing countries. The objective of this study was to describe oral and anal sex practices and identify associated factors among high school youth. Methods A cross-sectional study was conducted among high school youth in Addis Ababa, Ethiopia. A multi-stage sampling procedure was followed to select a representative sample of school youth. The total sample size for this study was 3840. Data were collected using a self-administered questionnaire. Data analysis was guided by the ecological framework. Results The overall proportion of people who reported ever having oral sex was 5.4% (190 and that of anal sex was 4.3% (154. Of these 51.6% (98 had oral sex and 57.1% (87 had anal sex in the past 12 months. Multiple partnerships were reported by 61.2% of the respondents who had oral sex and 51.1% of students practicing anal sex. Consistent condom use was reported by 12.2% of those practicing oral sex and 26.1% of anal sex. Reasons for oral and anal sex included prevention of pregnancy, preserving virginity, and reduction of HIV and STIs transmission. Oral sex practice was strongly and significantly associated with perception of best friends engagement in oral sex (AOR = 5.7; 95% CI 3.6-11.2 and having illiterate mothers (AOR = 11.5; 95%CI 6.4-18.5. Similarly, anal sex practice was strongly and significantly associated with favorable attitude towards anal sex (AOR = 6.2; 95%CI 3.8-12.4, and perceived best friends engagement in anal sex (AOR = 9.7; 95%CI 5.4-17.7. Conclusion Considerable proportion of adolescents had engaged in oral and anal sex practices. Multiple sexual partnerships were common while consistent condom use was low. Sexual health education and behavior change communication strategies need to

  2. Theoretical analysis of nuclear reactors (Phase II), I-V, Part V, Determining the fine neutron flux distribution by Pn method; Razrada metoda teorijske analize nuklearnih reaktora (II faza) I-V, V Deo, Odredjivanje fine raspodele fluksa Pn metodom

    Energy Technology Data Exchange (ETDEWEB)

    Pop-Jordanov, J [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1962-10-15

    Expression for spherical harmonic moments were applied. They were obtained by spherical harmonics expansion of monoenergetic transport equation. This report presents the procedure for calculating the neutron flux distribution in the nine-zone reactor cell of the RA reactor in Vinca. The procedure was modelled for digital computer ZUSE Z-23 by expansion of the diagram of the automated P{sub 3} code, which is adequate for P{sub n} code with minor changes. The needed subroutines were developed. The most important ones were those for modified first and second order Bessel functions of n-th order. Computer Z-23 was operating only 15 hours during three months, and thus only the subroutines for modified Bessel functions could be tested and the obtained results were excellent. For the mentioned reason the neutron flux distribution will be calculated in the forthcoming period. Koriscen je izraz za svernoharmonicne momente koji se dobija razvijanjem monoenergetske transportne jednacine u sverne harmonike. Dat je postupak za odredjivanje raspodele neutronskog fluksa u devet medijalnoj celiji reaktora RA u Vinci. Gornji postupak je logicki organizovan na digitalnoj masini ZUSE Z-23 razvijanjem tekuceg dijagrama automatskog P{sub 3} koda, koji sa malim izmenama odgovara Pn kodu. Razvijene su potrebne osnovne subrutine, medju kojima su najznacajnije one za modificirane Beselove funkcije prve i druge vrste n - tog reda. Masina ZUSE Z-23 bila je u radu svega 15 zasova u toku tri meseca, te sam stigao da testiram samo subrutine za modificirane Beselove funkcije koje su dale odlicne rezultate. Iz ovoga razloga nije se mogla dobiti trazena raspodela fluksa. To ce biti ucinjeno u narednom periodu posto cemo moci koristiti masinu Z-23 (author)

  3. Correlates of unprotected anal intercourse: the influence of anal sex position among men who have sex with men in Beijing, china.

    Science.gov (United States)

    Zhang, Heng; Lu, Hongyan; Pan, Stephen W; Xia, Dongyan; Zhao, Yuejuan; Xiao, Yan; He, Xiong; Yue, Hai; Sun, Zheya; Xu, Yunan; Ruan, Yuhua; Shao, Yiming

    2015-02-01

    Understanding barriers to consistent condom use among men who have sex with men (MSM) requires consideration of the context in which risk behaviors occur. Anal sex position is one such context. This pooled cross-sectional study used survey data from 1,230 MSM and their 2,618 reported male sexual partnerships. Overall, nearly half of the participants engaged in unprotected anal intercourse (UAI) with at least one of upto three partners in the past 6 months. "Insertive" men engaged in less UAI (39 %) than "receptive" (53 %) or "versatile" (51 %) men. Regardless of sexual position, UAI was associated with cohabiting with a male or female partner and perceiving great or moderate risk of HIV from male contact at the individual level, and steady (vs. casual) partnership at the dyad level. However, early MSM anal sex debut, high number of male partners, alcohol use, receiving and buying condoms, HIV testing, and MSM sex-seeking venues were found to be only statistically significantly correlated with UAI among some but not all sexual positions, implying that interventions to increase condom use should take into account how anal sex position may influence willingness and ability to engage in safer sex. Dyad level data appear to provide additional insight into the influence of sexual positions, and should be used to complement individual data for future intervention designs.

  4. Samatähenduslike sünteetiliste ja analüütiliste verbide kasutamine

    Directory of Open Access Journals (Sweden)

    Pille Eslon

    2015-10-01

    Full Text Available Huvi samatähenduslike sünteetiliste ja analüütiliste verbide vastu tekkis artikli esimesel autoril vene-eesti-vene tõlkesõnastikke toimetades, kui silma hakkasid regulaarsed valikud vene verbi grammatilise aspekti ning eesti keele sünteetiliste ja analüütiliste verbide vahel. Kuigi tegu on raskesti märgatava ja sugugi mitte sagedase nähtusega, tekitab see küsimusi: millal eelistab emakeelekõneleja kasutada sünteetilist, millal analüütilist verbi; kas lisaks samatähenduslikkusele ja vormilisele lihtsusele (sünteetiline verb koosneb ühest komponendist või keerukusele (analüütiline verb vähemalt kahest komponendist on veel tunnuseid, mis sünteetilise ja analüütilise verbi valikuid piiravad. Käesoleva uurimuse eesmärk on leida nendele küsimustele vastuseid. Analüüsitakse viit samatähendusliku sünteetilise ja analüütilise verbi paari (igatsema – igatsust tundma, lahkuma – ära minema, nõustuma – nõus olema, muretsema – muret tundma, töötama – tööd tegema, otsitakse mõlema verbi kasutusele omaseid keelestruktuure, analüüsitakse nende leksikaalsemantilise ja morfosüntaktilise varieerumise piire, võrreldakse verbide tähendusi. Nende tunnuste põhjal saab teha mõningaid järeldusi selle kohta, kas tegu võiks olla ühe verbi kahe vormiga või kahe erineva verbiga. Uurimuse empiiriline aspekt on seotud hüpoteesiga semantiliselt lähedaste sünteetiliste ja analüütiliste verbide tõmbumisest, millega kaasnevad ühelt poolt struktuursed, morfoloogilised, morfosüntaktilised ja leksikaalsemantilised kasutuspiirangud ning teisalt vaba varieerumine. Sisuliselt vastandlikud tendentsid – kinnistumine ja varieerumine – toimivad keele leksikaalgrammatilises perifeerias sama eesmärgi nimel, tagades keele pideva uuenemise ja säilimise.

  5. Cause-Specific Colostomy Rates After Radiotherapy for Anal Cancer: A Danish Multicentre Cohort Study

    DEFF Research Database (Denmark)

    Sunesen, Kåre G; Nørgaard, Mette; Lundby, Lilli

    2011-01-01

    In anal cancer, colostomy-free survival is a measure of anal sphincter preservation after treatment with radiotherapy or chemoradiotherapy. Failure to control anal cancer and complications of treatment are alternative indications for colostomy. However, no data exist on cause-specific colostomy...

  6. The Danish anal sphincter rupture questionnaire: Validity and reliability

    DEFF Research Database (Denmark)

    Due, Ulla; Ottesen, Marianne

    2008-01-01

    Objective. To revise, validate and test for reliability an anal sphincter rupture questionnaire in relation to construct, content and face validity. Setting and background. Since 1996 women with anal sphincter rupture (ASR) at one of the public university hospitals in Copenhagen, Denmark have been...... main questions but one. Two questions needed further explanation. Seven women made minor errors. Conclusion. The validated Danish questionnaire has a good construct, content and face validity. It is a well accepted, reliable, simple and clinically relevant screening tool. It reveals physical problems...... offered pelvic floor muscle examination and instruction by a specialist physiotherapist. In relation to that, a non-validated questionnaire about anal and urinary incontinence was to be answered six months after childbirth. Method. The original questionnaire was revised and a pilot test was performed...

  7. [Detection and analysis of the characteristic expression of microRNAs of anal fistula patients].

    Science.gov (United States)

    Qiu, Jianming; Yu, Jiping; Yang, Guangen; Xu, Kan; Tao, Yong; Lin, Ali; Wang, Dong

    2016-07-01

    To detect and analyze the characteristic miRNAs profile of anal fistula and explore their possible target genes and potential clinical significance. The anal mucosa close to the hemorrhoids were collected from three patients undergoing fistulectomy and hemorrhoidectomy (fistula group) as well as three patients receiving only hemorroidectomy(hemorrhoids group), matching with fistula group in age, gender and body weight. miRNA microarray was used to compare the expression of 1 285 human miRNAs of the anal mucosa between two groups. Cluster analysis was adopted to analyze the accumulation of the differentially expressed miRNAs(Pcharacteristic miRNAs profile in anal fistula patients, which may play a role in the occurrence and development of anal fistula.

  8. Tunni analüüs - mis see on? / Peep Leppik

    Index Scriptorium Estoniae

    Leppik, Peep

    2001-01-01

    Tunni analüüs, õppe-kasvatustöö eesmärgid. Tunni analüüs on hinnangu andmine protsessidele, mille kutsub esile õpetaja tegevus (või tegevusetus) tunnis. Tunni läbiviimise protsessi mõjutavad õpilaste koosseis klassis, erinevate õppevormide ja õppemeetodite kasutamine, kasutatud õppevõtete otstarbekus, erinevad metoodikad ja õppesüsteemid

  9. HPV and anal cancer in HIV-infected individuals: a review

    NARCIS (Netherlands)

    Schim van der Loeff, Maarten F.; Mooij, Sofie H.; Richel, Oliver; de Vries, Henry J. C.; Prins, Jan M.

    2014-01-01

    HIV infection is one of the strongest risk factors for anal squamous cell cancer (ASCC). Most ASCC are caused by HPV, and most HPV-associated ASCC are caused by HPV-16. Anal HPV infections are very common in men who have sex with men (MSM), and nearly universal among HIV-infected MSM. High-grade

  10. Candidíase vulvovaginal: sintomatologia, fatores de risco e colonização anal concomitante Vulvovaginal candidiasis: symptomatology, risk factors and concomitant anal colonization

    Directory of Open Access Journals (Sweden)

    Antônio Arildo Reginaldo de Holanda

    2007-01-01

    Full Text Available OBJETIVO: analisar pacientes com candidíase vulvovaginal quanto a sintomatologia, fatores de risco e resultados da cultura anal, identificar a freqüência de Candida albicans e não C. albicans e correlacionar as colonizações anal e vaginal. MÉTODOS: foram incluídas 99 pacientes com suspeita clínica de candidiase vulvovaginal, procedentes de Natal, RN, atendidas entre maio de 2003 e maio de 2005, perfazendo-se o total de 294 coletas. O material clínico, colhido por zaragatoas, foi semeado em CHROMagar Candida®. As leveduras foram identificadas pelo método clássico, além da prova de crescimento a 42 e 45ºC e da prova do caldo Sabouraud hipertônico. A sintomatologia, fatores de risco e colonização anal foram analisados de acordo com a positividade ou negatividade para Candida spp. As culturas positivas para C. albicans nos dois sítios foram comparadas com outros resultados encontrados. Para análise estatística utilizou-se o teste do chi2, com correção de Yates e o teste exato de Fisher. RESULTADOS: a espécie mais frequente foi C. albicans em 69% dos casos. Uso de roupas íntimas justas e/ou sintéticas, presença de doenças alérgicas, ocorrência de prurido, leucorréia e hiperemia apresentaram associação com a positividade vaginal para Candida spp. A chance de uma paciente com colonização anal positiva de apresentar positividade vaginal concomitante foi 2,8 e 4,9 vezes maior, respectivamente, para Candida spp e C. albicans. A chance de uma paciente com cultura anal positiva para C. albicans de apresentar resultado vaginal positivo foi 3,7 vezes maior quando comparada a espécies não C. albicans. CONCLUSÕES: C. albicans foi a espécie mais comum, tendo sido observada associação da positividade vaginal para Candida spp com uso de roupas justas e/ou sintéticas, doenças alérgicas, prurido, leucorréia e eritema (pPURPOSE: to analyze patients with vulvovaginal candidiasis with respect to risk factors, symptomatology

  11. The anal canal as a risk organ in cervical cancer patients with hemorrhoids undergoing whole pelvic radiotherapy.

    Science.gov (United States)

    Jang, Hyunsoo; Baek, Jong Geun; Jo, Sunmi

    2015-01-01

    Tolerance of the anal canal tends to be ignored in patients with cervical cancer undergoing whole pelvic radiotherapy. However, patients with hemorrhoids may be troubled with low radiation dose. We tried to analyze the dose-volume statistics of the anal canal in patients undergoing whole pelvic radiotherapy. The records of 31 patients with cervical cancer who received definite or postoperative radiotherapy at one institution were reviewed. Acute anal symptoms, such as anal pain and bleeding, were evaluated from radiotherapy start to 1 month after radiotherapy completion. Various clinical and dosimetric factors were analyzed to characterize relations with acute anal complications. The anal verge was located an average of 1.2 cm (range -0.6~3.9) below the lower border of the ischial tuberosity and an average of 2.7 cm (range -0.6~5.7) behind the sacral promontory level. The presence of hemorrhoids before radiotherapy was found to be significantly associated with acute radiation-induced anal symptoms (p = 0.001), and the mean induction dose for anal symptoms was 36.9 Gy. No patient without hemorrhoids developed an anal symptom during radiotherapy. Dosimetric analyses of V30 and V40 showed marginal correlations with anal symptoms (p = 0.07). The present study suggests a relation between acute anal symptoms following radiotherapy and acute hemorrhoid aggravation. Furthermore, the location of the anal verge was found to be variable, and consequently doses administered to the anal canal also varied substantially. Our results caution careful radiation treatment planning for whole pelvic radiotherapy, and that proper clinical management be afforded patients with hemorrhoids during radiotherapy.

  12. Methods for measuring nuclear properties of materials, Safety coefficient method and measurement of effective absorption coefficient of graphite by safety coefficient method; Razvijanje metoda merenja nuklearnih karakteristika materijala, Razrada metode koeficijenta opasnosti i merenje efektivnog apsorpcionog preseka grafita metodom koeficijenta opasnosti

    Energy Technology Data Exchange (ETDEWEB)

    Maglic, R [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1962-11-15

    Reactivity of a reactor depends on production, absorption and leaking of neutrons. Change of absorption causes reactivity change, and this fact is used for determining the neutron absorption cross section for the sample inserted in the reactor core. Method for determining the absorption cross section based on reactivity change is called method of safety coefficient. Measurements of neutron absorption cross section for graphite was done in the RA reactor vertical experimental channel VK-5. taking into account the results obtained for five types of graphite this method is considered to be reliable for use. Comparison of nuclear properties of different types of graphite was done as well. Reaktivnost reaktora zavisi od proizvodnje neutrona, apsorpcije i isticanja neutrona. Promena apsorpcije izaziva promene reaktivnosti reaktora pa se ova osobina koristi za odedjivanje neutronskog apsorpcionog preseka uzorka koji se unosi u reaktor. Metoda merenja apsorpcionog preseka na bazi promene reaktivnosti nazvana je metodom koeficijenta opasnosti. Merenje apsorpcionog preseka grafita uradjeno je na reaktoru RA u vertikalnom eksperimentalnom kanalu VK-5. S obzirom na rezultate koji su dobijeni za pet vrsta grafita moze se smatrati da je opravdano koriscenje ove metode. Izvrseno je i poredjenje nuklearnih osobina pomenutih tipova grafita.

  13. Anal HPV infection in HIV-positive men who have sex with men from China.

    Directory of Open Access Journals (Sweden)

    Lei Gao

    Full Text Available BACKGROUND: Anal HPV infection, which contributes to the development of anal warts and anal cancer, is well known to be common among men who have sex with men (MSM, especially among those HIV positives. However, HIV and anal HPV co-infection among MSM has not been addressed in China. METHODS: A cross-sectional study was conducted in Beijing and Tianjin, China. Study participants were recruited using multiple methods with the collaboration of local volunteer organizations. Blood and anal swabs were collected for HIV-1 serological test and HPV genotyping. RESULTS: A total of 602 MSM were recruited and laboratory data were available for 578 of them (96.0%. HIV and anal HPV prevalence were 8.5% and 62.1%, respectively. And 48 MSM (8.3% were found to be co-infected. The HPV genotypes identified most frequently were HPV06 (19.6%, HPV16 (13.0%, HPV52 (8.5% and HPV11 (7.6%. Different modes of HPV genotypes distribution were observed with respect to HIV status. A strong dose-response relationship was found between HIV seropositivity and multiplicity of HPV genotypes (p<0.001, which is consistent with the observation that anal HPV infection was an independent predictor for HIV infection. CONCLUSIONS: A high prevalence of HIV and anal HPV co-infection was observed in the MSM community in Beijing and Tianjin, China. Anal HPV infection was found to be independently associated with increased HIV seropositivity, which suggests the application of HPV vaccine might be a potential strategy to reduce the acquisition of HIV infection though controlling the prevalence of HPV.

  14. HIV-positive MSM's knowledge of HPV and anal cancer self-sampling: A scoping review.

    Science.gov (United States)

    Poon, M K L; Wong, J P H; Li, A T W; Manuba, M; Bisignano, A; Owino, M; Vahabi, M

    2018-02-01

    Human papillomavirus (hpv) infection is the cause of anal squamous cell cancer (ascc) in 80% of cases. Available research has also shown high prevalence of anal hpv infection among men who have sex with men (msm). However, hpv vaccination is low among msm in Canada. In light of this information, we conducted a scoping review with the aim of exploring (1) the knowledge of hpv and anal cancer among hiv-positive msm and (2) the acceptability of hpv and anal cancer self-sampling in this population. In conducting the review, we searched five electronic databases for peer-reviewed articles and abstracts published in English, between 2007 and 2017. A total of 803 articles were retrieved; after accounting for duplicates ( n= 40) and unmet criteria ( n= 754), a total of 794 articles were excluded. A final total of nine articles were used in this review. Results of this review show that hiv-positive msm have limited knowledge regarding the risks of anal cancer associated with hiv and hpv coinfection. Furthermore, there is limited research on hpv and anal cancer self-sampling in this population. However, the review of available studies suggested that hiv-positive msm were open to anal cancer self-sampling. It also identified potential barriers to self-sampling. In conclusion, we provide suggestions and future directions for policy-makers and educators to develop inclusive and accessible strategies to reach hiv-positive msm regarding anal cancer education and self-screening.

  15. Hereditary internal anal sphincter myopathy causing proctalgia fugax and constipation. A newly identified condition.

    Science.gov (United States)

    Kamm, M A; Hoyle, C H; Burleigh, D E; Law, P J; Swash, M; Martin, J E; Nicholls, R J; Northover, J M

    1991-03-01

    A newly identified myopathy of the internal anal sphincter is described. In the affected family, at least one member from each of five generations had severe proctalgia fugax; onset was usually in the third to fifth decades of life. Three members of the family have been studied in detail. Each had severe pain intermittently during the day and hourly during the night. Constipation was an associated symptom, in particular difficulty with rectal evacuation. Clinically the internal anal sphincter was thickened and of decreased compliance. The maximum anal canal pressure was usually increased with marked ultraslow wave activity. Anal endosonography confirmed a grossly thickened internal anal sphincter. Two patients were treated by internal anal sphincter strip myectomy; one showed marked improvement and one was relieved of the constipation but had only slight improvement of the pain. The hypertrophied muscle in two of the patients showed unique myopathic changes, consisting of vacuolar changes with periodic acid-Schiff-positive polyglycosan bodies in the smooth muscle fibers and increased endomysial fibrosis. In vitro organ-bath studies showed insensitivity of the muscle to noradrenaline, isoprenaline, carbachol, dimethylpiperazinium, and electrical-field stimulation. Immunohistochemical studies for substance P, calcitonin gene-related peptide, galanin, neuropeptide Y, and vasoactive intestinal peptide showed staining in a similar distribution to that in control tissue. A specific autosomal-dominant inherited myopathy of the internal anal sphincter that causes anal pain and constipation has been identified and characterized.

  16. Anal carcinoma in HIV-infected patients in the period 1995-2009

    DEFF Research Database (Denmark)

    Legarth, Rebecca; Helleberg, Marie; Kronborg, Gitte

    2013-01-01

    Abstract Background: Several studies have demonstrated an increased risk of non-AIDS cancers in HIV patients and, for some cancers, also in relatives of HIV patients. We aimed to estimate (1) the risk of anal carcinoma among HIV patients and their parents, and (2) the mortality after a diagnosis...... 1995-2009, and (2) parents of HIV patients compared with parents of controls for the period 1978-2009. Cancer diagnoses were identified from The Danish Cancer Registry. We further estimated the mortality rate ratios (MRR) of HIV patients compared with controls after the diagnosis of anal carcinoma....... Results: Thirty-six HIV patients versus 8 population controls were diagnosed with anal carcinoma. HIV patients had an increased risk of anal carcinoma (IRR 77.9, 95% CI 36.2-167.7), especially among men who have sex with men (MSM) (IRR 101.4, 95% CI 39.3-261.5). Fathers of HIV patients had an increased...

  17. Should anorectal ultrasonography be included as a diagnostic tool for chronic anal pain?

    Science.gov (United States)

    García-Montes, M J; Argüelles-Arias, Federico; Jiménez-Contreras, S; Sánchez-Gey, S; Pellicer-Bautista, F; Herrerías-Gutiérrez, J M

    2010-01-01

    To assess the efficiency of endorectal ultrasound (ERUS) in the study of chronic idiopathic anal pain (CIAP). This is a prospective and descriptive study in which 40 patients, 18 men and 22 women with an average of 47 years, were included. They had chronic anal pain of at least 3 months duration. A complete colonoscopy was performed in all patients, which found no abnormalities to explain clinical symptoms. Patients with anal fissure and internal hemorrhoids of any degree, perianal suppurative processes, and pelvic surgery were excluded from the study. An ALOKA ProSound SSD-4000 ultrasound console attached to a multifrequency radial transductor ASU-67 (7.5 and 10 MHz) was used. One patient could not tolerate the examination. In 8 patients (20% of cases) alterations were detected during ultrasonography: in 4 patients (10% of the cases; 1 man and 3 women) internal anal sphincter (IAS) hypertrophy, and in 5 patients (4 women and 1 man) a torn sphincter complex. A tear in the upper IAS canal and hypertrophy of the middle anal canal were observed in one patient (1 woman). ERUS is a simple, economic and useful test to study anorectal pathologies. Although in most studied cases no damage to the anal canal or rectal wall was detected, in a considerable number of patients we observed a thickening of the IAS, a probable cause of anal pain. Therefore, we understand that ERUS should be included in the study of CIAP.

  18. ESTUDIOS MACRO Y MICROSCOPICO DEL SACO ANAL DEL COIPO (Myocastor coypus)

    OpenAIRE

    Rafasquino, Marta E.; Ramos, Pablo A.; Alonso, Cristina R.; Idiart, Julio R.

    1998-01-01

    RESUMEN:Fue realizada la disección del saco anal de 44 coipos, de ambos sexos, de distintas edades y procedencias, observándose algunas características similares a los sacos anales del perro y gato, aunque es impar y está ubicado en ventral del ano. Es ovoídeo o piriforme, siendo más grande en los adultos y, entre éstos, más aún en los machos que en las hembras; posee un conducto que desemboca en el canal anal a un centímetro del ano y que se exterioriza en el momento de secretar el producto ...

  19. Primary radiation therapy in the treatment of anal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Cantril, S.T. (Children' s Hospital of San Francisco, CA); Green, J.P.; Schall, G.L.; Schaupp, W.C.

    1983-09-01

    From 1966 to 1981, 47 patients with a diagnosis of anal carcinoma were irradiated. This group was composed of 23 males and 24 females, with age ranging from 38 to 84 years (average 64.4 years). Five patients were treated preoperatively and 34 were treated definitively with cancericidal doses of irradiation. Acute radiation reactions requiring a rest-break were noted in 28% of patients, but all were managed as outpatients without untoward chronic sequelae. Chronic complications were noted in 13 patients, including two patients who required colostomy for severe anal stenosis and two who required A-P resection for large painful ulcers. Twenty-eight of 35 patients (80%) treated with irradiation alone have remained locally controlled without further treatment. An additional four have been salvaged by surgery. Only three patients had interstitial implants as part of their treatment course. Actuarial survival at five years for the N/sub 0/ patients and the group as a whole are 95.6 and 79.3%, respectively. It is concluded that external beam irradiation alone, properly fractionated to cancericidal doses, can control anal carcinoma with acceptable morbidity rates and without the use of either chemotherapy or interstitial implants in most cases. There is also a strong correlation suggesting that anal intercourse and male homosexuality play a significant role in the etiology of this disease.

  20. Primary radiation therapy in the treatment of anal carcinoma

    International Nuclear Information System (INIS)

    Cantril, S.T.; Green, J.P.; Schall, G.L.; Schaupp, W.C.

    1983-01-01

    From 1966 to 1981, 47 patients with a diagnosis of anal carcinoma were irradiated. This group was composed of 23 males and 24 females, with age ranging from 38 to 84 years (average 64.4 years). Five patients were treated preoperatively and 34 were treated definitively with cancericidal doses of irradiation. Acute radiation reactions requiring a rest-break were noted in 28% of patients, but all were managed as outpatients without untoward chronic sequelae. Chronic complications were noted in 13 patients, including two patients who required colostomy for severe anal stenosis and two who required A-P resection for large painful ulcers. Twenty-eight of 35 patients (80%) treated with irradiation alone have remained locally controlled without further treatment. An additional four have been salvaged by surgery. Only three patients had interstitial implants as part of their treatment course. Actuarial survival at five years for the N 0 patients and the group as a whole are 95.6 and 79.3%, respectively. It is concluded that external beam irradiation alone, properly fractionated to cancericidal doses, can control anal carcinoma with acceptable morbidity rates and without the use of either chemotherapy or interstitial implants in most cases. There is also a strong correlation suggesting that anal intercourse and male homosexuality play a significant role in the etiology of this disease

  1. Presence of skin metastasis related to an epidermoid carcinoma of anal canal

    International Nuclear Information System (INIS)

    Danta Fundora, Debora; Collado Otero, Juan Carlos; Vazquez Gonzalez, Jose Manuel; Paredes Lopez, Dagmar

    2009-01-01

    Appearance of spreading skin metastases in colorectal cancer and of anal canal is infrequent. The aim of present paper was to show an interesting case of skin metastasis related to an advanced carcinoma of anal canal infiltrating rectum

  2. Testing for and the role of anal and rectal sensation.

    Science.gov (United States)

    Rogers, J

    1992-03-01

    The rectum is insensitive to stimuli capable of causing pain and other sensations when applied to a somatic cutaneous surface. It is, however, sensitive to distension by an experimental balloon introduced through the anus, though it is not known whether it is the stretching or reflex contraction of the gut wall, or the distortion of the mesentery and adjacent structures which induces the sensation. No specific sensory receptors are seen on careful histological examination of the rectum in humans. However, myelinated and non-myelinated nerve fibres are seen adjacent to the rectal mucosa, but no intraepithelial fibres arise from these. The sensation of rectal distension travels with the parasympathetic system to S2, S3 and S4. The two main methods for quantifying rectal sensation are rectal balloon distension and mucosal electrosensitivity. The balloon is progressively distended until particular sensations are perceived by the patient. The volumes at which these sensations are perceived are recorded. Three sensory thresholds are usually defined: constant sensation of fullness, urge to defecate, and maximum tolerated volume. The modalities of anal sensation can be precisely defined. Touch, pain and temperature sensation exist in normal subjects. There is profuse innervation of the anal canal with a variety of specialized sensory nerve endings: Meissner's corpuscles which record touch sensation, Krause end-bulbs which respond to thermal stimuli, Golgi-Mazzoni bodies and pacinian corpuscles which respond to changes in tension and pressure, and genital corpuscles which respond to friction. In addition, there are large diameter free nerve endings within the epithelium. The nerve pathway for anal canal sensation is via the inferior haemorrhoidal branches of the pudendal nerve to the sacral roots of S2, S3 and S4. Anal sensation may be quantitatively measured in response to electrical stimulation. The technique involves the use of a specialized constant current generator

  3. Should anorectal ultrasonography be included as a diagnostic tool for chronic anal pain?

    Directory of Open Access Journals (Sweden)

    M. J. García-Montes

    Full Text Available Objective: to assess the efficiency of endorectal ultrasound (ERUS in the study of chronic idiopathic anal pain (CIAP. Material and method: this is a prospective and descriptive study in which 40 patients, 18 men and 22 women with an average of 47 years, were included. They had chronic anal pain of at least 3 months' duration. A complete colonoscopy was performed in all patients, which found no abnormalities to explain clinical symptoms. Patients with anal fissure and internal hemorrhoids of any degree, perianal suppurative processes, and pelvic surgery were excluded from the study. An ALOKA ProSound SSD-4000 ultrasound console attached to a multifrequency radial transductor ASU-67 (7.5 and 10 MHz was used. Results: one patient could not tolerate the examination. In 8 patients (20% of cases alterations were detected during ultrasonography: in 4 patients (10% of the cases; 1 man and 3 women internal anal sphincter (IAS hypertrophy, and in 5 patients (4 women and 1 man a torn sphincter complex. A tear in the upper IAS canal and hypertrophy of the middle anal canal were observed in one patient (1 woman. Conclusions: ERUS is a simple, economic and useful test to study anorectal pathologies. Although in most studied cases no damage to the anal canal or rectal wall was detected, in a considerable number of patients we observed a thickening of the IAS, a probable cause of anal pain. Therefore, we understand that ERUS should be included in the study of CIAP.

  4. Squamous cell carcinoma of the anal canal.

    LENUS (Irish Health Repository)

    Martin, F T

    2012-01-31

    Squamous cell carcinoma ofthe anal canal represents 1.5% of all malignancies affectingthe gastrointestinal tract. Over the past 20 years dramatic changes have been seen in both the epidemiological distribution of the disease and in the therapeutic modalities utilised to manage it. CLINICAL MANAGEMENT: Historically abdominoperineal resection had been the treatment of choice with local resection reserved for early stage disease. Work by Nigro et al. has revolutionised how we currently manage carcinoma of the anal canal, demonstrating combined modality chemoradiotherapy as an appropriate alternative to surgical resection with the benefit of preserving sphincter function. Surgery is then reserved for recurrent disease with salvage abdominoperineal resection. This article reviews current literature and highlights the changing therapeutic modalities with selected clinical cases

  5. [Proctalgia fugax. Differential diagnosis and therapy of fleeting anal cramp].

    Science.gov (United States)

    Staude, G

    1992-05-30

    Proctalgia fugax--short-lived anal spasm--is a common, extremely unpleasant, painful condition that occurs completely unexpectedly, often waking the victim at night. Scientific assessment is difficult on account of the functional nature of the condition and its multifactorial genesis. Before the patient is labeled "anal neurotic", however, he/she should be investigated by a specialist. The results of treating the rarely absent pathological organic findings give rise to optimism.

  6. Assertividade e autocontrole: interpretação analítico-comportamental

    Directory of Open Access Journals (Sweden)

    Vívian Marchezini-Cunha

    Full Text Available Questões relacionadas à assertividade têm recebido atenção por parte de terapeutas comportamentais há mais de três décadas. É mais recente, porém, o esforço de terapeutas analítico-comportamentais para examinar problemas dessa ordem com os mesmos recursos conceituais e metodológicos empregados por seus pares da pesquisa básica e conceitual. O presente trabalho tem como objetivo oferecer uma interpretação analítico-comportamental para padrões de comportamento assertivos, agressivos e passivos. Recuperamos algumas definições de assertividade/agressividade/passividade e examinamos os fenômenos correspondentes enquanto relações comportamentais; discutimos alguns aspectos da abordagem analítico-comportamental para o autocontrole; e sugerimos que as relações comportamentais definidas como assertividade/agressividade/passividade podem ser interpretadas enquanto instâncias de autocontrole ou impulsividade. A abordagem pode abrir novas perspectivas de investigação clínica de habilidades sociais sob um enfoque analítico-comportamental.

  7. Correlates of anal sex roles among Malay and Chinese MSM in Kuala Lumpur, Malaysia.

    Science.gov (United States)

    Dangerfield, Derek T; Gravitt, Patti; Rompalo, Anne M; Tai, Raymond; Lim, Sin How

    2016-03-01

    Identifying roles for anal sex is an important issue for populations of MSM. We describe the prevalence of identifying as being 'top', 'bottom', 'versatile', or 'don't know/not applicable' among Malay and Chinese MSM in Kuala Lumpur, Malaysia, and behavioural outcomes according to these labels for sexual role identity. Data analysis was conducted on a survey administered during weekly outreach throughout Kuala Lumpur in 2012. Pearson's Chi square tests were used to compare demographic and behavioural characteristics of MSM who reported roles for anal sex. Binary logistic regression was used to explore the odds of behavioural outcomes among MSM who identified as 'bottom', 'versatile,' and 'don't know' compared to MSM who reported that 'top' was their sexual role. Labels for anal sex roles were significantly associated with condom use for last anal sex. Among MSM who used labels for anal sex roles, MSM who identified as 'bottom' had highest level of not using condoms for last anal sex (24.1%, p = .045). In binary logistic regression model, identifying as 'top' was significantly associated with reporting using a condom during last anal sex and reported consistent condom use for anal sex in the past six months (p = .039 and .017, respectively). With regard to sexual role identity, some MSM may be a part of a special subgroup of at-risk men to be targeted. Future research should evaluate the origins, meanings, and perceptions of these labels, and the developmental process of how these MSM identify with any of these categories. Research should also uncover condom use decision making with regard to these labels for sexual positioning. © The Author(s) 2016.

  8. Anal canal duplication and triplication: a rare entity with different presentations.

    Science.gov (United States)

    Palazon, P; Julia, V; Saura, L; de Haro, I; Bejarano, M; Rovira, C; Tarrado, X

    2017-05-01

    Anal canal duplication (ACD) is the rarest of gastrointestinal duplications. Few cases have been reported. Most cases present as an opening in the midline, posterior to the normal anus. The aim of our revision is to contribute with eight new cases, some of them with unusual presentations: five presented as the typical form, one with a perianal nodule, and two presented as two separate orifices (anal canal triplication). Complete excision was performed in all patients with no complications. ACD is the most distal and the least frequent digestive duplication. Its treatment should be surgical excision, to avoid complications such as abscess, fistulization, or malignization. Anal canal triplication has never been described before.

  9. [Usefulness of human papillomavirus testing in anal intraepithelial neoplasia screening in a risk behaviour population].

    Science.gov (United States)

    Padilla-España, Laura; Repiso-Jiménez, Bosco; Fernández-Sánchez, Fernando; Frieyro-Elicegui, Marta; Fernández-Morano, Teresa; Pereda, Teresa; Rivas-Ruiz, Francisco; Redondo, Maximino; de-Troya Martín, Magdalena

    2014-11-01

    The incidence of intraepithelial anal neoplasia is increasing in certain risk behaviour groups, and human papillomavirus (HPV) infection is involved in its pathogenesis. The systematic use of anal cytology, and more recently HPV detection by hybrid capture and genotyping, have been introduced into screening programs in recent decades. A retrospective cohort study was carried out on individuals with risk behaviours of developing intraepithelial anal neoplasia and who attended Sexually Transmitted Infections clinics in the Dermatology area of the Hospital Costa del Sol from January 2010 to December 2012. The intraepithelial anal neoplasia screening was performed using anal cytology and HPV genotyping. Half (50%) of the study population were HIV positive. A high frequency of anal dysplasia and presence of HPV in cytology (82.1%) and genotype (79%) was found. A statistically significant association (P<.005) was obtained between the presence of high-risk HPV genotypes and the presence of high-grade dysplasia in the second directed cytology. HPV genotyping enabled 17 cases (22%) of severe dysplasia to be identified that were under-diagnosed in the first cytology. Cases of high-grade dysplasia can be under-diagnosed by a first anal cytology. Detection of HPV can supplement this procedure, leading to the identification of those patients most at risk of developing high-grade anal dysplasia. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  10. Addressing Risk and Reluctance at the Nexus of HIV and Anal Cancer Screening

    Science.gov (United States)

    Ka‘opua, Lana Sue I.; Cassel, Kevin; Shiramizu, Bruce; Stotzer, Rebecca L.; Robles, Andrew; Kapua, Cathy; Orton, Malulani; Milne, Cris; Sesepasara, Maddalynn

    2015-01-01

    Anal cancer disproportionately burdens persons living with human immunodeficiency virus (PLHIV) regardless of natal sex, sexual orientation, gender expression, and ethnic identity. Culturally competent communications are recommended to address health disparities, with sociocultural relevance ensured through constituent dialogic processes. Results are presented from six provider focus groups conducted to inform the promotion/education component of a Hawai‘i-based project on anal cancer screening tools. Krueger’s focus group methodology guided discussion queries. Verbatim transcripts of digitally recorded discussions were analyzed using grounded theory and PEN-3 procedures. Adherence to an audit trail ensured analytic rigor. Grounded theory analysis detected the overall theme of risk and reluctance to anal cancer screening, characterized by anal cancer not being “on the radar” of PLHIV, conflicting attributions of the anus and anal sex, fear of sex-shaming/-blaming, and other interrelated conceptual categories. PEN-3 analysis revealed strategies for destigmatizing anal cancer, through “real talk” (proactive, candid, nonjudgmental discussion) nested in a framework of sexual health and overall well-being, with additional tailoring for relevance to Native Hawaiians/Pacific Islanders, transgender persons, and other marginalized groups. Application of strategies for health practice are specific to the Hawai‘i context, yet may offer considerations for developing strengths-based, culturally relevant screening promotion/education with diverse PLHIV in other locales. PMID:26630979

  11. Addressing Risk and Reluctance at the Nexus of HIV and Anal Cancer Screening.

    Science.gov (United States)

    Ka'opua, Lana Sue I; Cassel, Kevin; Shiramizu, Bruce; Stotzer, Rebecca L; Robles, Andrew; Kapua, Cathy; Orton, Malulani; Milne, Cris; Sesepasara, Maddalynn

    2016-01-01

    Anal cancer disproportionately burdens persons living with human immunodeficiency virus (PLHIV) regardless of natal sex, sexual orientation, gender expression, and ethnic identity. Culturally competent communications are recommended to address health disparities, with sociocultural relevance ensured through constituent dialogic processes. Results are presented from six provider focus groups conducted to inform the promotion/education component of a Hawai'i-based project on anal cancer screening tools. Krueger's focus group methodology guided discussion queries. Verbatim transcripts of digitally recorded discussions were analyzed using grounded theory and PEN-3 procedures. Adherence to an audit trail ensured analytic rigor. Grounded theory analysis detected the overall theme of risk and reluctance to anal cancer screening, characterized by anal cancer not being "on the radar" of PLHIV, conflicting attributions of the anus and anal sex, fear of sex-shaming/-blaming, and other interrelated conceptual categories. PEN-3 analysis revealed strategies for destigmatizing anal cancer, through "real talk" (proactive, candid, nonjudgmental discussion) nested in a framework of sexual health and overall well-being, with additional tailoring for relevance to Native Hawaiians/Pacific Islanders, transgender persons, and other marginalized groups. Application of strategies for health practice are specific to the Hawai'i context, yet may offer considerations for developing strengths-based, culturally relevant screening promotion/education with diverse PLHIV in other locales. © 2015 Society for Public Health Education.

  12. Prevalence of Anal HPV Infection Among HIV-Positive Men Who Have Sex With Men in India.

    Science.gov (United States)

    Hernandez, Alexandra L; Karthik, Rajiv; Sivasubramanian, Murugesan; Raghavendran, Anantharam; Gnanamony, Manu; Lensing, Shelly; Lee, Jeannette Y; Kannangai, Rajesh; Abraham, Priya; Mathai, Dilip; Palefsky, Joel M

    2016-04-01

    India has a large population of HIV-positive individuals, including men who have sex with men (MSM), and the incidence of human papillomavirus (HPV)-related cancers is high. In developed countries, HIV-positive MSM exhibit the highest prevalence of anal HPV infection and incidence of anal cancer. Little is known about anal HPV infection in HIV-positive Indian MSM. We evaluated 300 HIV-positive MSM from 2 cities in India. Men were tested for anal HPV infection using L1-HPV DNA polymerase chain reaction with probes specific for 29 types and a mixture of 10 additional types. CD4 level and plasma HIV viral load were measured. Participants completed an interviewer-administered questionnaire including a sexual history. The prevalence of anal HPV was 95% (95% confidence interval: 91% to 97%). The 3 most common types were HPV 35 (20%), HPV 16 (13%), and HPV 6/11 (13%). History of taking antiretroviral medications decreased risk of anal HPV 16 infection [relative risk (RR): 0.6 (0.4-1.0)]. Having an increased number of vaginal sex partners lowered risk of any anal HPV infection. Ever having receptive sex increased risk of any anal HPV [RR: 1.2 (1.1-1.4)] and anal HPV 16 [RR: 6.5 (1.8-107)]. Almost all Indian HIV-positive MSM had anal HPV infection. The prevalence of HPV 16 was lower and the prevalence of other oncogenic HPV types was higher than in similar populations in North America and Europe. Vaccine-based prevention strategies for HPV infection in India should consider potential differences in HPV type distribution among HIV-infected MSM when designing interventions.

  13. Resisting the "Condom Every Time for Anal Sex" Health Education Message

    Science.gov (United States)

    Adams, Jeffery; Neville, Stephen

    2012-01-01

    Objective: Ensuring men who have sex with men (MSM) adopt and maintain condom use for anal sex is a challenging health education goal. In order to inform the development of social marketing practices to encourage safe-sex practices, the views of MSM about a key HIV health education message ("using a condom every time for anal sex") were…

  14. Anal sphincter electromyography in patients with Anorectal Dysfunctions

    International Nuclear Information System (INIS)

    Trinchet Soler, Rafael; Hidalgo Marrero, Yanet; Espichicoque Megret, Arianne; Manzano Suarez, Jianeya; Perez Gonzales, Ruth Maite

    2009-01-01

    The purpose of this work is to evaluate the electromyography value of anal sphincter in patients with anorectal dysfunctions. Anorectal dysfunctions are frequent reason of pediatric consultation in children, especially with anal incontinence. A study of series of cases in patient with anorectal dysfunctions was carried out from January 2002 to January of 2006. 65 patients were studied. Anorectal malformations (ARM) represented the predominant affection with 38 patients (58.5%), prevailing the male sex in 25 patients (65.8%). Encopresis and intestinal agagliosis dicrease was observed. Sphincter was found before surgical treatment through electromyography in patients with anorectal malformations and colostomy; in those with definitive operation and open colostomy, it avoided the operation in a patient that did not have muscular activity of the external sphincter. In children already operated and with closed colostomy several electromyography changes were observed in correspondence with different incontinence grades. In encopresis cases the study was useful to rule out sphincter functional alterations. Electromyography was pathological in all the operated patients of intestinal aganglionosis. This procedure was very useful for anal incontinence study that helped to determine and establish the prognosis. (author)

  15. Associação de agenesia sacrococcígea e atresia anal em gato sem raça definida Sacrococcygeal agenesis association and anal atresia in mixed breed cats

    Directory of Open Access Journals (Sweden)

    Felipe Purcell de Araújo

    2009-09-01

    Full Text Available O presente trabalho teve como objetivo descrever o caso de um felino, que desde o nascimento apresentou atresia anal, ausência de cauda e malformação dos membros pélvicos. Ao exame radiográfico, pôde-se observar presença de agenesia da sétima vértebra lombar, sacro e vértebras coccígeas, espinha bífida, meningocele, hiperflexão dos joelhos e desvio valgo dos tarsos, diagnosticando-se agenesia sacrococcígea associada à atresia anal.This paper has the objective to report a case of a cat that since birth had anal atresia, absence of tail and malformation of the pelvic member. The radiographic examination revealed agenesis of the seventh lumbar vertebra, sacral and coccygeal vertebrae, spina bifida, meningocele, hyperflexion of the knees and tarsal valgus deviation, diagnosing sacrococcygeal agenesis associated with anal atresia.

  16. Empaatia kogemus kunstiteoses kujutatud subjekti suhtes: fenomenoloogiline analüüs / Marge Paas

    Index Scriptorium Estoniae

    Paas, Marge, 1976-

    2015-01-01

    Analüüsitakse vaataja esteetilist kogemust kunstiteose suhtes. Autor tugineb Edith Steini empaatia kogemuse uurimusele ja fenomenoloogilisele uurimismeetodile. Vaataja empaatia kogemuse analüüs Maarit Murka maalisarjas "Hairpower" kujutatud subjekti suhtes

  17. Urinary and anal incontinence during pregnancy and postpartum: incidence, severity, and risk factors.

    Science.gov (United States)

    Solans-Domènech, Maite; Sánchez, Emília; Espuña-Pons, Montserrat

    2010-03-01

    To estimate frequency and severity and to identify risk factors of urinary incontinence (UI) and anal incontinence during pregnancy and after delivery in previously continent nulliparous women. We designed a cohort study of healthy, continent, nulliparous pregnant women attending public health care services. The field work was conducted during the control visits of the three trimesters of pregnancy, at the time of delivery, and postpartum. A self-administered questionnaire was used to assess UI (validated and adapted) and anal incontinence. Frequency of UI and anal incontinence and their confidence intervals (95% CIs) were calculated. The correlations between the severity of UI and the degree of effect on daily life were also estimated. Multivariable Cox models were applied to estimate hazard ratios for both incontinences (urinary/anal) during pregnancy and postpartum. The cumulative incidence rate during pregnancy was 39.1% (95% CI 36.3-41.9) for UI and 10.3% (95% CI 8.3-12.3) for anal incontinence. The correlation between severity of UI and effect on daily life was moderate. Age, baseline body mass index, and family history of UI were significantly associated with the occurrence of UI during pregnancy, while age and excess weight gain during pregnancy were associated with the occurrence of anal incontinence during pregnancy. Postpartum, the identified risk factors for both incontinences were incontinence during pregnancy and vaginal delivery. The occurrence of UI and anal incontinence during the postpartum period is related to the presence of incontinence in pregnancy, and vaginal delivery increases the risk of persistent incontinence. Some risk factors for both incontinences during pregnancy and postpartum are related to lifestyles and obstetric practices.

  18. Does Sacral Nerve Stimulation Improve Continence Through Enhanced Sensitivity of the Anal Canal?

    DEFF Research Database (Denmark)

    Haas, S; Brock, C; Krogh, K

    2016-01-01

    . DESIGN: This is an explorative study. PATIENTS: Fifteen women with idiopathic fecal incontinence (mean age, 58 ± 12.2 years) were selected. INTERVENTIONS: Cortical evoked potentials were recorded during repeated rapid balloon distension of the rectum and the anal canal both before and during temporary...... the threshold for urge to defecate elicited from the anal canal, whereas supraspinal responses remained unaltered. This may suggest that sacral nerve stimulation, at least in part, acts via somatic afferent fibers enhancing anal sensation....

  19. Anal carcinoma and HIV infection: is it time for screening?

    Science.gov (United States)

    Herranz-Pinto, P; Sendagorta-Cudós, E; Bernardino-de la Serna, J I; Peña-Sánchez de Rivera, J M

    2014-03-01

    A 38-year-old white man had a 10-year history of human immunodeficiency virus (HIV) infection (A3), with no episodes of opportunistic diseases and in good immunologic recovery (CD4 cell count: 450 and indetectable HIV viral load) while on HAART. He presented with a two-month history of mild anal symptoms, including pruritus and episodic bleeding. He referred past episodes of anal warts, self-treated with several topical compounds, all proven unsuccessful. Perianal examination showed erythema and scratching. A 0.5cm sized tumor, with infiltration at the base was detected on digital exam, located at 15mm from the anal margin. Local biopsy driven by high-resolution anuscopy (AAR) yielded a final diagnosis of infiltrative epidermoid carcinoma. Might that neoplasia have been prevented? Copyright © 2013 Elsevier España, S.L. All rights reserved.

  20. O terapêutico e o analítico em Freud

    Directory of Open Access Journals (Sweden)

    Vinicius Anciães Darriba

    2013-06-01

    Full Text Available Este artigo tem como objetivo investigar, na obra de Freud, a demarcação que se institui entre o terapêutico e o analítico. Tal investigação enfoca, primeiramente, a passagem da hipnose à associação livre e o direcionamento do autor à questão da causa, o que estabelece uma visada para a cura analítica em confluência com o que se desdobra da exploração do campo do inconsciente e da consideração de um domínio pulsional. Delimitados por esta via os objetivos terapêuticos e analíticos, interroga-se, em seguida, como a dimensão do terapêutico se veria reintroduzida nos termos da nova direção de cura proposta por Freud.

  1. Pouch failures following ileal pouch-anal anastomosis for ulcerative colitis

    DEFF Research Database (Denmark)

    Mark-Christensen, A; Erichsen, R; Brandsborg, S

    2018-01-01

    BACKGROUND: The ileal pouch-anal anastomosis is a procedure offered to patients with ulcerative colitis who opt for restoration of bowel continuity. The aim of this study was to determine the risk of pouch failure and ascertain risk factors associated with failure. METHOD: 1,991 patients with ulc......BACKGROUND: The ileal pouch-anal anastomosis is a procedure offered to patients with ulcerative colitis who opt for restoration of bowel continuity. The aim of this study was to determine the risk of pouch failure and ascertain risk factors associated with failure. METHOD: 1,991 patients......-anal anastomosis from Denmark, where pouch surgery is centralized, females had a higher risk of pouch failure. Of modifiable factors, low hospital volume and non-diversion were associated with a higher risk of pouch failure. This article is protected by copyright. All rights reserved....

  2. Analýza sportovního areálu vybranými metodami

    OpenAIRE

    Jelínek, Vojtěch

    2014-01-01

    Bakalářská práce se zabývá analýzou sportovního areálu U Hrocha, který má být dokončen v roce 2014. Obsahuje teoretická východiska, která jsou následně implementována do skutečné reality podniku, a to prostřednictvím PESTLE analýzy, Porterovy analýzy a SWOT analýzy. Závěrem je vyhodnocena situace a jsou navržena řešení pro optimalizaci chodu sportovního areálu. This bachelor´s thesis deals with analysis of the sports complex U Hrocha, which will be completed in 2014. It contains theoretica...

  3. Differences in the pressures of canal anal and rectal sensitivity in patients with fecal incontinence, chronic constipation and healthy subjects Diferencias en las presiones del canal anal y la sensibilidad rectal en pacientes con incontinencia anal, estreñimiento crónico y sujetos sanos

    Directory of Open Access Journals (Sweden)

    C. Ciriza de los Ríos

    2010-12-01

    Full Text Available Introduction: There exist a great variability in the manometric findings between patients with anal incontinence (AI and healthy subjects. The correlation between the pressures of the anal canal and the AI is not exact by the wide rank of normal values. Objectives: Prospective study to evaluate differences in the pressures of the anal canal and in rectal sensitivity in patients with AI, chronic constipation (CC and healthy subjects. Material and methods: Ninety four patients with AI, 36 patients with CC and 15 healthy subjects were included. The following data were obtained: age, sex, resting pressure, anal canal length (ACL, squeeze maximum pressure (SMP, squeeze pressure duration (SPD, first sensation, urge and maximum tolerated volume (MTV. Statistical study: test of Kruskal-Wallis, test of Mann-Whitney, and multinomial logistic regression test. Results: There were significant differences in the resting pressure (p Introducción: Existe gran variabilidad en los hallazgos manométricos entre pacientes con incontinencia anal (IA y sujetos sanos. La correlación entre las presiones del canal anal y la IA no es exacta por el amplio rango de valores normales. Objetivos: Estudio prospectivo para evaluar diferencias en las presiones del canal anal y en la sensibilidad rectal en pacientes con IA, estreñimiento crónico (EC y sujetos sanos. Material y métodos: Noventa y cuatro pacientes con IA, 36 pacientes con EC y 15 sujetos sanos. Se obtuvieron: edad, sexo, presión de reposo, longitud del canal anal (LCA, presión de máxima contracción voluntaria (PMCV, duración de la contracción voluntaria, primera sensación, sensación de urgencia y máximo volumen tolerado (MVT. Estudio estadístico: test de Kruskal-Wallis, test de Mann-Whitney, regresión logística multinomial. Resultados: Se encontraron diferencias significativas en la edad (p < 0,001, la presión de reposo (p < 0,001, la LCA (p < 0,001 y la PMCV (p < 0,01 en el grupo de IA con

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

    Directory of Open Access Journals (Sweden)

    Felicidad Gimenez

    2011-06-01

    Full Text Available CONTEXT: Anal cancer, although a still rare disease, is being observed in ascending rates among some population segments known to be at risk for the development of the disease. Human papillomavirus (HPV infection, immunodepression and anal intercourse are some factors associated with the development of the malignancy. Its similarities to cervical cancer have led to many studies aiming to establish guidelines for detecting and treating precursor lesions of anal cancer, with the goal of prevention. High-resolution anoscopy is routinely used for the diagnosis of anal cancer precursor lesions in many centers but the medical literature is still deficient concerning the role of this diagnostic modality. OBJECTIVES: To evaluate diagnostic validation and precision measures of high-resolution anoscopy in comparison to histopathological results of anal biopsies performed in HIV-positive patients treated at the Tropical Medicine Foundation of Amazonas, AM, Brazil. To observe any possible association between some risk factors for the development of anal cancer and the presence of anal squamous intraepithelial lesions. METHODS: A hundred and twenty-eight HIV-positive patients were submitted to anal canal cytological sampling for the detection of HPV infection by a PCR based method. High-resolution anoscopy was then performed after topical application of acetic acid 3% in the anal canal for 2 minutes. Eventual acetowhite lesions that were detected were recorded in respect to location, and classified by their tinctorial pattern, distribution aspect, relief, surface and vascular pattern. Biopsies of acetowhite lesions were performed under local anesthesia and the specimens sent to histopathological analysis. The patients were interviewed for the presence of anal cancer risk factors. RESULTS: The prevalences of anal HPV infection and of anal squamous intraepithelial lesions in the studied population were, respectively, 79% and 39.1%. High-resolution anoscopy

  5. Should anorectal ultrasonography be included as a diagnostic tool for chronic anal pain? ¿Se debe incluir la ecografía rectoanal como prueba diagnóstica del dolor anal crónico?

    Directory of Open Access Journals (Sweden)

    M. J. García-Montes

    2010-01-01

    Full Text Available Objective: to assess the efficiency of endorectal ultrasound (ERUS in the study of chronic idiopathic anal pain (CIAP. Material and method: this is a prospective and descriptive study in which 40 patients, 18 men and 22 women with an average of 47 years, were included. They had chronic anal pain of at least 3 months' duration. A complete colonoscopy was performed in all patients, which found no abnormalities to explain clinical symptoms. Patients with anal fissure and internal hemorrhoids of any degree, perianal suppurative processes, and pelvic surgery were excluded from the study. An ALOKA ProSound SSD-4000 ultrasound console attached to a multifrequency radial transductor ASU-67 (7.5 and 10 MHz was used. Results: one patient could not tolerate the examination. In 8 patients (20% of cases alterations were detected during ultrasonography: in 4 patients (10% of the cases; 1 man and 3 women internal anal sphincter (IAS hypertrophy, and in 5 patients (4 women and 1 man a torn sphincter complex. A tear in the upper IAS canal and hypertrophy of the middle anal canal were observed in one patient (1 woman. Conclusions: ERUS is a simple, economic and useful test to study anorectal pathologies. Although in most studied cases no damage to the anal canal or rectal wall was detected, in a considerable number of patients we observed a thickening of the IAS, a probable cause of anal pain. Therefore, we understand that ERUS should be included in the study of CIAP.Objetivo: evaluar el rendimiento de la ecografía rectoanal (ERA en el estudio del dolor anal crónico idiopático (DACI. Material y método: se trata de un estudio prospectivo y descriptivo en el que se han incluido 40 pacientes, 18 hombres y 22 mujeres, con edad media de 47 años, con clínica de dolor anal crónico de al menos 3 meses de evolución. A todos los pacientes se les había realizado una colonoscopia completa, en la que no se encontró anomalía que justificara la clínica. Se

  6. Primena cost-benefit-benefit analize u vrednovanju i izboru javnih projekata (ekonomski aspekt

    Directory of Open Access Journals (Sweden)

    Dragana N. Petrović

    2013-10-01

    Full Text Available Cost-benefit analiza je celovita analiza koristi i troškova koje jedan projekat donosi samom vlasniku projekta i društvu u celini (uključujući i investitora. Izbor najbolje investicione alternative ostvaruje na osnovu finansijske i ekonomske analize, kao dva integralna dela cost-benefit analize. Prvu od ovih analiza obradila je ista grupa autora u članku „Primena cost-benefit analize u vrednovanju i izboru javnih projekata (finansijski aspekt“, objavljenom u prethodnom broju časopisa Vojnotehnički glasnik. Predmet obrade ovog rada je ekonomska analiza, kao logički nastavak prethodnog rada. Zbog toga se na brojne oznake tabela, uključenih u sadržaj finansijske analize (1-–5, nadovezuju (prema hronološkom redu oznake tabela koje pripadaju ekonomskoj analizi (6–8 Sprovođenje ekonomske analize ostvaruje se prema određenoj, dosta složenoj proceduri, a završava se utvrđivanjem kriterijuma ekonomske (društvene isplativosti projekta. U radu su obrađeni osnovni pokazatelji ekonomskog (društvenog prinosa projekta,  kao što su: neto sadašnja vrednost novčanih tokova i cost-benefit koeficijent.

  7. Rare case of gastrointestinal stromal tumor of the anal canal

    Directory of Open Access Journals (Sweden)

    Madhu Kumar

    2013-01-01

    Full Text Available Gastrointestinal stromal tumor (GIST is a rare mesenchymal neoplasm of the gastrointestinal tract. GIST of anal canal is very rare representing only 3% of all anorectal mesenchymal tumors. We report an extremely rare case of GIST of the anal canal in 60-years-old man with history of irregular bowel habits with dark colored stool mixed with blood and constipation from 6 month. Diagnosis was made on the basis of histomorphological and immunohistochemical examination.

  8. Anal Papilloma: An Exceptional Presentation of Fibrocystic Disease in Anogenital Mammary-Like Glands

    Directory of Open Access Journals (Sweden)

    Priya Subashchandrabose

    2015-01-01

    Full Text Available Previously ectopic breast tissue was thought to be derived from the caudal remnants of the primitive embryonic milk ridges; anogenital mammary-like glands are presently considered as normal constituents of the anogenital region. We report a case of young female, who presented with an anal papilloma. Histopathological examination revealed extensive fibrocystic changes in anogenital mammary-like glands. To date, a lot of benign changes and a wide range of benign and malignant neoplasms have been reported in these glands. However, extensive fibrocystic change of these glands in anal region is very rare. In addition, fibrocystic disease of anal mammary glands, masquerading clinically as an anal papilloma, has not been reported in literature. Hence, it is essential for clinicians and the pathologists to be aware of such a rare presentation. The features of fibrocystic disease in perianal region are also discussed.

  9. Anal Papilloma: An Exceptional Presentation of Fibrocystic Disease in Anogenital Mammary-Like Glands.

    Science.gov (United States)

    Subashchandrabose, Priya; Esakkai, Muthuvel; Venugopal, Palani; Kannaiyan, Ilavarasan; Srinivasan, Chitra; Reddy, Punuru Tejashwini; Ebenezer, Evelyn Elizabeth

    2015-01-01

    Previously ectopic breast tissue was thought to be derived from the caudal remnants of the primitive embryonic milk ridges; anogenital mammary-like glands are presently considered as normal constituents of the anogenital region. We report a case of young female, who presented with an anal papilloma. Histopathological examination revealed extensive fibrocystic changes in anogenital mammary-like glands. To date, a lot of benign changes and a wide range of benign and malignant neoplasms have been reported in these glands. However, extensive fibrocystic change of these glands in anal region is very rare. In addition, fibrocystic disease of anal mammary glands, masquerading clinically as an anal papilloma, has not been reported in literature. Hence, it is essential for clinicians and the pathologists to be aware of such a rare presentation. The features of fibrocystic disease in perianal region are also discussed.

  10. Anal microbiota profiles in HIV-positive and HIV-negative MSM.

    Science.gov (United States)

    Yu, Guoqin; Fadrosh, Doug; Ma, Bing; Ravel, Jacques; Goedert, James J

    2014-03-13

    Because differences in anal microbial populations (microbiota) could affect acquisition of HIV or other conditions, especially among MSM, we profiled the microbiota of the anal canal, assessed its stability, and investigated associations with diversity and composition. Microbiota profiles in anal swabs collected from 76 MSM (52 in 1989, swab-1; 66 1-5 years later, swab-2) were compared by HIV status (25 HIV-positive), T-cell subsets, and questionnaire data. Bacterial 16S rRNA genes were amplified, sequenced (Illumina MiSeq), and clustered into species-level operational taxonomic units (QIIME and Greengenes). Regression models and Wilcoxon tests were used for associations with alpha diversity (unique operational taxonomic units, Shannon's index). Composition was compared by Adonis (QIIME). Most anal bacteria were Firmicutes (mean 60.6%, range 21.1-91.1%) or Bacteroidetes (29.4%, 4.1-70.8%). Alpha diversity did not change between the two swabs (N = 42 pairs). In swab-2, HIV-positives had lower alpha diversity (P ≤ 0.04) and altered composition, with fewer Firmicutes and more Fusobacteria taxa (P ≤ 0.03), not completely attributable to very low CD4(+) cell count (median 232 cells/μl), prior AIDS clinical diagnosis (N = 17), or trimethoprim-sulfamethoxazole use (N = 6). Similar but weaker differences were observed in swab-1 (HIV-positive median 580 CD4(+) cells/μl; no trimethoprim-sulfamethoxazole). Associations with T-cell subsets, smoking, and sexual practices were null or inconsistent. The anal microbiota of MSM was relatively stable over 1-5 years. However, with uncontrolled, advanced HIV infection, the microbiota had altered composition and reduced diversity partially attributable to antibiotics. Investigations of microbial community associations with other immune perturbations and clinical abnormalities are needed.

  11. Tumor Response and Survival Predicted by Post-Therapy FDG-PET/CT in Anal Cancer

    International Nuclear Information System (INIS)

    Schwarz, Julie K.; Siegel, Barry A.; Dehdashti, Farrokh; Myerson, Robert J.; Fleshman, James W.; Grigsby, Perry W.

    2008-01-01

    Purpose: To evaluate the response to therapy for anal carcinoma using post-therapy imaging with positron emission tomography (PET)/computed tomography and F-18 fluorodeoxyglucose (FDG) and to compare the metabolic response with patient outcome. Patients and Methods: This was a prospective cohort study of 53 consecutive patients with anal cancer. All patients underwent pre- and post-treatment whole-body FDG-PET/computed tomography. Patients had been treated with external beam radiotherapy and concurrent chemotherapy. Whole-body FDG-PET was performed 0.9-5.4 months (mean, 2.1) after therapy completion. Results: The post-therapy PET scan did not show any abnormal FDG uptake (complete metabolic response) in 44 patients. Persistent abnormal FDG uptake (partial metabolic response) was found in the anal tumor in 9 patients. The 2-year cause-specific survival rate was 94% for patients with a complete vs. 39% for patients with a partial metabolic response in the anal tumor (p = 0.0008). The 2-year progression-free survival rate was 95% for patients with a complete vs. 22% for patients with a partial metabolic response in the anal tumor (p < 0.0001). A Cox proportional hazards model of survival outcome indicated that a complete metabolic response was the most significant predictor of progression-free survival in our patient population (p = 0.0003). Conclusions: A partial metabolic response in the anal tumor as determined by post-therapy FDG-PET is predictive of significantly decreased progression-free and cause-specific survival after chemoradiotherapy for anal cancer

  12. Heterosexual anal intercourse and HIV infection risks in the context of alcohol serving venues, Cape Town, South Africa

    Directory of Open Access Journals (Sweden)

    Carey Kate B

    2011-10-01

    Full Text Available Abstract Background The most efficient sexual behavior for HIV transmission is unprotected receptive anal intercourse. However, it is unclear what role heterosexual unprotected anal sex is playing in the world's worst HIV epidemics of southern Africa. The objective is to examine the prevalence of heterosexual unprotected anal intercourse among men and women who drink at informal alcohol serving establishments (shebeens in South Africa. Methods Cross-sectional surveys were collected from a convenience sample of 5037 patrons of 10 shebeens in a peri-urban township of Cape Town, South Africa. Analyses concentrated on establishing the rates of unprotected anal intercourse practiced by men and women as well as the factors associated with practicing anal intercourse. Results We found that 15% of men and 11% of women reported anal intercourse in the previous month, with 8% of men and 7% of women practicing any unprotected anal intercourse. Multiple logistic regression showed that younger age, having primary and casual sex partners, and meeting sex partners at shebeens were independently associated with engaging in anal intercourse. Mathematical modeling showed that individual risks are significantly impacted by anal intercourse but probably not to the degree needed to drive a generalized HIV epidemic. Conclusions Anal intercourse likely plays a significant role in HIV infections among a small minority of South Africans who patronize alcohol serving establishments. Heterosexual anal intercourse, the most risky sexual behavior for HIV transmission, should not be ignored in HIV prevention for South African heterosexuals. However, this relatively infrequent behavior should not become the focus of prevention efforts.

  13. Symptom outcomes important to women with anal incontinence: a conceptual framework.

    Science.gov (United States)

    Sung, Vivian W; Rogers, Rebecca G; Bann, Carla M; Arya, Lily; Barber, Matthew D; Lowder, Jerry; Lukacz, Emily S; Markland, Alayne; Siddiqui, Nazema; Wilmot, Amanda; Meikle, Susan F

    2014-05-01

    To develop a framework that describes the most important symptom outcomes for anal incontinence treatment from the patient perspective. A conceptual framework was developed by the Pelvic Floor Disorders Network based on four semistructured focus groups and confirmed in two sets of 10 cognitive interviews including women with anal incontinence. We explored: 1) patient-preferred terminology for describing anal incontinence symptoms; 2) patient definitions of treatment "success"; 3) importance of symptoms and outcomes in the framework; and 4) conceptual gaps (defined as outcomes not previously identified as important). Sessions were conducted according to grounded theory transcribed, coded, and qualitatively and quantitatively analyzed to identify relevant themes. Content and face validity of the framework were further assessed using cognitive interviews. Thirty-four women participated in focus groups and 20 in cognitive interviews. Overall, 29 (54%) were aged 60 years or older, 42 (78%) were white, and 10 (19%) had a high school degree or less. Two overarching outcome themes were identified: "primary bowel leakage symptoms" and "ancillary bowel symptoms." Subdomains important in primary bowel leakage symptoms included leakage characteristics (symptom frequency, amount of leakage, symptom bother) and conditions when bowel leakage occurs (predictability, awareness, urgency). Subdomains important under ancillary bowel symptoms included emptying disorders (constipation, obstructed defecation, and wiping issues) and discomfort (pain, burning). New outcomes identified included predictability, awareness, wiping issues, and discomfort. Women with anal incontinence desire a wide range of symptom outcomes after treatment. These are captured in our conceptual framework, which can aid clinicians and researchers in assessing anal incontinence. LEVEL OF EVIEDENCE: II.

  14. Anal sphincter responses after perianal electrical stimulation

    DEFF Research Database (Denmark)

    Pedersen, Ejnar; Klemar, B; Schrøder, H D

    1982-01-01

    By perianal electrical stimulation and EMG recording from the external anal sphincter three responses were found with latencies of 2-8, 13-18 and 30-60 ms, respectively. The two first responses were recorded in most cases. They were characterised by constant latency and uniform pattern, were...... not fatigued by repeated stimulation, were most dependent on placement of stimulating and recording electrodes, and always had a higher threshold than the third response. The third response was constantly present in normal subjects. It had the longest EMG response and the latency decreased with increasing...... stimulation to a minimum of 30-60 ms. This response represented the clinical observable spinal reflex, "the classical anal reflex". The latencies of the two first responses were so short that they probably do not represent spinal reflexes. This was further supported by the effect of epidural anaesthesia which...

  15. High-Resolution Anoscopy: Clinical Features of Anal Intraepithelial Neoplasia in HIV-positive Men

    NARCIS (Netherlands)

    Richel, Olivier; Hallensleben, Nora D. L.; Kreuter, Alexander; van Noesel, Carel J. M.; Prins, Jan M.; de Vries, Henry J. C.

    2013-01-01

    BACKGROUND: High-resolution anoscopy is increasingly advocated to screen HIV+ men who have sex with men for anal cancer and its precursor lesions, anal intraepithelial neoplasia. A systematic comparison between clinical features and the histopathology of suspect lesions is lacking. OBJECTIVE: This

  16. Does endoscopic ultrasound improve detection of locally recurrent anal squamous-cell cancer?

    Science.gov (United States)

    Peterson, Carrie Y; Weiser, Martin R; Paty, Philip B; Guillem, Jose G; Nash, Garrett M; Garcia-Aguilar, Julio; Patil, Sujata; Temple, Larissa K

    2015-02-01

    Evaluating patients for recurrent anal cancer after primary treatment can be difficult owing to distorted anatomy and scarring. Many institutions incorporate endoscopic ultrasound to improve detection, but the effectiveness is unknown. The aim of this study is to compare the effectiveness of digital rectal examination and endoscopic ultrasound in detecting locally recurrent disease during routine follow-up of patients with anal cancer. This study is a retrospective, single-institution review. This study was conducted at an oncologic tertiary referral center. Included were 175 patients with nonmetastatic anal squamous-cell cancer, without persistent disease after primary chemoradiotherapy, who had at least 1 posttreatment ultrasound and examination by a colorectal surgeon. The primary outcomes measured were the first modality to detect local recurrence, concordance, crude cancer detection rate, sensitivity, specificity, and predictive value. Eight hundred fifty-five endoscopic ultrasounds and 873 digital rectal examinations were performed during 35 months median follow-up. Overall, ultrasound detected 7 (0.8%) mesorectal and 32 (3.7%) anal canal abnormalities; digital examination detected 69 (7.9%) anal canal abnormalities. Locally recurrent disease was found on biopsy in 8 patients, all detected first or only with digital examination. Four patients did not have an ultrasound at the time of diagnosis of recurrence. The concordance of ultrasound and digital examination in detecting recurrent disease was fair at 0.37 (SE, 0.08; 95% CI, 0.21-0.54), and there was no difference in crude cancer detection rate, sensitivity, specificity, and negative or positive predictive values. The heterogeneity of follow-up timing and examinations is not standardized in this study but is reflective of general practice. Endoscopic ultrasound did not provide any advantage over digital rectal examination in identifying locally recurrent anal cancer, and should not be recommended for

  17. Association of Human Papillomavirus Infection and Abnormal Anal Cytology among HIV-Infected MSM in Beijing, China

    Science.gov (United States)

    Zhang, Zhihui; Qian, Han-Zhu; Ruan, Yuhua; Zhou, Feng; Gao, Cong; Li, Mufei; Jin, Qi; Gao, Lei

    2012-01-01

    Background In the recent years, dramatic increases in HIV transmission among men who have sex with men (MSM) have been observed in China. Human papillomavirus (HPV) infection related anal cancer is more common among HIV-infected MSM as compared to the general population. However, HPV infection and anal cytology has been rarely studied in HIV-infected MSM in China. Methods HIV-infected MSM in Beijing, China were invited to participate in this study between January and April 2011. Anal swabs were collected for examining cytology and HPV genotypes. Results Ninety-five eligible participants with complete questionnaire and laboratory data were included in the analyses. Thirty six of them (37.9%) showed abnormal anal cytology as follows: atypical squamous cells of undetermined significance (ASC-US) in 19 (20.0%), atypical squamous cells but cannot exclude HSIL (ASC-H) in 1 (1.1%), low-grade squamous intraepithelial lesion (LSIL) in 15 (15.8%), and high-grade squamous intraepithelial lesion (HSIL) in 1 (1.1%). HPV6 (20.0%), HPV16 (10.9%), HPV56 (10.9%), HPV52 (9.1%) and HPV39 (9.1%) were observed most frequently among those with normal anal cytology, while different distribution was found in the ones with abnormal anal cytology as HPV6 (19.4%), HPV16 (19.4%), HPV45 (16.7%), HPV52 (16.7%) and HPV18 (11.1%). In addition, HPV16, HPV45, HPV52 and HPV18 were the most frequent high-risk types in patients with abnormal anal cytology. HPV multiplicity was found to be significantly related to the prevalence of abnormal anal cytology (p for trend = 0.04). Conclusions High prevalence of HPV infection and abnormal anal cytology was observed among HIV-infected MSM in China. Infection of multiple HPV types or high-risk types was found to be associated with an increased risk of abnormal anal cytology. PMID:22558293

  18. Association of human papillomavirus infection and abnormal anal cytology among HIV-infected MSM in Beijing, China.

    Directory of Open Access Journals (Sweden)

    Yu Yang

    Full Text Available BACKGROUND: In the recent years, dramatic increases in HIV transmission among men who have sex with men (MSM have been observed in China. Human papillomavirus (HPV infection related anal cancer is more common among HIV-infected MSM as compared to the general population. However, HPV infection and anal cytology has been rarely studied in HIV-infected MSM in China. METHODS: HIV-infected MSM in Beijing, China were invited to participate in this study between January and April 2011. Anal swabs were collected for examining cytology and HPV genotypes. RESULTS: Ninety-five eligible participants with complete questionnaire and laboratory data were included in the analyses. Thirty six of them (37.9% showed abnormal anal cytology as follows: atypical squamous cells of undetermined significance (ASC-US in 19 (20.0%, atypical squamous cells but cannot exclude HSIL (ASC-H in 1 (1.1%, low-grade squamous intraepithelial lesion (LSIL in 15 (15.8%, and high-grade squamous intraepithelial lesion (HSIL in 1 (1.1%. HPV6 (20.0%, HPV16 (10.9%, HPV56 (10.9%, HPV52 (9.1% and HPV39 (9.1% were observed most frequently among those with normal anal cytology, while different distribution was found in the ones with abnormal anal cytology as HPV6 (19.4%, HPV16 (19.4%, HPV45 (16.7%, HPV52 (16.7% and HPV18 (11.1%. In addition, HPV16, HPV45, HPV52 and HPV18 were the most frequent high-risk types in patients with abnormal anal cytology. HPV multiplicity was found to be significantly related to the prevalence of abnormal anal cytology (p for trend = 0.04. CONCLUSIONS: High prevalence of HPV infection and abnormal anal cytology was observed among HIV-infected MSM in China. Infection of multiple HPV types or high-risk types was found to be associated with an increased risk of abnormal anal cytology.

  19. Impact of hypothyroidism on primary anal malignant melanoma: A rare entity

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    Siddharth Singh

    2014-01-01

    Full Text Available Primary melanoma of the anal canal is rare and highly malignant condition, which is 1% of all invasive tumors in this site. This condition is often mistaken for benign conditions as either hemorrhoids or rectal polyp. Thyroid-stimulating hormone stimulation causes high proliferation of malignant melanoma. The association of hypothyroidism with primary malignant melanoma of anal canal is very rare. We are reporting such a very rare case.

  20. Impact of hypothyroidism on primary anal malignant melanoma: a rare entity.

    Science.gov (United States)

    Singh, Siddharth; Verma, Satyajeet; Kala, Sanjay

    2014-01-01

    Primary melanoma of the anal canal is rare and highly malignant condition, which is 1% of all invasive tumors in this site. This condition is often mistaken for benign conditions as either hemorrhoids or rectal polyp. Thyroid-stimulating hormone stimulation causes high proliferation of malignant melanoma. The association of hypothyroidism with primary malignant melanoma of anal canal is very rare. We are reporting such a very rare case.

  1. Estudio de la fisiología del esfínter anal interno porcino y de la rata, y de la fisiopatología de las alteraciones de la motilidad del esfínter anal interno en pacientes con fisura anal

    OpenAIRE

    Opazo Valdés, Álvaro Javier

    2011-01-01

    Descripció del recurs: el 01 setembre 2012 Las patologías anorectales benignas (fisura anal, incontinencia fecal, hemorroides) presentan una elevada prevalencia. De forma general, se desconoce la fisiopatología de estas enfermedades en las que se producen diversas alteraciones del esfínter anal interno (EAI). Los objetivos para esta tesis fueron: 1º Caracterizar los mecanismos y neurotransmisores implicados en el control del tono, la relajación y la contracción del EAI en dos modelos anima...

  2. Analysis and description of disease-specific quality of life in patients with anal fistula.

    Science.gov (United States)

    Ferrer-Márquez, Manuel; Espínola-Cortés, Natalia; Reina-Duarte, Ángel; Granero-Molina, José; Fernández-Sola, Cayetano; Hernández-Padilla, José Manuel

    2018-04-01

    In patients diagnosed with anal fistula, knowing the quality of life specifically related to the disease can help coloproctology specialists to choose the most appropriate therapeutic strategy for each case. The aim of our study is to analyzse and describe the factors related to the specific quality of life in a consecutive series of patients diagnosed with anal fistula. Observational, cross-sectional study carried out from March 2015 to February 2017. All patients were assessed in the colorectal surgery unit of a hospital in southeast of Spain. After performing an initial anamnesis and a physical examination, patients diagnosed with anal fistula completed the Quality of Life in Ppatients with Anal Fistula Questionnaire (QoLAF-Q). This questionnaire specifically measures quality of life in people with anal fistula and its score range is the following: zero impact = 14 points, limited impact = 15 to 28 points, moderate impact = 29 to 42 points, high impact = 43 to 56 points, and very high impact = 57 to 70 points. A total of 80 patients were included. The median score obtained in the questionnaire for the sample studied was 34.00 (range=14-68). Statistically significant differences between patients with "primary anal fistula" (n=65) and "recurrent anal fistula" (n=15) were observed (mean rank=42.96 vs. mean rank=29.83, p=0.048). Furthermore, an inverse proportion (P=.016) between "time with clinical symptoms" and "impact on quality of life" was found (5 years: mean rank = 19.00). There were no statistically significant differences (P=.149) between quality of life amongst patients diagnosed with complex (mean rank = 36.13) and simple fistulae (mean rank = 43.59). Anal fistulae exert moderate-high impact on patients' quality of life. "Shorter time experiencing clinical symptoms" and the "presence of primary fistula" are factors that can be associated with worse quality of life. Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Differential gene expression in patients with anal fistula reveals high levels of prolactin recepetor

    Directory of Open Access Journals (Sweden)

    Song Yi-Huan

    2017-01-01

    Full Text Available Background/Aim. There are limited data examining variations in the local expression of inflammatory mediators in anal fistulas where it is anticipated that an improved understanding of the inflammatory milieu might lead to the potential therapeutic option of instillation therapy in complicated cases. The aim of the present study was to examine prolactin receptors (PRLR as inflammatory markers and to correlate their expression with both the complexity of anal fistulas and the likelihood of fistula recurrence. Methods. Microarray was used to screen the differentially expressed gene profile of anal fistula using anal mucosa samples with hemorrhoids with ageand sex-matched patients as controls and then a prospective analysis of 65 patients was conducted with anal fistulas. PRLR immunohistochemistry was performed to define expression in simple, complex and recurrent anal fistula cases. The quantitative image comparison was performed combining staining intensity with cellular distribution in order to create high and low score PRLR immunohistochemical groupings. Results. A differential expression profile of 190 genes was found. PRLR expression was 2.91 times lower in anal fistula compared with control. Sixty-five patients were assessed (35 simple, 30 complex cases. Simple fistulas showed significantly higher PRLR expression than complex cases with recurrent fistulae showing overall lower PRLR expression than de novo cases (p = 0.001. These findings were reflected in measurable integrated optical density for complex and recurrent cases (complex cases, 8.31 ± 4.91 x 104 vs simple cases, 12.30 ± 6.91 x 104; p < 0.01; recurrent cases, 7.21 ± 3.51 x 104 vs primarily healing cases, 8.31 ± 4.91 x 104; p < 0.05. In univariate regression analysis, low PRLR expression correlated with fistula complexity; a significant independent effect maintained in multivariate analysis odds ratio [(OR low to high PRLR expression = 9.52; p = 0.001]. Conclusion. PRLR

  4. Conversor analógico digital basado en oscilador controlado por tensión

    OpenAIRE

    Cardes García, Fernando

    2012-01-01

    Convencionalmente, los micrófonos dan una salida analógica debida a la variación de presión que produce el sonido, y esta señal se digitaliza por medio de conversores analógico digitales tradicionales. En este proyecto se aborda el diseño de un sistema que obtenga como salida un código digitalizado a partir del sonido recibido por la cápsula microfónica. La principal ventaja de utilizar este sistema es que el circuito analógico que acondiciona la señal se simpli ca considerable...

  5. Frequency of operative trauma to anal sphincters: evaluation with endoanal ultrasound.

    Science.gov (United States)

    Stamatiadis, Apostolos; Konstantinou, Evangelos; Theodosopoulou, Eleni; Mamoura, Konstantinia

    2002-01-01

    Sphincter trauma after anorectal surgery is usually asymptomatic. Frequency of trauma cannot be established with the clinical examination only. The frequency of operative sphincter defects and their correlation with disorders of continence was evaluated with the endoanal ultrasound. This study includes 123 subjects who had undergone anorectal surgery in the past and were examined with endoanal ultrasound for various indications such as continence disorders, recurrent fistula, idiopathic perineal pain, or simple postoperative follow-up. No subjects had isolated external anal sphincter defects. Nineteen of 123 patients (15%) had minor or major continence disorders, 55 patients (45%) had no sphincter defects, 42 (34%) had only internal anal sphincter (IAS) defects, and 26 (21%) had simultaneously external and internal anal sphincter (EAS) defects. The incidence of IAS and EAS trauma after Milligan-Morgan hemorrhoidectomy was 1/18 (5.5%) and 0/18 respectively; after fistula repair, 24/42 (57%) and 12/42 (29%); and after anal dilatation, 13/17 (76%) and 4/17 (24%). Sixteen of 26 patients (62%) with EAS trauma and 51/68 patients (75%) with IAS trauma did not report any disorders of continence. In patients with two or more operations, the frequency of IAS trauma was 74%, 30% for EAS trauma, and 26% for continence disorders.

  6. Evaluation of radiotherapy and chemoradiotherapy for anal canal epidermoid cancer in our center

    International Nuclear Information System (INIS)

    Obara, Kunihiko; Sahara, Rikisaburo; Yamana, Tetsuro; Okamoto, Kinya; Takahashi, Tomoko; Furukawa, Satomi; Okada, Daisuke; Kaneko, Yasushi; Matsumoto, Atsuo

    2008-01-01

    The efficacy and safety of radiotherapy (RT) and chemoradiotherapy (CRT) for anal canal epidermoid cancer were evaluated. Twenty-four patients with anal canal epidermoid cancer were treated in our center between 1988 and 2006, consisting of 13 patients treated by RT and 11 by CRT. In these patients, the efficacy and safety of RT and CRT were evaluated in terms of adverse events, 5-year local control rates, 5-year disease-free survival rates, and 5-year survival rates. No grade 3 or higher adverse events were noted in patients receiving RT. In contrast, anorexia, diarrhea, neutropenia, and anemia were observed in 33.3%, 10%, 33.3%, and 10%, respectively, of the patients receiving CRT. The anal preserving rate, 5-year local control rate, 5-year disease-free survival rate, and 5-year survival rate were 66.7%, 73%, 77.5%, and 88.4%, respectively. RT and CRT for anal canal epidermoid cancer should be first-line treatments because of their safety and efficacy. (author)

  7. Risk factors of recurrent anal sphincter ruptures

    DEFF Research Database (Denmark)

    Jangö, Hanna; Langhoff-Roos, J; Rosthøj, Steen

    2012-01-01

    Please cite this paper as: Jangö H, Langhoff-Roos J, Rosthøj S, Sakse A. Risk factors of recurrent anal sphincter ruptures: a population-based cohort study. BJOG 2012;00:000-000 DOI: 10.1111/j.1471-0528.2012.03486.x. Objective  To determine the incidence and risk factors of recurrent anal sphincter...... were used to determine risk factors of recurrent ASR. Main outcome measures  The incidence of recurrent ASR and odds ratios for possible risk factors of recurrent ASR: age, body mass index, grade of ASR, birthweight, head circumference, gestational age, presentation, induction of labour, oxytocin...... augmentation, epidural, episiotomy, vacuum extraction, forceps, shoulder dystocia, delivery interval and year of second delivery. Results  Out of 159 446 women, 7336 (4.6%) experienced an ASR at first delivery, and 521 (7.1%) had a recurrent ASR (OR 5.91). The risk factors of recurrent ASR in the multivariate...

  8. De mundejarismo de los Anales Toledanos Segundos

    Directory of Open Access Journals (Sweden)

    Felipe MAÍLLO SALGADO

    2009-12-01

    Full Text Available Como es sabido los Anales Toledanos (Primeros, Segundos y Terceros, compuestos en su mayor parte durante el siglo XIII en distintos momentos y por diferentes manos, son piezas importantes de la historiografía medieval hispánica, tanto por recoger gran cantidad de noticias —por más que éstas sean escuetas— cuanto por estar todas ellas rigurosamente fechadas; de ahí que sean de gran utilidad para el historiador.De estos tres anales, los Segundos (A.T.II tienen unas peculiaridades que los distinguen fuertemente de los otros; sin embargo, en una primera hojeada el lector poco avisado vería que, por su aspecto formal, nada difieren de otros escritos del mismo género, un género éste cuya condición esencial radica en la consignación del evento fechado, esto es, se presenta en párrafos que comienzan o terminan —como es aquí el caso— con una fecha determinada. Nuestro imaginario lector, por otra parte, se encontraría con las peladas noticias típicas del género analístico, a saber: una serie de referencias que dan cuenta de fenómenos naturales (como son las sequías prolongadas o las excesivas lluvias, las heladas intempestivas, los terremotos, los eclipses..., que informan de las épocas de hambre o carestía, de los precios de los artículos, de prodigios, de acontecimientos locales, etc.; el todo amalgamado con noticias de carácter político-militar.

  9. HIV infection connected to rising anal cancer rates in men in the U.S.

    Science.gov (United States)

    Human immunodeficiency virus (HIV) infection contributes substantially to the epidemic of anal cancer in men, but not women in the United States, according to new research from NCI. Chart shows overall incidence rates of anal cancers in general population

  10. OCCULT ANAL SPHINCTER INJURIES (OASIS IN DEPARTMENT OF PERINATOLOGY IN LJUBLJANA – INCIDENCE AND RISK FACTORS

    Directory of Open Access Journals (Sweden)

    Katja Jakopič

    2018-02-01

    Full Text Available Background: Vaginal delivery is the most important risk factors for development of faecal incontinence, which significantly affects quality of life. Foreign studies show OASIS occur at 20 to 40 % of vaginal deliveries. In Slovenia we recognize sphincter injuries at 1.7 % of deliveries, while true incidence of OASIS in our population remains unknown. Caesarean section prevents anal sphincter injuries. Known risk factors in foreign studies include prolonged second stage of labour, fetal weight > 3500 g, malpresentation, forceps delivery, maternal age more than 35 years at the time of first delivery, first delivery. Few women complain about defecatory problems in puerperium unless they are directly asked about them, so true incidence of such injuries is grossly underestimated. Previously compensated anal sphincter dysfunction can clinically manifest as late as in menopause. The most probable cause is atrophy of muscle and fibrous tissue of pelvic floor and anal sphincter due to lack of estrogen support in this period. With anal ultrasound we tried to determine the incidence of occult damage to anal sphincter in primiparas after vaginal delivery and the relation of injury to symptoms 6 weeks after delivery and identify possible risk factors in our population. We also tried to find out how many patients with anal sphincter injury become symptomatic immediately after deliv- ery. Methods: From January to June 2009 we examined 26 primiparas after vaginal delivery in the Ljubljana Maternity Hospital with anal ultrasound and compared various data about the delivery from our national delivery form. We excluded all patients with caesarean section, recognized anal sphincter injury at the time of the delivery or previous anorectal surgery, history of irritable bowel syndrome or pre-existing inflammatory bowel disease. All patients completed a bowel-function questionnaire, which included questions about faecal urgency and involuntary passing of gas, liquid or

  11. A case of anal canal cancer which developed fournier's syndrome after chemoradiotherapy

    International Nuclear Information System (INIS)

    Momma, Tomoyuki; Kikuchi, Daiki; Watanabe, Yohei; Onozawa, Hisashi; Suzuki, Satoshi; Nakamura, Izumi; Ohki, Shinji; Takenoshita, Seiichi; Yoshida, Noriyuki

    2013-01-01

    Fournier's syndrome is an acute necrotizing fasciitis of the perineum which progresses rapidly, resulting in poor prognosis if not treated appropriately at an early stage. Here we report a case of anal canal cancer which developed Fournier's syndrome after chemoradiotherapy (CRT). A 79-year-old man with anal canal cancer received a double-barrel sigmoid colostomy followed by concurrent CRT (50.4 Gy) with S-1 (100 mg/body). Although the patient was discharged after CRT, he developed a fever at 10 days after discharge and visited our hospital complaining of pain in the anal region. He was hospitalized with a diagnosis of Fournier's syndrome. Extensive drainage, administration of antibiotics, additional drainage and continuous irrigation of the affected region improved the symptoms of Fournier's syndrome. Multiple liver metastases were found on a CT scan at 3 months after onset of Fournier's syndrome, and the patient was transferred to another hospital for systemic chemotherapy. There have been no reports on the onset of Fournier's syndrome after CRT for rectal cancer with anal canal involvement; we report this case with a review of the literature. (author)

  12. Role of age, bowel function and parity on anorectocele pathogenesis according to cinedefecography and anal manometry evaluation.

    Science.gov (United States)

    Soares, F A; Regadas, F S P; Murad-Regadas, S M; Rodrigues, L V; Silva, F R S; Escalante, R D; Bezerra, R F

    2009-11-01

    The study aimed to verify the role of parity, age and bowel function in the pathogenesis of anorectocele. A cross-sectional study was conducted regarding age, obstetrical history, Cleveland Clinic Constipation Score (CCCS), cinedefecography and anal manometry findings. Forty-five adult women complaining of obstructed defecation were evaluated; the median age was 46 years and median CCCS, 13. Fifteen patients were nulliparous and 23 multiparous (median parity 2). Eighteen had a history of episiotomy, fourteen delivered large babies and two had forceps-assisted delivery. Statistical analysis was performed using Spearman's correlation test and Fisher's exact test. Anal hypertonia was found in 14 (31.1%) patients, anal hypotonia in eight (17.8%), anismus in 13 (28.9%) and anorectoceles in 34 (75.6%) [median size 2.8 cm (0-6.4)]. There were no correlations between anorectocele and anal hypertonia (P = 0.7171), anismus (P = 0.4666), parity comparing nulliparous and multiparous patients (P = 1.000), episiotomy (P = 1.0000), forceps assistance (P = 1.0000), delivery of a large baby (P = 1.0000) anal resting pressure (P = 0.0883), anal voluntary pressure (P = 0.7327), parity (P = 0.4987) and age (P = 0.8603). There were correlations between anorectocele and the CCCS (P = 0.0082) and anal hypotonia (P = 0.0141). Anorectocele is not correlated with parity, age, episiotomy, delivery of a large baby and anismus. It was more frequent in patients with severe constipation and less common in patients with anal hypotonia.

  13. Paradoxical Impact of Ileal Pouch-Anal Anastomosis on Male and Female Fertility in Patients With Ulcerative Colitis.

    Science.gov (United States)

    Pachler, Frederik R; Brandsborg, Søren B; Laurberg, Søren

    2017-06-01

    Birth rates in males with ulcerative colitis and ileal pouch-anal anastomosis have not been studied. This study aimed to estimate birth rates in males and females with ulcerative colitis and study the impact of ileal pouch-anal anastomosis. This was a retrospective registry-based cohort study that was performed over a 30-year period. Records for parenting a child from the same period were cross-linked with patient records, and birth rates were calculated using 15 through 49 years as age limits. All data were prospectively registered. All patients with ulcerative colitis and ulcerative colitis with ileal pouch-anal anastomosis between 1980 and 2010 were identified in Danish national databases. The primary outcomes measured were birth rates in females and males with ulcerative colitis and ulcerative colitis with ileal pouch-anal anastomosis. We included 27,379 patients with ulcerative colitis (12,812 males and 14,567 females); 1544 had ileal pouch-anal anastomosis (792 males and 752 females). Patients with ulcerative colitis have slightly reduced birth rates (males at 40.8 children/1000 years, background population 43.2, females at 46.2 children/1000 years, background population 49.1). After ileal pouch-anal anastomosis, males had increased birth rates at 47.8 children/1000 years in comparison with males with ulcerative colitis without ileal pouch-anal anastomosis (40.5 children/1000 years), whereas females had reduced birth rates at 27.6 children/1000 years in comparison with females with ulcerative colitis without ileal pouch-anal anastomosis (46.8 children/1000 years). Only birth rates were investigated and not fecundability. Furthermore, there is a question about misattributed paternity, but this has previously been shown to be less than 5%. Ulcerative colitis per se has little impact on birth rates in both sexes, but ileal pouch-anal anastomosis surgery leads to a reduction in birth rates in females and an increase in birth rates in males. This has clinical

  14. Conservative management of anal and rectal cancer

    International Nuclear Information System (INIS)

    Gerard, J.P.; Romestaing, P.; Montbarbon, X.

    1989-01-01

    The role of irradiation in the management of anal and rectal cancer has changed during the past ten years. In small epidermoid carcinomas of the anal canal (T1 T2) irradiation is in most departments considered the primary treatment, giving a 5-year survival rate of between 60 and 80% with good sphincter preservation. Even in larger tumors, irradiation can still offer some chance of cure without colostomy. Surgery remains the basic treatment of rectal cancer but irradiation is used in association with surgery in many cases. Radiotherapy is of value in the conservative management of cancer of the rectum in three situations: In small polypoid cancers contact X-ray therapy can give local control in about 90%. In cancers of the middle rectum, preoperative external irradiation may increase the chances of restorative surgery and reduce the risk of local relapse. In inoperable patients, external radiotherapy and/or intracavitary irradiation may cure some patients with infiltrating tumors (T2 T3) without colostomy. (orig.)

  15. PENGARUH GROUP INVESTIGATION BERBASIS OUTDOOR STUDY TERHADAP KEMAMPUAN BERPIKIR ANALITIS SISWA

    Directory of Open Access Journals (Sweden)

    Valeriana Rasweda

    2016-02-01

    Full Text Available The purpose of research is to find out the Group Investigation outdoor study-based having an affect on student’s analytichal thinking ability. The type of research is PretestPosttest Control Group Design. The research was conducted at Lawang 1st Public Senior High School Malang Regency with experiment class X-IIS 1 and control class X-IIS 2. The data is an analytichal thinking ability. Data analysis was done by comparing the gain score student’s analytichal thinking ability using SPSS 17.0 for Windows. The results showed that Group Investigation outdoor study-based having an affect on student’s analytichal thinking ability.  Tujuan penelitian ini adalah untuk mengetahui apakah model Group Investigation berbasis outdoor study berpengaruh terhadap kemampuan berpikir analitis siswa. Penelitian ini merupakan jenis penelitian eksperimen semu (quasi experiment yang termasuk penelitian kuantitatif. Rancangan penelitian yang dikembangkan adalah Pretest-Posttest Control Group Design. Penelitian dilaksanakan di SMA Negeri 1 Lawang Kabupaten Malang. Kelas ekperimen ialah kelas X-IIS 1 dan kelas kontrol ialah kelas X-IIS 2. Data yang digunakan dalam penelitian ini adalah kemampuan berpikir analitis. Analisis data dilakukan dengan membandingkan gain score kemampuan berpikir analitis siswa menggunakan bantuan program SPSS 17.0 for Windows. Hasil dari penelitian ini menunjukkan bahwa model Group Investigation berbasis outdoor study berpengaruh terhadap kemampuan berpikir analitis siswa.

  16. Oral and Anal vaccination against enteric red mouth disease protection against yersiniosis

    DEFF Research Database (Denmark)

    Neumann, Lukas; Villumsen, Kasper Rømer; Kragelund Strøm, Helene

    dose of ERM bacterin fully protected rainbow trout when they are vaccinated anally. Oral vaccination can also induce full protection but the dose of the bacterin has to be 100 times higher than if the fish was to be vaccinated anally. This indicates that much of the oral feed bacteria is digested...... in the stomach of rainbow trout. This work has shown that it is possible to vaccinated orally against ERM, but the bacteria has to be coated in order to avoid digestion. Protection mechanisms will be discussed....... fish. The objective for this project is to investigate whether oral and anal vaccination of rainbow trout against Yersinia ruckeri O1 (biotype 1) causing Enteric Red Mouth disease (ERM) can protect rainbow trout against a subsequent experimental bath challenge.The rainbow trout were given oral...

  17. Diversity of human papillomavirus in the anal canal of men: the HIM Study.

    Science.gov (United States)

    Sichero, L; Nyitray, A G; Nunes, E M; Nepal, B; Ferreira, S; Sobrinho, J S; Baggio, M L; Galan, L; Silva, R C; Lazcano-Ponce, E; Giuliano, A R; Villa, L L

    2015-05-01

    Human papillomavirus (HPV) infections are associated with the development of anogenital lesions in men. There are no reports describing the distribution of non-α HPV types in the anal canal of a sexually diverse group of men. The HPV Infection in Men (HIM) Study is a multicentre study on the natural history of HPV infection in Brazil, Mexico, and the USA. At baseline, 12% of anal canal PCR HPV-positive specimens were not typed by the Roche Linear Array, and were considered to be unclassified. Our goals were to characterize HPVs among these unclassified specimens at baseline, and to assess associations with participant socio-demographic and behavioural characteristics. Unclassified HPVs were typed by sequencing of amplified PGMY09/11 products or cloning of PGMY/GP + nested amplicons followed by sequencing. Further analysis was conducted with FAP primers. Of men with unclassified HPV in the anal canal, most (89.1%) were men who have sex with women. Readable sequences were produced for 62.8% of unclassified specimens, of which 75.2% were characterized HPV types. Eighteen, 26 and three different α-HPV, β-HPV and γ-HPV types were detected, respectively. α-HPVs were more commonly detected among young men (18-30 years) than among older men (45-70 years), whereas β-HPVs were more frequent among mid-adult men (31-44 years). β-HPVs were more common among heterosexual men (85.0%) than among non-heterosexual men. All β-HPVs detected among non-heterosexual men were β2-HPV types. The high prevalence of β-HPV in the anal canal of men who do not report receptive anal sex is suggestive of other forms of transmission that do not involve penile-anal intercourse. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  18. Endosonographic appearance of the anal sphincters in patients following colostomy

    International Nuclear Information System (INIS)

    Sudol-Szopinska, I.; Jakubowski, W.; Szczepkowski, M.; Panorska, A.

    2002-01-01

    Background. The aim of the study was to visualize, by anal ultrasound (AUS), the suspected defects of the anal sphincters in the patients after colostomy and to analyze possible factors that could have led to such defects. Patients and methods. AUS, using a 7.0 MHz endorectal probe, was performed in a group of 25 patients with colostomy. The internal anal sphincter (IAS), external anal sphincter (EAS) and puborectalis muscle (PR) were visualized and the defects within them were qualified and quantified. For statistical analysis, the analysis of variance (ANOVA) was used. Results. The IAS was thin in all but three patients (22 patients; 88 %) with the mean thickness of 1.62 mm. A circular reduction of the thickness along the entire length of the IAS was seen in 20 patients (90.9 %). The echogenicity of the IAS was increased in 15 patients (60 %), and in 10 of them (66.6%), this defect embraced the whole length and circumference of the IAS. The margins of the IAS were not well-defined in 10 patients (40%). A significant correlation was found between the length of the patient's life with the stoma and the IAS echogenicity defect (p-value = 0.0001). No significant correlation was found between the dynamic examination, the IAS thickness and the IAS borders definition. Conclusion. The reduced thickness, increased echogenicity and borders definition defect of the IAS are seen in the patients after colostomy. The only significant correlation was confirmed between the length of the patient's life with the stoma and the IAS echogenicity defect. (author)

  19. Incontinence after primary repair of obstetric anal sphincter tears is related to relative length of reconstructed external sphincter

    DEFF Research Database (Denmark)

    Norderval, S; Røssaak, K.; Markskog, A

    2012-01-01

    To determine if anatomic primary repair with end-to-end reconstruction of the external anal sphincter (EAS) in its full length combined with separate repair of coexisting internal anal sphincter (IAS) tear, when present, results in less incontinence and better anal sphincter integrity compared...

  20. Topical 5-fluorouracil treatment of anal intraepithelial neoplasia in human immunodeficiency virus-positive men

    NARCIS (Netherlands)

    Richel, O.; Wieland, U.; de Vries, H. J. C.; Brockmeyer, N. H.; van Noesel, C.; Potthoff, A.; Prins, J. M.; Kreuter, A.

    2010-01-01

    Background Anal intraepithelial neoplasia (AIN), a human papillomavirus (HPV) induced potential precursor lesion of anal cancer, is frequent among human immunodeficiency virus (HIV)-positive men who have sex with men (MSM). So far, only a few prospective studies have been performed on the topical

  1. Prolonged-Release Oxycodone/Naloxone Improves Anal Sphincter Relaxation Compared to Oxycodone Plus Macrogol 3350

    DEFF Research Database (Denmark)

    Poulsen, Jakob Lykke; Brock, Christina; Grønlund, Debbie

    2017-01-01

    /naloxone or PR oxycodone plus macrogol 3350. Resting anal pressure, anal canal distensibility, and relaxation of the internal sphincter to rectal distension were evaluated before treatment (baseline) and on day 5. The Patient Assessment of Constipation Symptom (PAC-SYM) questionnaire, stool frequency, and stool...

  2. Fractal dimension and image statistics of anal intraepithelial neoplasia

    International Nuclear Information System (INIS)

    Ahammer, H.; Kroepfl, J.M.; Hackl, Ch.; Sedivy, R.

    2011-01-01

    Research Highlights: → Human papillomaviruses cause anal intraepithelial neoplasia (AIN). → Digital image processing was carried out to classify the grades of AIN quantitatively. → The fractal dimension as well as grey value statistics was calculated. → Higher grades of AIN yielded higher values of the fractal dimension. → An automatic detection system is feasible. - Abstract: It is well known that human papillomaviruses (HPV) induce a variety of tumorous lesions of the skin. HPV-subtypes also cause premalignant lesions which are termed anal intraepithelial neoplasia (AIN). The clinical classification of AIN is of growing interest in clinical practice, due to increasing HPV infection rates throughout human population. The common classification approach is based on subjective inspections of histological slices of anal tissues with all the drawbacks of depending on the status and individual variances of the trained pathologists. Therefore, a nonlinear quantitative classification method including the calculation of the fractal dimension and first order as well as second order image statistical parameters was developed. The absolute values of these quantitative parameters reflected the distinct grades of AIN very well. The quantitative approach has the potential to decrease classification errors significantly and it could be used as a widely applied screening technique.

  3. Thermal responses of shape memory alloy artificial anal sphincters

    Science.gov (United States)

    Luo, Yun; Takagi, Toshiyuki; Matsuzawa, Kenichi

    2003-08-01

    This paper presents a numerical investigation of the thermal behavior of an artificial anal sphincter using shape memory alloys (SMAs) proposed by the authors. The SMA artificial anal sphincter has the function of occlusion at body temperature and can be opened with a thermal transformation induced deformation of SMAs to solve the problem of severe fecal incontinence. The investigation of its thermal behavior is of great importance in terms of practical use in living bodies as a prosthesis. In this work, a previously proposed phenomenological model was applied to simulate the thermal responses of SMA plates that had undergone thermally induced transformation. The numerical approach for considering the thermal interaction between the prosthesis and surrounding tissues was discussed based on the classical bio-heat equation. Numerical predictions on both in vitro and in vivo cases were verified by experiments with acceptable agreements. The thermal responses of the SMA artificial anal sphincter were discussed based on the simulation results, with the values of the applied power and the geometric configuration of thermal insulation as parameters. The results obtained in the present work provided a framework for the further design of SMA artificial sphincters to meet demands from the viewpoint of thermal compatibility as prostheses.

  4. Apontamentos sobre a psicologia analítica de Carl Gustav Jung

    Directory of Open Access Journals (Sweden)

    Luís Marcelo Alves Ramos

    2002-01-01

    Full Text Available O texto faz uma introdução à Psicologia Analítica do psicólogo e psiquiatra suíço Carl Gustav Jung: define o conceito de Psicologia Analítica, traz uma biografia resumida de Carl Gustav Jung, indica as principais diferenças entre a Psicologia Analítica e a Psicanálise, descreve a estrutura e o funcionamento da psique e, por fim, apresenta sinteticamente as características dos tipos de personalidades traçadas por Jung. The text makes an introduction to the Analytical Psychology of the psychologist and swiss psychiatrist Carl Gustav Jung: it defines the concept of Analytical Psychology, brings a summarized biography of Carl Gustav Jung, indicates the main differences between Analytical Psychology and the Psychoanalysis, describes the structure and the functioning of psyche and, finally, presents synthetically the characteristics of the types of personalities traced by Jung.

  5. Hemorrhoids and anal fissures in inflammatory bowel disease.

    Science.gov (United States)

    D'Ugo, S; Stasi, E; Gaspari, A L; Sileri, P

    2015-12-01

    Perianal disease is a common complication of inflammatory bowel disease (IBD). It includes different conditions from more severe and potentially disabling ones, such as abscesses and fistulas, to more benign conditions such as hemorrhoids, skin tags and fissures. Most literature has been focused on anal sepsis and fistulae, as they carry the majority of disease burden and often alter the natural course of the disease. Hemorrhoids and anal fissures in patients with IBD have been overlooked, although they can represent a challenging problem. The management of hemorrhoids and fissures in IBD patients may be difficult and may significantly differ compared to the non-affected population. Historically surgery was firmly obstructed, and hemorrhoidectomy or sphincterotomy in patients with associated diagnosis of IBD was considered harmful, although literature data is scant and based on small series. Various authors reported an incidence of postoperative complications higher in IBD than in the general populations, with potential severe events. Considering that a spontaneous healing is possible, the first line management should be a medical therapy. In patients non-responding to conservative measures it is possible a judicious choice of surgical options on a highly selective basis; this can lead to acceptable results, but the risk of possible complications needs to be considered. In this review it is analyzed the current literature on the incidence, symptoms and treatment options of hemorrhoids and anal fissures in patients with Crohn's disease and ulcerative colitis.

  6. Incidence and survival patterns of rare anal canal neoplasms using the surveillance epidemiology and end results registry.

    Science.gov (United States)

    Metildi, Cristina; McLemore, Elisabeth C; Tran, Thuy; Chang, David; Cosman, Bard; Ramamoorthy, Sonia L; Saltzstein, Sidney L; Sadler, Georgia Robins

    2013-10-01

    Small cell, neuroendocrine tumors, and melanoma of the anus are rare. Limited data exist on the incidence and management for these rare tumors. A large, prospective, population-based database was used to determine incidence and survival patterns of rare anal neoplasms. The Surveillance, Epidemiology and End Results registry was queried to identify patients diagnosed with anal canal neoplasms. Incidence and survival patterns were evaluated with respect to age, sex, race, histology, stage, and therapy. We identified 7078 cases of anal canal neoplasms: melanoma (n = 149), neuroendocrine (n = 61), and small cell neuroendocrine (n = 26). Squamous cell carcinoma (SCC) (n = 6842) served as the comparison group. Anal melanoma (AM) demonstrated the lowest survival rate at 2.5 per cent. Neuroendocrine tumors (NETs) demonstrated similar survival as SCC (10-year survival for regional disease of 25 and 22.3%, respectively). Ten-year survival of small cell NETs resembled AM (5.3 vs 2.5%). Age 60 years or older, sex, black race, stage, and surgery were independent predictors of survival. This study presents the largest patient series of rare anal neoplasms. NETs of the anal canal demonstrate similar survival patterns to SCC, whereas small cell NETs more closely resemble AM. Accurate histologic diagnosis is vital to determine treatment and surgical management because survival patterns can differ among rare anal neoplasms.

  7. El juego simbólico una alternativa en las dilataciones anales

    OpenAIRE

    Aguinaga B. Oscar William

    1993-01-01

    "Las malformaciones ano-rectales están entre las más comunes de las malformaciones de tipo congénito causadas por anormalidades del desarrollo, aproximadamente uno de cada cinco mil partos con producto vivo, en Estados Unidos". Clasificaciones existen muchas, pero la de uso más generalizado y tenida en cuenta en el Hospital de la Misericordia, servicio de quirúrgicas, es: Estenosis anal congénita, agenecia anal, atresia rectal, fístula rectoperineal, fístula rectovaginal.

     

    ...

  8. Epidemiology of anal HPV infection in high-risk men attending a sexually transmitted infection clinic in Puerto Rico.

    Directory of Open Access Journals (Sweden)

    Vivian Colón-López

    Full Text Available Recent studies in Puerto Rico have reported an increasing incidence of anal cancer in Puerto Rican men. The objective of this study was to determine the prevalence, genotype distribution and risk factors associated with anal HPV infection among men attending an STI clinic in Puerto Rico.We conducted a cross-sectional study among 205 men 18 years and older. A comprehensive survey was administered that included a demographic and a behavioral assessment. Separate logistic regression models were performed to determine factors associated with any, high-risk (HR, and multiple anal HPV infection.The mean age of the study sample was 38.0±13.5 years. The most common HR types were 58, 51 and 31. Overall, HR anal HPV infection was found in 53.5% of the participants. Multiple HPV types in the anal canal were found in 47.6% of the sample. A third (29.8% of participants reported being men who had sex with men (MSM. MSM had a significantly higher prevalence of any, HR and multiple HPV infection (p-value<0.05. Separate multivariate logistic regression analyses showed that being MSM was associated with any (OR = 4.5; [95%CI: 1.9-10.7], HR (OR = 3.4; [95%CI: 1.1-10.3 and multiple anal HPV infection (OR = 3.6; [95%CI: 1.5-9.1. HIV was marginally associated with multiple anal HPV infection in multivariate analysis (OR = 3.3; 95%CI = 1.0-11.0.Anal HPV is common among sexually active men attending this STI clinic, with higher likelihood of anal HPV infection among MSM.

  9. Frequency of post-operative faecal incontinence in patients with closed and open internal anal sphincterotomy

    International Nuclear Information System (INIS)

    Ghayas, N.G.; Younus, S.M.; Mirani, A.J.; Ghayasuddin, M.

    2015-01-01

    Fissure in ano is one of the commonest benign and painful proctologic diseases causing considerable morbidity and reduction in quality of life. There are medical as well as surgical treatment options for anal fissure. The study was conducted to compare the frequency of postoperative faecal incontinence in patients with closed lateral internal anal sphincterotomy with von-greaves knife versus standard Parks operation (open method) for chronic anal fissure. Methods: This was a randomized controlled trial (RCT) was conducted at the Department of Surgery, KVSS, S.I.T.E. Hospital, Karachi, for a period of six months from 13th February to 12th August 2011. Ninety four consecutive patients having chronic anal fissure were assigned through blocked randomization to groups A and B, with 47 patients in each group. Closed lateral internal anal sphincterotomy (CLIAS) via von-greaves knife was carried out in patients of group-A whereas patients of group-B were subjected to open internal anal sphincterotomy (OIAS) also known as Parks procedure. Faecal incontinence was noted on the 5th post-operative day. Data was analysed using SPSS 16. Results: There were 81 (86.2%) males and 13 (13.8%) females with male to female ratio being 6:1. Mean age was 38.38 mp±14.56 years. Post-operative faecal incontinence in patients undergoing CLIAS was 4.3% while it was 21.3% in those undergoing OIAS with a p-value of 0.027. CLIAS with von-greaves knife is effective in reducing faecal incontinence on 5th postoperative day as compared to standard OIAS. Conclusion: CLIAS with von-greaves knife is effective in reducing faecal incontinence on 5th postoperative day as compared to OIAS (Park's procedure). Therefore, this technique may be used in future regularly to treat chronic anal fissure for prevention of this morbidity. (author)

  10. Analüütikud soovitavad Eesti Energia börsile viia / Piret Reiljan

    Index Scriptorium Estoniae

    Reiljan, Piret, 1983-

    2008-01-01

    Kohalikud analüütikud soovitavad viia Eesti Energia börsile, kuna see elavdaks aktsiaturgu ja tõmbaks ligi välisinvestoreid. Vt. samas: Raivo Vare: raske aeg töötab Eesti Energia börsiletoomise kasuks; Analüüs ootab pääsu valitsuskabinetti; Juhid ei püsi enam Eesti Energias. Diagrammid: Majandusnäitajad; Varade maht

  11. Genetic Architecture of the Variation in Male-Specific Ossified Processes on the Anal Fins of Japanese Medaka.

    Science.gov (United States)

    Kawajiri, Maiko; Fujimoto, Shingo; Yoshida, Kohta; Yamahira, Kazunori; Kitano, Jun

    2015-10-28

    Traits involved in reproduction evolve rapidly and show great diversity among closely related species. However, the genetic mechanisms that underlie the diversification of courtship traits are mostly unknown. Japanese medaka fishes (Oryzias latipes) use anal fins to attract females and to grasp females during courtship; the males have longer anal fins with male-specific ossified papillary processes on the fin rays. However, anal fin morphology varies between populations: the southern populations tend to have longer anal fins and more processes than the northern populations. In the present study, we conducted quantitative trait locus (QTL) mapping to investigate the genetic architecture underlying the variation in the number of papillary processes of Japanese medaka fish and compared the QTL with previously identified QTL controlling anal fin length. First, we found that only a few QTL were shared between anal fin length and papillary process number. Second, we found that the numbers of papillary processes on different fin rays often were controlled by different QTL. Finally, we produced another independent cross and found that some QTL were repeatable between the two crosses, whereas others were specific to only one cross. These results suggest that variation in the number of papillary processes is polygenic and controlled by QTL that are distinct from those controlling anal fin length. Thus, different courtship traits in Japanese medaka share a small number of QTL and have the potential for independent evolution. Copyright © 2015 Kawajiri et al.

  12. Morphologic changes of the anal sphincter musculature during and after temporary stool deviation.

    Science.gov (United States)

    Sailer, M; Fein, M; Fuchs, K H; Bussen, D; Grun, C; Thiede, A

    2001-04-01

    Temporary stool deviation, using a stoma, is a well-known surgical principle to protect low colorectal or coloanal anastomoses. The purpose of this study was to evaluate any morphologic changes with regard to the anal sphincter muscles during and after temporary ileostomy. Forty-four patients with rectal carcinomas were studied prospectively. All patients underwent low anterior resection. Reconstruction was performed using either a coloanal pouch or a straight end-to-end anastomosis. A protective stoma was fashioned in all 44 patients (ileostomy n=41; colostomy n=3). Stoma closure was carried out after a median of 85 days (41-330 days). Using a standard protocol, anal-sphincter thickness [m. puborectalis, external anal sphincter (EAS) and internal anal (IAS) sphincter] was assessed by means of endoanal ultrasonography preoperatively, at the time of stoma closure, and every 3 months thereafter for 1 year. The diameter of the puborectal muscle decreased from a median preoperative value of 6.3 mm to 5.7 mm at the time of stoma closure (P=0.03). After 3 months, 6.2 mm was measured. This value remained stable for the complete follow-up period. Similar results were recorded for the EAS. The IAS thickness remained stable throughout the study period, measuring between 2.1 mm and 2.4 mm. Temporary stool deviation does lead to morphologic changes of the anal sphincter. While the smooth muscle remains unchanged, the striated counterpart undergoes atrophic transformation. However, after passage reconstruction, i.e., stoma closure, a rapid regeneration of the voluntary muscles is observed.

  13. Hallazgos ecográficos en la proctalgia espontánea y postoperatoria Ultrasound findings in spontaneous and postoperative anal pain

    Directory of Open Access Journals (Sweden)

    I. Pascual

    2008-12-01

    Full Text Available Objetivo: valorar la utilidad de la ecografía endoanal como prueba de imagen para identificar la causa del dolor anal en los pacientes que presentan proctalgia idiopática o dolor postoperatorio y analizar cuáles son sus causas más frecuentes. Métodos: se realiza un estudio descriptivo de los hallazgos encontrados en las ecografías endoanales de pacientes con dolor anal en los últimos seis años. Todas las ecografías se llevaron a cabo con un ecógrafo B&K (Cheetah 2003, B&K Medical, Gentofte, Denmark con sonda endoanal de 7 MHz. Resultados: se estudiaron noventa y cinco casos de proctalgia mediante ecografía endoanal. Sesenta y siete correspondieron a pacientes con una cirugía previa perineal o pélvica tras la cual comenzó el dolor anal: 48 habían sido intervenidos de fisura anal, 12 de hemorroidectomía, 4 de episiotomía, 2 de fístula y 1 de prostatectomía. El hallazgo más frecuente tras la cirugía de fisura anal fue la presencia de una esfinterotomía incompleta. Entre los veintiocho pacientes sin cirugía previa, el 57,14% presentaba hipertrofia del esfínter anal interno como única alteración ecográfica. Conclusiones: los pacientes con proctalgia espontánea y postoperatoria pueden ser estudiados mediante ecografía endoanal ya que el uso de la sonda no impide completar la exploración. Con esta prueba se encontró una causa del dolor en el 81,93% de los casos. La hipertrofia del esfínter anal interno aislada es el hallazgo ecográfico más frecuente asociado a proctalgia espontánea.Objective: to assess the use of endoanal ultrasounds to identify anal pain etiology in patients with either spontaneous or postoperative pain, and to review the most frequent causes. Methods: a descriptive study of ultrasound findings in patients with anal pain during the last six years was performed. All ultrasound scans were performed using a B&K Diagnostic Ultrasound System (Cheetah 2003, B&K Medical, Gentofte, Denmark with a 7-MHz

  14. High Prevalence of Anal Human Papillomavirus-Associated Cancer Precursors in a Contemporary Cohort of Asymptomatic HIV-Infected Women.

    Science.gov (United States)

    Heard, Isabelle; Etienney, Isabelle; Potard, Valérie; Poizot-Martin, Isabelle; Moore, Catherine; Lesage, Anne-Carole; Ressiot, Emmanuelle; Crenn-Hebert, Catherine; Fléjou, Jean-François; Cubie, Heather; Costagliola, Dominique; Darragh, Teresa M

    2015-05-15

    Although human immunodeficiency virus (HIV)-infected women are at high risk for anal cancer, few data have been published on prevalence of and risk factors for anal precancer and potential screening strategies in this risk group. A cross-sectional anal screening study was nested in a gynecological cohort of HIV-infected women. Anal swab specimens were collected for cytology and human papillomavirus (HPV) testing. High-resolution anoscopy, with biopsy when indicated, was systematically performed. Among the 171 enrolled women, median age was 47.3 years and 98% were receiving combination antiretroviral therapy. Median CD4(+) count was 655 cells/µL and HIV load was associated with increased risk of HG-AIN+. Abnormal anal cytology and HPV-16 infection performed best as a screening strategy for HG-AIN+ histology, with positive likelihood ratios of 3.4 (95% CI, 2.3-5.1) and 4.7 (95% CI, 2.5-8.7) and negative likelihood ratios of 0.2 (95% CI, .07-.8) and 0.4 (95% CI, .2-.9), respectively. HIV-infected women with a history of HPV-associated cervical disease are at increased risk for HG-AIN+ and should be offered anal cancer screening. Anal cytology and HPV-16 genotyping had the best screening performance. Anal cytology is easy to perform routinely; it may be the best candidate for screening for HG-AIN among HIV-infected women. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  15. Assessing the impact of FDG-PET in the management of anal cancer

    International Nuclear Information System (INIS)

    Nguyen, Brandon T.; Joon, Daryl Lim; Khoo, Vincent; Quong, George; Chao, Michael; Wada, Morikatsu; Joon, Michael Lim; See, Andrew; Feigen, Malcolm; Rykers, Kym; Kai, Cynleen; Zupan, Eddy; Scott, Andrew

    2008-01-01

    Purpose: To assess the utility of FDG-PET in anal cancer for staging and impact on radiotherapy planning (RTP), response and detection of recurrent disease. Methods and materials: Fifty histopathological anal cancer patients were reviewed between 1996 and 2006. The median age was 58 years (range 36-85) with 19 males:31females. Clinical assessment with CT was compared to PET. Impact on management, disease response, recurrence and metastases was evaluated. Results: The non-PET staging was Stage I(8), Stage II(18), Stage III(22), and Stage IV(2)s. The primary was strongly FDG avid in 98% with non-excised tumors compared to CT (58%). PET upstaged 17% with unsuspected pelvic/inguinal nodal disease. Pre-treatment PET identified 11 additional by involved nodal groups in 48 patients causing RTP amendments in 19%. Post-treatment PETs at median 17 weeks (range 9-28) showed complete responses in 20 (80%) and 5 (20%) partial responses (PR). PRs were biopsy positive in 2 and negative in 3. Fifteen had follow-up scans of which all nine PETs detected recurrences were pathologically confirmed. Conclusions: Anal cancer is FDG-PET avid. PET upstages 17% and changes the RTP in 19%. PET can aid in anal cancer staging and identification of residual disease, recurrent/metastatic disease but warrants further prospective studies

  16. Prevalence and correlates of heterosexual anal and oral sex in adolescents and adults in the United States.

    Science.gov (United States)

    Leichliter, Jami S; Chandra, Anjani; Liddon, Nicole; Fenton, Kevin A; Aral, Sevgi O

    2007-12-15

    Heterosexual anal and oral sex are related to the acquisition of sexually transmitted infections, including human immunodeficiency virus infection. We examined the correlates of heterosexual anal and oral sex in the general population, using data from the National Survey of Family Growth. The sample included 12,571 men and women aged 15-44 years (79% response rate). One-third of men and women had ever had anal sex, and three-quarters had ever had oral sex. Condom use during last oral or anal sex was relatively uncommon. In separate models for men and women, having ever had anal sex was associated with white race, age of 20-44 years, and having had a non-monogamous sex partner. White race, age of 20-44 years, being married, and having higher numbers of lifetime sex partners were related to having ever given oral sex in men and women. Giving oral sex was associated with having a non-monogamous sex partner in men. Ever receiving oral sex was associated with white race and a non-monogamous sex partner in men and women. It would be beneficial to track the prevalence of heterosexual anal and oral sex and associated condom use on a more frequent basis.

  17. The impact of anal sphincter injury on perceived body image.

    Science.gov (United States)

    Iles, David; Khan, Rabia; Naidoo, Kristina; Kearney, Rohna; Myers, Jenny; Reid, Fiona

    2017-05-01

    Obstetric anal sphincter injury is common but the effect on body image is unreported. The aim of this study was to explore patient perceived changes in body image and other psychological aspects in women attending a perineal follow-up clinic. This retrospective study analysed women's responses to a self-reported questionnaire. Consecutive women with anal sphincter injury who attended a United Kingdom Maternity Hospital perineal follow-up clinic between January 1999 and January 2012 were identified and the records obtained and reviewed. Multivariate regression analyses were performed to examine variables influencing self-reported change in body image. Questionnaires and operation notes were analysed from 422 women who attended at a median of four months after delivery. 222 (53%) reported a change in body image with 80 (19%) reporting lower self-esteem and 75 (18%) a change in their personality due to the change in body image. 248 (59%) perceived an anatomical change due to the delivery. Factors associated with increased likelihood of reporting a change in body image were reporting a perceived change in anatomy due to the delivery, adjusted OR 6.11 (3.56-10.49), anal incontinence, OR 1.97 (1.16-3.36), and delivery by forceps, OR 2.59 (1.23-5.43). This is the first study to quantify body image changes in women after anal sphincter injury sustained in childbirth. These were found to be very common, affecting up to 50% of women. The study has several limitations but it does highlight the significant psychosocial problems of negative self-esteem and personality changes associated with a perceived change in body image that has not previously been reported. It also outlines the further research questions that need to be addressed. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Handedness is a biomarker of variation in anal sex role behavior and Recalled Childhood Gender Nonconformity among gay men.

    Science.gov (United States)

    Swift-Gallant, Ashlyn; Coome, Lindsay A; Monks, D Ashley; VanderLaan, Doug P

    2017-01-01

    Developmental theories of the biological basis of sexual orientation suggest that sexually differentiated psychological and behavioural traits should be linked with sexual orientation. Subgroups of gay men delineated by anal sex roles differ according to at least one such trait: gender expression. The present study assessed the hypothesis that handedness, a biologically determined sexually differentiated trait, corresponds to differences in subgroups of gay men based on anal sex role. Furthermore, it assessed whether handedness mediates the association between gender nonconformity and male sexual orientation. Straight and gay men (N = 333) completed the Edinburgh Inventory of Handedness and the Recalled Childhood Gender Nonconformity Scale. Gay men also completed measures of anal sex role preference. As in previous studies, gay men showed greater non-right-handedness and gender nonconformity than straight men. Also, among gay men, bottoms/versatiles (i.e., gay men who take a receptive anal sex role, or who take on both a receptive and insertive anal sex role) were more gender-nonconforming than tops (i.e., gay men who take an insertive anal sex role). In support of the hypothesis, bottoms/versatiles were more non-right-handed than tops and handedness mediated the male sexual orientation and anal sex role differences in Recalled Childhood Gender Nonconformity. Together, these findings suggest that developmental processes linked to handedness underpin variation among men in sexual orientation and gender nonconformity as well as variation among subgroups of gay men that are delineated by anal sex roles.

  19. Handedness is a biomarker of variation in anal sex role behavior and Recalled Childhood Gender Nonconformity among gay men.

    Directory of Open Access Journals (Sweden)

    Ashlyn Swift-Gallant

    Full Text Available Developmental theories of the biological basis of sexual orientation suggest that sexually differentiated psychological and behavioural traits should be linked with sexual orientation. Subgroups of gay men delineated by anal sex roles differ according to at least one such trait: gender expression. The present study assessed the hypothesis that handedness, a biologically determined sexually differentiated trait, corresponds to differences in subgroups of gay men based on anal sex role. Furthermore, it assessed whether handedness mediates the association between gender nonconformity and male sexual orientation. Straight and gay men (N = 333 completed the Edinburgh Inventory of Handedness and the Recalled Childhood Gender Nonconformity Scale. Gay men also completed measures of anal sex role preference. As in previous studies, gay men showed greater non-right-handedness and gender nonconformity than straight men. Also, among gay men, bottoms/versatiles (i.e., gay men who take a receptive anal sex role, or who take on both a receptive and insertive anal sex role were more gender-nonconforming than tops (i.e., gay men who take an insertive anal sex role. In support of the hypothesis, bottoms/versatiles were more non-right-handed than tops and handedness mediated the male sexual orientation and anal sex role differences in Recalled Childhood Gender Nonconformity. Together, these findings suggest that developmental processes linked to handedness underpin variation among men in sexual orientation and gender nonconformity as well as variation among subgroups of gay men that are delineated by anal sex roles.

  20. Handedness is a biomarker of variation in anal sex role behavior and Recalled Childhood Gender Nonconformity among gay men

    Science.gov (United States)

    Swift-Gallant, Ashlyn; Coome, Lindsay A.; Monks, D. Ashley; VanderLaan, Doug P.

    2017-01-01

    Developmental theories of the biological basis of sexual orientation suggest that sexually differentiated psychological and behavioural traits should be linked with sexual orientation. Subgroups of gay men delineated by anal sex roles differ according to at least one such trait: gender expression. The present study assessed the hypothesis that handedness, a biologically determined sexually differentiated trait, corresponds to differences in subgroups of gay men based on anal sex role. Furthermore, it assessed whether handedness mediates the association between gender nonconformity and male sexual orientation. Straight and gay men (N = 333) completed the Edinburgh Inventory of Handedness and the Recalled Childhood Gender Nonconformity Scale. Gay men also completed measures of anal sex role preference. As in previous studies, gay men showed greater non-right-handedness and gender nonconformity than straight men. Also, among gay men, bottoms/versatiles (i.e., gay men who take a receptive anal sex role, or who take on both a receptive and insertive anal sex role) were more gender-nonconforming than tops (i.e., gay men who take an insertive anal sex role). In support of the hypothesis, bottoms/versatiles were more non-right-handed than tops and handedness mediated the male sexual orientation and anal sex role differences in Recalled Childhood Gender Nonconformity. Together, these findings suggest that developmental processes linked to handedness underpin variation among men in sexual orientation and gender nonconformity as well as variation among subgroups of gay men that are delineated by anal sex roles. PMID:28234947

  1. NMR imaging of the anal levator and sphincter muscles in anorectal malformations

    International Nuclear Information System (INIS)

    Aoyagi, Hiroshi; Takahashi, Hideyo; Maie, Masahiko; Ohnuma, Naomi; Etoh, Takao; Iwai, Jun

    1986-01-01

    Magnetic resonance imaging (MRI) of the anal levater and sphincter muscles was obtained on 4 normal volunteers and 11 patients with postoperative anorectal malformations (including 8 supra-levator type and 3 low type). Balloon catheter were inserted into the rectum and marked it as the center of a anal canal. Four normal subjects revealed the levater and sphincter muscles were thick and well developed in all sections (Sagittal, Transevse, Coronal). In most of the supra-levator type of anorectal malformations, thin levator and sphincter muscles were observed by Sagittal and Coronal scans. Transeverse scan revealed that the neorectum was not effectively pull-throughed into the puborectal muscle in one patient. Coronal scan showed the dameged external sphincter muscle. In three low types of anorectal malformations, the levator and the sphincter muscles were all well developed, but in one patient the external sphincter muscle existed at the posterior part of the anal canal. These observations were usefull in managing the postoperative care of anorectal malformations. (author)

  2. SIA „Origami” saimnieciskās darbības analīze

    OpenAIRE

    Skalbiņš, Verners

    2014-01-01

    Bakalaura darba tēma ir „SIA „Origami” saimnieciskās darbības analīze”. Darbā apskatītais uzņēmums ir poligrāfijas nozares uzņēmums, kas specializējas lielformāta drukas jomā. Darba mērķis ir identificēt uzņēmuma stiprās un vājās puses, un izstrādāt priekšlikumus tā attīstībai un uzlabošanai. Mērķa sasniegšanai izvirzīti sekojoši uzdevumi: izpētīt uzņēmuma analīzes veikšanai nepieciešamo teorētisko bāzi, uz tās balstoties veikt uzņēmuma analīzi, kā arī izstrādāt secinājumus par līdzšinējo ...

  3. Disorders of the pelvic floor and anal sphincters; a gastroenterologist’s perspective

    Directory of Open Access Journals (Sweden)

    Eamonn M.M. Quigley, MD FRCP FACP FACG FRCPI

    2013-03-01

    Full Text Available The integration and coordination of the musculature of the pelvic floor and the anal sphincters is critical to two important physiological functions: defecation and continence. Consequently, disorders affecting the pelvic floor muscles, the anal sphincters, their innervation or their precise coordination will, depending on their nature, result either in obstructed defecation or fecal incontinence. Both of these disorders are much more common in females and the latter, in particular, is linked with parity. While the symptomatology, presentation and optimal mode of investigation of fecal incontinence are well standardized, considerable debate and controversy continues to surround the contributions of pelvic floor and anal sphincter dysfunction to chronic constipation and the optimal clinical approach to their investigation remains to be defined. In appropriately chosen cases surgical intervention may provide the best outcome for sufferers from incontinence; biofeedback approaches may be of value in both incontinence and obstructed defecation and surgery has little role to play in the latter.

  4. Detekce útoku DNS Amplification z pasivní analýzy DNS provozu

    OpenAIRE

    Míšaný, Daniel

    2014-01-01

    Táto práce je zaměřená na analýzu a detekci útoku DNS amplification, který patří mezi útoky typu DoS. Úvod práce je zaměřený na základní teorii zahrnující počítačové sítě, službu DNS a útoky typu DoS. Větší část práce se zabývá analýzou útoku DNS amplification, návrhem a implementací nástroje pro detekci v jazyce C++. Závěr je věnovaný analýze výsledků detekčního nástroje. This thesis is focused on the analysis and detection of DNS Amplification attack which is type of the DoS attack. Intr...

  5. Võlur Ozi eksperimentide kogumine ja partneri algatatud paranduste analüüs

    Directory of Open Access Journals (Sweden)

    Siiri Pärkson

    2011-05-01

    Full Text Available 2009. aastal viidi Eestis läbi teine võlur Ozi kirjalike eksperimentide seeria ning käesolev artikkel annab ülevaate eksperimentide korraldamisest ning kogutud dialoogide partneri algatatud paranduste analüüsimise tulemustest. Katseisikutel paluti testida interneti veebilehel asuvat programmi Aivo, mis on suuteline suhtlema inimesega kirjalikus eesti keeles. Tegelikkuses vastas inimeste küsimustele interneti vahendusel eksperimendi läbiviija (võlur Oz. Kogutud dialooge on analüüsitud toetudes vestlusanalüüsi meetodi mõistestikule. Tartu Ülikoolis välja töötatud dialoogiaktide tüpoloogia järgi jaguneb partneri algatatud parandus üleküsimiseks, ümbersõnastamiseks ja mittemõistmiseks. Artiklis analüüsitakse näidetele toetudes eelnimetatud kolme partneri algatatud paranduse esinemist kogutud dialoogides, pidades silmas tulevikus loodavaid reaalseid dialoogsüsteeme, mis suudaksid arvutikasutajaga suhelda loomulikus eesti keeles. http://dx.doi.org/10.5128/ERYa7.12

  6. Significance of the thickness of the anal sphincters with age and its relevance in faecal incontinence.

    Science.gov (United States)

    Papachrysostomou, M; Pye, S D; Wild, S R; Smith, A N

    1994-08-01

    Ultrasonographic studies in healthy volunteers showed that the external anal sphincter (EAS) and internal anal sphincter (IAS) thicknesses were inversely related at rest. The functional importance of the two sphincters in continence control was demonstrated in the relationship between the sum of the thicknesses of the two sphincters and the anal canal resting pressure. The aims of the present study were to assess the morphometric appearance of the anal sphincters by endosonography in faecally incontinent patients and to contrast this with that of older healthy subjects. Twenty-eight female patients with neurogenic faecal incontinence (FI) were studied. An older group of 7 healthy women, aged 41-75 years, and a young group of 11 nulliparous healthy women, aged 20-23 years, served as control groups. Anal endosonography was performed with a radial rotating endoprobe, with the subject in the left lateral position. Conventional anal manometry was performed in all subjects. The EAS in the FI group was thicker than the EAS in the old (p IAS thickness in the FI group did not differ from that in the older group. In both these groups the IAS was thicker than in the young women (p IAS in the FI group does not seem to compensate for function and results in a failure of the sphincter mechanism to maintain continence, whereas in healthy elderly subjects the increased IAS thickness appears to be compensatory and important for continence control.

  7. DISOCIJATIVNI PROSTOR MODERNOSTI: diskurs praznine u arhitekturi i vizuelnim umetnostima XX i početka XXI veka

    OpenAIRE

    Milićević, Slađana

    2018-01-01

    Tema ove studije je teorijsko uobličavanje definicije disocijativnog prostora, kojim se opisuje specifično moderni odnos subjekta i prostora, odnosno koekstenzivni (ekstimni) karakter prostornosti i subjektivnosti u modernoj epohi. Analiza prostora u polju disocijativnosti sprovedena je u oblasti arhitekture i vizuelnih umetnosti, prevashodno se oslanjajući na istraživanja u oblasti filozofije, psihologije i teorijske psihoanalize.

  8. Patterns of repeated anal cytology results among HIV-positive and HIV-negative men who have sex with men

    Directory of Open Access Journals (Sweden)

    Hilary A. Robbins

    2018-06-01

    Full Text Available Background: Men who have sex with men (MSM are at increased risk for anal cancer. In cervical cancer screening, patterns of repeated cytology results are used to identify low- and high-risk women, but little is known about these patterns for anal cytology among MSM. Methods: We analyzed Multicenter AIDS Cohort Study (MACS data for MSM who were offered anal cytology testing annually (HIV-positive or every 2 years (HIV-negative for 4 years. Results: Following an initial negative (normal cytology, the frequency of a second negative cytology was lower among HIV-positive MSM with CD4 ≥ 500 (74% or CD4 < 500 (68% than HIV-negative MSM (83% (p < 0.001. After an initial abnormal cytology, the frequency of a second abnormal cytology was highest among HIV-positive MSM with CD4 < 500 (70% compared to CD4 ≥ 500 (53% or HIV-negative MSM (46% (p = 0.003. Among HIV-positive MSM with at least three results, 37% had 3 consecutive negative results; 3 consecutive abnormal results were more frequent among CD4 < 500 (22% than CD4 ≥ 500 (10% (p = 0.008. Conclusions: More than one-third of HIV-positive MSM have consistently negative anal cytology over three years. Following abnormal anal cytology, a repeated cytology is commonly negative in HIV-negative or immunocompetent HIV-positive men, while persistent cytological abnormality is more likely among HIV-positive men with CD4 < 500. Keywords: Anal cancer, Anal cytology, HIV, MSM, Anal cancer screening

  9. Multidisciplinary training in perineal care during labor and delivery for the reduction of anal sphincter injuries.

    Science.gov (United States)

    Frost, Jonathan; Gundry, Rowan; Young, Helen; Naguib, Adel

    2016-08-01

    To determine whether the introduction of a multidisciplinary intrapartum perineal-care training program reduced the rate of obstetric anal sphincter injuries in patients undergoing vaginal deliveries. A prospective observational cohort study enrolled women undergoing vaginal deliveries at a district general hospital maternity unit in the United Kingdom between April 1, 2012 and March 31, 2014. All women experiencing obstetric anal sphincter injuries during the study period were identified and the rate of obstetric anal sphincter injuries before (2012-2013) a multidisciplinary training program was implemented was compared with the rate after (2013-2014) implementation using logistic regression analysis. The study enrolled 4920 patients. Following the implementation of the training program, the rate of obstetric anal sphincter injuries decreased from 4.8% to 3.1% of vaginal deliveries (odds ratio 0.66; 95% confidence interval 0.493-0.899; P = 0.008). The integration of intrapartum perineal-care training into mandatory annual staff training was associated with a statistically and clinically significant reduction in the rate of obstetric anal sphincter injuries. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  10. The increasing incidence of anal cancer: can it be explained by trends in risk groups?

    NARCIS (Netherlands)

    van der Zee, R. P.; Richel, O.; de Vries, H. J. C.; Prins, J. M.

    2013-01-01

    Anal cancer incidence is gradually increasing. The cause of this increase is not exactly known. This systematic literature review aimed to investigate the trend in time of anal cancer incidence and to find an explanation for the supposed increase. The TRIP database and PubMed were searched for

  11. Event-Level Analysis of Anal Sex Roles and Sex Drug Use Among Gay and Bisexual Men in Vancouver, British Columbia, Canada.

    Science.gov (United States)

    Rich, Ashleigh J; Lachowsky, Nathan J; Cui, Zishan; Sereda, Paul; Lal, Allan; Moore, David M; Hogg, Robert S; Roth, Eric A

    2016-08-01

    This study analyzed event-level partnership data from a computer-assisted survey of 719 gay and bisexual men (GBM) enrolled in the Momentum Health Study to delineate potential linkages between anal sex roles and the so-called "sex drugs," i.e., erectile dysfunction drugs (EDD), poppers, and crystal methamphetamine. Univariable and multivariable analyses using generalized linear mixed models with logit link function with sexual encounters (n = 2514) as the unit of analysis tested four hypotheses: (1) EDD are significantly associated with insertive anal sex roles, (2) poppers are significantly associated with receptive anal sex, (3) both poppers and EDD are significantly associated with anal sexual versatility, and (4) crystal methamphetamine is significantly associated with all anal sex roles. Data for survey respondents and their sexual partners allowed testing these hypotheses for both anal sex partners in the same encounter. Multivariable results supported the first three hypotheses. Crystal methamphetamine was significantly associated with all anal sex roles in the univariable models, but not significant in any multivariable ones. Other multivariable significant variables included attending group sex events, venue where first met, and self-described sexual orientation. Results indicate that GBM sex-drug use behavior features rational decision-making strategies linked to anal sex roles. They also suggest that more research on anal sex roles, particularly versatility, is needed, and that sexual behavior research can benefit from partnership analysis.

  12. Histopathologic observations of anorectal abnormalities in anal atresia.

    Science.gov (United States)

    Meier-Ruge, W A; Holschneider, A M

    2000-01-01

    Over the years from 1992 to 1997, 41 anorectal malformations (ARM) with histopathologic alterations were investigated to determine which morphologic abnormalities of the distal rectum accompany ARMs. Three other cases showed normal neuromuscular morphology; 9 further cases could not be evaluated owing to scanty biopsies. All resected specimens were caudocranially coiled and cryostat cut at -20 degrees C into serial sections, which were stained with a lactic dehydrogenase, succinic dehydrogenase, nitroxide synthase, and acetylcholinesterase reaction as well as hemalum and sirius red. Ten low, 15 intermediate, and 10 high forms of anal atresia (AA) were studied. In addition, six cloacal abnormalities were investigated. In 7 cases (17%) (5 intermediate, 2 low AAs), the characteristics of Hirschsprung's disease were observed. Oligoneuronal hypoganglionosis of the myenteric plexus proximal to the anal floor was diagnosed in 7 AAs (12%). In 10 children with high-type AA and resection of 1-5 cm distal rectum and in all cloacal anomalies (n = 6) defects of the muscularis propria were seen in the rectal-atresia sac. These defects were characterized by hypoplasia of the circular-muscle layer and/or the internal anal sphincter (IAS). Intestinal neuronal dysplasia of the submucous plexus was most frequently observed (12%) in high-type AA. A correlation between innervation anomalies or anomalies of the muscularis propria and the type of fistula could not be seen. In conclusion, all cases with high-type AA and cloacal anomalies were characterized by anomalies of the muscularis propria and/or IAS but this was not the case in intermediate and low-type AAs. Anomalies of the enteric nervous system were diagnosed in 60% of AAs.

  13. Prevalence of cutaneous beta and gamma human papillomaviruses in the anal canal of men who have sex with women

    Directory of Open Access Journals (Sweden)

    Vitaly Smelov

    2017-06-01

    Full Text Available Background: Data regarding anal cutaneous HPV detection among HIV-positive and HIV-negative persons largely relies on studies among men who have sex with men in limited geographical settings. Understanding the distribution, determinants, and potential human health effects of anal cutaneous HPV types among men who have sex with women (MSW is important. Methods: Anal canal swab samples from 415 Russian MSW (384 HIV-negative and 31 HIV-positive were tested for 43 β-HPVs and 29 γ-HPVs, using a multiplex PCR combined with Luminex technology. Results: β-HPV was detected in 24.4% and γ-HPV in 15.9% of anal samples of all Russian MSW. In total, 34 β-HPV and 19 γ-HPV types were detected, with the most commonly detected β-HPV types being 110, 22 and 124 and the most common γ-HPV types being 95, 132 and 50. For both genera, being HIV-positive at the time of testing was a significant determinant of detection (74.2% for β-HPVs and 48.4% for γ-HPVs compared to 20.1% and 12.5% in HIV-negative MSW, respectively. Conclusions: A wide spectrum and moderate prevalence of anal β-HPV and γ-HPV types was found in our MSW study sample, suggesting that routes other than penile-anal intercourse may be important in cutaneous HPV transmission. Keywords: Anal cutaneous HPV, Beta-HPV, Gamma-HPV, HIV-negative MSW, Penile-anal, HPV transmission

  14. Clinical application of continent anal plug in bedridden patients with intractable diarrhea.

    Science.gov (United States)

    Kim, J; Shim, M C; Choi, B Y; Ahn, S H; Jang, S H; Shin, H J

    2001-08-01

    Some patients bedridden from various causes such as stroke or spinal cord injury experience poor control of bowel movement. This causes fecal leakage and diarrhea, increases the risk of perianal excoriation and bed sores, and is a burden on caregivers. To evaluate the efficacy of fecal evacuation and the prevention and treatment of skin complications in intractable diarrhea patients using a new device. A continent anal plug (US Patent No. 5 569 216) comprises an inner balloon surrounded by an outer balloon, both of which are mounted on a silicone tube containing a pair of air passages and an enema fluid inlet. The tube is secured in place in the rectum by the inflatable outer balloon and is designed to drain fecal matter through a thin collapsible hose situated in the anal canal. Thirty-two patients (21 male; median age 61 (range, 28-76) years) were evaluated after fully informed consent. Median duration was 12 (range, 3-37) days. The continent anal plug evacuated efficiently in those patients with loose or watery stools who only required irrigation once daily or not at all. Skin excoriations improved in three to seven days. Minimal leakage was seen around the anus. There was no anorectal mucosal injury noted over 37 days. The continent anal plug is an efficient method of treating patients with loss of bowel control and incontinence because it enables controlled fecal evacuation and helps reduce skin complications without causing anorectal mucosal injury.

  15. Behavioral and psychosocial correlates of anal sex among male clients of female sex workers in Tijuana, Mexico.

    Science.gov (United States)

    Semple, Shirley J; Strathdee, Steffanie A; Pitpitan, Eileen V; Chavarin, Claudia; Patterson, Thomas L

    2015-05-01

    Most studies of heterosexual sex risk practices have focused on condomless vaginal sex despite evidence that condomless anal sex has a significantly higher risk of HIV transmission. The present study focused on male clients' anal sex practices with female sex workers (FSWs) in Tijuana, Mexico, where an HIV epidemic is growing among high-risk groups. Logistic regression analyses were used to identify psychosocial and behavioral correlates of anal sex among male clients. Our sample of HIV-negative men (N = 400) was predominantly Latino (87.5 %), born in Mexico (78.8 %), never married (36.8 %) or in a regular or common-law marriage (31.5 %), and employed (62.8 %), with an average age and education of 37.8 and 9.2 years, respectively. Eighty-nine percent identified as heterosexual and 11 % as bisexual. By design, 50 % of the sample resided in Tijuana and the other 50 % in San Diego County. Nearly half (49 %) reported at least one incident of anal sex with a FSW in Tijuana in the past 4 months; of those participants, 85 % reported that one or more of their anal sex acts with FSWs had been without a condom. In a multivariate model, anal sex with a FSW in the past 4 months was associated with bisexual identification, methamphetamine use with FSWs, repeat visits to the same FSW, higher scores on perceived stigma about being a client of FSWs, and sexual compulsivity. Prevention programs are needed that address the behavioral and psychosocial correlates of heterosexual anal sex in order to reduce HIV/STI transmission risk among male clients, FSWs, and their sexual network members.

  16. Development of Cerebral Metastasis after Medical and Surgical Treatment of Anal Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Andrew Austin Gassman

    2012-01-01

    Full Text Available Squamous cell carcinoma of the anus is a relatively uncommon GI malignancy. When it does occur, it metastasizes in only a small minority of patients. Spread of anal squamous cell carcinoma to the brain is exceedingly rare, and has been previously reported only three times in the medical literature. We report the case of a 67 year old male who was diagnosed on presentation with a poorly differentiated anal squamous cell carcinoma that already had a solitary metastasis to the liver. While the tumors were initially responsive to chemoradiotherapy, the patient’s primary and liver lesions recurred. The patient then underwent synchronous abdominoperineal resection for the primary lesion and a liver lobectomy for the metastasis. Soon thereafter, the patient developed focal neurologic symptoms and was found to have an intracranial lesion that on biopsy demonstrated metastatic squamous cell carcinoma. This case highlights the fact that patients with a previous history of anal squamous cell carcinoma can occasionally develop cerebral metastasis. Furthermore, cerebral metastases from anal squamous cell carcinoma portend a dismal prognosis even in the face of aggressive medical and surgical therapy.

  17. Uptake and Predictors of Anal Cancer Screening in Men Who Have Sex With Men

    Science.gov (United States)

    D'Souza, Gypsyamber; Rajan, Shirani D.; Bhatia, Rohini; Cranston, Ross D.; Plankey, Michael W.; Silvestre, Anthony; Ostrow, David G.; Wiley, Dorothy; Shah, Nisha; Brewer, Noel T.

    2013-01-01

    Objectives. We investigated attitudes about and acceptance of anal Papanicolaou (Pap) screening among men who have sex with men (MSM). Methods. Free anal Pap screening (cytology) was offered to 1742 MSM in the Multicenter AIDS Cohort Study, who reported history of, attitudes about, and experience with screening. We explored predictors of declining screening with multivariate logistic regression. Results. A history of anal Pap screening was uncommon among non–HIV-infected MSM, but more common among HIV-infected MSM (10% vs 39%; P < .001). Most participants expressed moderate or strong interest in screening (86%), no anxiety about screening (66%), and a strong belief in the utility of screening (65%). Acceptance of screening during this study was high (85%) across all 4 US sites. Among those screened, most reported it was “not a big deal” or “not as bad as expected,” and 3% reported that it was “scary.” Declining to have screening was associated with Black race, anxiety about screening, and low interest, but not age or HIV status. Conclusions. This study demonstrated high acceptance of anal Pap screening among both HIV-infected and non–HIV-infected MSM across 4 US sites. PMID:23865658

  18. Anal Cytology and Human Papillomavirus Genotyping in Women With a History of Lower Genital Tract Neoplasia Compared With Low-Risk Women.

    Science.gov (United States)

    Robison, Katina; Cronin, Beth; Bregar, Amy; Luis, Christine; DiSilvestro, Paul; Schechter, Steven; Pisharodi, Latha; Raker, Christina; Clark, Melissa

    2015-12-01

    To compare the prevalence of abnormal anal cytology and high-risk human papillomavirus (HPV) among women with a history of HPV-related genital neoplasia with women without a history of HPV-related genital neoplasia. A cross-sectional cohort study was performed from December 2012 to February 2014. Women were recruited from outpatient clinics at an academic medical center. Women with a history of high-grade cervical, vulvar, or vaginal cytology, dysplasia, or cancer were considered the high-risk group. Women with no history of high-grade anogenital dysplasia or cancer were considered the low-risk group. Human immunodeficiency virus-positive women were excluded. Anal cytology and HPV genotyping were performed. Women with abnormal anal cytology were referred for high-resolution anoscopy. There were 190 women in the high-risk group and 83 in the low-risk group. The high-risk group was slightly older: 57 years compared with 47 years (P=.045); 21.7% of low-risk women had abnormal anal cytology compared with 41.2% of high-risk women (P=.006). High-risk HPV was detected in the anal canal of 1.2% of the low-risk group compared with 20.8% of the high-risk group (PHuman immunodeficiency virus-negative women with a history of lower genital tract neoplasia are more likely to have positive anal cytology, anal high-risk HPV, and anal intraepithelial neoplasia. Anal cancer screening should be considered for these high-risk women. II.

  19. Intensity-modulated radiation therapy for anal carcinoma

    International Nuclear Information System (INIS)

    Peiffert, D.; Moreau-Claeys, M.V.; Tournier-Rangeard, L.; Huger, S.; Marchesi, V.

    2011-01-01

    Anal canal carcinoma are highly curable by irradiation, combined with chemotherapy in locally advanced disease, with preservation of sphincter function. The clinical target volume for the nodes is extended, often including the inguinal nodes, which is not usual for other pelvic tumours. Acute and late effects are correlated with the volume and dose delivered to organs at risk, i. e. small bowel, bladder and increased by concomitant chemotherapy. Intensity modulated irradiation (IMRT) makes it possible to optimize the dose distribution in this 'complex U shaped' volume, while maintaining the dose distribution for the target volumes. The conversion from conformal irradiation to IMRT necessitates good knowledge of the definition and skills to delineate target volumes and organs at risk, including new volumes needed to optimize the dose distribution. Dosimetric and clinical benefits of IMRT are described, based on early descriptions and evidence-based publication. The growing development of IMRT in anal canal radiotherapy must be encouraged, and long-term benefits should be soon published. Radiation oncologists should precisely learn IMRT recommendations before starting the technique, and evaluate its early and late results for adverse effects, but also for long-term tumour control. (authors)

  20. Analüütilised voolud psühholoogias ja nende rakendamine pedagoogikas / Aleksander Elango

    Index Scriptorium Estoniae

    Elango, Aleksander, 1902-2004

    2001-01-01

    Analüütise psühholoogia kolm koolkonda - S.Freudì koolkond e. päris-psühhoanalüüs, A.Adlerì koolkond e. individuaalpsühholoogia ja C.G.Jungì psühhoanalüüsi ja individuaalpsühholoogia sünteesi luua püüdev koolkond. Analüütise psühholoogia koolkondade ja pedagoogika suhetest

  1. De chirurgische betekenis van de inwendige kringspier van het anale kanaal : een klinisch en manometrisch onderzoek

    NARCIS (Netherlands)

    W.R. Schouten (Ruud)

    1990-01-01

    textabstractThe high pressure zone within the anal canal is largely due to the activity of the internal anal sphincter and provides an effective barrier against rectal pressure. The continuous contraction of the internal sphincter also has a congesting effect on the vascular cushions, thereby

  2. Design of sEMG assembly to detect external anal sphincter activity: a proof of concept.

    Science.gov (United States)

    Shiraz, Arsam; Leaker, Brian; Mosse, Charles Alexander; Solomon, Eskinder; Craggs, Michael; Demosthenous, Andreas

    2017-10-31

    Conditional trans-rectal stimulation of the pudendal nerve could provide a viable solution to treat hyperreflexive bladder in spinal cord injury. A set threshold of the amplitude estimate of the external anal sphincter surface electromyography (sEMG) may be used as the trigger signal. The efficacy of such a device should be tested in a large scale clinical trial. As such, a probe should remain in situ for several hours while patients attend to their daily routine; the recording electrodes should be designed to be large enough to maintain good contact while observing design constraints. The objective of this study was to arrive at a design for intra-anal sEMG recording electrodes for the subsequent clinical trials while deriving the possible recording and processing parameters. Having in mind existing solutions and based on theoretical and anatomical considerations, a set of four multi-electrode probes were designed and developed. These were tested in a healthy subject and the measured sEMG traces were recorded and appropriately processed. It was shown that while comparatively large electrodes record sEMG traces that are not sufficiently correlated with the external anal sphincter contractions, smaller electrodes may not maintain a stable electrode tissue contact. It was shown that 3 mm wide and 1 cm long electrodes with 5 mm inter-electrode spacing, in agreement with Nyquist sampling, placed 1 cm from the orifice may intra-anally record a sEMG trace sufficiently correlated with external anal sphincter activity. The outcome of this study can be used in any biofeedback, treatment or diagnostic application where the activity of the external anal sphincter sEMG should be detected for an extended period of time.

  3. Preoperative Therapy for Lower Rectal Cancer and Modifications in Distance From Anal Sphincter

    International Nuclear Information System (INIS)

    Gavioli, Margherita; Losi, Lorena; Luppi, Gabriele; Iacchetta, Francesco; Zironi, Sandra; Bertolini, Federica; Falchi, Anna Maria; Bertoni, Filippo; Natalini, Gianni

    2007-01-01

    Purpose: To assess the frequency and magnitude of changes in lower rectal cancer resulting from preoperative therapy and its impact on sphincter-saving surgery. Preoperative therapy can increase the rate of preserving surgery by shrinking the tumor and enhancing its distance from the anal sphincter. However, reliable data concerning these modifications are not yet available in published reports. Methods and Materials: A total of 98 cases of locally advanced cancer of the lower rectum (90 Stage uT3-T4N0-N+ and 8 uT2N+M0) that had undergone preoperative therapy were studied by endorectal ultrasonography. The maximal size of the tumor and its distance from the anal sphincter were measured in millimeters before and after preoperative therapy. Surgery was performed 6-8 weeks after therapy, and the histopathologic margins were compared with the endorectal ultrasound data. Results: Of the 90 cases, 82.5% showed tumor downsizing, varying from one-third to two-thirds or more of the original tumor mass. The distance between the tumor and the anal sphincter increased in 60.2% of cases. The median increase was 0.73 cm (range, 0.2-2.5). Downsizing was not always associated with an increase in distance. Preserving surgery was performed in 60.6% of cases. It was possible in nearly 30% of patients in whom the cancer had reached the anal sphincter before the preoperative therapy. The distal margin was tumor free in these cases. Conclusion: The results of our study have shown that in very low rectal cancer, preoperative therapy causes tumor downsizing in >80% of cases and in more than one-half enhances the distance between the tumor and anal sphincter. These modifications affect the primary surgical options, facilitating or making sphincter-saving surgery possible

  4. High prevalence and incidence of HPV-related anal cancer precursor lesions in HIV-positive women in the late HAART era.

    Science.gov (United States)

    Hidalgo-Tenorio, Carmen; de Jesus, Samantha E; Esquivias, Javier; Pasquau, Juan

    2017-12-02

    Anal cancer is one of the most common non-AIDS defining malignancies, especially in men who have sex with men and women living with HIV (WLHIV). To evaluate the prevalence and incidence of precursor lesions (high-grade squamous intraepithelial lesions [HSIL]) and anal cancer in our cohort of women and to compare them to cervical lesions; to calculate the percentage of patients that acquire and clear oncogenic genotypes (HR-HPV) in the anal canal; and to determine predictive factors for anal HPV infection. Prospective-longitudinal study (May 2012-December 2016). At baseline (V1) and follow up visits, anal mucosa samples were taken in liquid medium for cytology and HPV PCR. In cases of abnormal anal cytology and/or positive HR-HPV PCR results, a high resolution anoscopy was performed. Patients were also referred to the gynaecologist. Ninety five women with an average age of 43.7years were included. At baseline, 11.6% had cervical abnormalities (4.1% CIN1, 2.2% CIN2/3, 1.1% cervical cancer), 64.3% anal abnormalities (50% LSIL/AIN1, 9.5% HSIL/AIN2/3 and 2.4% anal cancer) and 49.4% had HR-HPV genotypes. During 36months of follow up, the incidence of anal HSIL was 16×1,000 person-years; 14.8% acquired HR-HPV genotypes and 51.2% cleared them, P=.007. No patients presented CIN1/2/3/ or cervical cancer. In the multivariate analysis we found the following predictive factors for HR-HPV infection: smoking (RR: 1.55, 95%CI: 0.99-2.42), number of sexual partners >3 (RR: 1.69; 95%CI: 1.09-2.62), cervical and anal dysplasia (RR: 1.83; 95%CI: 1.26-2.67) and (RR: 1.55; 95%CI: 1.021-2.35), respectively. Despite clearance rates of anal oncogenic genotypes being higher than acquisition rates, prevalence and incidence of HSIL were still high and greater than cervical HSIL. Therefore, screening for these lesions should perhaps be offered to all WLHIV. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights

  5. Anal cytological abnormalities and epidemiological correlates among men who have sex with men at risk for HIV-1 infection

    Directory of Open Access Journals (Sweden)

    Donà Maria

    2012-10-01

    Full Text Available Abstract Background The incidence of anal cancer, a Human Papillomavirus (HPV-related neoplasia, has been increasing in recent decades, mainly in men who have sex with men (MSM. Cytological changes of the anal epithelium induced by HPV can be detected through an anal pap smear. This study aimed to evaluate the prevalence and epidemiological correlates of anal cytological abnormalities among relatively young MSM at risk for HIV-1 infection, to help clarify whether or not this population deserves further investigation to assess the presence of anal cancer precursor lesions. Methods MSM were recruited among attendees of a large STI clinic for a HIV-1 screening program. Anal samples, collected with a Dracon swab in PreservCyt, were used both for liquid-based cytology and HPV testing by the Linear Array HPV Genotyping Test. Data regarding socio-demographic characteristics and sexual behavior were collected in face-to-face interviews. Results A total of 346 MSM were recruited (median age 32 years. Overall, 72.5% of the individuals had an anal HPV infection, with 56.1% of them being infected by oncogenic HPV genotypes. Anal cytological abnormalities were found in 29.8% of the cases (16.7% ASC-US and 13.1% L-SIL. Presence of ASC-US+ was strongly associated with infection by any HPV type (OR=4.21, 95% CI: 1.97-9.23, and particularly by HPV 16 and/or 18 (OR=5.62, 95% CI: 2.33-13.81. A higher proportion of ASC-US+ was found in older MSM, in those with a higher number of lifetime partners and in those with a history of ano-genital warts. However, none of these variables or the others analyzed showed any significant association with abnormal cytological findings. Conclusions The presence of anal cytological abnormalities in about one third of the recruited MSM and their strong association with HPV infection, in particular that caused by HPV 16 and/or 18, might provide a further complement to the data that now support the introduction of HPV vaccination among

  6. Anal cytological abnormalities and epidemiological correlates among men who have sex with men at risk for HIV-1 infection.

    Science.gov (United States)

    Donà, Maria Gabriella; Benevolo, Maria; Vocaturo, Amina; Palamara, Guido; Latini, Alessandra; Giglio, Amalia; Moretto, Domenico; Rollo, Francesca; Impara, Giampaolo; Ensoli, Fabrizio; Pimpinelli, Fulvia; Di Carlo, Aldo; Giuliani, Massimo

    2012-10-16

    The incidence of anal cancer, a Human Papillomavirus (HPV)-related neoplasia, has been increasing in recent decades, mainly in men who have sex with men (MSM). Cytological changes of the anal epithelium induced by HPV can be detected through an anal pap smear. This study aimed to evaluate the prevalence and epidemiological correlates of anal cytological abnormalities among relatively young MSM at risk for HIV-1 infection, to help clarify whether or not this population deserves further investigation to assess the presence of anal cancer precursor lesions. MSM were recruited among attendees of a large STI clinic for a HIV-1 screening program. Anal samples, collected with a Dracon swab in PreservCyt, were used both for liquid-based cytology and HPV testing by the Linear Array HPV Genotyping Test. Data regarding socio-demographic characteristics and sexual behavior were collected in face-to-face interviews. A total of 346 MSM were recruited (median age 32 years). Overall, 72.5% of the individuals had an anal HPV infection, with 56.1% of them being infected by oncogenic HPV genotypes. Anal cytological abnormalities were found in 29.8% of the cases (16.7% ASC-US and 13.1% L-SIL). Presence of ASC-US+ was strongly associated with infection by any HPV type (OR = 4.21, 95% CI: 1.97-9.23), and particularly by HPV 16 and/or 18 (OR = 5.62, 95% CI: 2.33-13.81). A higher proportion of ASC-US+ was found in older MSM, in those with a higher number of lifetime partners and in those with a history of ano-genital warts. However, none of these variables or the others analyzed showed any significant association with abnormal cytological findings. The presence of anal cytological abnormalities in about one third of the recruited MSM and their strong association with HPV infection, in particular that caused by HPV 16 and/or 18, might provide a further complement to the data that now support the introduction of HPV vaccination among MSM to protect them from the development of HPV

  7. Adenocarcinoma in the anal canal after ileal pouch-anal anastomosis for familial adenomatous polyposis using a double-stapled technique: report of two cases

    NARCIS (Netherlands)

    Vrouenraets, Bart C.; van Duijvendijk, Peter; Bemelman, Willem A.; Offerhaus, G. Johan A.; Slors, J. Frederik M.

    2004-01-01

    Restorative proctocolectomy with an ileal pouch-anal anastomosis is thought to abolish the risk of colorectal adenoma development in patients suffering from familial adenomatous polyposis. Both after mucosectomy with a handsewn anastomosis and after a double-stapled anastomosis, rectal mucosa is

  8. Prevalence of and risk factors for anal human papillomavirus infection in men who have sex with women: a cross-national study.

    Science.gov (United States)

    Nyitray, Alan G; Smith, Dan'elle; Villa, Luisa; Lazcano-Ponce, Eduardo; Abrahamsen, Martha; Papenfuss, Mary; Giuliano, Anna R

    2010-05-15

    Although the primary cause of anal cancer is human papillomavirus (HPV) infection in the anal canal, little attention has been paid to the epidemiology of anal HPV infection in men who have sex with women (MSW). Exfoliated cells from the anal canal of 902 MSW in Brazil (São Paulo), Mexico (Cuernavaca), and the United States (Tampa) were tested for HPV DNA. The prevalence of HPV infection in the anal canal (12.0%) was similar among MSW in each city (P=.77), whereas 7.0% had infection with oncogenic types. Men in Tampa had a 4-fold higher prevalence of infection with HPV type 16 (HPV-16) than that among men in São Paulo or Cuernavaca (PMen who have a larger lifetime number of female sex partners, who are in a sexual relationship of men were most likely to have an anal HPV infection.

  9. Time-dose considerations in the treatment of anal cancer

    International Nuclear Information System (INIS)

    Constantinou, Eugene C.; Daly, William; Fung, Claire Y.; Willett, Christopher G.; Kaufman, Donald S.; DeLaney, Thomas F.

    1997-01-01

    Purpose: To analyze the impact of patient and treatment parameters in concurrent chemoradiation treatment for anal carcinoma. Methods and Materials: Retrospective review of 50 MO anal cancer patients treated from 1984-1994. Most patients received concurrent 5-FU, mitomycin, and radiation. Local control and disease-free/overall survival were determined and analyzed according to patient and treatment parameters. Results: With 43 month median follow-up, projected overall survival is 66% at 5 and 8 years. Disease-free survival is 67% at 5 years and 59% at 8 years. Local control is 70% at 5 and 8 years. Doses of ≥54 Gy are associated with improved 5-year survival (84 vs. 47%, p = 0.02), disease-free survival (74 v. 56%, p = 0.09), and local control (77 vs. 61%, p = 0.04). Although local control, disease-free survival, and overall survival were improved in patients whose overall treatment time was <40 days, this was not statistically significant. Outcome in the four patients with pretreatment hemoglobin (Hgb) <10 appeared worse with 3-year overall survival 50 vs. 68% (p = 0.07), disease-free survival 0 vs. 67% (p = 0.11), and local control 0 vs. 74% (p = 0.05). Projected 5-year overall survival, relapse-free survival, and local control in 4 HIV (+) patients is 0, 75, and 75%. Multivariate analysis reveals that dose (p 0.02) and Hgb (p = 0.05) independently affect local control, dose (p = 0.02) affects disease-free survival, and dose (p = 0.01), Hgb (p = 0.03), T-stage (p = 0.03), and HIV-status (0.07) independently influence overall survival. Conclusion: Radiation doses of ≥54 Gy are associated with significantly improved survival and local control in anal cancer patients treated with chemoradiation. Overall treatment times of less than 40 days are associated with a trend towards improved outcome, but this is not significant. Pretreatment hemoglobin <10 is associated with worse treatment outcome. Survival of HIV (+) patient is poor, but the majority of such patients

  10. Analytic and clinical performance of cobas HPV testing in anal specimens from HIV-positive men who have sex with men.

    Science.gov (United States)

    Wentzensen, Nicolas; Follansbee, Stephen; Borgonovo, Sylvia; Tokugawa, Diane; Sahasrabuddhe, Vikrant V; Chen, Jie; Lorey, Thomas S; Gage, Julia C; Fetterman, Barbara; Boyle, Sean; Sadorra, Mark; Tang, Scott Dahai; Darragh, Teresa M; Castle, Philip E

    2014-08-01

    Anal human papillomavirus (HPV) infections are common, and the incidence of anal cancer is high in HIV-infected men who have sex with men (MSM). To evaluate the performance of HPV assays in anal samples, we compared the cobas HPV test (cobas) to the Roche Linear Array HPV genotyping assay (LA) and cytology in HIV-infected MSM. Cytology and cobas and LA HPV testing were conducted for 342 subjects. We calculated agreement between the HPV assays and the clinical performance of HPV testing and HPV genotyping alone and in combination with anal cytology. We observed high agreement between cobas and LA, with cobas more likely than LA to show positive results for HPV16, HPV18, and other carcinogenic types. Specimens testing positive in cobas but not in LA were more likely to be positive for other markers of HPV-related disease compared to those testing negative in both assays, suggesting that at least some of these were true positives for HPV. cobas and LA showed high sensitivities but low specificities for the detection of anal intraepithelial neoplasia grade 2/3 (AIN2/3) in this population (100% sensitivity and 26% specificity for cobas versus 98.4% sensitivity and 28.9% specificity for LA). A combination of anal cytology and HPV genotyping provided the highest accuracy for detecting anal precancer. A higher HPV load was associated with a higher risk of AIN2/3 with HPV16 (P(trend) < 0.001), HPV18 (P(trend) = 0.07), and other carcinogenic types (P(trend) < 0.001). We demonstrate that cobas can be used for HPV detection in anal cytology specimens. Additional tests are necessary to identify men at the highest risk of anal cancer among those infected with high-risk HPV. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  11. Tracking vaginal, anal and oral infection in a mouse papillomavirus infection model.

    Science.gov (United States)

    Hu, Jiafen; Budgeon, Lynn R; Cladel, Nancy M; Balogh, Karla; Myers, Roland; Cooper, Timothy K; Christensen, Neil D

    2015-12-01

    Noninvasive and practical techniques to longitudinally track viral infection are sought after in clinical practice. We report a proof-of-principle study to monitor the viral DNA copy number using a newly established mouse papillomavirus (MmuPV1) mucosal infection model. We hypothesized that viral presence could be identified and quantified by collecting lavage samples from cervicovaginal, anal and oral sites. Nude mice infected at these sites with infectious MmuPV1 were tracked for up to 23 weeks starting at 6 weeks post-infection. Viral DNA copy number was determined by SYBR Green Q-PCR analysis. In addition, we tracked viral DNA load through three complete oestrous cycles to pinpoint whether there was a correlation between the DNA load and the four stages of the oestrous cycle. Our results showed that high viral DNA copy number was reproducibly detected from both anal and cervicovaginal lavage samples. The infection and disease progression were further confirmed by histology, cytology, in situ hybridization, immunohistochemistry and transmission electron microscopy. Interestingly, the viral copy number fluctuated over the oestrous cycle, with the highest level at the oestrus stage, implying that multiple sampling might be necessary to provide a reliable diagnosis. Virus DNA was detected in oral lavage samples at a later time after infection. Lower viral DNA load was found in oral samples when compared with those in anal and vaginal tracts. To our knowledge, our study is the first in vivo study to sequentially monitor papillomavirus infection from mucosal anal, oral and vaginal tracts in a preclinical model.

  12. The male bulbospongiosus muscle and its relation to the external anal sphincter.

    Science.gov (United States)

    Peikert, Kevin; Platzek, Ivan; Bessède, Thomas; May, Christian Albrecht

    2015-04-01

    The bulbospongiosus muscle is part of the superficial muscular layer of the perineum and pelvic floor. Its morphology remains controversial in the literature. Therefore, we reinvestigated the fascial arrangement and fiber courses of the bulbospongiosus muscle and its topographical relation to the external anal sphincter. The perineum was dissected in 9 male cadavers (mean ± SD age 78.3 ± 10.7 years). Select samples were obtained for histology and immunohistochemistry. In 43 patients (mean age 60.7 ± 12 years) the topographical relation between the bulbospongiosus muscle and the external anal sphincter was determined by magnetic resonance imaging. The perineum contains several fascial layers consisting of elastic and collagen fibers as well as bundles of smooth muscle cells. The bulbospongiosus muscle was subdivided into a ventral and dorsal portion, which developed in 4 variants. The ventral insertion formed a morphological unity with the ischiocavernous muscle while the dorsal origin had a variable relation to the external anal sphincter (5 variants). A muscle-like or connective tissue-like connection was frequently present between the muscles. However, in some cases the muscles were completely separated. We suggest a concept of variations of bulbospongiosus muscle morphology that unifies the conflicting literature. Its ventral fiber group and the ischiocavernosus muscle form a functional and morphological unity. While the bulbospongiosus muscle and the external anal sphincter remain independent muscles, their frequent connection might have clinical implications for perineal surgery and anogenital disorders. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  13. FDG-PET/CT in the evaluation of anal carcinoma

    International Nuclear Information System (INIS)

    Cotter, Shane E.; Grigsby, Perry W.; Siegel, Barry A.

    2006-01-01

    Purpose: Surgical staging and treatment of anal carcinoma has been replaced by noninvasive staging studies and combined modality therapy. In this study, we compare computed tomography (CT) and physical examination to [ 18 F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (FDG-PET/CT) in the staging of carcinoma of the anal canal, with special emphasis on determination of spread to inguinal lymph nodes. Methods and Materials: Between July 2003 and July 2005, 41 consecutive patients with biopsy-proved anal carcinoma underwent a complete staging evaluation including physical examination, CT, and 2-FDG-PET/CT. Patients ranged in age from 30 to 89 years. Nine men were HIV-positive. Treatment was with standard Nigro regimen. Results: [ 18 F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (FDG-PET/CT) detected 91% of nonexcised primary tumors, whereas CT visualized 59%. FDG-PET/CT detected abnormal uptake in pelvic nodes of 5 patients with normal pelvic CT scans. FDG-PET/CT detected abnormal nodes in 20% of groins that were normal by CT, and in 23% without abnormality on physical examination. Furthermore, 17% of groins negative by both CT and physical examination showed abnormal uptake on FDG-PET/CT. HIV-positive patients had an increased frequency of PET-positive lymph nodes. Conclusion: [ 18 F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography detects the primary tumor more often than CT. FDG-PET/CT detects substantially more abnormal inguinal lymph nodes than are identified by standard clinical staging with CT and physical examination

  14. Cause-specific colostomy rates after radiotherapy for anal cancer: a Danish multicentre cohort study.

    Science.gov (United States)

    Sunesen, Kåre G; Nørgaard, Mette; Lundby, Lilli; Havsteen, Hanne; Buntzen, Steen; Thorlacius-Ussing, Ole; Laurberg, Søren

    2011-09-10

    In anal cancer, colostomy-free survival is a measure of anal sphincter preservation after treatment with radiotherapy or chemoradiotherapy. Failure to control anal cancer and complications of treatment are alternative indications for colostomy. However, no data exist on cause-specific colostomy rates. We examined this in a cohort study. Through national registries and review of medical records, we identified patients with anal cancer diagnosed from 1995 to 2003 who had curative-intent radiotherapy or chemoradiotherapy in four Danish centers. We computed cumulative incidence of tumor-related colostomy and therapy-related colostomy, treating colostomy and death as competing events. Follow-up started at completion of radiotherapy and continued throughout 2008. We used competing risk regression to compute hazard ratios (HRs) to compare the cumulative incidence of cause-specific colostomies between age, sex, tumor size, chemotherapy, and local excision before radiotherapy. We included 235 patients with anal cancer. The 5-year cumulative incidences of tumor-related and therapy-related colostomy were 26% (95% CI, 21% to 32%) and 8% (95% CI, 5% to 12%), respectively. Tumor size greater than 6 cm versus less than 4 cm was a risk factor for tumor-related colostomy (adjusted HR, 3.8; 95% CI, 1.7 to 8.1), and local excision before radiotherapy was a risk factor for therapy-related colostomy (adjusted HR, 4.5; 95% CI, 1.5 to 13.5). After curative-intent radiotherapy or chemoradiotherapy, one third of patients had a colostomy, of which one third were related to therapy. Large tumor size was associated with a higher risk of tumor-related colostomy, whereas history of prior excision was associated with an increased incidence of therapy-related colostomy.

  15. Gender Nonconformity and Birth Order in Relation to Anal Sex Role Among Gay Men.

    Science.gov (United States)

    Swift-Gallant, Ashlyn; Coome, Lindsay A; Monks, D Ashley; VanderLaan, Doug P

    2018-05-01

    Androphilia is associated with an elevated number of older brothers among natal males. This association, termed the fraternal birth order effect, has been observed among gay men who exhibit marked gender nonconformity. Gender nonconformity has been linked to gay men's preferred anal sex role. The present study investigated whether these two lines of research intersect by addressing whether the fraternal birth order effect was associated with both gender nonconformity and a receptive anal sex role (243 gay men, 91 heterosexual men). Consistent with previous research, we identified the fraternal birth order effect in our sample of gay men. Also, gay men were significantly more gender-nonconforming on adulthood and recalled childhood measures compared to heterosexual men. When gay men were compared based on anal sex role (i.e., top, versatile, bottom), all groups showed significantly greater recalled childhood and adult male gender nonconformity than heterosexual men, but bottoms were most nonconforming. Only gay men with a bottom anal sex role showed evidence of a fraternal birth order effect. A sororal birth order effect was found in our sample of gay men, driven by versatiles. No significant associations were found between fraternal birth order and gender nonconformity measures. These results suggest that the fraternal birth order effect may apply to a subset of gay men who have a bottom anal sex role preference and that this subgroup is more gender-nonconforming. However, there were no significant associations between fraternal birth order and gender nonconformity at the individual level. As such, based on the present study, whether processes underpinning the fraternal birth order effect influence gender nonconformity is equivocal.

  16. Comparison of anal HPV natural history among men by country of residence: Brazil, Mexico, and the United States.

    Science.gov (United States)

    Sudenga, Staci L; Nyitray, Alan G; Torres, B Nelson; Silva, Roberto; Villa, Luisa; Lazcano-Ponce, Eduardo; Abrahamsen, Martha; Baggio, Maria Luiza; Salmeron, Jorge; Quiterio, Manuel; Giuliano, Anna R

    2017-07-01

    Globally, anal cancer incidence is rare, but is increasing in some world regions. Our objective was to assess differences in anal HPV natural history in three countries. Men aged 18-70 years were recruited from the US (n = 634), Mexico (n = 665), and Brazil (n = 731). Anal specimens were collected every six-months. HPV genotyping was assessed by Linear Array. Anal HPV prevalence was compared using the Fisher's exact test. HPV infection incidence rates (IR) and 95% confidence intervals (CI) were calculated. Any anal HPV prevalence was highest among men from Brazil (24%) compared to Mexico (15%) and the US (15%). When stratified by sexual history, the prevalence of any HPV among MSM/MSMW was 43%, 37%, and 45% and 9%, 12%, and 10% for MSW from Brazil, Mexico, and US, respectively. Any HPV incidence was significantly higher among men from Brazil compared to US men (IRR = 2.4, 95% CI = 1.7-3.4) and comparable between men from Mexico and the US (IRR = 1.2, 95% CI = 0.8-1.8). Men in Brazil and Mexico often have similar, if not higher incidence of anal HPV compared to men from the U.S., and may benefit from gender neutral HPV vaccine policies. Copyright © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  17. Relationship between external anal sphincter atrophy at endoanal magnetic resonance imaging and clinical, functional, and anatomic characteristics in patients with fecal incontinence

    NARCIS (Netherlands)

    Terra, Maaike P.; Deutekom, Marije; Beets-Tan, Regina G. H.; Engel, Alexander F.; Janssen, Lucas W. M.; Boeckxstaens, Guy E. E.; Dobben, Annette C.; Baeten, Cor G. M. I.; de Priester, Jacobus A.; Bossuyt, Patrick M. M.; Stoker, Jaap

    2006-01-01

    PURPOSE: External anal sphincter atrophy at endoanal magnetic resonance imaging has been associated with poor outcome of anal sphincter repair. We studied the relationship between external anal sphincter atrophy on endoanal magnetic resonance imaging and clinical, functional, and anatomic

  18. coloproctectomie avec anastomose colo-sus-anale pour tumeur ...

    African Journals Online (AJOL)

    Une coloproctectomie fut réalisée le 30/06/2014 avec anastomose colo-anale, colostomie de protection sous-couvert d'une transfusion sanguine. L'examen histologique du segment colorectal prélevé objectiva une rectocolite granulomateuse autour de nombreux oeufs de schistosomes. En effet, le patient a vécu à Pahou, ...

  19. Acute anal stretch inhibits NMDA-dependent pelvic-urethra reflex potentiation via spinal GABAergic inhibition in anesthetized rats.

    Science.gov (United States)

    Chen, Sung-Lang; Huang, Yu-Hui; Kao, Yu-Lin; Chen, Gin-Den; Cheng, Chen-Li; Peng, Hsien-Yu; Liao, Jiuan-Miaw; Huang, Pei-Chen; Tsai, Shih-Jei; Lin, Tzer-Bin

    2008-10-01

    The impact of acute anal stretch on the pelvic-urethra reflex potentiation was examined in urethane-anesthetized rats by recording the external urethra sphincter electromyogram activity evoked by the pelvic afferent stimulation. Test stimulation (1 stimulation/30 s) evoked a baseline reflex activity with a single action potential that was abolished by gallamine (5 mg/kg iv). On the other hand, the repetitive stimulation (1 stimulation/1 s) induced spinal reflex potentiation (SRP) that was attenuated by intrathecal 6-cyano-7-nitroquinoxaline-2,4-dione (a glutamatergic alpha-amino-3-hydroxy-5-methyl-4-isoxazoleproprionat receptor antagonist, 100 microM, 10 microl) and d-2-amino-5-phosphonovalerate [a glutamatergic N-methyl-D-aspartate (NMDA) antagonist, 100 microM, 10 microl]. Acute anal stretch using a mosquito clamp with a distance of 4 mm exhibited no effect, whereas distances of 8 mm attenuated and 12 mm abolished the repetitive stimulation-induced SRP. Intrathecal NMDA (100 microM, 10 microl) reversed the abolition on SRP caused by anal stretch. On the other hand, pretreated bicuculline [gamma-aminobutyric acid (GABA) A receptor antagonist, 100 microM, 10 microl] but not hydroxysaclofen (GABAB receptor antagonist) counteracted the abolition on the repetitive stimulation-induced SRP caused by the anal stretch. All of the results suggested that anal stretch may be used as an adjunct to assist voiding dysfunction in patients with overactive urethra sphincter and that GABAergic neurotransmission is important in the neural mechanisms underlying external urethra sphincter activity inhibited by anal stretch.

  20. Postpartum two- and three-dimensional ultrasound evaluation of anal sphincter complex in women with obstetric anal sphincter injury.

    Science.gov (United States)

    Ros, C; Martínez-Franco, E; Wozniak, M M; Cassado, J; Santoro, G A; Elías, N; López, M; Palacio, M; Wieczorek, A P; Espuña-Pons, M

    2017-04-01

    To compare the sensitivity and specificity of two- (2D) and three- (3D) dimensional transperineal ultrasound (TPUS) and 3D endovaginal ultrasound (EVUS) with the gold standard 3D endoanal ultrasound (EAUS) in detecting residual defects after primary repair of obstetric anal sphincter injuries (OASIS). External (EAS) and internal (IAS) anal sphincters were evaluated by the four ultrasound modalities in women with repaired OASIS. 2D-TPUS was evaluated in real-time, whereas 3D-TPUS, 3D-EVUS and 3D-EAUS volumes were evaluated offline by six blinded readers. The presence/absence of any tear in EAS or IAS was recorded and defects were scored according to the Starck system. Sensitivity, specificity and predictive values were calculated, using 3D-EAUS as reference standard. Inter- and intraobserver analyses were performed for all 3D imaging modalities. Association between patients' symptoms (Wexner score) and ultrasound findings (Starck score) was calculated. Images from 55 patients were analyzed. Compared with findings on 3D-EAUS, the agreement for EAS evaluation was poor for 3D-EVUS (κ = 0.01), fair for 2D-TPUS (κ = 0.30) and good for 3D-TPUS (κ = 0.73). The agreement for IAS evaluation was moderate for both 3D-EVUS (κ = 0.41) and 2D-TPUS (κ = 0.52) and good for 3D-TPUS (κ = 0.66). Good intraobserver (3D-EAUS, κ = 0.73; 3D-TPUS, κ = 0.78) and interobserver (3D-EAUS, κ = 0.68; 3D-TPUS, κ = 0.60) agreement was reported. Significant association between Starck and Wexner scores was found only for 3D-EAUS (Spearman's rho = 0.277, P = 0.04). 2D-TPUS and 3D-EVUS are not accurate modalities for the assessment of anal sphincters after repair of OASIS. 3D-TPUS shows good agreement with the gold standard 3D-EAUS and a high sensitivity in detecting residual defects. It, thus, has potential as a screening tool after primary repair of OASIS. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2016 ISUOG

  1. Clinical, manometric, and ultrasonographic results of pneumatic balloon dilatation vs. lateral internal sphincterotomy for chronic anal fissure: a prospective, randomized, controlled trial.

    Science.gov (United States)

    Renzi, Adolfo; Izzo, Domenico; Di Sarno, Giandomenico; Talento, Pasquale; Torelli, Francesco; Izzo, Giuseppe; Di Martino, Natale

    2008-01-01

    This prospective, randomized, controlled trial was designed to compare the clinical, functional, and morphologic results of pneumatic balloon dilatation with lateral internal sphincterotomy for the treatment of chronic anal fissure. All patients with symptomatic chronic anal fissure were randomly assigned to pneumatic balloon dilatation or lateral internal sphincterotomy and invited to complete a standardized questionnaire inquiring about their symptoms. Anal ultrasonography and anal manometry were performed before and six months after surgery. A proctologic examination was performed between the fifth and sixth postoperative weeks. Anal continence, scored by using a validated continence grading scale, was evaluated preoperatively at 1 and 6 weeks and at 12 and 24 months. Fifty-three patients, who satisfied selection criteria, were enrolled in the trial. Four patients (7.5 percent) were lost to follow-up. Twenty-four patients (11 males; mean age, 42 +/- 8.2 years) underwent pneumatic balloon dilatation and 25 patients (10 males; mean age, 44 +/- 7.3 years) underwent lateral internal sphincterotomy. Fissure-healing rates were 83.3 percent in the pneumatic balloon dilatation and 92 percent in the lateral internal sphincterotomy group. Recurrent anal fissure was observed in one patient (4 percent) after lateral internal sphincterotomy. At anal manometry, mean resting pressure decrements obtained after pneumatic balloon dilatation and lateral internal sphincterotomy were 30.5 and 34.3 percent, respectively. After pneumatic balloon dilatation, anal ultrasonography did not show any significant sphincter damage. At 24-month follow-up, the incidence of incontinence, irrespective of severity, was 0 percent in the pneumatic balloon dilatation group and 16 percent in the lateral internal sphincterotomy group (P < 0.0001). As lateral internal sphincterotomy, pneumatic balloon dilatation grants a high anal fissure-healing rate but with a statistically significant reduction in

  2. Radiochemotherapy in Anal Cancer: cCR, clinical outcomes and quality of life using two different treatment schedules.

    Science.gov (United States)

    Di Santo, Sara; Trignani, Marianna; Neri, Matteo; Milano, Angelo; Innocenti, Paolo; Taraborrelli, Maria; Augurio, Antonietta; Vinciguerra, Annamaria; Di Tommaso, Monica; Ursini, Lucia Anna; Di Pilla, Angelo; Di Nicola, Marta; Genovesi, Domenico

    2015-01-01

    Main endpoint was a response rate to therapy; secondary endpoints were disease-free survival, overall survival, acute and late toxicities, specially in terms of anorectal and urinary continence. Radiochemotherapy for anal cancer achieves a good clinical response, locoregional control, anal function preservation. However, oncologic outcomes can differ using radiotherapy plus fluorouracil and mytomicin vs. cisplatin and fluorouracil. Between 2000 and 2012, 27 anal cancer patients receiving radiotherapy combined with two different radiochemotherapy schedules, fluorouracil and mytomicin (group A) and cisplatin plus fluorouracil (group B). The Kaplan-Meier method was also used to estimate local control, overall survival and disease free survival. Statistical significance between curves was evaluated using the Log-rank test. Complete pathological response was found in 85.2% of patients, with higher rates of response in the group A (100% vs. 63.6%, p = 0.039). No significantly difference was found between the two groups for the other endpoints. Low rates of both acute and late toxicities were recorded. Radiotherapy plus fluorouracil and mytomicin provide a better complete pathological response than radiotherapy plus cisplatin and fluorouracil and a greater rate of anal sphincter function preservation. Globally, radiochemotherapy of the anal cancer provides excellent clinical outcomes with a good profile of acute and late toxicity, without difference between the two groups studied.

  3. Design and Psychometric Evaluation of the Quality of Life in Patients With Anal Fistula Questionnaire.

    Science.gov (United States)

    Ferrer-Márquez, Manuel; Espínola-Cortés, Natalia; Reina-Duarte, Angel; Granero-Molina, José; Fernández-Sola, Cayetano; Hernández-Padilla, José Manuel

    2017-10-01

    Quality of life is often considered when deciding and evaluating the treatment strategy for patients diagnosed with anal fistula. The purpose of this study was to develop and psychometrically test the Quality of Life in Patients with Anal Fistula Questionnaire. This was an observational cross-sectional study for the development and validation of a psychometric tool. The study was conducted at a general hospital in the southeast of Spain. A convenience sample included 54 patients diagnosed with anal fistula. The reliability of the tool was assessed through its internal consistency (Cronbach α) and temporal stability (Spearman correlation coefficient (r) between test-retest). The content validity index of the items and the scale was calculated. Correlation analysis and an ordinal regression analysis between the developed tool and the Short Form 12 Health Survey examined its concurrent validity. Principal component analysis and known-group analysis using the Kruskal-Wallis test examined its construct validity. The reliability of the developed questionnaire was very high (α = 0.908; r = 0.861; p questionnaire to detect expected differences in patients presenting with different symptomatology. The major limitations of this study were the use of a small sample of Spanish-speaking patients, not including patients in the initial development of the questionnaire, and developing the scoring system using a summation method. The Quality of Life in Patients with Anal Fistula Questionnaire has proven to be a valid, reliable, and concise tool that could contribute to the evaluation of quality of life among patients with an anal fistula. See Video Abstract at http://links.lww.com/DCR/A368.

  4. RA reactor kinetic parameters - Progress report; Kineticki parametri reaktora RA - Izvestaj o napredovanju -

    Energy Technology Data Exchange (ETDEWEB)

    Petrovic, M; Obradovic, D; Jevtovic, V; Velickovic, Lj [Institute of nuclear sciences Boris Kidric, Vinca, Beograd (Yugoslavia)

    1965-11-15

    The objective of nuclear reactor kinetics study is to analyze the stability of reactor operation in practice. The obtained parameters should define the needed properties of automatic control system relevant for the stability of the designed reactor system. Refining the analytical models is done by using the analysis and interpretation of experimental data. Results of measured the reactor response obtained by using the reactor oscillator ROB-1 are explained by using the space independent model of the zero power reactor, by power reactor model with one feedback circuit, and by a complex model. It was assumed that the perturbations of the system are small and that linearized kinetic equations could be used. Linearized kinetic equation of the reactor system are transformed into the frequency region in order to analyze the measured values directly. The objective of this paper is to measure the RA reactor kinetics parameters, and analyze the stability of reactor operation at power levels high than nominal. Istrazivanja u oblasti kinetike nuklearnih reaktora imaju za cilj da dovedu analizu stabilnosti rada reaktora na nivo 'radne tehnologije'. Dobijeni pararametri treba da specificiraju potrebne karakteristike sistema automatske kontrole za odgovarajucu stabilnost projektovanog reaktorskog sistema. Doterivanjem analitickih modela do takvog nivoa da se zapazeni fenomeni mogu anailitcki predvideti ide preko analize i interpretacije eksperimentalnih podataka. Eksperimentalni rezultati merenja odziva reaktora, izvedeni reaktorskim oscilatorom ROB-1, interpretirani su na osnovu prostorno nezavisnog modela za reaktor nulte snage, modelom reaktora snage sa jednim kolom povratne sprege, kao i kompleksnim modelom. U ovom radu se poslo od toga da su perturbacije parametara sistema male, pa se mogu upotrebiti linearizovane kineticke jednacine. Linearizovane kineticke jednacine reaktorskog sistema transformirane su u frekventno podrucje s ciljem direktne analize mernih rezultata

  5. Radiological diagnosis in constipation and anal incontinence due to changes in the pelvic floor and sphincter apparatus of the anus

    International Nuclear Information System (INIS)

    Bistolfi, F.; Grillo Ruggeri, F.; Siragusa, A.

    1987-01-01

    Rectal constipation, anal incontinence and constipation combined with incontinence, are often caused by organic or simply functional changes in the pelvic floor and sphincterial apparatus. Therefore morphological as well as manometric and electromyographic studies of these anatomical parts are required. This is possible by combining two techniques: Intestinal Transit Time (ITT) and Defecatory Proctogram with Balloon (DPB). Personal experience of 38 patients with constipation with or without incontinence is reported. The results lead to the following conclusion: 1) ITT is a simple and non-invasive radiological technique that provides us with objective evidence of an impairment, i.e. constipation, whose symptoms are often only subjective; especially is allows us to identify rectal constipation, that can be caused by impairment of the anal sphincteral apparatus. 2) Using an uroprophylactic with a collar that adapts to the size of the anal duct, DPB always permits visualization of the duct with good representation of the recto-anal angle, whose changes may be the expression of organic or only functional impairments of the anal sphincterial apparatus. Increasing use of the two radiological techniques is therefore recommended in the diagnosis of alterations of the pelvic floor or anal sphincter

  6. Rectocele and anal sphincter defect – surgical anatomy and ...

    African Journals Online (AJOL)

    carefully directed translabial ultrasound scan of the rectum and anal sphincters. The ultrasound examination was performed by a radi- ologist with specific understanding of the pathology. Conventional two-dimensional ultrasound imaging was performed using a 4 - 8. MHz curved array probe. The patient was in the left ...

  7. Clinical Application of F-18 FDG PET (PET/CT) in Colo-rectal and Anal Cancer

    International Nuclear Information System (INIS)

    Kim, Byung Il

    2008-01-01

    In the management of colo-retal and anal cancer, accurate staging, treatment evaluation, early detection of recurrence are main clinical problems. F-18 FDG PET (PET/CT) has been reported as useful in the management of colo-rectal and anal cancer because that PET has high diagnostic performance comparing to conventional studies. In case of liver metastases, for confirmation of no extrahepatic metastases, in case of high risk of metastasis, for avoiding unnecessary operation, PET (PET/CT) is expected more useful. In anal cancer, PET is expected useful in lymph node staging. For the early prediction of chemotherapy or radiation therapy effect PET has been reported as useful, also. In early detection of recurrence by PET, cost-benefit advantages has been suggested, also. PET/CT is expected to have higher diagnostic performance than PET alone

  8. Preoperative chemoradiotherapy and colonic J-pouch anal anastomosis for lower rectal cancer

    International Nuclear Information System (INIS)

    Inoue, Yasuhiro; Okigami, Masato; Kawamoto, Aya; Hiro, Junichiro; Toiyama, Yuji; Kobayashi, Minako; Tanaka, Koji; Miki, Chikao; Kusunoki, Masato

    2011-01-01

    We performed colonic J-pouch anal anastomosis in 61 patients with rectal cancer located <4 cm from the anal verge. Surgical and oncological results were evaluated in multimodality therapy for advanced rectal cancer. According to Wexner's score, 7% of patients were fully continent, 71% had acceptable function with minor continence problems, and 22% were incontinent. No patients required intermittent self-catheterization during follow-up. After a median follow-up of 49 months, there was only 1 case of local recurrence after surgery. Our surgical approach irrespective of internal sphincter resection produces satisfactory functional and oncological results in multimodality therapy using preoperative chemoradiotherapy for lower rectal cancer. (author)

  9. Anal carcinomas: the role of endoanal ultrasound and magnetic resonance imaging in staging, response evaluation and follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Parikh, Jyoti; Shaw, Aidan; Griffin, Nyree [Guys and St. Thomas' Hospital, Department of Radiology, London (United Kingdom); Grant, Lee A. [Royal Marsden Hospital, Department of Radiology, London (United Kingdom); Schizas, Alexis M.P.; Datta, Vivek; Williams, Andrew B. [Guys and St. Thomas' Hospital, Department of General Surgery, London (United Kingdom)

    2011-04-15

    Anal carcinoma is an important but rare condition, managed in specialist centres. Both endoanal ultrasound and magnetic resonance imaging (MRI) can be used in the locoregional staging and follow-up of patients with anal cancer, and both may assist in treatment planning and prognosis. Recent guidelines published by the European Society for Medical Oncology have recommended MRI as the technique of choice for assessment of locoregional disease. This paper describes the techniques for both endoanal ultrasound and MRI, and compares the relative merits and disadvantages of each in the local assessment of anal carcinoma. (orig.)

  10. Posterior perineal support as treatment for anal fissures--preliminary results with a new toilet seat device.

    Science.gov (United States)

    Tan, Kok-Yang; Seow-Choen, Francis; Hai, Chew Heng; Thye, Gan Kok

    2009-03-01

    Anal fissures can cause morbidity in an otherwise healthy young patient. The process of evacuation results in stretching and descent of the anoderm and perineum especially posteriorly. Posterior perineal support may provide counter pressure at the posterior aspect of the pelvic floor, balancing the pressure exerted by the faeces on the anal wall, thus improving evacuation and reducing the trauma associated with it, and reducing symptoms of anal fissures. Symptoms of constipation may also be reduced secondarily. We report the preliminary results with a novel, simple and noninvasive method of treatment provided by a toilet seat device. A prospective study was performed in 32 patients. The study was designed mainly to investigate the patients' subjective perceptions of their symptoms related to anal fissures and constipation. Questionnaires were provided to patients before, during and after treatment. The study revealed statistically significant improvement in pain, bleeding, symptoms of constipation and abdominal discomfort after 3 months usage of the device. The odds of patients perceiving an improvement in symptoms were also significantly increased after 3 months of treatment compared to 2 weeks of treatment. This preliminary study revealed that a posterior perineal support device can bring about significant improvement in the symptoms of patients with anal fissures. There may also be secondary benefits of a reduction in the symptoms of constipation. Although not conclusive, these results should serve as a springboard for further research into this area.

  11. The diagnostic accuracy of endovaginal and transperineal ultrasound for detecting anal sphincter defects: The PREDICT study

    Energy Technology Data Exchange (ETDEWEB)

    Roos, A.-M., E-mail: annemarie.roos@gmail.com [Department of Obstetrics and Gynaecology, Mayday University Hospital, Croydon (United Kingdom); Abdool, Z. [Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria (South Africa); Sultan, A.H.; Thakar, R. [Department of Obstetrics and Gynaecology, Mayday University Hospital, Croydon (United Kingdom)

    2011-07-15

    Aim: To determine the accuracy and predictive value of transperineal (TPU) and endovaginal ultrasound (EVU) in the detection of anal sphincter defects in women with obstetric anal sphincter injuries and/or postpartum symptoms of faecal incontinence. Materials and methods: One hundred and sixty-five women were recruited, four women were excluded as they were seen years after their last delivery. TPU and EVU, followed by endonanal ultrasound (EAU), were performed using the B and K Viking 2400 scanner. Sensitivity and specificity, as well as predictive values with 95% confidence intervals, for detecting anal sphincter defects were calculated for EVU and TPU, using EAU as the reference standard. Results: On EAU a defect was found in 42 (26%) women: 39 (93%) had an external (EAS) and 23 (55%) an internal anal sphincter (IAS) defect. Analysable images of one level of the EAS combined with an analysable IAS were available in 140 (87%) women for EVU and in 131 (81%) for TPU. The sensitivity and specificity for the detection of any defect was 48% (30-67%) and 85% (77-91%) for EVU and 64% (44-81%) and 85% (77-91%) for TPU, respectively. Conclusion: Although EAU using a rotating endoprobe is the validated reference standard in the identification of anal sphincter defects, it is not universally available. However while TPU and/or EVU with conventional ultrasound probes can be useful in identifying normality, for clinical purposes they are not sensitive enough to identify an underlying sphincter defect.

  12. The diagnostic accuracy of endovaginal and transperineal ultrasound for detecting anal sphincter defects: The PREDICT study

    International Nuclear Information System (INIS)

    Roos, A.-M.; Abdool, Z.; Sultan, A.H.; Thakar, R.

    2011-01-01

    Aim: To determine the accuracy and predictive value of transperineal (TPU) and endovaginal ultrasound (EVU) in the detection of anal sphincter defects in women with obstetric anal sphincter injuries and/or postpartum symptoms of faecal incontinence. Materials and methods: One hundred and sixty-five women were recruited, four women were excluded as they were seen years after their last delivery. TPU and EVU, followed by endonanal ultrasound (EAU), were performed using the B and K Viking 2400 scanner. Sensitivity and specificity, as well as predictive values with 95% confidence intervals, for detecting anal sphincter defects were calculated for EVU and TPU, using EAU as the reference standard. Results: On EAU a defect was found in 42 (26%) women: 39 (93%) had an external (EAS) and 23 (55%) an internal anal sphincter (IAS) defect. Analysable images of one level of the EAS combined with an analysable IAS were available in 140 (87%) women for EVU and in 131 (81%) for TPU. The sensitivity and specificity for the detection of any defect was 48% (30-67%) and 85% (77-91%) for EVU and 64% (44-81%) and 85% (77-91%) for TPU, respectively. Conclusion: Although EAU using a rotating endoprobe is the validated reference standard in the identification of anal sphincter defects, it is not universally available. However while TPU and/or EVU with conventional ultrasound probes can be useful in identifying normality, for clinical purposes they are not sensitive enough to identify an underlying sphincter defect.

  13. Hereditary vacuolar internal anal sphincter myopathy causing proctalgia fugax and constipation: a new case contribution.

    Science.gov (United States)

    de la Portilla, Fernando; Borrero, Juan José; Rafel, Enrique

    2005-03-01

    Hereditary anal sphincter myopathy is rare. We present a family with one affected member with proctalgia fugax, constipation and internal anal sphincter hypertrophy. Ultrastructural findings show vacuolization of smooth muscle cells without the characteristic polyglucosan inclusion. Further relief of symptoms was obtained using an oral calcium antagonist. Based on clinical presentation, endosonography and morphological findings, we consider our case is a histological variant of the vacuolar myopathy originally described.

  14. Prevalence of anal infection due to high-risk human papillomavirus and analysis of E2 gene integrity among women with cervical abnormalities.

    Science.gov (United States)

    Gonzalez-Losa, María Del Refugio; Puerto-Solís, Marylin; Ayora-Talavera, Guadalupe; Gómez-Carvallo, Jesús; Euán-López, Alejandra; Cisneros-Cutz, José I; Rosado-López, Ariel; Echeverría Salazar, Jesúa; Conde-Ferráez, Laura

    2018-04-01

    High-risk human papillomaviruses (HR-HPV) infection has been associated with 90% of anal cancer cases. Women with abnormal cytology are a high-risk group to develop anal neoplasia. The aim of this study is to describe the prevalence and epidemiology of HR-HPV 16, 18, 45, and 58 anal infections in women with cervical abnormalities, as well as to assess E2 gene integrity. A cross-sectional study was performed on 311 cervical and 311 anal samples from patients with abnormal cytology in two colposcopy clinics in Yucatan, Mexico. A specific PCR for oncogenes was performed in order to identify HVP 16, 18, 45 and 58. Real time PCR was used to amplify the whole HPV 16, 18, and 58 E2 gene to verify its integrity in anal samples. High risk HPV 16, 18, 58, and/or 45 were found in 41.47% (129/311) of cervical samples, and in 30.8% (96/331) of anal samples, with 18% (57/311) of the patients being positive in both samples. The same genotypes in both anatomical sites were observed in 11.25% (35/311). The E2 gene was disrupted in 82% of all tested samples. The frequency of genome disruption viral integration in anal samples by genotype was: HPV 58 (97.2%); HPV 16 (72.4%), and HPV 18 (0%). Women with cervical disease have HR-HPV anal infections, and most of them have the E2 gene disrupted, which represents a risk to develop anal cancer. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  15. Unsatisfactory exfoliative anal cytology samples, 15-year experience with histologic, cytologic, and molecular follow-up.

    Science.gov (United States)

    Khattab, Ruba; McMeekin, Emily; Taege, Alan J; Hekman, James M; Brainard, Jennifer A; Underwood, Dawn; Procop, Gary W; Sturgis, Charles D

    2018-02-01

    The incidence of anal carcinoma has risen in recent decades. Exfoliative cytology screening of selected high risk patients is performed in many centers. Unsatisfactory cytology results are frustrating to patients, clinicians, and laboratorians. The aim of this study is to ascertain outcomes of patients with non-diagnostic anal cytology. A retrospective review of anal cytology testing performed at the Cleveland Clinic between 01/01/2001 and 12/31/2015 was performed. All cases were received as liquid-based samples and processed as ThinPreps (Hologic, Marlborough, MA). Co-testing for HR-HPV DNA was performed using Hybrid Capture 2® (Qiagen, Germantown, MD) in the majority of patients. Of 1,276 ThinPrep anal cytology samples, 130 (10%) were deemed unsatisfactory. 77% of patients were HIV positive. 85% were males. Of the unsatisfactory cases, 116 (89%) were co-tested for HR-HPV DNA. Of those, 40 patients (34%) had a simultaneous positive HR-HPV DNA. Adequate follow up cytology within a one year and a two year period revealed that 18/130 (14%) and 26/130 (20%) of patients had ASC or SIL respectively. Histologic follow-up within one and two years showed 3 patients (2%) and 8 patients (6%) with HSIL or worse. High risk patients with unsatisfactory anal cytology are not "negative". At least one-third proved to be concomitantly HR-HPV DNA positive with one-fifth showing subsequent cytologic squamous abnormalities and with more than 5% being diagnosed with a high grade intraepithelial lesion within two years. Prompt repeat cytology and/or HR-HPV DNA is recommended for high risk patients with non-diagnostic cytology. © 2017 Wiley Periodicals, Inc.

  16. Incidence, Trends and Ethnic Differences of Oropharyngeal, Anal and Cervical Cancers: Singapore, 1968-2012

    Science.gov (United States)

    Lam, Jennifer O.; Lim, Wei-Yen; Chow, Khuan-Yew; D’Souza, Gypsyamber

    2015-01-01

    In recent decades, several Western countries have reported an increase in oropharyngeal and anal cancers caused by human papillomavirus (HPV). Trends in HPV-associated cancers in Asia have not been as well described. We describe the epidemiology of potentially HPV-related cancers reported to the Singapore Cancer Registry from 1968–2012. Analysis included 998 oropharyngeal squamous cell carcinoma (OPSCC), 183 anal squamous cell carcinoma (ASCC) and 8,019 invasive cervical cancer (ICC) cases. Additionally, 368 anal non-squamous cell carcinoma (ANSCC) and 2,018 non-oropharyngeal head and neck carcinoma (non-OP HNC) cases were included as comparators. Age-standardized incidence rates (ASR) were determined by gender and ethnicity (Chinese, Malay and Indian). Joinpoint regression was used to evaluate annual percentage change (APC) in incidence. OPSCC incidence increased in both genders (men 1993–2012, APC = 1.9%, pSingapore, but Pap screening programs have led to consistently decreasing incidence. PMID:26720001

  17. [Clinical significance of detection of internal anal sphincter in children with functional constipation].

    Science.gov (United States)

    Hou, Xiang-yu; Wang, Ling-yun; Wang, Wei-lin; Li, Yong; Bai, Yu-zuo

    2011-10-01

    To investigate the structural and functional changes of internal anal sphincter (IAS) in children with functional constipation (FC), and to evaluate the association between the thickness of IAS and the severity of clinical symptoms. A total of 35 children with FC(constipation group,17 with incontinence) between June 2008 and December 2008 at the Shengjing Hospital of China Medical University were evaluated using anal manometry and endosonography. These patients were compared to 23 hospitalized children who were excluded for digestive and endocrinal diseases(control group). A validated symptom score(SS) was used to assess the severity of symptoms. The sum of SS ranged between 0 and 65. Anorectal manometry showed reflex relaxation of IAS in response to distension of rectal balloon in all patients. Rectal perceptional threshold in FC group was significantly higher than that in the controls[(42.4 ± 19.5) ml vs.(29.1 ± 15.6) ml, PIAS was significantly higher than that in the controls [(55.6 ± 31.6) ml vs.(30.5 ±13.8) ml, PIAS was noted in all the patients[(3.8 ± 1.7) mm vs.(2.5 ± 1.0) mm, P0.05]. The median symptom score was 9.3 ± 4.3 in the FC group. The thickness of IAS correlated significantly with total symptom severity score(r=0.407, PIAS and age, sex, or duration of disease(P>0.05). Structural and functional changes of internal anal sphincter exist in children with functional constipation. The thickness of internal anal sphincter correlates significantly with symptom severity.

  18. Feasibility of preference-driven radiotherapy dose treatment planning to support shared decision making in anal cancer

    DEFF Research Database (Denmark)

    Rønde, Heidi S; Wee, Leonard; Pløen, John

    2017-01-01

    PURPOSE/OBJECTIVE: Chemo-radiotherapy is an established primary curative treatment for anal cancer, but clinically equal rationale for different target doses exists. If joint preferences (physician and patient) are used to determine acceptable tradeoffs in radiotherapy treatment planning, multipl...... that preference-informed dose planning is feasible for clinical studies utilizing shared decision making....... dose plans must be simultaneously explored. We quantified the degree to which different toxicity priorities might be incorporated into treatment plan selection, to elucidate the feasible decision space for shared decision making in anal cancer radiotherapy. MATERIAL AND METHODS: Retrospective plans.......7%-points; (0.3; 30.6); p decision space available in anal cancer radiotherapy to incorporate preferences, although tradeoffs are highly patient-dependent. This study demonstrates...

  19. Clinical and manometric evaluation of women with chronic anal fissure before and after internal subcutaneous lateral sphincterotomy

    Directory of Open Access Journals (Sweden)

    Silvana Marques e Silva

    2012-06-01

    Full Text Available OBJECTIVE: To evaluate clinical and manometric parameters of chronic anal fissure females undergoing lateral internal sphincterotomy (LIS. METHODS: A total of eight women with chronic anal fissure who underwent LIS were included in this study. The preoperative assessment was performed one week before surgery and included general and anorectal examination, anorectal manometry, and Jorge Wexner questionnaire. The post operative follow up was made every 15 days until complete healing. Jorge Wexner questionnaires and anorectal manometry were repeated at 1 month and 3 months after the surgery. Time to healing, manometric changes and complications were assessed. RESULTS: All patients had preoperative increased anal resting pressure. The resting pressures and anal canal length were significantly decreased 3 months after surgery. Patients' complaints of itching and bleeding were also reduced. Fissures healed in 7 patients and median healing time was 45 days. No complications were observed due to the procedure. One patient had transient incontinence to flatus. CONCLUSION: Lateral internal sphincterotomy provided clinical improvement and reduced resting pressure of the internal anal sphincter in women with chronic anal fissure.OBJETIVO: Avaliar a evolução clínica e manométrica de mulheres com fissura anal crônica submetidas à esfincterotomia lateral interna subcutânea. MÉTODOS: Estudo prospectivo com oito pacientes. A avaliação inicial foi realizada por meio de questionários, exame físico e manometria anorretal na semana anterior ao procedimento cirúrgico. Durante o período pós-operatório, as pacientes foram avaliadas clinicamente a cada 15 dias, até a cicatrização completa. Os questionários e a manometria anorretal foram repetidos 1 mês e 3 meses após a operação. Foi avaliado o tempo para cicatrização da fissura, as alterações manométricas e as complicações decorrentes do procedimento. RESULTADOS: Todas as pacientes

  20. Identification of episomal human papillomavirus and other DNA viruses in cytological anal samples of HIV-uninfected men who have sex with men.

    Directory of Open Access Journals (Sweden)

    Maria Gabriella Donà

    Full Text Available To date, there have been only few studies that investigated integration of anal Human Papillomavirus (HPV. Most of them were conducted on HIV-infected individuals and mainly analyzed samples from high-grade lesions and invasive cancer. We aimed to investigate HPV physical status in HIV-negative men who have sex with men (MSM with a detectable anal HPV infection, irrespective of the presence of lesions. We also sought to explore the presence of other circular DNA viruses in the anal region. Study participants were attendees of an STI screening program, which were also screened for anal HPV infection and cytological abnormalities. HPV physical status was assessed using multiply-primed RCA. HPV16-positive samples were also analyzed using E2/E6 multiplex PCR, qRT-PCR and APOT assay. RCA and virus-specific PCR were employed to investigate the presence of other DNA viruses. Anal HPV infection was detected in 76.9% of the 230 MSM enrolled. The anal cytological reports were: 129 NILM, 37 ASC-US and 28 L-SIL (36 samples were inadequate for interpretation. HPV physical status was evaluated in the 109 anal specimens that harbored one or two different HPV genotypes. Integration was observed only in one HPV16-positive sample (0.9%, in which integrate-derived viral transcripts of type B were detected. Integration occurred in chromosome 14 q. In 22 of the 53 (41.5% mucosal HPV-negative samples, RCA restriction results would seem to indicate the presence of circular DNA viruses. Indeed, cutaneous HPV (4 samples, MCPyV (5 samples and TTV (4 samples were detected. In conclusion, anal HPV integration was rarely evidenced in HIV-uninfected MSM with no or mild anal cytological abnormalities, although the integration rate may have been underestimated because of the limitations of the employed assays. Other DNA viruses were detected in the anal samples of these individuals, although the significance of this occurrence needs to be assessed.

  1. Quality of life outcomes in patients with anal cancer after combined radiochemotherapy

    International Nuclear Information System (INIS)

    Welzel, Grit; Haegele, Verena; Wenz, Frederik; Mai, Sabine Kathrin

    2011-01-01

    Purpose: To assess self-reported quality of life (QoL) experienced by anal cancer patients after radiochemotherapy, and to identify patient- and disease-related factors associated with QoL. Patients and Methods: A total of 88 patients treated for anal cancer at our institution between 1990 and 2006 were identified from our database. Of these, 15 patients had died, and 4 were lost to follow-up. QoL was assessed using the EORTC QLQ-C30 questionnaire (cancer-specific QoL) and the colorectal cancer module QLQ-CR38 (site-specific QoL); 52 responses were received. The median follow-up was 36 months (range, 5-137 months). Results: As for cancer-specific QoL, global health QoL score (mean 60.4) was similar to the general German population, whereas most of the function and symptom scale scores were considerably lower/higher in anal cancer patients. The most prominent mean score differences were observed in role functioning (-21.8 points), emotional functioning (-20.7 points), social functioning (-28.9 points), diarrhea (+34.6 points), and financial difficulties (+26.9 points; p < 0.001). As for site-specific QoL, the mean function scale scores ranged from 22.1 (sexual function) to 63.2 (body image), and the mean symptom scale scores from 14.7 (weight loss) to 69.0 (stoma-related problems, 4 patients) and 67.9 (male sexual dysfunction), respectively. Most of the QoL scores were not affected by late toxicity, patient- or disease-related factors. Fatigue (+18.2 points) emerged as the strongest predictor of impaired QoL. Conclusion: The global health QoL of anal cancer patients is comparable with that of the general German population, but there are specific limitations, e.g., sexual dysfunction, urological/gastrointestinal complaints, financial difficulties, fatigue, and a reduction in emotional and social well-being. (orig.)

  2. Quality of life outcomes in patients with anal cancer after combined radiochemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Welzel, Grit; Haegele, Verena; Wenz, Frederik; Mai, Sabine Kathrin [Universitaetsklinikum Heidelberg, Mannheim (Germany). Dept. of Radiation Oncology

    2011-03-15

    Purpose: To assess self-reported quality of life (QoL) experienced by anal cancer patients after radiochemotherapy, and to identify patient- and disease-related factors associated with QoL. Patients and Methods: A total of 88 patients treated for anal cancer at our institution between 1990 and 2006 were identified from our database. Of these, 15 patients had died, and 4 were lost to follow-up. QoL was assessed using the EORTC QLQ-C30 questionnaire (cancer-specific QoL) and the colorectal cancer module QLQ-CR38 (site-specific QoL); 52 responses were received. The median follow-up was 36 months (range, 5-137 months). Results: As for cancer-specific QoL, global health QoL score (mean 60.4) was similar to the general German population, whereas most of the function and symptom scale scores were considerably lower/higher in anal cancer patients. The most prominent mean score differences were observed in role functioning (-21.8 points), emotional functioning (-20.7 points), social functioning (-28.9 points), diarrhea (+34.6 points), and financial difficulties (+26.9 points; p < 0.001). As for site-specific QoL, the mean function scale scores ranged from 22.1 (sexual function) to 63.2 (body image), and the mean symptom scale scores from 14.7 (weight loss) to 69.0 (stoma-related problems, 4 patients) and 67.9 (male sexual dysfunction), respectively. Most of the QoL scores were not affected by late toxicity, patient- or disease-related factors. Fatigue (+18.2 points) emerged as the strongest predictor of impaired QoL. Conclusion: The global health QoL of anal cancer patients is comparable with that of the general German population, but there are specific limitations, e.g., sexual dysfunction, urological/gastrointestinal complaints, financial difficulties, fatigue, and a reduction in emotional and social well-being. (orig.)

  3. Treatment results in anal cancer: non-operative treatment versus operative treatment

    Energy Technology Data Exchange (ETDEWEB)

    Chie, Eui Kyu; Park, Jae Gahb; Bang, Yung Jue; Heo, Dae Seog; Kim, Noe Kyeong [Seoul National University College of Medicine, Seoul (Korea, Republic of); Ha, Sung Whan [Medical Reasearch Center, Seoul National University, Seoul (Korea, Republic of)

    2002-03-15

    This study was undertaken to analyze the efficacy and sphincter preservation rate of platinum based neoadjuvant chemotherapy plus radiotherapy versus abdominoperineal resection and postoperative radiotherapy for anal cancer. Data of forty-two patients with anal cancer were retrospectively analyzed. Among thirty-eight patients with epidermoid histology, four patients received radiotherapy, and nineteen patients received abdominoperineal resection and adjuvant radiotherapy with or without chemotherapy (APR + RT {+-} CT), and fifteen patients received neoadjuvant chemotherapy and radiotherapy (CRT). The CRT regimen was composed of three cycles of 5-fluorouracil (1,000 mg/m{sup 2} bolus on D1 {approx} 5) and cisplatin (60 mg/m{sup 2} bolus on D1) followed by 50.4 Gy to the tumor bed and regional lymphatics over 5.5 weeks. Both inguinal lymphatics were treated with an identical dose schedule. Residual disease was treated with an additional three cycles of identical adjuvant chemotherapy. An identical dose schedule was used for post-operative radiotherapy. Median follow-up period was eighty-five months. Overall five-year survival rates were 80.3%, 88.9% and 79.4% for entire patients, APR + RT {+-} CT group, and the CRT group, respectively. No significant difference was found between the two groups ({rho} = 0.49). Anus preservation rate for the CRT group was 86.7%. Age ({rho} = 0.0164) and performance status ({rho} = 0.0007) were found to be significant prognostic factors by univariate analysis. Age ({rho} = 0.0426), performance status ({rho} = 0.0068), and inguinal lymph node metastasis ({rho} = 0.0093) were statistically significant prognostic factors by multivariate analysis. No case of RTOG grade 3 complication or higher was reported. This and other recent studies have shown that combined chemotherapy plus radiotherapy for anal cancer results in a high rate of anal sphincter preservation as well as local control and survival. Furthermore, neoadjuvant use of

  4. Doenças anais concomitantes à doença hemorroidária: revisão de 1.122 pacientes Anal diseases associated to hemorrhoids: review of 1.122 patients

    Directory of Open Access Journals (Sweden)

    Geraldo Magela Gomes da Cruz

    2006-12-01

    Full Text Available Em 34.000 pacientes coloproctológicos foi feito o diagnóstico de doença hemorroidária (DH, como doença coloproctológica principal, em 9.289 pacientes (27,3%, dos quais 1.122 (12,1% eram portadores de doenças anais concomitantes à DH (DAC. Dos 9.289 portadores de DH, 2.417 foram operados de DH (26,0% e destes, 729 foram operados, ao mesmo tempo, de DAC (30,2%. Assim, dos 1.122 portadores de DAC, 729 foram operados delas (65,0%. Em relação aos 9.289 portadores de DH, a DAC mais comum foi a fissura anal (541 casos, 5,8%, seguida de hipertrofia de papilas anais (312 casos, 3,4%, fístulas anais (117 casos, 1,3%, hipotonia anal com incontinência parcial (112 casos, 1,2%, condilomas anais acuminados (37 casos, 0,4% e tumores anais (3 casos, 0,03%; e a mesma ordem foi verificada em relação às 1.122 DAC: fissura anal (48,2%, hipertrofia de papilas anais (27,8%, fístulas anais (10,4%, hipotonia anal com incontinência parcial (10,0%, condilomas anais acuminados (3,3% e tumores anais (0,3%. Em relação à cirurgia, das 1.122 DAC 729 foram operadas (65,0% nesta ordem: fissura anal (317 casos, 28,3%, hipertrofia de papilas anais (267 casos, 23,8%, fístulas anais (89 casos, 7,9%, hipotonia anal com incontinência parcial (31 casos, 2,8%, condilomas anais acuminados (22 casos, 1,9% e tumores anais (3 casos 0,3%; e em relação às próprias DAC as incidências de cirurgias foram: tumor anal (100,0%, hipertrofia de papilas anais (85,6%, fístulas anais (76,0%, condilomas anais acuminados (59,6%, fissuras anais (58,6% e hipotonia com incontinência anal parcial (25,8%. A confirmação dos diagnósticos das DAC pelo exame histopatológico foi de 72,8%, em ordem decrescente: condilomas anais e fístulas anais (100,0%, hipertrofia de papilas anais (79,0%, fissuras anais (68,5% e tumores anais (66,7%.In a 38-year period of practice in Coloproctology, the author had the opportunity to attend 34,000 patients and the diagnosis of hemorrhoid as the

  5. Diseño, fabricación y aplicaciones analíticas de nanocelulosa y sus híbridos

    OpenAIRE

    Ruiz-Palomero, Celia

    2017-01-01

    El gran avance nanotecnológico que ha experimentado la Química Analítica en los últimos años ha sido un indicador del grado de bienestar de la sociedad. La multidisciplinaridad de la Nanociencia y Nanotecnología ha sido esencial para el avance de los métodos y herramientas analíticas, así como para llevar a cabo la automatización, simplificación y miniaturización de los procesos analíticos integrados en los laboratorios [1]. En este campo, son muchos los nanomateriales explorados por sus ...

  6. Congenital anorectal atresia: MR imaging of late post-operative appearances in adult patients with anal incontinence

    International Nuclear Information System (INIS)

    Gartner, Louise; Peiris, Chand; Marshall, Michele; Taylor, Stuart A.; Halligan, Steve

    2013-01-01

    To describe the MR imaging findings in adults presenting with anal incontinence following pull-through perineoplasty for anorectal atresia. 15 adults (12 male, 3 female; age 22-52 years) with anal incontinence following a prior perineal pull-through procedure as an infant for anorectal atresia were identified retrospectively. MR imaging was performed using either an endoanal coil or body coil. MR images were reviewed by three observers who noted whether pelvic floor and sphincter muscles were present and, if so, whether they were thinned or not. Data were tabulated and raw frequencies determined. Images were unavailable for one patient, leaving 14 for analysis. Anal stenosis prevented endoanal coil placement in 5. The pull-through was anatomically correct in 12 (86 %) patients but was misdirected in 2. Thinned muscle was seen in 11 (79 %) patients. External sphincter thinning was commonest (present in 10 patients), with levator plate thinning least common (present in 4 patients). Only one patient had thinning of all muscle groups. MR imaging may be used to determine the extent and quality of residual pelvic floor and anal sphincter muscle in adults who have functional disability following pull-through perineoplasty for anorectal agenesis. (orig.)

  7. High rates of incident and prevalent anal human papillomavirus infection among young men who have sex with men.

    Science.gov (United States)

    Glick, Sara Nelson; Feng, Qinghua; Popov, Viorica; Koutsky, Laura A; Golden, Matthew R

    2014-02-01

    There are few published estimates of anal human papillomavirus (HPV) infection rates among young men who have sex with men (YMSM). We estimated incidence and prevalence of type-specific anal HPV infection using clinician-collected anal swabs for HPV DNA testing obtained during a 1-year prospective study of 94 YMSM (mean age, 21 years) in Seattle. Seventy percent of YMSM had any HPV infection detected during the study, and HPV-16 and/or -18 were detected in 37%. The incidence rate for any new HPV infection was 38.5 per 1000 person-months and 15.3 per 1000 person-months for HPV-16/18; 19% had persistent HPV-16/18 infection. No participant tested positive for all 4 HPV types in the quadrivalent vaccine. The number of lifetime male receptive anal sex partners was significantly associated with HPV infection. The prevalence of HPV-16/18 was 6% among YMSM with a history of 1 receptive anal sex partner and 31% among YMSM with ≥ 2 partners. Although the high prevalence of HPV among YMSM highlights the desirability of vaccinating all boys as a strategy to avert the morbidity of HPV infection, most YMSM appear to remain naive to either HPV-16 or -18 well into their sexual lives and would benefit from HPV immunization.

  8. Influence of human papillomavirus and p16INK4a on treatment outcome of patients with anal cancer

    International Nuclear Information System (INIS)

    Koerber, Stefan Alexander; Schoneweg, Clara; Slynko, Alla; Krug, David; Haefner, Matthias F.; Herfarth, Klaus; Debus, Juergen; Sterzing, Florian; Knebel Doeberitz, Magnus von

    2014-01-01

    Background: The purpose of this study was to evaluate HPV-DNA and p16 INK4a (p16) expression as prognostic markers for outcome in patients with anal cancer. Methods: From January 2000 to December 2011 a cohort of 105 anal cancer patients was treated with definitive chemoradiation at our institution. Tumor biopsies from 90 patients were analyzed for HPV-DNA by polymerase chain reaction and for p16 expression by immunohistochemistry. Results: Median follow-up was 48.6 months (range 2.8–169.1 months). HPV-DNA or p16-expression was found in 75 anal cancers each (83.3%), concordance was detectable in 70 tumors (77.8%). Significantly improved overall survival (OS) [77.1% vs. 51.4%, p = 0.005], progression-free survival (PFS) [64.0% vs. 35.0%, p < 0.001] and improved local control [81.0% vs. 55.9%, p = 0.023] was found for concomitant HPV- and p16-positive anal carcinomas (cHPPAC) in univariate analysis. Multivariate analysis showed better OS [p = 0.015] and PFS [p = 0.002] for cHPPAC. Conclusion: The combination of HPV-DNA and p16 can be used as an independent prognostic parameter in anal cancer patients

  9. [Evaluation of the quality of Anales Españoles de Pediatría versus Medicina Clínica].

    Science.gov (United States)

    Bonillo Perales, A

    2002-08-01

    To compare the scientific methodology and quality of articles published in Anales Españoles de Pediatría and Medicina Clínica. A stratified and randomized selection of 40 original articles published in 2001 in Anales Españoles de Pediatría and Medicina Clínica was made. Methodological errors in the critical analysis of original articles (21 items), epidemiological design, sample size, statistical complexity and levels of scientific evidence in both journals were compared using the chi-squared and/or Student's t-test. No differences were found between Anales Españoles de Pediatría and Medicina Clínica in the critical evaluation of original articles (p > 0.2). In original articles published in Anales Españoles de Pediatría, the designs were of lower scientific evidence (a lower proportion of clinical trials, cohort and case-control studies) (17.5 vs 42.5 %, p 0.05), sample sizes were smaller (p 0.003) and there was less statistical complexity in the results section (p 0.03). To improve the scientific quality of Anales Españoles de Pediatría, improved study designs, larger sample sizes and greater statistical complexity are required in its articles.

  10. Anal lymphogranuloma venereum infection screening with IgA anti-Chlamydia trachomatis-specific major outer membrane protein serology.

    Science.gov (United States)

    de Vries, Henry J C; Smelov, Vitaly; Ouburg, Sander; Pleijster, Jolein; Geskus, Ronald B; Speksnijder, Arjen G C L; Fennema, Johannes S A; Morré, Servaas A

    2010-12-01

    Anal lymphogranuloma venereum (LGV) infections, caused by Chlamydia trachomatis biovar L (Ct+/LGV+), are endemic among men who have sex with men (MSM). Anal non-LGV biovar Ct infections (Ct+/LGV-) can be eradicated with 1 week doxycycline, whereas Ct+/LGV+ infections require 3-week doxycycline. To differentiate Ct+/LGV+ from Ct+/LGV- infections, biovar-specific Nucleic Acid Amplification Test (NAAT) are standard, but also expensive and laborious. A chlamydia-specific serological assay could serve as an alternative test. MSM were screened for anal Ct+/LGV+ and Ct+/LGV- infections with a commercial nonspecific NAAT and an in house biovar L-specific NAAT. Serum samples were evaluated with chlamydia-specific anti-Major Outer Membrane Protein (MOMP) and antilipopolysaccharide assays of IgA and IgG classes. Asymptomatic patients were identified as: (1) no anal complaints or (2) no microscopic inflammation (i.e., <10 leucocytes per high power field in anal smears). The best differentiating assay was subsequently evaluated in 100 Ct+/LGV+ and 100 Ct+/LGV- MSM using different cut-off points. The anti-MOMP IgA assay was the most accurate to differentiate Ct+/LGV+ (n = 42) from Ct+/LGV- (n = 19) with 85.7% sensitivity (95% confidence interval [CI], 72.2-93.3) and 84.2% specificity (95% CI, 62.4-94.5), even among asymptomatic patients. In a population comprising 98 Ct+/LGV+ and 105 Ct+/LGV- patients, the anti-MOMP IgA assay scored most accurate when the cut-off point was set to 2.0 with 75.5% (95% CI, 65.8-83.6) sensitivity and 74.3% (95% CI, 64.8-82.3) specificity. The IgA anti-MOMP assay can identify a considerable proportion of the (asymptomatic) anal LGV infections correctly. Yet, biovar L-specific NAAT are still the preferred diagnostic tests in clinical settings.

  11. The diagnostic accuracy of endovaginal and transperineal ultrasound for detecting anal sphincter defects: The PREDICT study.

    Science.gov (United States)

    Roos, A-M; Abdool, Z; Sultan, A H; Thakar, R

    2011-07-01

    To determine the accuracy and predictive value of transperineal (TPU) and endovaginal ultrasound (EVU) in the detection of anal sphincter defects in women with obstetric anal sphincter injuries and/or postpartum symptoms of faecal incontinence. One hundred and sixty-five women were recruited, four women were excluded as they were seen years after their last delivery. TPU and EVU, followed by endonanal ultrasound (EAU), were performed using the B&K Viking 2400 scanner. Sensitivity and specificity, as well as predictive values with 95% confidence intervals, for detecting anal sphincter defects were calculated for EVU and TPU, using EAU as the reference standard. On EAU a defect was found in 42 (26%) women: 39 (93%) had an external (EAS) and 23 (55%) an internal anal sphincter (IAS) defect. Analysable images of one level of the EAS combined with an analysable IAS were available in 140 (87%) women for EVU and in 131 (81%) for TPU. The sensitivity and specificity for the detection of any defect was 48% (30-67%) and 85% (77-91%) for EVU and 64% (44-81%) and 85% (77-91%) for TPU, respectively. Although EAU using a rotating endoprobe is the validated reference standard in the identification of anal sphincter defects, it is not universally available. However while TPU and/or EVU with conventional ultrasound probes can be useful in identifying normality, for clinical purposes they are not sensitive enough to identify an underlying sphincter defect. Copyright © 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  12. Pelvic floor ultrasound and anal incontinence in primiparous women

    DEFF Research Database (Denmark)

    Sakse, Abelone Elisabeth

    2010-01-01

    Afhandlingen havde til formål at undersøge muskulære forandringer på bækkenbundsmuskulaturen i relation til første fødsel, med særligt fokus på anal inkontinens. Forsvaret fandt sted d. 10. september 2010 kl. 14:00 i Auditoriet på Hvidovre Hospital.   ...

  13. Manejo dos portadores das neoplasias intraepiteliais anais Managment of anal intra-epithelial neoplasia patients

    Directory of Open Access Journals (Sweden)

    Sidney Roberto Nadal

    2008-12-01

    Full Text Available Acredita-se que a neoplasia intraepitelial anal (NIA, provocada pelo HPV, seja a lesão precursora do carcinoma anal. Segundo a literatura, são encontradas entre 11% e 52% dos homens infectados pelo HIV, entre 6% a 20% dos homens e 1% a 2,8% das mulheres sem essa infecção. Entre 8,5% e 13% das NIA de alto grau evoluirão para carcinoma invasivo, indicando a necessidade do rastreamento e do seguimento desses doentes para prevenção. Não há tratamento satisfatório com baixos índices de morbidez e a recidiva é comum. Em geral, as formas de tratamento podem de ser divididas em tópicas, entre elas, ácido tricloroacético, podofilina, podofilotoxina, imiquimod, terapia fotodinâmica, e ablativas, ou seja, excisão cirúrgica, ablação pelo LASER, coagulação pelo infravermelho e eletrofulguração. Há, ainda, os que consideram aceitável a conduta expectante. O tratamento tópico se justifica pelo caráter multifocal da lesão e os ablativos têm taxas de complicação e recidiva muito semelhantes. De qualquer forma, doentes com qualquer anormalidade histológica necessitam de seguimento adequado, principalmente com colposcopia e citologia anal.Anal intra-epithelial neoplasia (AIN, provoked by HPV, is considered as an anal cancer precursor. Some articles noticed that it occurred among 11% and 52% of men who have sex with men (MSM infected with HIV and, among seronegatives, from 6% to 20% of men and from 1% to 2.8% of women. From 8.5% to 13% of high grade AIN will evolve to invasive carcinoma, needing follow-up and screening for prevention. There is no satisfactory treatment with low morbidity and recurrence is frequent. There are two main forms of treatment: topics (trichloroacetic acid, podophylin, podophylotoxin, imiquimod, photodynamic therapy and ablatives (chirurgical excision, LASER, infrared, eletrocautery. Others consider acceptable an expectant management. Topical therapy is justified because of multifocal presentation of HPV

  14. Comentarios sobre dibujo analítico

    OpenAIRE

    Mata Botella, Elena

    2004-01-01

    Cuaderno de apoyo a la docencia del DIBUJO DE ARQUITECTURA que pretende hacer reflexionar al alumno (de primero o segundo de carrera) sobre un tipo de dibujo que aquí se ha llamado “dibujo analítico”. Un dibujo que a través de operaciones gráficas y conceptuales como la esquematización y la selección de información, tiende a alejarse de la descripción del objeto arquitectónico para adentrarse en determinados aspectos o dimensiones que subyacen en el proyecto arquitectónico. Unas notas intr...

  15. Penile duplication and two anal openings; report of a very rare case.

    Science.gov (United States)

    Bakheet, Mohamed Abdel Al M; Refaei, Mohammad

    2012-03-01

    Penile duplication (diphallus) is an extremely rare disorder. It is almost always associated with other malformations like double bladder, exstrophy of the cloacae, imperforate anus, duplication of the rectosigmoid and vertebral deformities. Meanwhile anal canal duplication, the most distal and least common duplication of the digestive tube and is a very rare congenital malformation. A 21 days old Egyptian neonate is reported with complete penile duplication and two scrotums with each one carrying two palpable testes. Both penises have normal shaft with normally located meatus. Clear urine voids from both meati spontaneously. The child had also a fold of redundant skin about 4×5 cm at the anal region in which two separate anal openings are present. In rectal examination we found two normal anuses passing stool spontaneously. Ascending (voiding) cystourethrography revealed two penises with two separate meatuses and one bladder from which the two urethras go out separately. Intravenous pyelogram (IVP) revealed two normal kidneys and ureters. Barium study revealed duplication of rectum and colon, otherwise normal GIT. In our review of the literature, we did not come across any other case of this variety of the penile duplication and congenital presence of two anuses. Unfortunately the patient expired before any surgical correction.

  16. Is dynamic two-dimensional anal ultrasonography useful in the assessment of anismus? A comparison with manometry

    Directory of Open Access Journals (Sweden)

    Sthela Maria Murad-Regadas

    2010-12-01

    Full Text Available CONTEXT: Anismus is a prevalent functional cause of outlet delay. It is characterized by symptoms of obstructed defecation associated with paradoxical contraction of the pelvic floor muscles. OBJECTIVE: To evaluate the ability of two dimensional anal ultrasonography to identify anismus patients with paradoxical contraction or normal relaxation, comparing findings with manometric measurements. METHODS: Forty-nine women presenting with outlet delay and a mean validated Wexner constipation score of 13.5 were included in a prospective study. Following screening with anal manometry, the patients were assigned to one of two groups: G-I -with normal relaxation and G-II -patients with anismus. Dynamic anorectal ultrasonography was used to quantifier the movement of the puborectalis muscle and to measure changes in the angle between two converging lines drawn from the 3 o'clock and the 9 o'clock positions of the endoprobe circumference to the internal border of the puborectalis muscle. The angle decreases during straining in patients with normal relaxation, but increases in patients with anismus. The agreement between the two techniques was verified with the Kappa index. RESULTS: In manometry, during straining the anal canal pressure decreased by 41.3% in G-I and increased by 168.6% in G-II, indicating a diagnosis of anismus for the second group. In US, during straining, the angle produced by the movement of the puborectalis muscle decreased from 63 ± 1.31 to 58 ± 1.509 degrees (P = 0.0135 in 23 of the 30 patients in G-I, indicating normal relaxation, and increased from 66 ± 0.972 to 72 ± 0.897 degrees (P = 0.0001 in 16 of the 19 patients in G-II, indicating anismus. The index of agreement between manometry and two dimensional anal ultrasonography was moderate: 77% (23/30 for G-I and 84% (16/19 for G-II. CONCLUSION: Two-dimensional dynamic anal ultrasonography showed similar results previously suggested by anal manometry at identifying patients with

  17. Is dynamic two-dimensional anal ultrasonography useful in the assessment of anismus? A comparison with manometry.

    Science.gov (United States)

    Murad-Regadas, Sthela Maria; Regadas, Francisco Sérgio P; Barreto, Rosilma Gorete Lima; Rodrigues, Lusmar Veras; Fernandes, Graziela Olivia da Silva; Lima, Doryane Maria dos Reis

    2010-01-01

    Anismus is a prevalent functional cause of outlet delay. It is characterized by symptoms of obstructed defecation associated with paradoxical contraction of the pelvic floor muscles. To evaluate the ability of two dimensional anal ultrasonography to identify anismus patients with paradoxical contraction or normal relaxation, comparing findings with manometric measurements. Forty-nine women presenting with outlet delay and a mean validated Wexner constipation score of 13.5 were included in a prospective study. Following screening with anal manometry, the patients were assigned to one of two groups: G-I -with normal relaxation and G-II -patients with anismus. Dynamic anorectal ultrasonography was used to quantifier the movement of the puborectalis muscle and to measure changes in the angle between two converging lines drawn from the 3 o'clock and the 9 o'clock positions of the endoprobe circumference to the internal border of the puborectalis muscle. The angle decreases during straining in patients with normal relaxation, but increases in patients with anismus. The agreement between the two techniques was verified with the Kappa index. In manometry, during straining the anal canal pressure decreased by 41.3% in G-I and increased by 168.6% in G-II, indicating a diagnosis of anismus for the second group. In US, during straining, the angle produced by the movement of the puborectalis muscle decreased from 63 ± 1.31 to 58 ± 1.509 degrees (P = 0.0135) in 23 of the 30 patients in G-I, indicating normal relaxation, and increased from 66 ± 0.972 to 72 ± 0.897 degrees (P = 0.0001) in 16 of the 19 patients in G-II, indicating anismus. The index of agreement between manometry and two dimensional anal ultrasonography was moderate: 77% (23/30) for G-I and 84% (16/19) for G-II. Two-dimensional dynamic anal ultrasonography showed similar results previously suggested by anal manometry at identifying patients with normal relaxation or paradoxical contraction.

  18. Has F.D.G. PET/CT an impact on the management of patients with anal carcinoma?

    International Nuclear Information System (INIS)

    Vercellino, L.; Nataf, V.; Kerrou, K.; Huchet, V.; Pascal, O.; Montravers, F.; Talbot, J.N.; De Parades, V.; Bauer, P.; Touboul, E.

    2010-01-01

    Purpose: To evaluate the impact of F.D.G. PET/C Ton the management of patients referred for the staging and/or the follow-up of anal carcinoma, and PET/CT on patient management. Patients and methods: We included patients referred to our department for anal carcinoma whose therapeutic management was evaluable thanks to follow-up data during at least 6 months. Results: Data of 44 patients were analysed: 22 had PET/CT for initial staging and 36 during follow-up. PET/CT had impact in nine patients out of 44 (20%) and it was relevant in eight of them. Conclusion: F.D.G. PET/CT is an accurate imaging modality in anal cancer, its impact on patient management is more obvious when persistence or recurrence of disease is suspected. (authors)

  19. Nanopartículas como herramientas analíticas y estudios toxicológicos asociados

    OpenAIRE

    Caballero-Díaz, E.

    2014-01-01

    Las nanopartículas (NPs) exhiben unas magníficas propiedades fisicoquímicas que las hacen ser excelentes candidatas para su uso en numerosos campos de aplicación incluyendo el ámbito de la Química Analítica. Con este fin, las NPs pueden emplearse como materiales sorbentes en los métodos de tratamiento de muestra que constituyen la primera etapa de la mayoría de los procedimientos analíticos [1]. La enorme habilidad de adsorción superficial que muestran hacia numerosos compuestos tanto orgánic...

  20. Anal HPV genotypes and related displasic lesions in Italian and foreign born high-risk males.

    Science.gov (United States)

    Orlando, Giovanna; Beretta, Rosangela; Fasolo, M Michela; Amendola, Antonella; Bianchi, Silvia; Mazza, Francesca; Rizzardini, Giuliano; Tanzi, Elisabetta

    2009-05-29

    Anal intraepithelial neoplasia and anal cancer are closely related to infection from high-risk Human Papilloma Virus (HPV) genotypes. Since HPVs involved in disease progression are reported to vary by geographical regions, this study focuses on HPV genotypes spectrum in 289 males attending a Sexual Transmitted Diseases (STD) unit according to their nationality. Anal cytology, Digene Hybrid Capture Assay (HC2) and HPV genotyping were evaluated in 226 Italian (IT) and 63 foreign born (FB) subjects, recruited between January 2003 and December 2006. FB people were younger (median 32y-IQR 27-35 vs 36y-IQR 31-43, respectively; Mann-Whitney test por=atypical squamous cells of undetermined significance (ASCUS)) on anal cytology (95.0% vs 84.04%) (p=0.032; OR 3.61; 95% CI 1.04-1.23). HPV-16 is by far the most common genotype found in anal cytological samples independently from nationality while differences in distribution of other HPV genotypes were observed. The probability of infection from high-risk HPVs was higher in FB (OR 1.69; 95% CI 1.07-2.68) and is due to a higher rate of HPV-58 (OR 4.98; 95% CI 2.06-12.04), to a lower rate of HPV-11 (OR 0.35; 95% CI 0.16-0.77), to the presence of other high-risk genotypes (HPV-45, HPV-66, HPV-69). Multiple infections rate was high and comparable between IT and FB people. The relative contribution of each HPV genotype in the development of pre-neoplastic disease to an early age in the FB group cannot be argued by this study and more extensive epidemiological evaluations are needed to define the influence of each genotype and the association with the most prevalent high-risk HPVs on cytological intraepithelial lesions development.

  1. Rectal squamous cell carcinoma in immunosuppressed populations: is this a distinct entity from anal cancer?

    Science.gov (United States)

    COGHILL, Anna E.; SHIELS, Meredith S.; RYCROFT, Randi K.; COPELAND, Glenn; FINCH, Jack L.; HAKENEWERTH, Anne M.; PAWLISH, Karen S.; ENGELS, Eric A.

    2015-01-01

    Objective Squamous cell carcinoma (SCC) of the rectum is rare, but as with anal cancer, risk may be increased among immunosuppressed individuals. We assessed risk of rectal SCC in HIV-infected people. Design Population-based registry Methods We utilized the HIV/AIDS Cancer Match, a linkage of US HIV and cancer registries (1991–2010), to ascertain cases of anal SCC, rectal SCC, rectal non-SCC, and colon non-SCC. We compared risk in HIV-infected persons to the general population using standardized incidence ratios (SIRs) and evaluated risk factors using Poisson regression. We reviewed cancer registry case notes to confirm site and histology for a subset of cases. Results HIV-infected persons had an excess risk of rectal SCC compared to the general population (SIR=28.9; 95%CI 23.2–35.6), similar to the increase for anal SCC (SIR=37.3). Excess rectal SCC risk was most pronounced among HIV-infected men who have sex with men (MSM, SIR=61.2). Risk was not elevated for rectal non-SCC (SIR=0.88) or colon non-SCC (SIR=0.63). Individuals diagnosed with AIDS had higher rectal SCC rates than those with HIV-only (incidence rate ratio=1.86; 95%CI 1.04–3.31). Based on available information, one-third of rectal SCCs were determined to be misclassified anal cancer. Conclusions HIV-infected individuals, especially with advanced immunosuppression, appear to have substantially elevated risk for rectal SCC. As for anal SCC, rectal SCC risk was highest in MSM, pointing to involvement of a sexually transmitted infection such as human papillomavirus. Site misclassification was present, and detailed information on tumor location is needed to prove that rectal SCC is a distinct entity. PMID:26372482

  2. Oral and Anal Vaccination Confers Full Protection against Enteric Redmouth Disease (ERM) in Rainbow Trout

    Science.gov (United States)

    Ohtani, Maki; Strøm, Helene Kragelund; Raida, Martin Kristian

    2014-01-01

    The effect of oral vaccines against bacterial fish diseases has been a topic for debate for decades. Recently both M-like cells and dendritic cells have been discovered in the intestine of rainbow trout. It is therefore likely that antigens reaching the intestine can be taken up and thereby induce immunity in orally vaccinated fish. The objective of this project was to investigate whether oral and anal vaccination of rainbow trout induces protection against an experimental waterborne infection with the pathogenic enterobacteria Yersinia ruckeri O1 biotype 1 the causative agent of enteric redmouth disease (ERM). Rainbow trout were orally vaccinated with AquaVac ERM Oral (MERCK Animal Health) or an experimental vaccine bacterin of Y. ruckeri O1. Both vaccines were tested with and without a booster vaccination four months post the primary vaccination. Furthermore, two groups of positive controls were included, one group receiving the experimental oral vaccine in a 50 times higher dose, and the other group receiving a single dose administered anally in order to bypass the stomach. Each group was bath challenged with 6.3×108 CFU/ml Y. ruckeri, six months post the primary vaccination. The challenge induced significant mortality in all the infected groups except for the groups vaccinated anally with a single dose or orally with the high dose of bacterin. Both of these groups had 100% survival. These results show that a low dose of Y. ruckeri bacterin induces full protection when the bacterin is administered anally. Oral vaccination also induces full protection, however, at a dose 50 times higher than if the fish were to be vaccinated anally. This indicates that much of the orally fed antigen is digested in the stomach before it reaches the second segment of the intestine where it can be taken up as immunogenic antigens and presented to lymphocytes. PMID:24705460

  3. Fecal incontinence, sexual complaints, and anorectal function after third-degree obstetric anal sphincter injury (OASI): 5-year follow-up

    NARCIS (Netherlands)

    Visscher, A.P.; Lam, T.J.; Hart, N.; Felt-Bersma, R.

    2014-01-01

    Introduction and hypothesis: Our aim was to evaluate alterations in anorectal function after anal sphincteroplasty for third-degree obstetric anal sphincter injury (OASI) in relation to clinical outcome. Methods: In this retrospective, descriptive, cross-sectional study conducted between 1998 and

  4. Comparison of botox and lateral internal sphincterotomy treatment outcomes in chronic anal fissures

    Directory of Open Access Journals (Sweden)

    Tolga Dinç

    2014-03-01

    Full Text Available Objective: Both botox and lateral internal sfinkterotomi are treatment technics used in chronic anal fissure; provide the relaxation of anal sphincter and as a result of this, healing occurs. Aim of this study is to compare efficacy of botox and LIS treatment in chronic anal fissure and discussing with the literature. Methods: 60 of 66 patients who has chronic anal fissure, that we reached, treated but not healed with medical therapy, appealed to the Dr. Sami Ulus Hospital included the study. Gender, age, fissure localization, complaints (pain, bleeding, itching, constipation, complaint length, recurrences after treatment, continence conditions and complications of patients were registered. Results: Sixty patients were enrolled the study. Of the 60 patients; 38(63.3% were male and 22 (27.7% were female. Mean age of all patients was 35.93 ± 11.45 (21 -60. Pain was the common complaint of the all patients. 10 (32.3% recurrence were detected in botox treatment group (Group-I, only 1 (3.4% recurrence was in LIS group (Group-II. There was no complication as an incontinence in group-I but 3 cases with incontinence (10.39% were obtained in group-II. In the evaluation of these 3 cases by Cleveland Clinic Continence Scoring System, 2 cases classified as gas incontinence and 1 case as moderate fecal incontinence. Conclusion: Although botulinum toxin injection seen as an alternative treatment method with low complication rates such as incontinence, high recurrence is an important shortcoming of this technic. LIS performed by experienced surgeons remained the most popular treatment modality with low complication rates and great deal of healing success.

  5. Loovutatava isiku õigused loovutamismenetluses. Kohtupraktika analüüs / Marje Allikmets

    Index Scriptorium Estoniae

    Allikmets, Marje, 1989-

    2013-01-01

    Euroopa vahistamismääruse alusel toimuvast loovutamismenetlusest. Loovutatava isiku õiguste kaitse probleemidest. Artikkel põhineb autori 2013. a. Tartu Ülikooli õigusteaduskonnas kaitstud magistritööl "Loovutatava isiku õigused loovutamismenetluses - kohtupraktika analüüs"

  6. Sonographic assessment of the anal sphincter after obstetric anal sphincter injury (OASI) using transperineal ultrasound (TPUS).

    Science.gov (United States)

    Eisenberg, Vered H; Valsky, Dan V; Yagel, Simcha

    2018-03-24

    Obstetric anal sphincter injury (OASI) is the most common cause of anal incontinence and ano-rectal symptoms in women 1 . Reported rates of anal incontinence following primary repair of OASI range between 15-61%, with a mean of 39% 2, 3 . Other possible complications of OASI include perineal pain, dyspareunia, and less commonly, abscess formation, wound breakdown, and rectovaginal fistulae. Symptom onset may occur immediately, several years postpartum, or only late in life when aging of tissues adds to the delivery insult. Having sustained an OASI may impact significantly on women's physical and emotional health. Missed OASI, inadequate repair or lack of follow up are potential sources of litigation 4 . The reported incidence of OASI may be as high as 4-6.6% 4 , averaging 2.9% in the UK 3 . The incidence is higher in primiparae (6.1%) than in multiparae (1.7%) 3 . Recent years are seeing an increased awareness and structured training programs, which appear to have resulted in an increase in the detection rate of OASI 3 . The following risk factors have been identified with varying risk rates reported 3 : Asian ethnicity (OR 2.27, 95% CI 2.14-2.41), nulliparity (relative risk [RR] 6.97, 95% CI 5.40-8.99), birth weight greater than 4 kg (OR 2.27, 95% CI 2.18-2.36), shoulder dystocia (OR 1.90, 95% CI 1.72-2.08), occipito-posterior position (RR 2.44, 95% CI 2.07-2.89), prolonged second stage of labor (up to RR 2.02, 95% CI 1.62-2.51 after four hours duration). Instrumental deliveries and episiotomy use have been extensively studied resulting in the following evidence: Vacuum delivery without episiotomy (OR 1.89, 95% CI 1.74-2.05); vacuum delivery with episiotomy is protective (OR 0.57, 95% CI 0.51-0.63); forceps delivery without episiotomy carries the highest potential risk (OR 6.53, 95% CI 5.57-7.64); and forceps delivery with episiotomy (OR 1.34, 95% CI 1.21-1.49). Other potential risk factors have been suggested with varying evidence such as advanced maternal age at

  7. Theoretical analysis of nuclear reactors (Phase III), I-V, Part V, Establishment of Monte Carlo method for solving the integral transport equation; Razrada metoda teorijske analize nuklearnih reaktora (III faza) I-V, V Deo, Postavljanje Monte Carlo metode za resavanje integralnog oblika transportne jednacine

    Energy Technology Data Exchange (ETDEWEB)

    Pop-Jordanov, J [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1963-02-15

    General mathematical Monte Carlo approach is described with the elements which enable solution of specific problems (verification was done by estimation of a simple integral). Special attention was devoted to systematic presentation which demanded explanation of fundamental topics of statistics and probability. This demands a procedure for modelling the stochastic process i.e. Monte Carlo method. Dat je matematicki prilaz Monte Carlo metodi uopste, a po elementima koji dozvoljavaju konkretno resavanje izvesnih problema. (Provera je izvrsena na estimiranju prostog integrala). Narocito je vodjeno racuna o sistematicnosti izlaganja materije sto je mestimicno zahtevalo tretiranje i osnovnih pojmova, statistike i verovatnoce, a sve to skupa zahteva postupak modeliranja stohastickog procesa odnosno Monte Carlo metod (author)

  8. The deposition of anal excretions by Melipona favosa foragers (Apidae: Meliponinae): behavioural observations concerning the location of food sources

    NARCIS (Netherlands)

    Aguilar, I. (Ingrid); Sommeijer, M.J.

    2000-01-01

    Melipona favosa consistently deposited anal excretions while foraging. Anal depositions were released more frequently and by more bees on artificial food sources at a greater distance from the nest. Our hypothesis that these deposits serve as scent marks is supported by experimental evidence

  9. Dosimetric planning study for the prevention of anal complications after post-operative whole pelvic radiotherapy in cervical cancer patients with hemorrhoids.

    Science.gov (United States)

    Baek, J G; Kim, E C; Kim, S K; Jang, H

    2015-01-01

    Radiation-induced anal toxicity can be induced by low radiation doses in patients with haemorrhoids. The object of this study was to determine the dosimetric benefits of different whole pelvic radiotherapy (WPRT) techniques in terms of dose delivered to the anal canal in post-operative patients with cervical cancer. The planning CT images of 10 patients with cervical cancer undergoing postoperative radiotherapy were used for comparison of three different plans. All patients had been treated using the conventional box technique WPRT (CV-WPRT), and we tried low-margin-modified WPRT (LM-WPRT), three-dimensional conformal techniques WPRT (CF-WPRT) and intensity-modulated WPRT (IM-WPRT) planning for dosimetric comparison of the anal canal, retrospectively. Mean anal canal doses of the IM-WPRT were significantly lower (p 99%, and the proportion that received ≥108% of the prescribed dose for IM-WPRT was <2%. Volumes of bladders and rectums that received ≥30 or ≥40 Gy were significantly lower for IM-WPRT than for three of the four-field WPRT plans (p = 0.000). IM-WPRT can significantly reduce radiation dose delivered to the anal canal and does not compromise PTV coverage. In patients with haemorrhoids, IM-WPRT may be of value for the prevention of anal complications. Although tolerance of the anal canal tends to be ignored in patients undergoing post-operative WPRT, patients with haemorrhoids may suffer complications at low radiation doses. The present study shows IM-WPRT can be meaningful in these patients.

  10. Mikroekonomická analýza odběratelů společnosti

    OpenAIRE

    Voháňková, Petra

    2007-01-01

    Práce se zabývá analýzou vývoje a struktury odběratelů společnosti, která vyrábí růžový porcelán. V práci je popsána pozice společnosti na trhu z hlediska dostupnosti zdrojů, možnosti ovlivnění cen výrobků a vyráběného množství. Poslední část práce je zaměřena na zjednodušenou analýzu elasticity poptávky po produktech společnosti a je vysloven názor na možnosti jejího ovlivnění.

  11. Prevalence status and association with human papilloma virus of anal squamous proliferative lesions in a patient sample in Taiwan.

    Science.gov (United States)

    Tsai, Tsen-Fang; Kuo, Guan-Tin; Kuo, Lu-Ting; Hsiao, Cheng-Hsiang

    2008-08-01

    Anal squamous proliferative lesions, including condyloma, anal high-grade squamous intraepithelial lesion (AHSIL) and squamous cell carcinoma (SCC), are associated with human papilloma virus (HPV) infection. The objectives of the study were to investigate the HPV prevalence of anal squamous proliferative lesion in Taiwan. From 1991 to 2005, 41 cases with condyloma, 12 cases with AHSIL, and 13 cases with SCC were collected. DNA was extracted from the tissue sections of these patients, and the HPV genotype was identified using polymerase chain reaction and gene chip. The integration status of HPV16 DNA was also evaluated by quantitative real-time polymerase chain reaction. Anal condyloma mainly occurred in young males, but AHSIL and anal SCC developed in older patients. In the patients with human immunodeficiency virus (HIV) infection, AHSIL developed much earlier than patients without HIV infection (36 vs. 61 years). HPV DNA was detected in all 56 patients whose specimens contained adequate DNA. High-risk HPVs (type 16, 58, etc.) were mainly detected in the AHSIL and SCC. Multiple HPV infection was found in AHSIL (4 of 12) and condyloma (11 of 34) but was rare in invasive cancer (1 of 12). Seven of 8 patients with HPV16 infection had coexistent episomal and integrated forms. HPV58 is a unique high-risk HPV prevalent in Taiwan. The integration status of HPV seems not correlated with the severity of the dysplasia. In our study, emerging HIV-positive AHSIL in recent years indicates that we should devote more efforts to promote sexual safety among the people who engaged in anal intercourse.

  12. Health-Related Quality of Life and Sexual Functioning of HIV-Positive Men Who Have Sex With Men Who Are Treated for Anal Intraepithelial Neoplasia

    NARCIS (Netherlands)

    Siegenbeek van Heukelom, Matthijs L.; Richel, Olivier; Nieuwkerk, Pythia T.; de Vries, Henry J. C.; Prins, Jan M.

    2016-01-01

    The impact of the treatment of precursor lesions of anal cancer (anal intraepithelial neoplasia) on health-related quality of life has not been investigated. This study aimed to evaluate the impact of 3 treatment options for anal intraepithelial neoplasia on health-related quality of life and sexual

  13. Case of anal fistula with Fournier's gangrene in an obese type 2 diabetes mellitus patient.

    Science.gov (United States)

    Yoshino, Hiroshi; Kawakami, Kyoko; Yoshino, Gen; Sawada, Katsuhiro

    2016-03-01

    A 64-year-old man was admitted to Shin-suma General Hospital, Kobe, Japan, complaining of a 3-day history of scrotal swelling and high fever. He had type 2 diabetes mellitus. On examination, his body temperature had risen to 38.5 °C. Examination of the scrotum showed abnormal enlargement. Laboratory data were as follows: white cell count 35,400/μL and glycated hemoglobin 9.6%. Anal fistula was found in an endorectal ultrasound. Computed tomography scan showed a relatively high density of subcutaneous tissue and elevated air density. Thus, he was diagnosed with Fournier's gangrene. On the fourth hospital day, the patient underwent debridement of gangrenous tissue. Seton surgery was carried out for anal fistula on the 34th hospital day. He responded to the treatment very well. He was discharged on the 33rd postoperative day. Once Fournier's gangrene has been diagnosed, considering the association of anal fistula and perianal abscess is important.

  14. US Intergroup Anal Carcinoma Trial: Tumor Diameter Predicts for Colostomy

    Science.gov (United States)

    Ajani, Jaffer A.; Winter, Kathryn A.; Gunderson, Leonard L.; Pedersen, John; Benson, Al B.; Thomas, Charles R.; Mayer, Robert J.; Haddock, Michael G.; Rich, Tyvin A.; Willett, Christopher G.

    2009-01-01

    Purpose The US Gastrointestinal Intergroup Radiation Therapy Oncology Group 98-11 anal carcinoma trial showed that cisplatin-based concurrent chemoradiotherapy resulted in a significantly higher rate of colostomy compared with mitomycin-based therapy. Established prognostic variables for patients with anal carcinoma include tumor diameter, clinical nodal status, and sex, but pretreatment variables that would predict the likelihood of colostomy are unknown. Methods A secondary analysis was performed by combining patients in the two treatment arms to evaluate whether new predictive and prognostic variables would emerge. Univariate and multivariate analyses were carried out to correlate overall survival (OS), disease-free survival, and time to colostomy (TTC) with pretreatment and treatment variables. Results Of 682 patients enrolled, 644 patients were assessable and analyzed. In the multivariate analysis, tumor-related prognosticators for poorer OS included node-positive cancer (P ≤ .0001), large (> 5 cm) tumor diameter (P = .01), and male sex (P = .016). In the treatment-related categories, cisplatin-based therapy was statistically significantly associated with a higher rate of colostomy (P = .03) than was mitomycin-based therapy. In the pretreatment variables category, only large tumor diameter independently predicted for TTC (P = .008). Similarly, the cumulative 5-year colostomy rate was statistically significantly higher for large tumor diameter than for small tumor diameter (Gray's test; P = .0074). Clinical nodal status and sex were not predictive of TTC. Conclusion The combined analysis of the two arms of RTOG 98-11, representing the largest prospective database, reveals that tumor diameter (irrespective of the nodal status) is the only independent pretreatment variable that predicts TTC and 5-year colostomy rate in patients with anal carcinoma. PMID:19139424

  15. Epidermoid carcinomas of the anal canal treated with definitive radiation therapy in a series of 305 patients; Carcinomes epidermoides du canal anal traites par irradiation a visee curative: a propos de 305 patients

    Energy Technology Data Exchange (ETDEWEB)

    Deniaud-Alexandre, E.; Touboul, E.; Huang, R.; Qu, S.H.; Pene, F.; Schlienger, M. [Hopital Tenon, Service d' Oncologie-Radiotherapie, 75 - Paris (France); Tiret, E.; Parc, R. [Hopital Saint-Antoine, Service de Chirurgie Digestive, 75 - Paris (France); Sezeur, A. [Hopital des Diaconesses, Service de Chirurgie Generale, 75 - Paris (France); Houry, S. [Hopital Tenon AP-HP, Service de Chirurgie Digestive, 75 - Paris (France); Gallot, D. [Groupe Hospitalier Bichat-Claude-Bernard, Service de Chirurgie Generale et Digestive B, 75 - Paris (France)

    2003-08-01

    Purpose. - To identify prognostic factors and treatment toxicity in a series of epidermoid cancers of the anal canal without evident metastasis. Patients and methods. - Between June 1972 and January 1997, 305 patients (pts) were treated with curative-intent radiation therapy (RT). The T-stages according to the 1987 UICC classification were: 26 T1, 141 T2, 104 T3, and 34 T4. There were 49 pts with nodal involvement at presentation. Pretreatment anal function scoring according to our in-house system was: 22 scored 0, 182 scored 1, 74 scored 2, 7 scored 3. 11 scored 4, and 9 not available pts. The treatment started with external beam RT (EBRT) in 303 pts (median dose: 45 Gy). After a rest period of 4 to 6 weeks, a boost of 20 Gy was delivered by EBRT in 279 pts and by interstitial {sup 192}Ir brachytherapy (Bcy) in 17 pts. Seven pts received only one course of EBRT (mean dose: 49.5 Gy) and 2 pts were treated with interstitial {sup 192}Ir Bcy alone (55 and 60 Gy, respectively). concomitant chemotherapy (5-fluoro-uracil and either mitomycin C or cisplatin) was delivered to 19 pts. Mean follow-up was 103 months. Results. - At the end of RT local tumor clinical complete response (cCR) rate was 80%. Out of 61 non responders or local progressive tumors 27 (44%) were salvaged with abdomino-perineal resection (APR). The rate of local tumor relapse (LR) was 12%. Out of 37 LTR, 20 (54%) were salvaged with APR and one with interstitial {sup 192}Ir Bcy. The overall local tumor control (LC) rate with or without salvage local treatment was 84%. LC rate with a good anal function scoring (score 0 and 1) was 56.5%0. Among 181/186 available pts who preserved their anus, 94% had a good anal function scoring. For a subgroup of 15 pts with length tumor <2 cm-N0, the LC rate after the end of RT was 100% the LC rate with or without local salvage treatment was 100%, and among 13 available pts who preserved their anus, the anal function scoring was good in 12 pts (92%). The 10-years disease

  16. Sexual restrictions beyond anti-gay prejudice: Anal sex, oral sex, masculinity and sexual prejudice in Jamaica

    OpenAIRE

    West, Keon

    2016-01-01

    This is the first quantitative research to investigate attitudes toward heterosexual anal and oral sex in Jamaica, compare them to anti-gay and anti-lesbian attitudes, and frame them within a broader understanding of sexual prejudice based on gender norms. Fifty Jamaican participants’ attitudes toward heterosexual anal sex were as negative as attitudes toward gay male sex, and more negative than attitudes toward lesbian sex. Negative attitudes toward male sexual behaviours were predicted by m...

  17. Riskide analüüs aitab kriisi puhuks varusid planeerida / Janis Toomla

    Index Scriptorium Estoniae

    Toomla, Janis

    2005-01-01

    Riskide hindamisele järgnevast organisatsiooni jätkusuutlikkuse planeerimise faasist, kus toimub kriisistsenaariumide analüüs, võimalike kahjude suuruse hindamine ja taasteaja määratlemine (Business Impact Analyse)

  18. Treating High-grade Lesions to Prevent Anal Cancer in HIV-infected People

    Science.gov (United States)

    This study, called the ANCHOR trial, will investigate whether screening and prevention methods similar to those used to prevent cervical cancer can help prevent anal cancer in HIV-infected men and women.

  19. Management of rare, low anal anterior fistula exception to Goodsall′s rule with Kṣārasūtra

    Directory of Open Access Journals (Sweden)

    Pradeep S Shindhe

    2014-01-01

    Full Text Available Anal fistula (bhagandara is a chronic inflammatory condition, a tubular structure opening in the ano-rectal canal at one end and surface of perineum/peri-anal skin on the other end. Typically, fistula has two openings, one internal and other external associated with chronic on/off pus discharge on/off pain, pruritis and sometimes passing of stool from external opening. This affects predominantly male patients due to various etiologies viz., repeated peri-anal infections, Crohn′s disease, HIV infection, etc., Complex and atypical variety is encountered in very few patients, which require special treatment for cure. The condition poses difficulty for a surgeon in treating due to issues like patient hesitation, trouble in preparing kṣārasūtra, natural and routine infection with urine, stool etc., and dearth of surgical experts and technique. We would like to report a complex and atypical, single case of anterior, low anal fistula with tract reaching to median raphe of scrotum, which was managed successfully by limited application of kṣārasūtra.

  20. The immediate effect of vaginal and caesarean delivery on anal sphincter measurements.

    Science.gov (United States)

    Karcaaltincaba, Deniz; Erkaya, Salim; Isik, Hatice; Haberal, Ali

    2016-08-01

    This study evaluated the effects of vaginal and caesarean delivery on internal and external anal sphincter muscle thickness using translabial ultrasonography (TL-US). This prospective cohort study enrolled nulliparous women who either had vaginal or caesarean deliveries. The thickness of the hypoechoic internal anal sphincter (IAS) and hyperechoic external anal sphincter (EAS) at the 12, 3, 6, and 9 o'clock positions at the distal level were measured before delivery and within 24-48 h after delivery. A total 105 consecutive women were enrolled in the study: 60 in the vaginal delivery group and 45 in the caesarean delivery group. The IAS muscle thickness at the 12 o'clock position in the vaginal delivery group was significantly thicker before compared with after delivery (mean ± SD: 2.31 ± 0.74 mm versus 1.81 ± 0.64 mm, respectively). The EAS muscle thickness at the 12 o'clock position in the vaginal delivery group was significantly thicker before compared with after delivery (mean ± SD: 2.42 ± 0.64 mm versus 1.97 ± 0.85, respectively). There was significant muscle thinning of both the IAS and EAS at the 12 o'clock position after vaginal delivery, but not after caesarean delivery. © The Author(s) 2016.

  1. Seroconversion Following Anal and Genital HPV Infection in Men: The HIM Study.

    Science.gov (United States)

    Giuliano, Anna R; Viscidi, Raphael; Torres, B Nelson; Ingles, Donna J; Sudenga, Staci L; Villa, Luisa L; Baggio, Maria Luiza; Abrahamsen, Martha; Quiterio, Manuel; Salmeron, Jorge; Lazcano-Ponce, Eduardo

    2015-12-01

    Protection from naturally acquired human papillomavirus (HPV) antibodies may influence HPV infection across the lifespan. This study describes seroconversion rates following genital, anal, and oral HPV 6/11/16/18 infections in men and examines differences by HPV type and anatomic site. Men with HPV 6/11/16/18 infections who were seronegative for those genotypes at the time of DNA detection were selected from the HPV Infection in Men (HIM) Study. Sera specimens collected ≤36 months after detection were analyzed for HPV 6/11/16/18 antibodies using a virus-like particle-based ELISA. Time to seroconversion was separately assessed for each anatomic site, stratified by HPV type. Seroconversion to ≥1 HPV type (6/11/16/18) in this sub-cohort (N=384) varied by anatomic site, with 6.3, 18.9, and 0.0% seroconverting following anal, genital, and oral HPV infection, respectively. Regardless of anatomic site, seroconversion was highest for HPV 6 (19.3%). Overall, seroconversion was highest following anal HPV 6 infection (69.2%). HPV persistence was the only factor found to influence seroconversion. Low seroconversion rates following HPV infection leave men susceptible to recurrent infections that can progress to HPV-related cancers. This emphasizes the need for HPV vaccination in men to ensure immune protection against new HPV infections and subsequent disease.

  2. Dose-time considerations in the treatment of anal cancer

    International Nuclear Information System (INIS)

    Constantinou, Eugene C.; Daly, William; Fung, Claire Y.; Willett, Christopher G.; De Laney, Thomas F.

    1996-01-01

    Purpose: Concurrent chemoradiation has become the standard initial treatment of primary anal carcinomas. The objective of this study was to analyze the impact on treatment outcome of a variety of patient and treatment variables including radiation dose and overall treatment time in patients treated with concurrent chemoradiation for anal carcinomas. Materials and Methods: Retrospective chart review on 50 patients with MO anal cancer treated with concurrent chemoradiation during the years 1984-1993. Patients were identified from the hospital tumor registries. The majority of patients received treatment with 5-FU 1000 mg/m 2 days 1-4, 29-33 and Mitomycin 10-15 mg/m 2 days 1 ± 29. Radiation was given at 180-200 cGy daily starting at day 1 to total doses of 23.6-67.2 Gy (median 54 Gy) usually by shrinking field technique. Local control, disease-free survival, and overall survival of the group was determined and then analyzed with respect to a variety of patient characteristics including T and N stage, histology, radiation dose, overall treatment time, hemoglobin at the start of treatment, age, HIV status, and sex. Local control, disease-free and overall survival were calculated using the Kaplan-Meier method. Tests for significance were done using the log-rank method. Results: Patient characteristics were: (1) histology-squamous 78 %, cloacogenic/basaloid 20%, and adenosquamous 2%; (2) age- range 30-82 years (median 58.5), (3) sex- female 58%, male 42%; (4) T stage- T1 16%, T2 46%, T3 24%, T4 8%, TX 6%; (5) N stage- NO 69%, N+ 23 %, NX 8%; (6) HIV (+) 8%, HIV(-/?) 92%. Follow-up ranged from 2-132 months (median 43 months). Overall survival was 66% and 44% at 5 and 10 years. Disease-free survival was 67% at 5 years and 59% at 10 years. Local control was 70% at 5 and 10 years. Five year local control by T stage: T stage- T1 87.5 %, T2 63%, T3 83%, T4 67%, TX 50%. Doses of ≥ 54 Gy are associated with improved 5-year survival (84 % vs. 47%, p=0.02), disease-free survival

  3. Correlates of condomless anal sex among men who have sex with men (MSM) in Tijuana, Mexico: The role of public sex venues.

    Science.gov (United States)

    Semple, Shirley J; Pitpitan, Eileen V; Goodman-Meza, David; Strathdee, Steffanie A; Chavarin, Claudia V; Rangel, Gudelia; Torres, Karla; Patterson, Thomas L

    2017-01-01

    Condomless anal sex between male partners is the primary risk factor for HIV transmission among men who have sex with men (MSM). Correlates of condomless anal sex have been well-studied in developed countries, but they have received less attention in lower-to-middle income countries (LMIC), where MSM are often subject to stigma, discrimination, intolerance, and even the criminalization of same sex behavior. In Mexico, a LMIC where traditional views on homosexuality are common, HIV prevalence among MSM is high (16.9%), yet little research has been conducted on the correlates of condomless anal sex in this high-risk population. The present study examined correlates of condomless anal sex among 201 MSM recruited in Tijuana, Mexico, with a focus on the role of public sex venues in relation to sexual risk behavior. Eligibility requirements were: biologically male, 18 years of age or older, resident of Tijuana, and self-reported anal or oral sex with a male partner in the past year. Participants completed an interviewer-administered, demographic and psychosocial survey, and were tested for HIV and syphilis. A hierarchical multiple linear regression model was tested to identify correlates of condomless anal sex. Thirty-eight percent of participants (N = 76) reported condomless anal sex with a male partner in the past 2 months. Higher levels of condomless anal sex were associated with higher levels of depressive symptoms, greater sexual compulsivity, and more frequent seeking out of sex partners in a public venue in the past 2 months. In view of these findings, we recommend the development of multi-level, "combination" interventions, which in the Mexican context should include enhanced condom promotion and distribution, improved availability and access to mental health treatment and counseling services, and expanded HIV/STI testing in public venues.

  4. Topographic Anatomy of the Anal Sphincter Complex and Levator Ani Muscle as It Relates to Intersphincteric Resection for Very Low Rectal Disease.

    Science.gov (United States)

    Tsukada, Yuichiro; Ito, Masaaki; Watanabe, Kentaro; Yamaguchi, Kumiko; Kojima, Motohiro; Hayashi, Ryuichi; Akita, Keiichi; Saito, Norio

    2016-05-01

    Intersphincteric resection has become a widely used treatment for patients with rectal cancer. However, the detailed anatomy of the anal canal related to this procedure has remained unclear. The purpose of this study was to clarify the detailed anatomy of the anal canal. This is a descriptive study. Histologic evaluations of paraffin-embedded tissue specimens were conducted at a tertiary referral hospital. Tissue specimens were obtained from cadavers of 5 adults and from 13 patients who underwent abdominoperineal resection for rectal cancer. Sagittal sections from 9 circumferential portions of the cadaveric anal canal (histologic staining) and 3 circumferential portions from patients were studied (immunohistochemistry for smooth and skeletal muscle fibers). Longitudinal fibers between the internal and external anal sphincters consisted primarily of smooth muscle fibers that continued from the longitudinal muscle of the rectum. The levator ani muscle attached directly to the lateral surface of the longitudinal smooth muscle of the rectum. The length of the attachment was longer in the anterolateral portion and shorter in the posterior portion of the anal canal. In the lateral and posterior portions, the levator ani muscle partially overlapped the external anal sphincter; however, there was less overlap in the anterolateral portion. In the posterior portion, thick smooth muscle was present on the surface of the levator ani muscle and it continued to the longitudinal muscle of the rectum. We observed only limited portions in some surgical specimens because of obstruction by tumors. The levator ani muscle attaches directly to the longitudinal muscle of the rectum. The spatial relationship between the smooth and skeletal muscles differed in different portions of the anal canal. For intersphincteric resection, dissection must be performed between the longitudinal muscle of the rectum and the levator ani muscle/external anal sphincter, and the appropriate surgical lines

  5. Interest of retro-anal levator plate myorrhaphy in selected cases of descending perineum syndrome with positive anti-sagging test

    Directory of Open Access Journals (Sweden)

    Beco Jacques

    2008-07-01

    Full Text Available Abstract Background Levator plate sagging (LPS, usually called descending perineum syndrome, is one of the main defects encountered in perineology. This defect is classically associated with colo-proctologic functional troubles (dyschesia and anal incontinence but can also induce perineodynia, gynaecological and lower urinary tract symptoms. Methods A retrospective case series of nine female patients (mean age: 44.3 underwent an isolated retro-anal levator plate myorrhaphy (RLPM to treat symptomatic LPS confirmed by rectal examination and/or Perineocaliper®. An anti-sagging test (support of the posterior perineum must significantly improve the symptoms that were resistant to conservative treatment. The effect of the procedure on the symptoms of the 3 axes of the perineum (urological, colo-proctologic and gynecological and on perineodynia was evaluated during a follow up consultation more than 9 months after surgery. The effect of RLPM on the position of the anal margin and on the levator plate angle was studied using rectal examination, Perineocaliper® and retro-anal ultrasound. Results Before surgery, anti-sagging tests were positive for dyschesia, urinary urgency and pain. After a mean follow-up of 16.1 months, RLPM resolved or improved 2/2 cases of stress urinary incontinence, 3/5 of urinary urgency, 3/4 of dysuria, 3/3 of anal incontinence, 7/8 of dyschesia, 3/4 of cystocele, 4/5 of rectocele, 5/8 of dyspareunia and 6/7 of perineodynia. Rectal examination showed a complete suppression of sagging in 4 patients and an improvement in the 5 others. The mean reduction of perineal descent was 1.08 cm (extremes: 0–1.5. Using retro-anal ultrasound of the levator plate, the mean reduction of sagging was 12.67 degrees (extremes: 1 – 21. Conclusion Anti-sagging tests can be used before surgery to simulate the effect of RLPM. This surgical procedure seems to improve stress urinary incontinence, frequency, nocturia, urgency, dysuria, anal

  6. Teetering near the edge; women's experiences of anal incontinence following obstetric anal sphincter injury: an interpretive phenomenological research study.

    Science.gov (United States)

    Tucker, Julie; Clifton, Vicki; Wilson, Anne

    2014-08-01

    Obstetric anal sphincter injury (OASIS) following vaginal delivery increases the risk of anal incontinence (AI). Subsequent vaginal delivery and ageing increase the risk of worsening symptoms. Very little literature describes any in-depth understanding of what it is like to live with AI following a history of known OASIS. To describe and interpret women's experience of AI following OASIS and its impact on quality of life. An interpretive phenomenological study was conducted in a level 2 tertiary hospital in South Australia. Women with a history of OASIS and AI were purposefully recruited. The St Marks Vaizey score was utilised to identify symptom severity. Semi-structured open-ended interviews were conducted, and data were analysed utilising Van Manen thematic analysis. Participants (n = 10) aged 26-56 years. All women were symptomatic of AI following OASIS, and 80% had received a primary OASIS at their first vaginal delivery. The St Marks Vaizey score mean was 9.1 (range within 4-22). Three essential themes grieving for loss, silence, striving for normality with eight subthemes identified a significant sense of loss and psychological impact of AI for this group of women. Health professionals require a greater understanding of the negative impact of OASIS and AI on women's quality of life. This may improve the management, education and clinical care of this condition which may result as a consequence of OASIS. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  7. Incidence and cost of anal, penile, vaginal and vulvar cancer in Denmark

    Directory of Open Access Journals (Sweden)

    Olsen Jens

    2012-12-01

    Full Text Available Abstract Background Besides being a causative agent for genital warts and cervical cancer, human papillomavirus (HPV contributes to 40-85% of cases of anal, penile, vaginal and vulvar cancer and precancerous lesions. HPV types 16 & 18 in particular contribute to 74-93% of these cases. Overall the number of new cases of these four cancers may be relatively high implying notable health care cost to society. The aim of this study was to estimate the incidence and the health care sector costs of anal, penile, vaginal and vulvar cancer. Methods New anogenital cancer patients were identified from the Danish National Cancer Register using ICD-10 diagnosis codes. Resource use in the health care sector was estimated for the year prior to diagnosis, and for the first, second and third years after diagnosis. Hospital resource use was defined in terms of registered hospital contacts, using DRG (Diagnosis Related Groups and DAGS (Danish Outpatient Groups System charges as cost estimates for inpatient and outpatient contacts, respectively. Health care consumption by cancer patients diagnosed in 2004–2007 was compared with that by an age- and sex-matched cohort without cancer. Hospital costs attributable to four anogenital cancers were estimated using regression analysis. Results The annual incidence of anal cancer in Denmark is 1.9 per 100,000 persons. The corresponding incidence rates for penile, vaginal and vulvar cancer are 1.7, 0.9 and 3.6 per 100,000 males/females, respectively. The total number of new cases of these four cancers in Denmark is about 270 per year. In comparison, the total number of new cases cervical cancer is around 390 per year. The total cost of anogenital cancer to the hospital sector was estimated to be 7.6 million Euros per year. Costs associated with anal and vulvar cancer constituted the majority of the costs. Conclusions Anogenital cancer incurs considerable costs to the Danish hospital sector. It is expected that the current

  8. A CLINICAL STUDY ON PERI ANAL TUBERCULOSIS IN S.V.R.R.G.G. HOSPITAL TIRUPATI

    Directory of Open Access Journals (Sweden)

    Sobha Rani

    2015-09-01

    Full Text Available Tuberculosis around the anus is a rare form of extra pulmonary tuberculosis It is necessary to recognize it due to a specific treatment. (1 Perianal tuberculosis is an uncommon condition; it may not be easily distinguishable from the other inflammatory anal diseases. Undiagnosed cases are associated with high recurrence rates. Perianal tuberculosis can have varied presentation, frequently mimicking other common as well as rare diseases. Ano pe rianal tuberculosis may be associated with abdominal tuberculosis either as an extension of the original lesion or due to its spread via the lymphatics. AIMS & OBJECTIVES OF STUDY : To study the prevalence of ano - perianal tuberculosis in patients attending surgery OPD, SVRR Government General Hospital, Tirupati. To prevent recurrence and morbidity due to peri anal tuberculosis by early detection and intervention with anti tuberculous drugs . MATERIALS AND METHODS : STUDY DESIGN : Prospective study . STUDY SETTING : The present study was conducted at Department of General Surgery, SVRR Government General Hospital, and Tirupati. After getting institutional approval, written and informed consent was taken from each patient. PERIOD OF STUDY : 12 months . SAMPLE SI ZE : 142 patients who attended Surgery OP and were admitted in General Surgery ward, SVRR Government General Hospital, Tirupati with anal and perianal lesions like anal fistulae, perianal suppurations, growths, ulcers during the study period. INCLUSION CRIT ERIA : Age more than 15 years , Both men and women are included , Both sputum positive and negative for AFB , Both HIV positive and negative patients , All Anal and perianal (more than 3cm and within 3cm of anal verge lesions are included , Willingness of the p atient to participate in the study . EXCLUSION CRITERIA : Age less than 15 years , Patients who are not willing to participate in the study . CONCLUSION : Tuberculosis was responsible for 11% cases in recurrent fistula - in - ano

  9. Dialoogiaktid ja suhtlusstrateegiad : eesti dialoogikorpuse analüüs / Liina Eskor

    Index Scriptorium Estoniae

    Eskor, Liina

    2005-01-01

    Artikkel põhineb autori magistritööl, mille eesmärgiks oli kohandada soome arvutilingvisti Kristiina Jokineni suhtlusstrateegiate teooriat eestikeelse infodialoogiga ning leida ja analüüsida strateegiate ja dialoogiaktide seoseid. Tutvustatakse ka eesti dialoogikorpust ja dialoogiaktide tüpoloogiat

  10. Management of anal fistula by ligation of the intersphincteric fistula tract

    DEFF Research Database (Denmark)

    Zirak-Schmidt, Samira; Perdawood, Sharaf

    2014-01-01

    INTRODUCTION: Ligation of the intersphincteric fistula tract (LIFT) is a sphincter-preserving procedure for treatment of anal fistulas described in 2007 by Rojanasakul et al. Several studies have since then assessed the procedure with varied results. This review assesses the relevant literature o...

  11. Postoperative versus definitive chemoradiation in early-stage anal cancer. Results of a matched-pair analysis

    Energy Technology Data Exchange (ETDEWEB)

    Berger, B.; Menzel, M.; Bamberg, M.; Weinmann, M. [Tuebingen Univ. (Germany). Dept. of Radiation Oncology; Breucha, G. [Kreiskrankenhaus Hechingen, Tuebingen Univ. (Germany). Dept. of Surgery

    2012-07-15

    Background and purpose: The goal of the present study was to comparatively assess the results of definitive chemoradiation (CRT) with or without previous macroscopically complete resection in patients with early-stage node-negative (T1-2 N0) anal carcinoma. Patients and methods: A total of 20 patients with T1-2 N0 anal carcinoma who received radiotherapy (RT) with or without chemotherapy following incidental R0/1 tumor resection (S/CRT group) were selected. These were matched to 20 comparable patients who underwent definitive chemoradiation without previous surgery (CRT group). Major objectives of this analysis were treatment outcomes in terms of locoregional tumor control (LRC), overall survival (OS), colostomy-free survival, and toxicity. Results: Patients treated postoperatively received significantly lower RT doses (median 54.0 Gy vs. 59.7 Gy; p < 0.001) and less frequently concomitant chemotherapy than those treated definitely. The 5-year LRC and 5-year OS rates were 97.5% and 90.0%, respectively, without significant differences between the S/CRT and the CRT groups. The distribution of acute and late toxicities was comparable, and the 5-year colostomy-free survival was 95% in both groups. Conclusion: This matched-pair comparison of incidental R0/1 resection plus dose-reduced CRT with standard definitive CRT of early-stage anal cancer shows similar treatment results. Thus, dose-reduced RT with or without chemotherapy may be considered in R0/1 resected patients with T1-2 N0 anal carcinoma. (orig.)

  12. Chronic anal fissures: Open lateral internal sphincterotomy result; a case series study

    Directory of Open Access Journals (Sweden)

    Abdulwahid M. Salih

    2017-03-01

    Conclusion: lateral sphincterotomy for internal anal sphincter, along, is the procedure of choice for management of CAF because it is effective and it can cure the disease in nearly all patients with good patient satisfaction.

  13. Papilomavírus Humano (HPV e sua associação entre lesões cervical e anal em mulheresHuman papillomavirus (HPV and its association between cervical and anal injuries in womendoi:10.12662/2317-3076jhbs.v4i3.860.p174-180.2016

    Directory of Open Access Journals (Sweden)

    Luciane Maria Oliveira Brito

    2016-09-01

    Full Text Available Introdução: Entre as doenças virais sexualmente transmissíveis, a infecção pelo Papilomavírus Humano (HPV configura-se como a mais comum, e sua incidência vem aumentando acentuadamente nos últimos trinta anos. A infecção anal por subtipos específicos do HPV predispõe o indivíduo à neoplasia intraepitelial anal, que pode evoluir para o câncer de forma similar ao colo uterino. Portanto, o objetivo deste estudo foi avaliar a associação tipo-específica entre infecções anais e cervicais, assim como os aspectos citopatológicos das lesões anais pelo vírus HPV em mulheres de São Luís, Maranhão. Métodos: Estudo analítico transversal com 27 mulheres atendidas no Centro de Pesquisa Clínica da UFMA, entre agosto de 2012 e julho de 2015, mediante entrevista e realização de exames complementares. Resultados: As mulheres tinham, em média, 32 anos. Em relação ao resultado do PCR, 77,7% das pacientes apresentaram resultado positivo para HPV anal, sendo o subtipo 16 o mais frequente (47,6%. Na região cervical, 88,8% apresentaram PCR positivo, sendo o mais comum o subtipo 16 (47,8%. A coinfecção anal e cervical pelo HPV foi observada em 74% das mulheres. 93,3% dos resultados de citologia anal não apresentaram alteração, assim como 72,2% das anuscopias realizadas. Conclusões: A infecção cervical por HPV é um fator sugestivo de risco para o desenvolvimento da infecção na região anal.

  14. Relation between flexor spasms, uninhibited detrusor contractions and anal sphincter activity

    DEFF Research Database (Denmark)

    Pedersen, E; Petersen, T; Schrøder, H D

    1986-01-01

    The time relation between flexor spasms, detrusor contractions and anal sphincter activity was recorded in a consecutive series of 111 patients with hyperreflexic bladder and flexor spasms. In 76 of the patients flexor spasms were preceded by detrusor contractions. The opposite pattern, namely de...

  15. High survivin expression as a risk factor in patients with anal carcinoma treated with concurrent chemoradiotherapy

    International Nuclear Information System (INIS)

    Fraunholz, Ingeborg; Rödel, Claus; Distel, Luitpold; Rave-Fränk, Marget; Kohler, Daniela; Falk, Stefan; Rödel, Franz

    2012-01-01

    To investigate the prognostic value of survivin expression in pretreatment specimens from patients with anal cancer treated with concurrent 5-FU and mitomycin C-based chemoradiation (CRT). Immunohistochemical staining for survivin was performed in pretreatment biopsies of 62 patients with anal carcinoma. Survivin expression was correlated with clinical and histopathological characteristics as well as local failure free- (LFFS), distant metastases free- (DMFS), cancer specific- (CSS), and overall survival (OS). Survivin staining intensity was weak in 10%, intermediate in 48% and intense in 42% of the patients. No association between survivin expression and clinicopathologic factors (tumor stage, age and HIV status) could be shown. In univariate analysis, the level of survivin staining was significantly correlated with DMFS (low survivin vs. high survivin: 94% vs. 74%, p = 0.04). T-stage, N-stage and the tumor grading were significantly associated with OS and CSS and with DMFS and LFFS, respectively. In multivariate analysis, survivin was confirmed as independent prognostic parameter for DMFS (RR, 0.04; p = 0.02) and for OS (RR, 0.27; p = 0.04). Our results demonstrated that the level of pretreatment survivin is correlated with the clinical outcome in patients with anal carcinoma treated with concurrent CRT. Further studies are warranted to elucidate the complex role of survivin for the oncologic treatment and to exploit the protein as a therapeutic target in combined modality treatment of anal cancer

  16. Comparison of nuclear reactor types of the next generation; Komparativni prikaz novih tipova reaktorskih komercijalnih postrojenja slijedece generacije

    Energy Technology Data Exchange (ETDEWEB)

    Pavlovic, Z; Kastelan, M [NPP Krsko (Slovenia)

    1992-07-01

    The paper presents a comparison for a selected relevant set of parameters for different commercial nuclear reactor types at the next generation. This parameters overview could serve as the base for the semi-quantitative decision bases for the selection of the future nuclear strategy. The number of advanced reactor designs of the LWR, HWR, GCR and LMR type are presented. Even currently many of them are still on the drawing boards, the concepts and designs should be assessed in the sense of sensible approach for planning the possible future nuclear strategy. (author) Clanek predstavlja usporedbu odabranih bitnih parametara karakteristicnih za razlicite tipove energetskih nuklearnih postrojenja slijedece generacije. Prikazani pregled parametara omogucava osnov za polu kvantitativnu osnovu za odlucivanje u svrhu donosenja odluke oko odrednica buduce strategije uporabe nuklearne energije. Brojni koncepti naprednih nuklearnih reaktora tipa LWR, HWR, GCR i LMR su prezentirani. S obzirom na cinjenicu da se mnogi of prezentiranih nalaze jos uvijek na crtacim daskama projektanata, koncepti i projekti koji su iz njih proizasli zahtijevaju analizu u smislu kvalitativnog pristupa planiranja moguce buduce nuklearne startegije. (author)

  17. Internal anal sphincter myopathy causing proctalgia fugax and constipation: further clinical and radiological characterization in a patient.

    Science.gov (United States)

    Guy, R J; Kamm, M A; Martin, J E

    1997-02-01

    We report a case of a distinctive familial internal anal sphincter myopathy with unique histological and radiological features. A 67-year-old woman presented with a 20-year history of proctalgia fugax and outlet obstruction; other family members were similarly affected. Computed tomograpy and magnetic resonance imaging demonstrated a grossly hypertrophied internal anal sphincter. Strip myectomy of the sphincter was carried out with improvement in evacuation but little relief of proctalgia. Further relief of symptoms was obtained using oral and transdermal nitrates and a calcium antagonist. Histological examination of the excised muscle revealed hypertrophy and an abnormal arrangement of fibres in whorls; many fibres contained vacuoles with inclusion bodies positive for periodic acid-Schiff. This description of a specific anal sphincter myopathy illustrates the potential importance of histopathological studies of smooth muscle in functional disorders of the gut.

  18. Male sex workers who sell sex to men also engage in anal intercourse with women: evidence from Mombasa, Kenya.

    Directory of Open Access Journals (Sweden)

    Priya Mannava

    Full Text Available To investigate self-report of heterosexual anal intercourse among male sex workers who sell sex to men, and to identify the socio-demographic characteristics associated with practice of the behavior.Two cross-sectional surveys of male sex workers who sell sex to men in Mombasa, Kenya.Male sex workers selling sex to men were invited to participate in surveys undertaken in 2006 and 2008. A structured questionnaire administered by trained interviewers was used to collect information on socio-demographic characteristics, sexual behaviors, HIV and STI knowledge, and health service usage. Data were analyzed through descriptive and inferential statistics. Bivariate logistic regression, after controlling for year of survey, was used to identify socio-demographic characteristics associated with heterosexual anal intercourse.From a sample of 867 male sex workers, 297 men had sex with a woman during the previous 30 days - of whom 45% did so with a female client and 86% with a non-paying female partner. Within these groups, 66% and 43% of male sex workers had anal intercourse with a female client and non-paying partner respectively. Factors associated with reporting recent heterosexual anal intercourse in bivariate logistic regression after controlling for year of survey participation were being Muslim, ever or currently married, living with wife only, living with a female partner only, living with more than one sexual partner, self-identifying as basha/king/bisexual, having one's own children, and lower education.We found unexpectedly high levels of self-reported anal sex with women by male sex workers, including selling sex to female clients as well as with their own partners. Further investigation among women in Mombasa is needed to understand heterosexual anal sex practices, and how HIV programming may respond.

  19. Seroconversion following anal and genital HPV infection in men: The HIM study

    Directory of Open Access Journals (Sweden)

    Anna R. Giuliano

    2015-12-01

    Full Text Available Background: Protection from naturally acquired human papillomavirus (HPV antibodies may influence HPV infection across the lifespan. This study describes seroconversion rates following genital, anal, and oral HPV 6/11/16/18 infections in men and examines differences by HPV type and anatomic site. Methods: Men with HPV 6/11/16/18 infections who were seronegative for those genotypes at the time of DNA detection were selected from the HPV Infection in Men (HIM Study. Sera specimens collected ≤36 months after detection were analyzed for HPV 6/11/16/18 antibodies using a virus-like particle-based ELISA. Time to seroconversion was separately assessed for each anatomic site, stratified by HPV type. Results: Seroconversion to ≥1 HPV type (6/11/16/18 in this sub-cohort (N=384 varied by anatomic site, with 6.3%, 18.9%, and 0.0% seroconverting following anal, genital, and oral HPV infection, respectively. Regardless of anatomic site, seroconversion was highest for HPV 6 (19.3%. Overall, seroconversion was highest following anal HPV 6 infection (69.2%. HPV persistence was the only factor found to influence seroconversion. Conclusions: Low seroconversion rates following HPV infection leave men susceptible to recurrent infections that can progress to HPV-related cancers. This emphasizes the need for HPV vaccination in men to ensure immune protection against new HPV infections and subsequent disease. Keywords: HPV, Men, Seroconversion, HPV antibodies, Human papillomavirus

  20. Of mice and men: an introduction to mouseology or, anal eroticism and Disney.

    Science.gov (United States)

    Berger, A A

    1991-01-01

    This essay deals with two important comics, Walt Disney's Mickey Mouse and George Herriman's Krazy Kat, and considers the social, cultural, psychological and symbolic significance of the main characters and their creators. In the discussion of Disney and his work (based, in part on writings about him) it is suggested that he exhibited traits associated with anal eroticism, which raises an interesting question about the popularity of his work with the American public. The two dominant themes found in Krazy Kat are described as "the triumph of illusion over reality" and "anti-authoritarianism." In a comparison of the two characters, it is shown they are polar opposites: Mickey Mouse is sadistic, asexual, and anal while Ignatz Mouse, the hero of Krazy Kat, is playful, sexual, and phallic.

  1. Incidence and cost of anal, penile, vaginal and vulvar cancer in Denmark

    DEFF Research Database (Denmark)

    Olsen, J.; Jorgensen, T. R.; Kofoed, K.

    2012-01-01

    Background: Besides being a causative agent for genital warts and cervical cancer, human papillomavirus (HPV) contributes to 40-85% of cases of anal, penile, vaginal and vulvar cancer and precancerous lesions. HPV types 16 & 18 in particular contribute to 74-93% of these cases. Overall the number...... of new cases of these four cancers may be relatively high implying notable health care cost to society. The aim of this study was to estimate the incidence and the health care sector costs of anal, penile, vaginal and vulvar cancer. Methods: New anogenital cancer patients were identified from the Danish...... Groups) and DAGS (Danish Outpatient Groups System) charges as cost estimates for inpatient and outpatient contacts, respectively. Health care consumption by cancer patients diagnosed in 2004-2007 was compared with that by an age-and sex-matched cohort without cancer. Hospital costs attributable to four...

  2. Colposcopic characteristics and Lugol׳s staining differentiate anal high-grade and low-grade squamous intraepithelial lesions during high resolution anoscopy

    Directory of Open Access Journals (Sweden)

    Naomi Jay

    2015-12-01

    Full Text Available Background: Anal squamous intraepithelial lesions (SIL and cancers are increased in immunocompromised populations. Based upon anatomic and histologic similarities, the cervix is used as the model for anal screening. During cervical colposcopy, acetic acid (AA and Lugol׳s staining (LS result in characteristic changes that help distinguish low-grade (LSIL from high-grade (HSIL. Lesion characteristics were evaluated for their ability to distinguish anal (aLSIL from anal (aHSIL during high-resolution anoscopy after application of AA and LS. Methods: AA-stained lesions were described using standard cervical colposcopic criteria. LS was then applied and lesions were characterized as Lugol׳s-negative (L−, Lugol׳s-partial (L+/−, or Lugol׳s positive (L+ and then biopsied. Biopsies were characterized as benign, squamous atypia, LSIL or HSIL. Results: 835 anal lesions were analyzed. Sensitivity and positive predictive value (PPV for aHSIL were highest for characteristics associated with cervical (cHSIL. L− was independently associated with aHSIL (OR=4.7, 95% CI=3.4–6.7. In multiple logistic regression analysis, significant predictors of aHSIL were flat contour (OR=2.24, 95% CI=1.3–3.8, mosaic pattern (OR=2.0, 95% CI=1.4–2.9, vascular punctation (OR=1.5, 95% CI=1.1–2.1 and L− (OR=2.3, 95% CI=1.5–3.4. L− staining improved the PPV of aHSIL almost twofold in lesions that otherwise had a colposcopic impression of LSIL. Conclusions: Evaluating acetowhite lesions for contour, surface, vascularity, and LS may maximize the likelihood of identifying aHSIL. Keywords: Anal, HSIL, High resolution anoscopy, Lugol׳s staining

  3. Remedial chemo-radiotherapy for mediastinum and pleuro-pulmonary metastases of an anal canal cancer; Chimio-radiotherapie de rattrapage pour metastases mediastinales et pleuropulmonaires d'un cancer du canal anal

    Energy Technology Data Exchange (ETDEWEB)

    Moreau, M.V.; Tournier-Rangeard, L.; Peiffert, D. [Centre Alexis-Vautrin, Service de Radiotherapie, 54 - Nancy (France)

    2006-11-15

    A fifty seven years woman received ten years ago, a radiotherapy with iodine for a Basedow hyperthyroidism. In 2001 she was damaged bu an epidermoid carcinoma of the anal canal. Radiotherapy, then chemotherapy, then brachytherapy. During three years noting special to declare. In 2004, respiratory insufficiency leads her to consult. A PET scanography shows an inter-aortic-pulmonary hyper-metabolism. Cortico-therapy and radiotherapy by X rays are delivered. In front of the positive response a new chemoradiotherapy and three cycles of chemotherapy are made. After twenty five months the patient is in complete remission of her metastases after this remedial treatment. This observation illustrates the radiosensitivity of the anal canal cancers of including metastases situation, the interest of the PET scanography and utility of a remedial treatment with curative goal. (N.C.)

  4. The frequency of herpes simplex virus changes in anal Pap smear and its association with squamous intraepithelial lesions in high-risk male patients.

    Science.gov (United States)

    Greebon, Leslie J; Avery, Diane L; Prihoda, Thomas J; Valente, Philip T; Policarpio-Nicolas, Maria Luisa C

    2014-06-01

    While there are studies postulating a model of synergism between human papillomavirus (HPV) and herpes simplex virus (HSV) in cervical carcinogenesis, the frequency of anal herpes as well as its association with anal squamous intraepithelial lesions (ASILs) has been understudied in men. This study evaluates the frequency of HSV changes in anal Pap smears and its association with ASILs in a high-risk population. A computerized search for specimens associated with anal cytology that had positive findings of HSV was performed. The electronic medical records were examined for past diagnosis of herpes, HSV serology prior to or after cytology, and if the patient received treatment after cytologic diagnosis of HSV. Of the 470 anal Pap smears (Thin-prep) examined, seven had cellular changes consistent with HSV infection. All patients were asymptomatic human immunodeficiency virus (HIV) positive males with no prior HSV serology tests. Two patients had prior diagnoses of HSV infection. Cytologic abnormalities were identified in 86% ranging from atypical squamous cells of undetermined significance to high grade squamous intraepithelial lesion. Three patients were treated after the HSV cytologic diagnosis. The frequency of HSV changes in anal Pap smear is low (1.48%), but the presence of concomitant cytologic abnormalities is high (86%). While our findings suggest the possible role of HSV as a HPV co-factor in ASILs, larger studies are needed to support this. Identification of HSV infection on anal Pap smear is important for institution of patient treatment and subsequent reduction of transmission. Copyright © 2014 Wiley Periodicals, Inc.

  5. PR-spetsid annavad Partsile nõu puhata ja analüüsida

    Index Scriptorium Estoniae

    2005-01-01

    TÜ avalikkussuhete õppejõud Kaja Saksakulm-Tampere soovitab Juhan Partsil toimunut analüüsida, suhtekorraldusspetsialist Ivo Rulli arvates oleks Juhan Partsil mõistlik võtta oma edasises avalikus elus pikem paus, taanduda Res Publica esimehe kohalt ja tegutseda parlamendis opositsioonis

  6. Paroxysmal anal hyperkinesis: a characteristic feature of proctalgia fugax.

    Science.gov (United States)

    Rao, S S; Hatfield, R A

    1996-10-01

    Proctalgia fugax is a common problem, yet its pathophysiology is poorly understood. The objective was to characterise colorectal disturbances in a paraplegic patient with a 10 year history of proctalgia fugax that began two years after an attack of transverse myelitis. Standard anorectal manometry and prolonged 33 hour ambulatory colonic manometry at six sites in the colon were performed together with myoelectrical recording of the anus. Provocative tests designed to simulate psychological and physical stress and two types of meals were included. Anorectal manometry showed normal internal sphincter tone and normal rectoanal inhibitory reflex but an inability to squeeze or to bear down or to expel a simulated stool. Rectal sensation (up to 360 ml inflation) was absent. Pudendal nerve latency was prolonged (4.5 ms (normal 3.2 mv), high frequency (5-50/min) anal myoelectrical activity, particularly after stress tests, meals, and at night. The myoelectrical disturbance only occurred with proctalgia. Intermittently, 16 bursts of 3 cycles/ min phasic rectal contractions were seen, but only six were associated with proctalgia. Colonic motility was reduced compared with normal subjects. The temporal association between a high amplitude, high frequency myoelectrical activity of the anal sphincter, and the occurrence of proctalgia suggests that paroxysmal hyperkinesis of the anus may cause proctalgia fugax.

  7. Anal cancer: ESMO–ESSO–ESTRO clinical practice guidelines for diagnosis, treatment and follow-up

    International Nuclear Information System (INIS)

    Glynne-Jones, Robert; Nilsson, Per J.; Aschele, Carlo; Goh, Vicky; Peiffert, Didier; Cervantes, Andrés; Arnold, Dirk

    2014-01-01

    Squamous cell carcinoma of the anus (SCCA) is a rare cancer but its incidence is increasing throughout the world, and is particularly high in the human immunodeficiency virus positive (HIV+) population. A multidisciplinary approach is mandatory (involving radiation therapists, medical oncologists, surgeons, radiologists and pathologists). SCCA usually spreads in a loco-regional manner within and outside the anal canal. Lymph node involvement at diagnosis is observed in 30–40% of cases while systemic spread is uncommon with distant extrapelvic metastases recorded in 5–8% at onset, and rates of metastatic progression after primary treatment between 10% and 20%. SCCA is strongly associated with human papilloma virus (HPV, types 16–18) infection. The primary aim of treatment is to achieve cure with loco-regional control and preservation of anal function, with the best possible quality of life. Treatment dramatically differs from adenocarcinomas of the lower rectum. Combinations of 5FU-based chemoradiation and other cytotoxic agents (mitomycin C) have been established as the standard of care, leading to complete tumour regression in 80–90% of patients with locoregional failures in the region of 15%. There is an accepted role for surgical salvage. Assessment and treatment should be carried out in specialised centres treating a high number of patients as early as possible in the clinical diagnosis. To date, the limited evidence from only 6 randomised trials [1,2,3,4,5,6,7], the rarity of the cancer, and the different behaviour/natural history depending on the predominant site of origin, (the anal margin, anal canal or above the dentate line) provide scanty direction for any individual oncologist. Here we aim to provide guidelines which can assist medical, radiation and surgical oncologists in the practical management of this unusual cancer

  8. Toward a definition of a threshold for harmless doses to the anal-sphincter region and the rectum

    International Nuclear Information System (INIS)

    Al-Abany, Massoud; Helgason, Asgeir R.; Agren Cronqvist, Anna-Karin; Lind, Bengt; Mavroidis, Panayiotis; Wersaell, Peter; Lind, Helena; Qvanta, Eva; Steineck, Gunnar

    2005-01-01

    Purpose: To investigate dysfunction caused by unwanted radiation to the anal-sphincter region and the rectum. Methods and materials: A questionnaire assessing bowel symptoms, sexual function, and urinary symptoms was sent to 72 patients with clinically localized prostatic adenocarcinoma treated by external beam radiation therapy at the Radiumhemmet, Karolinska Hospital, in Stockholm, Sweden, 2-4 years after treatment. The mean percentage dose-volume histograms for patients with and without the specific symptom were calculated. Results: Of the 65 patients providing information, 9 reported fecal leakage, 10 blood and mucus in stools, 10 defecation urgency, and 7 diarrhea or loose stools. None of the 19 and 13 patients who received, respectively, a dose of ≥35 Gy to ≤60% or ≥40 Gy to ≤40% of the anal-sphincter region volume reported fecal leakage (p < 0.05). In dose-volume histograms, a statistically significant correlation was found between radiation to the anal-sphincter region and the risk of fecal leakage in the interval 45-55 Gy. There was also a statistically significant correlation between radiation to the rectum and the risk of defecation urgency and diarrhea or loose stools in the interval 25-42 Gy. No relationship was found between anatomic rectal wall volume and the investigated late effects. Conclusions: Although the limited data in this study prevent the definition of a conclusive threshold regarding volume and dose to the anal-sphincter region and untoward morbidity, it seems that careful monitoring of unnecessary irradiation to this area should be done because it can potentially help reduce the risk of adverse effects, such as fecal leakage. Future studies should pay more attention to the anal-sphincter region and help to more rigorously define its radiotherapeutic tolerance

  9. Preliminary results of a screening program for anal cancer and its precursors for HIV-infected men who have sex with men in Vigo-Spain

    Directory of Open Access Journals (Sweden)

    Mauricio Iribarren-Díaz

    Full Text Available Background and aims: Men who have sex with men (MSM infected with human immunodeficiency virus (HIV have the highest risk of developing anal cancer (AC. The objective of this study was to describe our screening implementation program in this population, and report the prevalence of human papillomavirus (HPV anal infection, and cytological and histological findings in a Spanish medium-size community (Vigo, Spain. Method: Prospective cohort analysis of 240 HIV-infected MSM. Cellular anal sample and high risk HPV (HR-HPV-tests were performed to study cytological changes and HPV genotyping. High resolution anoscopy (HRA was performed in 209 patients. Results were analyzed with respect to epidemiological, clinical and analytical factors. Results: Of 209 patients selected for HRA, the prevalence of HR-HPV anal infection, cytological and histological alterations was 85.6%, 47.5%, and 39.8%, respectively. Sensitivity and specificity for ≥ ASCUS (atypia of squamous cells of undetermined significance cytology in relation to histological alterations were 61% and 85%, (OR: 8.7; IC 95%: 4.4-17.2, respectively. Observed concordance between high-grade squamous intraepithelial lesion (HSIL cytology and HSIL anal intraepithelial neoplasia types 2 and 3 (AIN-2/3 histology was 64% (OR: 11.4; IC 95%: 3.6-36.7. One patient with HSIL cytology presented a prevalent anal squamous carcinoma. Conclusions: HRA was feasible with similar results to relevant groups. There was a high prevalence of anal HR-HPV infection, and cytological and histological alterations.

  10. Rastreamento de lesões precursoras do carcinoma espino-celular anal em indivíduos portadores do HIV Tracking precursor lesions of anal squamous cell carcinoma in individuals with HIV

    Directory of Open Access Journals (Sweden)

    Caio Sergio Rizkallah Nahas

    2011-06-01

    Full Text Available INTRODUÇÃO: O carcinoma espino-celular do canal anal é doença que atinge os adultos de meia idade e corresponde a 4% dos cânceres do trato gastrointestinal baixo. Na população geral a incidência é de 1 em 100.000 habitantes, e entre os homens que fazem sexo com homens essa incidência atinge 35 por 100.000 habitantes, sendo que os portadores de HIV têm esse risco duplicado (70 por 100.000 habitantes. MÉTODO: Foi realizada revisão da literatura com consulta nos periódicos das bases Medline/Pubmed, Scielo e Lilacs cruzando os descritores Rastreamento, Lesões pré-cancerosas, Neoplasias do ânus e HIV. Além da revisão bibliográfica, foi adicionada a este trabalho a experiência pessoal dos autores, e a obtida no Departamento de Gastroenterologia - Divisão Cirúrgica, no ICESP - Instituto do Câncer do Estado de São Paulo Octávio Frias de Oliveira, no Departamento de Moléstias Infeciosas - Casa da AIDS e no Serviço de Coloproctologia do Hospital das Clínicas da Universidade de São Paulo, SP, Brasil. CONCLUSÕES: HIV+ é um grande fator de risco no desenvolvimento de carcinoma espino-celular anal em indivíduos infectados por HPV. A avaliação desses pacientes não deve se restringir à erradicação de condilomas, mas principalmente incluir o rastreamento de lesões displásicas subclínicas potencialmente neoplásicas. Apesar dos métodos de rastreamento ainda não serem ideais, o grande benefício do rastreamento baseia-se no fato de oferecer acompanhamento rigoroso, tornando possível à prevenção ou detecção cada vez mais precoce do carcinoma espino-celular anal.INTRODUCTION: Squamous cell carcinoma of the anal canal is a disease that affects the middle-aged adults and accounts for 4% of cancers of the gastrointestinal tract below. In the general population the incidence is 1 in 100,000, and among men who have sex with men the incidence is 35 per 100,000 inhabitants, those with HIV have doubled this risk (70 per 100

  11. Prevalence of Anal Human Papillomavirus Infection and Risk Factors among HIV-positive Patients in Tokyo, Japan.

    Directory of Open Access Journals (Sweden)

    Naoyoshi Nagata

    Full Text Available Oncogenic human papillomavirus (HPV infection, particularly multiple HPV types, is recognized as a necessary cause of anal cancer. However, a limited number of studies have reported the prevalence of anal HPV infection in Asia. We determined the prevalence, genotypes, and risk factors for anal HPV infection in Japanese HIV-positive men who have sex with men (MSM, heterosexual men, and women.This cross-sectional study included 421 HIV-positive patients. At enrollment, we collected data on smoking, alcohol, co-morbidities, drugs, CD4 cell counts, HIV RNA levels, highly active anti-retroviral therapy (HAART duration, sexually transmitted infections (STIs, and serological screening (syphilis, hepatitis B virus, Chlamydia trachomatis, Entamoeba histolytica. Anal swabs were collected for oncogenic HPV genotyping.Oncogenic HPV rate was 75.9% in MSM, 20.6% in heterosexual men, and 19.2% in women. HPV 16/18 types were detected in 34.9% of MSM, 17.7% of heterosexual men, and 11.5% of women. Multiple oncogenic HPV (≥2 oncogenic types rate was 54.6% in MSM, 8.8% in heterosexual men, and 0% in women. In univariate analysis, younger age, male sex, MSM, CD4 50,000, no administration of HAART, and having ≥2 sexually transmitted infections (STIs were significantly associated with oncogenic HPV infection, whereas higher smoking index and corticosteroid use were marginally associated with oncogenic HPV infection. In multivariate analysis, younger age (OR, 0.98 [0.96-0.99], MSM (OR, 5.85 [2.33-14.71], CD4 <100 (OR, 2.24 [1.00-5.01], and having ≥2 STIs (OR, 2.81 [1.72-4.61] were independently associated with oncogenic HPV infection. These 4 variables were also significant risk factors for multiple oncogenic HPV infection.Among Japanese HIV-infected patients, approximately two-thirds of MSM, one-fifth of heterosexual men, and one-fifth of women have anal oncogenic HPV infection. Younger age, MSM, ≥2 STIs, and immunosuppression confer a higher risk of

  12. McDonald’s mārketinga komunikāciju analīze

    OpenAIRE

    Grigore, Lolita

    2008-01-01

    Maģistra darba tēma ir „McDonald’s mārketinga komunikāciju analīze”. Mārketinga komunikācijas ir viens no mārketinga mix elementiem, un tam ir svarīga nozīme attiecību veidošanā ar patērētājiem, tāpēc to veidošanai un uzturēšanai ir jāpievērš pastiprināta uzmanība. Darba mērķis ir McDonald’s veikto mārketinga komunikāciju izpēte (analīze) pasaules un Latvijas mērogā un noteikt mārketinga komunikāciju lomu faktoru kopā, kas ietekmē Latvijas iedzīvotāju uzvedību, izvēloties ātrās ēdināšanas...

  13. Assessment of fistulectomy combined with sphincteroplasty in the treatment of complicated anal fistula

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    Fakhrolsadat Anaraki

    2017-07-01

    Full Text Available Introduction: The ideal method of treating the complex anal fistula is to eradicate the sepsis and preserve the anal sphincter; since there is no definite consensus on the surgical method of treating it. Recent studies show that fistulectomy and immediate sphincteroplasy are a safe and appropriate way to treat the fistula-in-ano. The aim of this study was to evaluate the long term outcomes of fistulectmy and sphincteroplasty in the treatment of complex perianal fistula. Methods: In this prospective study, we have analyzed the data of 80 patients who underwent fistulectomy and sphincteroplasty from May 2013 to May 2016. Preoperative information included physical examination, preoperative fecal incontinence evaluation and taking a complete history about underlying diseases and past related surgeries were collected. Results: Of all 80 patients with complex fistula, 57.5% (46 patients were male. 70-Patients were presented with high transsphincteric fistula (87.5% and anterior fistula was diagnosed in 10 of them (12.5%. 9 patients (11.3% suffered from hypertension and 43 patients (53.75% had recurrent fistula after previous surgeries. During the follow-up period, the overall success rate was 98.8% (98.8% and fistulectomy and sphincteroplasty failed in only one patient (failure rate: 1.3%. preoperative and post-operative scoring showed mild fecal incontinence in 8 patients (10%. We have found no significant relation between the age, gender, hypertension, previous surgery and post-operative recurrence. Conclusion: Fistulectomy and sphincteroplasty is a safe surgical procedure in the treatment of anterior anal fistula in females and high transsphincteric fistulas. Resumo: Introdução: o método ideal para tratar a fístula anal complexa consiste em erradicar a sepse e preservar o esfíncter anal, uma vez que não existe consenso definitivo com relação ao método cirúrgico para tratamento desse problema. Estudos recentes demonstram que a

  14. A Rare Case of Anal and Perianal Chemical Burn in a Child due to Potassium Permanganate Crystals.

    Science.gov (United States)

    Dash, Suvashis; Bhojani, Jatin; Sharma, Sharadendu

    2018-02-09

    Many chemicals used as medical treatments can cause chemical burns as an untoward side effect. One of such chemicals is potassium permanganate. It is a caustic chemical used as a disinfectant. The most common sites of burn by potassium permanganate are exposed sites like the face and hands. Chemical burns in the perianal and anal region are rare in clinical practice and even sparser in the pediatric age group. In this article, we report a case of perianal and anal chemical burn in an 18-month-old, male child, caused by potassium permanganate crystal applied wrongly for the treatment of pinworm infestation. As a chemical burn in this region can have serious complications, it is necessary to be vigilant when using such chemicals in these cases. Early and timely management in such cases leads to good outcomes. This is the first of such cases of chemical burn caused by potassium permanganate in the anal and perianal region.

  15. Partner-Level Factors Associated with Insertive and Receptive Condomless Anal Intercourse Among Transgender Women in Lima, Peru.

    Science.gov (United States)

    Satcher, Milan F; Segura, Eddy R; Silva-Santisteban, Alfonso; Sanchez, Jorge; Lama, Javier R; Clark, Jesse L

    2017-08-01

    Condomless anal intercourse among transgender women (TW) in Peru has been shown to vary by the type of partner involved (e.g. primary vs. casual vs. transactional sex partner), but no previous studies have explored variations in partner-level patterns of condom use according to type of anal intercourse. We evaluated the relationship between partnership characteristics and condom use during insertive (IAI) versus receptive anal intercourse (RAI) among TW with recent, non-female partners. Condomless IAI was more common with transactional and casual sex partners and by TW who self-reported HIV-uninfected serostatus (p < 0.05), alcohol use disorders, or substance use before sex. Condomless RAI was more common with primary partners and by TW who described their HIV serostatus as unknown (p < 0.05). Examining partner-level differences between condomless IAI and RAI reveals distinct patterns of HIV/STI risk among TW, suggesting a need for HIV prevention strategies tailored to the specific contexts of partners, practices, and networks.

  16. Carcinoma of the anal canal: Intensity modulated radiation therapy (IMRT) versus three-dimensional conformal radiation therapy (3DCRT)

    OpenAIRE

    Sale, Charlotte; Moloney, Phillip; Mathlum, Maitham

    2013-01-01

    Introduction Patients with anal canal carcinoma treated with standard conformal radiotherapy frequently experience severe acute and late toxicity reactions to the treatment area. Roohipour et al. (Dis Colon Rectum 2008; 51: 147–53) stated a patient's tolerance of chemoradiation to be an important prediction of treatment success. A new intensity modulated radiation therapy (IMRT) technique for anal carcinoma cases has been developed at the Andrew Love Cancer Centre aimed at reducing radiation ...

  17. Familial disseminated plaque type porokeratosis with multiple horns and squamous cell carcinoma involving anal skin

    Directory of Open Access Journals (Sweden)

    Sarma Nilendu

    2009-01-01

    Full Text Available Porokeratosis is a disorder of keratinization showing a well-defined lesion with a hyperkeratotic ridge on the border that contains the coronoid lamella. We report familial (autosomal dominant with reduced penetrance disseminated plaque type (Mibelli′s type porokeratosis in a father and son. In the father, there were multiple horns and a large squamous cell carcinoma in a large lesion over the perianal region that reached up to the squamo-columnar junction of the anal mucosa and even invaded the anal sphincteric muscles. Disseminated lesions of the Mibelli′s type, development of horns, and malignancy in this unusual location have not been previously reported.

  18. Anal manometric evaluation of children with encopresis

    OpenAIRE

    CESAR, Maria Auxiliadora Prolungatti; MOURA, Brenda C de; SILVA, Fernanda Perez Adorno da; BARBIERI, Dorina; BRUNO, Rodrigo Ciotolla; BERTOLI, Ciro João; ORTIZ, Jorge Alberto

    2010-01-01

    INTRODUÇÃO: A constipação crônica é doença comum na infância, ocorrendo em 5 a 10% dos pacientes pediátricos, considerada a segunda maior causa de procura nos consultórios de pediatria, sendo a encoprese decorrente de constipação grave associada à impactação fecal no reto. Dentre os exames diagnósticos, a manometria anal é utilizada para a avaliação de pacientes com distúrbios funcionais, como a constipação intestinal e a incontinência fecal, em alguns serviços para a avaliação de pacientes c...

  19. Pressões retais e anais em primigestas ao defecar Rectal and anal straining pressures in primigravidae

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    Wilmar Artur Klug

    2008-04-01

    Full Text Available OBJETIVO: O estudo teve o objetivo de avaliar as mudanças nas pressões do reto e ânus de primigestas ao simular defecação. MÉTODOS: Selecionamos 60 mulheres no Ambulatório de Pré-natal e no de Cirurgia da Santa Casa de São Paulo. Estas formaram quatro grupos de 15: a grupo-controle: nuligestas; b primigestas no 1º trimestre; c primigestas no 2º trimestre; d primigestas no 3º trimestre. Em todas realizamos manometria retal e anal e as seguintes medidas: a pressão retal em repouso; b pressão retal ao esforço de defecação; c pressão anal à defecação. RESULTADOS: Observamos que as pressões retais ao esforço de defecar aumentam em grávidas em menor proporção que nas nuligestas; estas pressões caíram de 53,9 ± 17,9 em nuligestas para 36,3± 19,6, 38,1 ± 16,2 e 30,5 ± 17,0 nos três trimestres. As pressões anais de defecação foram maiores nas nuligestas (46,9± 17,6 que nas gestantes, respectivamente 37,5 ± 15,5, 32,1 ± 6,2 e 32,9 ± 8,7. Houve maior queda das pressões anais na gestação mais avançada, que compensa a dificuldade para elevar a pressão intra-retal de esforço. CONCLUSÃO: A gravidez altera as pressões retais e anais ao simular defecação, diminuindo- as, mas de forma a compensarem-se mutuamente.OBJECTIVE: This study intended to evaluate rectal and anal straining pressures in primigravidae, at simulated defecation. METHODS: The present study is based on 60 women from de Antenatal Care of Santa Casa de Misericórdia - São Paulo. Patients were divided into four groups of 15: a Control group: nuligravidae; b 1st trimester primigravidae; c 2nd trimester primigravidae; d 3rd trimester primigravidae. All patients underwent rectal and anal measurements to obtain: a Resting rectal pressure; b Straining rectal pressure; c Minimal straining anal pressure. RESULTS: Data was analyzed using statistical methods and reached, the same results: it was observed that the straining rectal pressure decreased from 53

  20. Genetic relatedness among vaginal and anal isolates of Candida albicans from women with vulvovaginal candidiasis in north-east Brazil.

    Science.gov (United States)

    Araújo Paulo de Medeiros, Mariana; Vieira de Melo, Ana Patrícia; Gonçalves, Sarah Santos; Milan, Eveline Pipolo; Chaves, Guilherme Maranhão

    2014-11-01

    Vulvovaginal candidiasis (VVC) is one of the most common causes of vaginitis and affects about 75% of women of reproductive age. In order to better understand the epidemiology and pathogenesis of this disease, we evaluated genetic relatedness among 62 clinical isolates of Candida albicans sequentially obtained from the anus and vagina of patients with sporadic and recurrent VVC. Evaluation of patients' demographic and clinical data, direct examination, and colony forming units (c.f.u.) counts of vaginal and anal samples were also performed. The genotypes of strains were determined with ABC genotyping and Randomly Amplified Polymorphic DNA (RAPD). Genotype A was the most prevalent (93.6%), followed by genotype C (6.4%), whereas genotype B was not found. We found the maintenance of the same ABC genotype, regardless of the body site of each patient. Most of the vaginal strains suffered microevolution, whereas most of the anal strains were replaced during the period of study. Vaginal and anal isolates of C. albicans obtained simultaneously from the same patient showed the same ABC genotype and high genetic similarity as determined by RAPD. Genotype A seemed to be dominant in both vaginal and anal isolates of patients with VVC. Our results corroborate the hypothesis that there are 'substrains' of the C. albicans vaginal clone successfully established, which dominate in an apparently random manner over the course of time. It is suggested that the anal reservoir constitutes a possible source for vaginal infection in most of the cases. © 2014 The Authors.

  1. Syndemic synergy of HPV and other sexually transmitted pathogens in the development of high-grade anal squamous intraepithelial lesions

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    Jenny C. McCloskey

    2017-12-01

    Full Text Available Background: Anal intraepithelial neoplasia is associated with high-risk human papillomavirus (hrHPV as a precursor to anal cancer. However, factors other than hrHPV are likely to be involved and further study of cofactors is required because of the possibility of syndemic interactions. Methods: Three hundred and fourteen patients underwent 457 operations. Histopathology and hrHPV testing using the Digene Hybrid Capture 2 (HC 2 method were performed. Demographic factors and sexually transmissible infections (STIs were recorded. Results: Results showed that hrHPV alone was associated with HSIL (OR = 4.65, p < 0.001. None of the other STIs were alone associated with HSIL but amplification of risk was found when hrHPV infection occurred with HIV (OR = 11.1; syphilis (OR = 5.58; HSV 2 (OR = 7.85; gonorrhoea (OR = 6.45 and some other infections. Conclusions: These results suggest that hrHPV is a sufficient cause of anal HSIL. Seropositivity for HIV, HSV 2, T. pallidum, HBV and HCV and a history of gonorrhoea or chlamydia exert a powerful amplifying factor increasing the risk of HSIL above the risk with hrHPV alone. Other co-factors which are associated with an increased risk of HSIL are increased age, male gender, MSM behaviour and self-reported history of more than 50 sexual partners. This pattern of disease in patients with warts is characteristic of a syndemic with potential serious increased risk of anal carcinoma. Keywords: HSIL, Anal warts, Sexually transmissible infections, High-risk HPV, HIV, Syndemic

  2. Isosorbide dinitrate ointment vs botulinum toxin A (Dysport®) as the primary treatment for chronic anal fissure: a randomized multicentre study

    NARCIS (Netherlands)

    Berkel, A.E.M.; Rosman, C.; Koop, R.; van Duijvendijk, P.; van der Palen, Jacobus Adrianus Maria; Klaase, J.M.

    2014-01-01

    Aim Nitric oxide donors, such as isosorbide dinitrate ointment (ISDN), are considered as first-choice agents in the treatment of chronic anal fissure. Injection with botulinum toxin A in the internal anal sphincter is often used as a second-line therapy, although it may give better results and fewer

  3. Frequency of anal sphincter rupture at delivery in Sweden and Finland--result of difference in manual help to the baby's head.

    Science.gov (United States)

    Pirhonen, J P; Grenman, S E; Haadem, K; Gudmundsson, S; Lindqvist, P; Siihola, S; Erkkola, R U; Marsal, K

    1998-11-01

    Anal sphincter rupture is a serious complication of vaginal delivery and almost half the affected women have persistent defecatory symptoms despite adequate primary repair. During the past decade, the incidence of anal sphincter ruptures has been increasing in Sweden and is currently estimated to occur in 2.5% of vaginal deliveries. The aim of the study was to report the frequency of anal sphincter ruptures in two university hospitals in two Scandinavian countries, Malmö in Sweden and Turku in Finland, and analyze the potential determinants. Retrospective analysis of a population of 30,933 deliveries (26,541 vaginal) during the years 1990 to 1994. The incidence of anal sphincter ruptures in Malmö, Sweden was 2.69%, and in Turku, Finland 0.36%. There were no significant population differences for the known risk factors (fetal weight, nulliparity or fetal head circumference). However, there is a difference in manual support given to the perineum and to the baby's head when crowning through the vaginal introitus between Malmö and Turku. The proportion of operative vaginal deliveries and abnormal presentations was significantly higher in Turku reflected in the lower Apgar score at 5 minutes and longer duration of second phase of labor. When high risk deliveries (operative vaginal delivery, abnormal presentation and newborns over 4,000 g) were excluded, the risk for anal sphincter ruptures was estimated to be 13 times higher in Malmö than in Turku. The difference in the incidence of anal sphincter rupture between Malmö, Sweden and Turku, Finland may be due to the difference in manual control of the baby's head when crowning.

  4. Resultados do tratamento do carcinoma espinocelular anal e do seu precursor em doentes HIV-positivos Outcome of treatment of anal squamous cell carcinoma and its precursor in HIV-infected patients

    Directory of Open Access Journals (Sweden)

    Sidney Roberto Nadal

    2007-08-01

    Full Text Available OBJETIVO: A incidência de carcinomas espinocelulares anais vem aumentando nos doentes HIV-positivos. O tratamento consiste de radio e/ou quimioterapia, eventualmente seguidos pela ressecção do tumor. O objetivo é avaliar o seguimento desses doentes para verificar as recidivas e a evolução do NIAA para câncer. Apresentação da casuística da Equipe Técnica de Proctologia do Instituto de Infectologia Emílio Ribas, de São Paulo. MÉTODOS: Acompanhamos 45 doentes HIV-positivos portadores de carcinoma espinocelular anal e seu precursor no período de 1996 a 2006. Eram 30 neoplasias intra-epiteliais anais de alto grau (NIAA, tratadas com ressecção local e 15 carcinomas invasores do canal anal. Nove das 15 lesões invasivas foram submetidas ao esquema de Nigro isolado ou associado à ressecção local, amputação abdominoperineal ou colostomia para derivação. RESULTADOS: No seguimento ambulatorial das NIAA tivemos recidiva em 16,7% e não observamos evolução para carcinoma, num período mínimo de três anos. Entre os nove tumores submetidos ao esquema de Nigro, com ou sem operação complementar, cinco estão livres de tumor. Nenhum tratamento foi feito em cinco doentes. Em três, devido às péssimas condições clínicas, e em dois, pois recusaram tratamento. Outro teve diagnóstico na vigência de oclusão intestinal sendo submetido à colostomia de derivação. CONCLUSÃO: Concluímos que a NIAA pode reincidir após excisão local em doentes HIV-positivos, mas não evolui para carcinoma invasor e que os doentes de câncer anal invasor podem ser tratados da mesma maneira que a população soronegativa para o HIV desde que as condições clínicas o permitam.OBJECTIVE: Incidence of anal squamous cell carcinoma is increasing mainly among HIV-positive patients. Treatment consists of radiotherapy and chemotherapy, sometimes followed by tumor resection. The objective was to evaluate the follow-up of such patients to verify recurrences

  5. Tehnoloogia aitab varusid juhtida ja analüüsida / Aleksei Dobrõshman

    Index Scriptorium Estoniae

    Dobrõshman, Aleksei

    2005-01-01

    Autor tutvustab logistikavaldkonnas kasutatavaid uusi tarkvaralahendusi: marketingi- ja CRM-süsteemi, elektrooniliste dokumentide vahetamise süsteemi, juhtimise ja analüüsi süsteemi, täiustatud veebitellimuste süsteemi, kliendihaldussüsteemi liikuvatele töötajatele. Lisa: Veebilahendus on mugavam

  6. Theoretical analysis of nuclear reactors (Phase III), I-V, Part IV, Influence of isotopic composition of nuclear fuel on the reactivity with constant flux; Razrada metoda teorijske analize nuklearnih reaktora (III faza) I-IV, IV Deo, Uticaj promene izotopnog sastava goriva na reaktivnost uz konstantan fluks

    Energy Technology Data Exchange (ETDEWEB)

    Pop-Jordanov, J [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1963-01-15

    Part one of this report presents a series of differential equations describing the nuclear fuel depletion during reactor operation. This series of differential equations is extended to describe the fission products. This part includes equations for effective multiplication factor k{sub eff} and reactivity {rho} as a function of irradiation {tau}. Part two includes results obtained on the analog computer PACE 231 R, and related to Calder Hall type reactor. Part three covers detailed preparation of the series of equations for solution by using the analog computer. Part four includes the list of references related to this task.

  7. ZS "Avotiņi" saimnieciskās darbības analīze un nākotnes attīstības perspektīvas

    OpenAIRE

    Beķere, Ināra

    2016-01-01

    Maģistra darbā ir veikta ZS “Avotiņi” saimnieciskā darba analīze, izmantojot sekojošas analīzes metodes: •pārskata lasīšana; •horizontālā analīze; •vertikālā analīze; •finanšu koeficientu aprēķināšana. Finanšu pārskatu lietotāji, veicot finanšu analīzi, var iegūt informāciju par uzņēmuma saimniecisko vai finanšu stāvokli. Tas ļauj pieņemt lēmumus par līdzekļu investēšanu, tādejādi jebkurš lēmums var būtiski ietekmēt tālāku saimniecisko un finansiālo darbību. Darba teorētiskajā daļā autore m...

  8. The prevalence of anal human papillomavirus among young HIV negative men who have sex with men

    Directory of Open Access Journals (Sweden)

    Zou Huachun

    2012-12-01

    Full Text Available Abstract Men who have sex with men (MSM especially those who are HIV positive are at risk for HPV-associated anal cancer. We systematically reviewed studies with data on the prevalence of vaccine preventable anal HPV among men who have sex with men aged 25 or younger and identified 6 studies. None of these studies were specifically designed to determine the prevalence of HPV in this population. Available data, albeit limited, suggest many young MSM may not already be HPV infected. Further studies using representative sampling focused on teenage MSM are required to confirm this.

  9. Conservative management of anal and rectal cancer. The role of radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Gerard, J.P.; Romestaing, P.; Montbarbon, X. (Centre Hospitalier Lyon Sud, 69 - Pierre-Benite (France). Dept. of Radiotherapy)

    1989-01-01

    The role of irradiation in the management of anal and rectal cancer has changed during the past ten years. In small epidermoid carcinomas of the anal canal (T1 T2) irradiation is in most departments considered the primary treatment, giving a 5-year survival rate of between 60 and 80% with good sphincter preservation. Even in larger tumors, irradiation can still offer some chance of cure without colostomy. Surgery remains the basic treatment of rectal cancer but irradiation is used in association with surgery in many cases. Radiotherapy is of value in the conservative management of cancer of the rectum in three situations: In small polypoid cancers contact X-ray therapy can give local control in about 90%. In cancers of the middle rectum, preoperative external irradiation may increase the chances of restorative surgery and reduce the risk of local relapse. In inoperable patients, external radiotherapy and/or intracavitary irradiation may cure some patients with infiltrating tumors (T2 T3) without colostomy. (orig.).

  10. Handedness is a biomarker of variation in anal sex role behavior and Recalled Childhood Gender Nonconformity among gay men

    OpenAIRE

    Swift-Gallant, Ashlyn; Coome, Lindsay A.; Monks, D. Ashley; VanderLaan, Doug P.

    2017-01-01

    Developmental theories of the biological basis of sexual orientation suggest that sexually differentiated psychological and behavioural traits should be linked with sexual orientation. Subgroups of gay men delineated by anal sex roles differ according to at least one such trait: gender expression. The present study assessed the hypothesis that handedness, a biologically determined sexually differentiated trait, corresponds to differences in subgroups of gay men based on anal sex role. Further...

  11. Rectal prolapse and anal incontinence treated with a modified Roscoe Graham operation

    DEFF Research Database (Denmark)

    Klaaborg, K E; Qvist, N; Kronborg, O

    1985-01-01

    The results of abdominal mobilization of the rectum and repair of the pelvic floor behind the anorectal junction are reported in 23 patients with rectal prolapse, being accompanied by some form of anal incontinence in 12. Within 20 months, on the average, three patients had recurrent prolapse. Tw...

  12. Clinical role of a modified seton technique for the treatment of trans-sphincteric and supra-sphincteric anal fistulas.

    Science.gov (United States)

    Tokunaga, Yukihiko; Sasaki, Hirokazu; Saito, Tohru

    2013-03-01

    We have devised a modified seton technique that resects the external fistula tract while preserving the anal sphincter muscle. This study assessed the technique when used for the management of complex anal fistulas. Between January 2006 and December 2007, 239 patients (208 males and 31 females, median age: 41 years) underwent surgery for complex anal fistulas using the technique. Of the 239 patients, 198 patients had trans-sphincteric fistula and 41 patients had supra-sphincteric fistula. The durations of the surgeries were 17 min (47, 13) [median (range, interquartile range)] for trans-sphincteric fistulas and 38 (44, 16) for supra-sphincteric fistulas. The durations of the surgeries were significantly (P trans-sphincteric fistula. The hospital stays were 4 (13, 2) days and 5 (14, 3) days, respectively, for trans- and supra-sphincteric fistulas. The durations of seton placement until the spontaneous dropping of the seton were 42 (121, 48) and 141 (171, 55) days respectively. The recurrence rate was 0 % in patients with trans-sphincteric fistulas and 4.9 % (2 of 41) in patients with supra-sphincteric fistulas (P < 0.01). Serious incontinence was not observed. The technique provided favorable results for the treatment of complex anal fistulas and could be safely applied while preserving the sphincter function and conserving fecal continence.

  13. MRI in children following surgery for anal and rectal atresia

    International Nuclear Information System (INIS)

    Krahe, T.; Herold, A.; Doelken, W.; Hoecht, B.; Wuerzburg Univ.

    1989-01-01

    MRI of the pelvis was performed in 17 children following surgical correction of anal and rectal atresias and in five children without ano-rectal malformations. A muscle score was used to characterize the muscles of the pelvic floor and their relationship to the rectum. There was close agreement between the MRI muscle score and clinical continence. MRI provided additional information that should improve continence following conservative and surgical treatment. (orig.) [de

  14. Viewing of Internet-Based Sexually Explicit Media as a Risk Factor for Condomless Anal Sex among Men Who Have Sex with Men in Four U.S. Cities.

    Science.gov (United States)

    Schrimshaw, Eric W; Antebi-Gruszka, Nadav; Downing, Martin J

    2016-01-01

    The last decade has seen a dramatic increase in the availability of sexually explicit media (SEM) on the Internet. Men who have sex with men (MSM) report near universal use of SEM. However, this widespread use of SEM among MSM may contribute to more condomless anal sex. To examine the association of viewing SEM on the Internet and the number of condomless anal sex encounters among MSM, in 2012, an online survey was conducted of 265 MSM from New York, Philadelphia, Baltimore, or Washington D.C. who reported viewing SEM online in the past 3 months. Analyses were performed using negative binomial regression. Nearly all men reported viewing SEM featuring anal sex with (91%) or without (92%) condoms in the past 3 months. Neither viewing more hours of SEM per week or compulsively viewing SEM were associated with more condomless anal sex encounters. Rather, viewing a greater proportion of SEM containing condomless anal sex was associated with engaging in more condomless anal encounters (IRR = 1.25), while viewing a greater proportion of SEM containing anal sex where condoms were used was associated with fewer condomless anal sex encounters (IRR = 0.62). MSM reported that viewing SEM caused changes in their sexual fantasies, desires, and behaviors. These findings provide important insights for health policy and the design of interventions addressing SEM and condomless sex among MSM. The findings suggest that condom use by SEM performers may benefit not only actor health, but also have health implications for SEM viewers.

  15. Reproducibility and genital sparing with a vaginal dilator used for female anal cancer patients

    International Nuclear Information System (INIS)

    Briere, Tina Marie; Crane, Christopher H.; Beddar, Sam; Bhosale, Priya; Mok, Henry; Delclos, Marc E.; Krishnan, Sunil; Das, Prajnan

    2012-01-01

    Purpose: Acute vulvitis, acute urethritis, and permanent sexual dysfunction are common among patients treated with chemoradiation for squamous cell carcinoma of the anal canal. Avoidance of the genitalia may reduce sexual dysfunction. A vaginal dilator may help delineate and displace the vulva and lower vagina away from the primary tumor. The goal of this study was to evaluate the positional reproducibility and vaginal sparing with the use of a vaginal dilator. Materials and methods: Ten female patients treated with IMRT for anal cancer were included in this study. A silicone vaginal dilator measuring 29 mm in diameter and 114 mm in length was inserted into the vagina before simulation and each treatment. The reproducibility of dilator placement was investigated with antero-posterior and lateral images acquired daily. Weekly cone beam CT (CBCT) imaging was used to confirm coverage of the GTV, which was typically posterior and inferior to the dilator apex. Finally, a planning study was performed to compare the vaginal doses for these 10 patients to a comparable group of 10 female patients who were treated for anal cancer with IMRT without vaginal dilators. Results: The absolute values of the location of the dilator apex were 7.0 ± 7.8 mm in the supero-inferior direction, 7.5 ± 5.5 mm in the antero-posterior, and 3.8 ± 3.1 mm in the lateral direction. Coverage of the GTV and CTV was confirmed from CBCT images. The mean dose to the vagina was lower by 5.5 Gy, on average, for the vaginal dilator patients, compared to patients treated without vaginal dilators. Conclusion: The vaginal dilator tended to be inserted more inferiorly during treatment than during simulation. For these ten patients, this did not compromise tumor coverage. Combined with IMRT treatment planning, use of a vaginal dilator could allow for maximum sparing of female genitalia for patients undergoing radiation therapy for anal cancer.

  16. A project proposal for the implementation of IMRT in anal canal tumors in the INOR

    International Nuclear Information System (INIS)

    Perez, Lourdes; Alert, Jose; Larrinaga, Eduardo

    2009-01-01

    The treatment of choice for locally advanced tumors of the anal canal is to radio chemotherapy, patients being treated for these tumors have a very prolonged therapeutic range due to the high toxicity of treatment, which negatively affects the results. Intensity Modulated Radiation therapy has been to improve this situation by allowing an adequate tolerance of treatment. The main objective is to reduce the toxicity of treatment and thus the therapeutic range, which will improve treatment outcomes. Inclusion criteria: We included all patients with tumors of the anal canal, with locally advanced disease or those with early stage tumors not amenable to surgical treatment for medical contraindications. All patients should be discussed at the Central in the gastrointestinal tract. Planning CT scan in all patients by placing a radiopaque marker to the anus. Volumes were selected to be irradiated, which will include the anal canal, rectum and nodal regions, including the groin. Be designed all organs at risk. Treatment was performed in 3 phases, using five fields and energy combinations. The treatment was performed in 1220 of INOR LINAC and treatment planning will be held in the PRESICA PLAN. Patients will be followed for 3 years in order to evaluate late toxicity and survival and disease-free interval. (Author)

  17. PENGARUH MODEL PROBLEM BASED LEARNING TERHADAP KEMAMPUAN BERPIKIR ANALITIS DAN KETERAMPILAN PROSES SAINS KIMIA PESERTA DIDIK

    Directory of Open Access Journals (Sweden)

    Eli Rohaeti

    2017-10-01

    Full Text Available This research aimed to investigate the effect of PBL model on students’ analytical thinking abilities and science process skills at rate reaction. This research was quasi experimental research using posttest-only control design. The sample was consisted 2 classess, experiment class used Problem Based Learning model and control class used Direct Instruction model with a total sample of 61 students. Instruments of this research were the observation sheet for measuring science process skills and the integrated assessment instrument which involved two indicators, analytical thinking abilities and science process skills. The result of this study shows that PBL model can increase students’ analytical thinking abilities and science process skills. The mean of posttest analytical thinking abilities and science process skills in experiment class is better than control class. The result of the statistic tests using ancova analysis shows that significance 0.000 < 0.05 at 5% significance level, so there’s effect of the using of PBL model on students’ analytical thinking abilities and science process skills. Abstrak Penelitian ini bertujuan untuk menguji pengaruh model PBL terhadap kemampuan berpikir analitis dan keterampilan proses sains kimia peserta didik pada materi laju reaksi menggunakan instrumen penilaian terintegrasi. Jenis penelitian ini adalah penelitian eksperimen semu. Desain penelitian yang digunakan, yaitu posttest control group design. Sampel dalam penelitian ini sebanyak 61 peserta didik yang dibagi dalam dua kelas, yaitu kelas eksperimen dan kelas kontrol. Kelas eksperimen menggunakan model Problem Based Learning, sedangkan kelas kontrol menggunakan model Direct Instruction. Instrumen yang digunakan dalam penelitian, yaitu lembar observasi untuk mengukur keterampilan proses sains kimia dan instrumen penilaian terintegrasi yang mencakup indikator kemampuan berpikir analitis dan keterampilan proses sains kimia peserta didik. Hasil

  18. Unexpected Anal Squamous Cells Carcinoma after Open Hemorrhoidectomy

    Directory of Open Access Journals (Sweden)

    Navarra Luca

    2015-01-01

    Full Text Available We report a case of unexpected anal squamous cells carcinoma found in hemorrhoidectomy specimen. The patient had a 3-year history of prolapsing hemorrhoids. A prolapsing hemorrhoid was present at eleven o’clock in lithotomy. Milligan-Morgan was performed and gross examination of the specimen was unremarkable. Histopathologic evaluation showed noninvasive squamous cells carcinoma. The present case report evidences the opportunity of routine histopathologic analysis of hemorrhoidal specimens particularly in case of long-standing prolapse. Questions arise in the option of those techniques where no specimens are collected or tissue is excised far from deceased area.

  19. Problems and personal preferences in the therapy of rectal and anal cancers

    International Nuclear Information System (INIS)

    Rangabashyam, N.

    1985-01-01

    The three modalities of treatment for rectal cancer are radiotherapy chemotherapy and surgery. The problems in the therapy of rectal and anal cancers are discussed. For maximum benefit a combination of pre-operative irradiation and chemotherapy followed by surgery and if needed continued post-operative irradiation therapy is recommended. (author)

  20. Trypanosoma cruzi in the anal glands of urban opossums: I- isolation and experimental infections

    Directory of Open Access Journals (Sweden)

    S Urdaneta-Morales

    1996-08-01

    Full Text Available Opossums (Didelphis marsupialis captured in intensely urbanized areas of the city of Caracas, Venezuela, were found infected with Trypanosoma cruzi. The developmental cycle of trypomastigote-epimastigote-metacyclic infective trypomastigote, usually occurring in the intestine of the triatomine vector, was taking place in the anal odoriferous glands of the opossums. Material from the glands, inoculated in young, healthy opossums and white mice by different routes, subcutaneously, intraperitoneally, orally, and into the eye, induced T. cruzi infections in all animals. Parasitemia, invasion of cardiac and skeletal muscle, and intracellular multiplication of amastigotes were observed. Inoculation of metacyclics from anal glands, cultured in LIT medium, gave equivalent results. All opossums survived; all mice died. Excreta of opossums may thus transmit Chagas' disease by contamination, even in urban areas where insect vectors are not present.

  1. Tumor de células granulares de la región anal: Presentación de 1 caso

    Directory of Open Access Journals (Sweden)

    Isnerio Valerio Arzuaga Ánderson

    2001-06-01

    Full Text Available Se informa un caso de tumor de células granulares (mioblastoma de la región anal, en una mujer de 54 años de edad que acudió al Hospital Clinicoquirúrgico Docente "Joaquín Albarrán" por "quiste palpable en las márgenes del ano. El tratamiento que se realizó fue la resección local del tumor. Se analizaron los patrones histopatológicos e inmunohistoquímicos, los cuales se correspondieron con los reportados en la literatura médica hasta el presenteThe authors present a case of granular cell tumor (myoblastoma of the anal region in a woman aged 54, who was attended at "Joaquin Albarrán" Clinical Surgical Hospital due to a palpable "cyst" in the anal edges. The treatment applied consisted in local resection of the tumor. Histopathologic and immunohistochemical patterns were analyzed and they corresponded to those reported in medical literature

  2. Restoration of continence following rectopexy for rectal prolapse and recovery of the internal anal sphincter electromyogram.

    Science.gov (United States)

    Farouk, R; Duthie, G S; Bartolo, D C; MacGregor, A B

    1992-05-01

    Twenty-two patients with full-thickness rectal prolapse underwent ambulatory fine wire electromyography of the internal and sphincter (IAS), external and sphincter and puborectalis, together with anorectal manometry, using a computerized system. Examinations were performed both before and 3 to 4 months after rectopexy. The median (interquartile range (i.q.r.)) preoperative IAS electromyogram (EMG) frequency was 0.18 (0.05-0.31) Hz and the median (i.q.r.) preoperative resting anal pressure was 28 (15-64) cmH2O. An improvement in the IAS EMG frequency, median (i.q.r.) 0.29 (0.19-0.38) Hz (P less than 0.03), and resting anal pressure, median (i.q.r.) 41 (20-72) cmH2O (P less than 0.05), was recorded after operation, but these variables remained significantly lower than those found in normal controls: median (i.q.r.) IAS EMG frequency 0.44 (0.36-0.48) Hz and median (i.q.r.) resting anal pressure 92 (74-98) cmH2O. We suggest that repair of the prolapse allows the IAS to recover by removing the cause of persistent rectoanal inhibition.

  3. 2q24 deletion in a 9-month old girl with anal atresia, hearing impairment, and hypotonia.

    Science.gov (United States)

    Zhao, Peiwei; Mao, Bing; Cai, Xiaonan; Jiang, Jun; Liu, Zhisheng; Lin, Jun; He, Xuelian

    2018-06-01

    Deletion of 2q24.2 is a rare cytogenetic aberration in patients, exhibiting heterogeneous clinical features, and common phenotypes included developmental delay, intellectual disability, hypotonia, and mild dysmorphic features. Hearing impairment and anal atresia are rarely described. Here we described a 9-month-old female patient with hypotonia in all four limbs, developmental delay, and intellectual disability. In addition, congenital anal atresia was diagnosed and treated after birth, and hearing impairment was found in right ear. Single nucleotide polymorphisms (SNP) array detected a 5.2 Mb deletion on 2q24.2q24.3, including 19 genes (ITGB6; TBR1; SLC4A10; KCNH7 SCN3A; SCN2A et al.). Among these genes, it is affirmative that TBR1 is a causative gene for intellectual disability; however, the pathogenic genes of other phenotypes remain unclear. We briefly review the knowledge of genes likely involved in these clinical features, including hearing impairment, anal atresia, and developmental delay. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Assessment and in vitro experiment of artificial anal sphincter system based on rebuilding the rectal sensation function.

    Science.gov (United States)

    Zan, Peng; Liu, Jinding; Jiang, Enyu; Wang, Hua

    2014-05-01

    In this paper, a novel artificial anal sphincter (AAS) system based on rebuilding the rectal sensation function is proposed to treat human fecal incontinence. The executive mechanism of the traditional AAS system was redesigned and integrated for a simpler structure and better durability. The novel executive mechanism uses a sandwich structure to simulate the basic function of the natural human anal sphincter. To rebuild the lost rectal sensation function caused by fecal incontinence, we propose a novel method for rebuilding the rectal sensation function based on an Optimal Wavelet Packet Basis (OWPB) using the Davies-Bouldin (DB) index and a support vector machine (SVM). OWPB using a DB index is used for feature vector extraction, while a SVM is adopted for pattern recognition.Furthermore, an in vitro experiment with the AAS system based on rectal sensation function rebuilding was carried out. Experimental results indicate that the novel executive mechanism can simulate the basic function of the natural human anal sphincter, and the proposed method is quite effective for rebuilding rectal sensation in patients.

  5. A New Method to Treat High Anal Fistula - Bidirectional Isobaric Drainage

    DEFF Research Database (Denmark)

    Zheng, Linghua; Wang, Yanmei; Zhao, Jingbo

    2016-01-01

    -category verbal rating scale, VRS), and the score of anal function (Wexner Incontinence Score) were quantitatively evaluated. Results: Comparison of the efficacy between two groups indicated that the complete cure rate differed significantly between two groups (P... in the Experimental group than in the Control group (PVRS and Wexner scores were significantly smaller in Experimental group than in Control group (P

  6. Is neoadjuvant chemotherapy prior to radio-chemotherapy beneficial in T4 anal carcinoma?

    Science.gov (United States)

    Moureau-Zabotto, L; Viret, F; Giovaninni, M; Lelong, B; Bories, E; Delpero, J R; Pesenti, C; Caillol, F; de Chaisemartin, C; Minsat, M; Monges, G; Sarran, A; Resbeut, M

    2011-07-01

    This study retrospectively describes the outcome of a series of 38 patients (pts) with T4 anal carcinoma exclusively treated by radio and chemotherapy. From 1992 to 2007, 38 pts with UST4-N0-2-M0 anal carcinoma were treated with exclusive radiotherapy and chemotherapy. All patients received external beam radiotherapy (EBRT) (median dose 45 Gy) with a concomitant chemotherapy (5-fluorouracil-cisplatin). Eleven patients received neo-adjuvant chemotherapy (5-fluorouracil-cisplatin). After 2-8 weeks, a 15-20 Gy boost was delivered either with EBRT (20 pts) or interstitial (192)Ir brachytherapy (18 pts). Mean follow-up was 66 months. After chemoradiation therapy (CRT), 13 pts (34%) had a complete response, 23 pts (60%) a response >50% (2 pts were not evaluated). The 5-year-disease-free survival was 79.2 ± 6.5%, and the 5-year overall survival was 83.9 ± 6%. Eight patients developed tumor progression (mean delay 8.8 months), six of them requiring a salvage surgery with definitive colostomy for local relapse. Late severe complication requiring colostomy was observed in 2 pts. The 5-year-colostomy-free survival was 78 ± 6.9%. Patients who received primary chemotherapy had a statistically significant better 5-year colostomy-free survival (100% vs. 38 ± 16.4%, P = 0.0006). T4 anal carcinoma can be treated with a curative intent using a sphincter-sparing approach of CRT, and neo-adjuvant chemotherapy should be considered prior to radiotherapy. Copyright © 2011 Wiley-Liss, Inc.

  7. Võlur Ozi eksperimentide kogumine ja partneri algatatud paranduste analüüs / Siiri Pärkson

    Index Scriptorium Estoniae

    Pärkson, Siiri

    2011-01-01

    Kirjeldatakse teise võlur Ozi kirjalike eksperimentide seeria analüüsi tulemusi. Materjal pärineb dialoogidest, kus katseisikutel paluti testida kirjalikus eesti keeles suhtlevat internetilehel asuvat programmi

  8. Radiotherapy for carcinomas of the anal canal Tenon hospital experience

    International Nuclear Information System (INIS)

    Touboul, E.; Moureau-Zabotto, L.; Lerouge, D.; Pene, F.; Deniaud-Alexandre, E.; Schlienger, M.; Laugier, A.; Tiret, E.; Parc, R.; Sezeur, A.; Houry, S.; Gallot, D.

    2003-01-01

    Since 1980, curative-intent radiation therapy of epidermoid carcinoma of the anal canal is the standard first line treatment. The combined concomitant chemotherapy and radiation therapy is presently established for locally advanced tumors more than 4 cm in length and/or with nodal involvement. We report the Tenon hospital experience since 1972 concerning the long term results after radiation therapy, the modifications of the radiation technique, and the evolution of treatment strategy. (author)

  9. Secretory leukocyte protease inhibitor expression and high-risk HPV infection in anal lesions of HIV positive patients

    Science.gov (United States)

    NUOVO, Gerard J.; GRINSZTEJN, Beatriz; FRIEDMAN, Ruth K.; VELOSO, Valdiléa G.; CUNHA, Cynthia B.; COUTINHO, José R.; VIANNA-ANDRADE, Cecilia; OLIVEIRA, Nathalia S.; WOODHAM, Andrew W.; DA SILVA, Diane M.; KAST, W. Martin

    2016-01-01

    Objective The aim of the current study was to evaluate secretory leukocyte protease inhibitor (SLPI) expression in anal biopsies from HIV-positive (HIV+) individuals, and compare that to anal intraepithelial neoplasia (AIN) diagnoses and human papillomavirus (HPV) status. Design This is a cross-sectional study of a cohort of 54 HIV+ (31 males and 23 females) from an AIDS clinic in Rio de Janeiro, Brazil. Methods The study material consisted of anorectal tissue biopsies obtained from HIV+ subjects, which were used to construct tissue microarray paraffin blocks for immunohistochemical analysis of SLPI expression. Biopsies were evaluated by an expert pathologist and classified as low-grade anal intraepithelial neoplasia (AIN1), high-grade anal intraepithelial neoplasia (AIN2/3), or normal squamous epithelium. Additionally, DNA from the biopsies was extracted and analyzed for the presence of low- or high-risk HPV DNA. Results Histologically normal squamous epithelium from the anorectal region showed strong positive SLPI staining in 17/20 (85%) samples. In comparison, 9/17 (53%) dysplastic squamous epithelial samples from AIN1 patients showed strong SLPI staining, and only 5/17 (29%) samples from AIN2-3 patients exhibited strong SPLI staining, which both were significantly fewer than those from normal tissue (p=0.005). Furthermore, there was a significantly higher proportion of samples in which oncogenic high-risk HPV genotypes were detected in low SLPI expressing tissues than that in tissues with high SLPI expression (p=0.040). Conclusion Taken together these results suggest that low SLPI expression is associated with high-risk HPV infections in the development of AIN. PMID:27149102

  10. Laevade erinevate soetamisviiside kommertstingimuste võrdlev analüüs / Ain Eidast, Allan Kivi

    Index Scriptorium Estoniae

    Eidast, Ain, 1939-2013

    2005-01-01

    Laevade erinevate soetamisviiside analüüs näitab, et ühtse, kõikidele osapooltele vastuvõetavate tingimuste väljatöötamine ja rakendamine ei ole tehniliselt võimalik ning majanduslikult õigustatud. Tabelid. Diagrammid

  11. What drives the number of high-risk human papillomavirus types in the anal canal in HIV-positive men who have sex with men?

    NARCIS (Netherlands)

    del Amo, Julia; González, Cristina; Geskus, Ronald B.; Torres, Montse; del Romero, Jorge; Viciana, Pompeyo; Masiá, Mar; Blanco, Jose R.; Hernández-Novoa, Beatriz; Ortiz, Marta; Peña, Alejandro; García, Federico; Torres, Montserrat; Ocampo, Antonio; Da Silva, Alfredo Rodríguez; Miralles, Celia; Mauricio Iribarren, Gustavo; Madrid, Nadia; Dronda, Fernando; Benito, Amparo; Sanz, Itziar; Vera, Mar; Rodríguez, Carmen; Martín Alegre, Carmen; Carlos Carrió, Juan; Raposo, Montse; Trastoy, Mónica; Fontillón, Maria; Robledano, Catalina; Gutierrez, Félix; Padilla, Sergio; Andrada, Encarna; Cervero, Miguel; Ramón Blanco, José; Pérez, Laura; Portilla, Joaquín; Portilla, Irene; Angel Vonwichmann, Miguel; Antonio Iribarren, José; Camino, Xabier; Sendagorta, Elena; Herranz, Pedro; Rodríguez, Patricia; Luis Gómez, Juan; Rosado, Dacil; Alejos, Belén; Angeles Rodríguez, Maria

    2013-01-01

    We estimated the effect of sexual behavior, age, and immunodeficiency on the number of high-risk human papillomavirus (HR-HPV) types in the anal canal among human immunodeficiency virus-positive men who have sex with men (MSM). Anal samples were genotyped with the Linear Array HPV Genotyping Test,

  12. Sources and severity of self-reported food intolerance after ileal pouch-anal anastomosis

    NARCIS (Netherlands)

    Steenhagen, E.; Roos, de N.M.; Bouwman, C.A.; Laarhoven, van C.J.H.M.; Staveren, van W.A.

    2006-01-01

    Data on food intolerance after ileal pouch-anal anastomosis are scarce. The aim of this study was to identify foods causing intolerance and to determine the nature and severity of reported symptoms. Patients from the Dutch Crohn's and Ulcerative Colitis Association were mailed a survey on food

  13. La Contabilidad Analítica en los Hospitales Públicos

    OpenAIRE

    Ma Silvia Fresneda Fuentes

    1998-01-01

    La confección de presupuestos públicos austeros para la consecución de los criterios de convergencia impuestos por el Tratado de Maastricht ha originado una preocupación en todo el Sector Público en general, y en el hospitalario en particular, por la contención de los costes. Esta situación ha puesto de manifiesto la necesidad de introducir sistemas de Contabilidad para la Gestión interna de las organizaciones hospitalarias públicas. Así, la Contabilidad Analítica o de Costes se constituye co...

  14. Metastatic anal sac carcinoma with hypercalcaemia and associated hypertrophic osteopathy in a dog

    Directory of Open Access Journals (Sweden)

    A. Giuliano

    2015-05-01

    Full Text Available A seven-year-old male neutered Irish setter was treated for a metastatic anal sac adenocarcinoma (ASAC and hypercalcaemia by complete surgical excision of the primary tumour and partial excision of the sublumbar lymph nodes. Further enlargement of the sublumbar lymph nodes was linked to recurrent hypercalcaemia 3 months after surgical treatment. Medical treatment with Toceranib and Clodronate showed modest results in the treatment of the tumour and the hypercalcaemia. Radiotherapy of the sublumbar lymph nodes and later concurrent carboplatin chemotherapy resulted in partial tumour remission with marked reduction in size of the lymph nodes and normalization of the calcaemia. Unfortunately, concurrently with subsequent relapse of the hypercalaemia, the dog developed hypertrophic osteopathy (HO and lumbar spinal metastasis and the dog was euthanized. To the authors’ knowledge, this is the second case of metastatic apocrine gland carcinoma of the anal sac associated with HO and the first case that describe the development of HO late in the stage of the disease.

  15. Alcance y disyuntivas de la ética analógica de M. Beuchot

    Directory of Open Access Journals (Sweden)

    Miquel Seguró

    2016-01-01

    Full Text Available En el presente artículo se discute críticamente el alcance axiológico de la "hermenéutica analógica" de Mauricio Beuchot. Para ello se expone en primer lugar el fundamento ontológico sobre el que se sustenta su propuesta hermenéutica, para luego proceder a una clarificación de su traslación al campo axiológico y de sus problemas. Una vez ponderado y discutido críticamente su planteamiento, en un tercer momento se deducen los principios aporéticos que se vislumbran en los intentos de resolución analógica de los dilemas éticos. El telón de fondo de toda la problemática no es otro que el de la insoslayable finitud primera que constituye la realidad ontológica humana y su capital influencia en el planteamiento fundamental de la cuestión ética.

  16. Analítica o evocadora: el debate olvidado de la autoetnografía

    Directory of Open Access Journals (Sweden)

    Xavier Montagud Mayor

    2016-07-01

    Full Text Available Existe la necesidad de una estrategia metodológica eficaz para sostener la investigación sobre la práctica profesional de los servicios sociales. La oposición entre el trabajo autoetnográfico de Carolyn ELLIS y Arthur BOCHNER (2000, 2006 y la propuesta analítica de Leon ANDERSON sirven como una lente a través de la cual explorar los aspectos clave de esta discusión. Mientras ELLIS y BOCHNER rechazan cualquier intento de abstracción o sistematización teórica, ANDERSON pretende tender puentes entre la tradición etnográfica y las formas emergentes de narrativa personal. Después de revisar la literatura autoetnográfica, concluyo que si bien la autoetnografía evocadora parece gozar del apoyo mayoritario en este campo, podría ser enriquecida por el enfoque analítico. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1603124

  17. Fecoflowmetric Analysis of Anorectal Motor Function in Postoperative Anal-Preserving Surgery Patients With Low Rectal Cancer Comparison With the Wexner Score and Anorectal Manometry

    Science.gov (United States)

    Ryu, Yasuhiko; Akagi, Yoshito; Yagi, Minoru; Sasatomi, Teruo; Kinugasa, Tetsushi; Yamaguchi, Keizo; Oka, Yousuke; Fukahori, Suguru; Shiratsuchi, Ichitaro; Yoshida, Takefumi; Gotanda, Yukito; Tanaka, Natsuki; Ohchi, Takafumi; Romeo, Kansakar; Shirouzu, Kazuo

    2015-01-01

    The aim of this study was to elucidate whether fecoflowmetry (FFM) could evaluate more detailed evacuative function than anorectal manometry by comparing between FFM or anorectal manometric findings and the clinical questionnaires and the types of surgical procedure in the patients who received anal-preserving surgery. Fifty-three patients who underwent anal-preserving surgery for low rectal cancer were enrolled. The relationships between FFM or the manometric findings and the clinical questionnaires and the types of procedure of anal-preserving surgery were evaluated. There were significant differences between FFM markers and the clinical questionnaire and the types of the surgical procedure, whereas no significant relationship was observed between the manometric findings and the clinical questionnaire and the types of the surgical procedure. FFM might be feasible and useful for the objective assessment of evacuative function and may be superior to manometry for patients undergoing anal-preserving surgery. PMID:25594637

  18. Faecal incontinence after chemoradiotherapy in anal cancer survivors: Long-term results of a national cohort

    International Nuclear Information System (INIS)

    Bentzen, Anne Gry; Guren, Marianne G.; Vonen, Barthold; Wanderås, Eva H.; Frykholm, Gunilla; Wilsgaard, Tom; Dahl, Olav; Balteskard, Lise

    2013-01-01

    Purpose: To examine the prevalence and severity of faecal incontinence amongst anal cancer survivors after chemoradiotherapy. Material and methods: Anal cancer survivors from a complete, unselected, national cohort, minimum 2-years follow-up, were invited to a cross-sectional study. The St. Mark’s incontinence score was used to evaluate occurrence and degree of faecal incontinence the last four weeks. The results were compared to age- and sex-matched volunteers from the general population. Results: Of 199 invited survivors and 1211volunteers, 66% and 21%, respectively, signed informed consent. The survivors had significantly higher St. Mark’s score than the volunteers (mean 9.7 vs. 1.1, p < 0.001). Incontinence of stool of any degree was reported by 43% vs. 5% (OR 4.0, CI 2.73–6.01), and urgency was reported by 64% vs. 6% (OR 6.6, CI 4.38–9.90) of the survivors and volunteers, respectively. Only 29% of those with leakage of liquid stool used constipating drugs. Survivors of locally advanced tumours had a higher incontinence score (p < 0.01). Conclusions: Moderate to severe faecal incontinence is common amongst anal cancer survivors. Post-treatment follow-up should include the evaluation of continence, and incontinent survivors should be offered better symptom management and multidisciplinary approach if simple measures are insufficient

  19. High-resolution magnetic resonance imaging of the anal sphincter using a dedicated endoanal receiver coil

    International Nuclear Information System (INIS)

    DeSouza, N.M.; Williams, A.D.; Gilderdale, D.J.

    1999-01-01

    The use of a surface coil in MR imaging improves signal-to-noise ratio of adjacent tissues of interest. We therefore devised an endoanal receiver coil for imaging the anal sphincter. The probe is solid and re-usable: it comprises a saddle geometry receiver with integral tuning, matching and decoupling. It is placed in the anal canal and immobilised externally. Both in vitro and in vivo normal anatomy is identified. The mucosa is high signal intensity, the submucosa low signal intensity, the internal sphincter uniformly high signal intensity and the external sphincter low signal intensity on T1- and T2-weighted images. In females, the transverse perineal muscle bridges the inferior part of the external sphincter anteriorly. In perianal sepsis, collections and the site of the endoanal opening are identified. In early-onset fecal incontinence following obstetric trauma/surgery, focal sphincter defects are demonstrated; in late-onset fecal incontinence external sphincter atrophy is seen. In fecally incontinent patients with scleroderma, forward deviation of the anterior sphincter musculature with descent of rectal air and feces into the anal canal is noted. The extent of sphincter invasion is assessed in low rectal tumours. In children with congenital anorectal anomalies, abnormalities of the muscle components are defined using smaller-diameter coils. Such information is invaluable in the assessment and surgical planning of patients with a variety of anorectal pathologies. (orig.)

  20. Unusual and unique distribution of anal high-risk human papillomavirus (HR-HPV among men who have sex with men living in the Central African Republic.

    Directory of Open Access Journals (Sweden)

    Ralph-Sydney Mboumba Bouassa

    Full Text Available High-risk (HR human papillomavirus (HPV infection remains a great concern in relation to African men who have sex with men (MSM, especially those infected with HIV. The prevalence of HR-HPV and associated risk factors was estimated in a cross-sectional observational study covering MSM living in Bangui, Central African Republic.MSM receiving care at the Centre National de Référence des Infections Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, were included. HIV serostatus and socio-demographic and behavioral characteristics were collected. HPV DNA was detected and genotyped on anal swabs using Anyplex™ II HPV28 test (Seegene, South Korea, and HSV DNA by in-house real-time PCR. Logistic regression analyses were used to determine risk factors associated with HPV outcomes.42 MSM (mean age, 23.2 years; range, 14-39 including 69.1% HIV-1-positive and 30.9% HIV-negative were prospectively enrolled. The prevalence of anal HPV was 69.1%, including 82.7% of HR-HPV which were multiple in 52.0%. The most prevalent genotypes were HPV-35, HPV-58, HPV-59 and HPV-31. While, HPV-16 and HPV-18 were present in a minority of samples. Multiple HR-HPV infection was more frequent in HIV-positive MSM (41.4% with 2.7 genotypes per anal samples than in HIV-negative (7.7% with 1.5 genotypes per anal samples. HPV types included in the prophylactic Gardasil-9® vaccine were detected in 68.9% of specimens and HPV-58 was the most frequently detected. MSM infected by HPV-16 and HPV-18 were all infected by HIV-1. Few anal swabs (11.9% contained HSV-2 DNA without relationship with HPV detection. Condomless receptive anal intercourse was the main risk factor to being infected with any type of HPV and condomless insertive anal intercourse was significantly less associated with HPV contamination than receptive anal intercourse (Odd ratio = 0.02.MSM in Bangui are at-risk of HIV and HR-HPV anal infections. The unusual distribution of HPV-35 as

  1. OPEC usub analüütikutest erinevalt nafta hinna langusesse / Annika Matson

    Index Scriptorium Estoniae

    Matson, Annika, 1976-

    2004-01-01

    Ilmunud ka: Delovõje Vedomosti 1. sept. lk. 19. Vaherahu sõlmimine. Iraagi sõda langetas nafta hinda maailmaturul. Analüütikud prognoosivad aga nafta nõudluse jätkuva kasvu tõttu hinnatõusu. Kommenteerib Pärt Kivaste. Graafik: Toornafta hinna langus veab alla ka naftafirmade aktsiad. Tabel: Viie suurema hulgas kolm Euroopa naftafirmat

  2. ARM tõestab, et ka analüütikud eksivad / Fredy-Edwin

    Index Scriptorium Estoniae

    Esse, Fredy-Edwin

    2011-01-01

    Apple'i iPadidele ja iPhone'idele kiipe tootva Suurbritannia firma ARM Holdings aktsia on kõige suurem tõusja Londoni FTSE 100 indeksi kuue kuu, 12 kuu, 18 kuu, kahe aasta ja kolme aasta lõikes, samas on analüütikud kõigist indeksi aktsiatest kõige negatiivsemalt meelestatud just ARM Holdingsi suhtes. Graafik

  3. External anal sphincter atrophy on endoanal magnetic resonance imaging adversely affects continence after sphincteroplasty

    NARCIS (Netherlands)

    Briel, J. W.; Stoker, J.; Rociu, E.; Laméris, J. S.; Hop, W. C.; Schouten, W. R.

    1999-01-01

    There is still considerable debate about the value of preoperative anorectal physiological parameters in predicting the clinical outcome after sphincteroplasty. Recently it has been reported that atrophy of the external anal sphincter can be clearly shown with endoanal magnetic resonance imaging

  4. Endoanal MRI of the anal sphincter complex: correlation with cross-sectional anatomy and histology

    NARCIS (Netherlands)

    S.M. Hussain (Shahid); J. Stoker (Jacob); A.W. Zwamborn; J.C. den Hollander (Jan); J.-W. Kuiper (Jan-Willem); C.A. Entius; J.S. Lameris

    1996-01-01

    textabstractThe purpose of this study was to correlate the in vivo endoanal MRI findings of the anal sphincter with the cross-sectional anatomy and histology. Fourteen patients with rectal tumours were examined with a rigid endoanal MR coil before undergoing

  5. Changes in the absorption of bile acids after total colectomy in patients with an ileostomy or pouch-anal anastomosis

    International Nuclear Information System (INIS)

    Nasmyth, D.G.; Johnston, D.; Williams, N.S.; King, R.F.; Burkinshaw, L.; Brooks, K.

    1989-01-01

    Bile acid absorption was investigated using 75 Se Taurohomocholate (SeHCAT) in controls and patients who had undergone total colectomy with either conventional ileostomy or pouch-anal anastomosis for ulcerative colitis or adenomatous polyposis. Whole-body retention of SeHCAT after 168 hours was greater in the controls than the patients who had undergone colectomy (P less than .05). Retention of SeHCAT did not differ significantly between patients with an ileostomy and patients with pouch-anal anastomosis, but patients with an ileostomy and ileal resection of more than 20 cm retained less SeHCAT than patients with a pouch-anal anastomosis (P less than .01). Analysis of fecal bile acids from ileostomies and pouches showed that bacterial metabolism of primary conjugated bile acids was greater in patients with a pouch. It was concluded that bile acid absorption was not significantly impaired by construction of a pouch compared with conventional ileostomy, but bacterial metabolism of bile acids was greater in the pouches

  6. Changes in the absorption of bile acids after total colectomy in patients with an ileostomy or pouch-anal anastomosis

    Energy Technology Data Exchange (ETDEWEB)

    Nasmyth, D.G.; Johnston, D.; Williams, N.S.; King, R.F.; Burkinshaw, L.; Brooks, K.

    1989-03-01

    Bile acid absorption was investigated using /sup 75/Se Taurohomocholate (SeHCAT) in controls and patients who had undergone total colectomy with either conventional ileostomy or pouch-anal anastomosis for ulcerative colitis or adenomatous polyposis. Whole-body retention of SeHCAT after 168 hours was greater in the controls than the patients who had undergone colectomy (P less than .05). Retention of SeHCAT did not differ significantly between patients with an ileostomy and patients with pouch-anal anastomosis, but patients with an ileostomy and ileal resection of more than 20 cm retained less SeHCAT than patients with a pouch-anal anastomosis (P less than .01). Analysis of fecal bile acids from ileostomies and pouches showed that bacterial metabolism of primary conjugated bile acids was greater in patients with a pouch. It was concluded that bile acid absorption was not significantly impaired by construction of a pouch compared with conventional ileostomy, but bacterial metabolism of bile acids was greater in the pouches.

  7. Televīzijas loma neapmierinātībā ar politiku: LTV1, LNT, TV3 nedēļas analītisko raidījumu satura, to veidotāju un ekspertu vērtējumu analīze (2008.gada oktobris-2009.gada marts)

    OpenAIRE

    Novodvorskis, Vladimirs

    2009-01-01

    Maģistra darbu „Televīzijas loma neapmierinātībā ar politiku: LTV1, LNT, TV3 nedēļas analītisko raidījumu satura, to veidotāju un ekspertu vērtējumu analīze (2008. gada oktobris – 2009. gada marts)” izstrādāja Latvijas Universitātes Komunikācijas studiju nodaļas students Vladimirs Novodvorskis. Darbs veltīts auditorijas negatīvas attieksmes veidošanas problēmas izpētei televīzijas informatīvi analītiskajos raidījumos Panorāma, De facto (LTV1), LNT Top 10 (LNT), Nekā personīga (TV3) pret pol...

  8. Role of 18F-FDG PET/CT in Posttreatment Evaluation of Anal Carcinoma.

    Science.gov (United States)

    Houard, Clémence; Pinaquy, Jean-Baptiste; Mesguich, Charles; Henriques de Figueiredo, Bénédicte; Cazeau, Anne-Laure; Allard, Jean-Baptiste; Laharie, Hortense; Bordenave, Laurence; Fernandez, Philippe; Vendrely, Véronique

    2017-09-01

    The aim of this study was to evaluate the relevance of PET/CT and 18 F-FDG as a strategy for response evaluation after chemoradiotherapy for anal cancer. For this, the performance of posttreatment 18 F-FDG PET/CT, the impact on patient care, and the predictive value of metabolic response were assessed. Methods: This was a retrospective and multicenter analysis of 87 patients treated by chemoradiotherapy for anal squamous cell carcinoma between October 2007 and October 2013. All patients underwent systematic posttreatment 18 F-FDG PET/CT and were followed with at least a clinical examination every 4 mo for 2 y and every 6 mo thereafter. Disease progression was confirmed by biopsy for all patients in the case of local recurrence before surgery. Kaplan-Meier and Cox regression models were used to test for associations between metabolic or clinical endpoints and progression-free survival (PFS) or cause-specific survival (CSS). Results: The median follow-up was 25 mo. 18 F-FDG PET/CT was performed 1-8 mo (median, 4 mo) after completion of chemoradiotherapy. Overall, 25 patients relapsed and 13 died. The posttherapy 18 F-FDG PET/CT did not show any abnormal 18 F-FDG uptake (complete metabolic response [CMR]) in 55 patients whereas 32 displayed incomplete response (non-CMR): 15 patients with partial response and 17 with disease progression. The sensitivity of 18 F-FDG PET/CT to detect residual tumor tissue was 92% (95% confidence interval [CI], 75%-97%), specificity was 85% (95% CI, 75%-92%), positive predictive value was 72% (95% CI, 61%-90%), and negative predictive value was 96.4% (95% CI, 90%-98.7%). The 2-y PFS was 96% (95% CI, 90-100) for patients with CMR and 28% (95% CI, 14-47) for non-CMR patients ( P PET/CT changed patient management in 14 cases (16%), with relevant modifications in 12 (14%). A Cox proportional hazards model of survival outcome indicated that a CMR was the only significant predictor of PFS and CSS ( P PET/CT shows good accuracy in posttreatment

  9. Schenker laseb kliendil analüüsida teenuse võtmenäitajaid / Toomas Udu

    Index Scriptorium Estoniae

    Udu, Toomas

    2005-01-01

    Logistikaettevõtte Schenker IT- ja arendusdirektor tutvustab klientidele mõeldud veebipõhist analüüsitööriista KPI (Key Performance Indicator - soorituse võtmenäitajad), mille abil on võimalik jälgida saadetise kohaletoimetamise tähtaegadest kinnipidamist. Ekraanipildid

  10. Dose-Painted Intensity-Modulated Radiation Therapy for Anal Cancer: A Multi-Institutional Report of Acute Toxicity and Response to Therapy

    International Nuclear Information System (INIS)

    Kachnic, Lisa A.; Tsai, Henry K.; Coen, John J.; Blaszkowsky, Lawrence S.; Hartshorn, Kevan; Kwak, Eunice L.; Willins, John D.; Ryan, David P.; Hong, Theodore S.

    2012-01-01

    Purpose: Chemoradiation for anal cancer yields effective tumor control, but is associated with significant acute toxicity. We report our multi-institutional experience using dose-painted IMRT (DP-IMRT). Patients and Methods: Between August 2005 and May 2009, 43 patients were treated with DP-IMRT and concurrent chemotherapy for biopsy-proven, squamous cell carcinoma of the anal canal at two academic medical centers. DP-IMRT was prescribed as follows: T2N0: 42 Gy, 1.5 Gy/fraction (fx) to elective nodal planning target volume (PTV) and 50.4 Gy, 1.8 Gy/fx to anal tumor PTV; T3-4N0-3: 45 Gy, 1.5 Gy/fx to elective nodal PTV, and 54 Gy, 1.8 Gy/fx to the anal tumor and metastatic nodal PTV >3 cm with 50.4 Gy, 1.68 Gy/fx to nodal PTVs ≤3 cm in size. Acute and late toxicity was reported by the treating physician. Actuarial analysis was performed using the Kaplan-Meier method. Results: Median age was 58 years; 67% female; 16% Stage I, 37% II; 42% III; 5% IV. Fourteen patients were immunocompromised: 21% HIV-positive and 12% on chronic immunosuppression. Median follow-up was 24 months (range, 0.6–43.5 months). Sixty percent completed chemoradiation without treatment interruption; median duration of treatment interruption was 2 days (range, 2–24 days). Acute Grade 3+ toxicity included: hematologic 51%, dermatologic 10%, gastrointestinal 7%, and genitourinary 7%. Two-year local control, overall survival, colostomy-free survival, and metastasis-free survival were 95%, 94%, 90%, and 92%, respectively. Conclusions: Dose-painted IMRT appears effective and well-tolerated as part of a chemoradiation therapy regimen for the treatment of anal canal cancer.

  11. Dose-Painted Intensity-Modulated Radiation Therapy for Anal Cancer: A Multi-Institutional Report of Acute Toxicity and Response to Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kachnic, Lisa A., E-mail: lisa.kachnic@bmc.org [Department of Radiation Oncology, Boston Medical Center, Boston, MA (United States); Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Tsai, Henry K. [Harvard Radiation Oncology Program, Harvard Medical School, Boston, MA (United States); Coen, John J. [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Blaszkowsky, Lawrence S. [Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Hartshorn, Kevan [Department of Medicine, Boston Medical Center, Boston, MA (United States); Kwak, Eunice L. [Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Willins, John D. [Department of Radiation Oncology, Boston Medical Center, Boston, MA (United States); Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Ryan, David P. [Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Hong, Theodore S. [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)

    2012-01-01

    Purpose: Chemoradiation for anal cancer yields effective tumor control, but is associated with significant acute toxicity. We report our multi-institutional experience using dose-painted IMRT (DP-IMRT). Patients and Methods: Between August 2005 and May 2009, 43 patients were treated with DP-IMRT and concurrent chemotherapy for biopsy-proven, squamous cell carcinoma of the anal canal at two academic medical centers. DP-IMRT was prescribed as follows: T2N0: 42 Gy, 1.5 Gy/fraction (fx) to elective nodal planning target volume (PTV) and 50.4 Gy, 1.8 Gy/fx to anal tumor PTV; T3-4N0-3: 45 Gy, 1.5 Gy/fx to elective nodal PTV, and 54 Gy, 1.8 Gy/fx to the anal tumor and metastatic nodal PTV >3 cm with 50.4 Gy, 1.68 Gy/fx to nodal PTVs {<=}3 cm in size. Acute and late toxicity was reported by the treating physician. Actuarial analysis was performed using the Kaplan-Meier method. Results: Median age was 58 years; 67% female; 16% Stage I, 37% II; 42% III; 5% IV. Fourteen patients were immunocompromised: 21% HIV-positive and 12% on chronic immunosuppression. Median follow-up was 24 months (range, 0.6-43.5 months). Sixty percent completed chemoradiation without treatment interruption; median duration of treatment interruption was 2 days (range, 2-24 days). Acute Grade 3+ toxicity included: hematologic 51%, dermatologic 10%, gastrointestinal 7%, and genitourinary 7%. Two-year local control, overall survival, colostomy-free survival, and metastasis-free survival were 95%, 94%, 90%, and 92%, respectively. Conclusions: Dose-painted IMRT appears effective and well-tolerated as part of a chemoradiation therapy regimen for the treatment of anal canal cancer.

  12. Nerve supply to the internal anal sphincter differs from that to the distal rectum: an immunohistochemical study of cadavers.

    Science.gov (United States)

    Kinugasa, Yusuke; Arakawa, Takashi; Murakami, Gen; Fujimiya, Mineko; Sugihara, Kenichi

    2014-04-01

    Fecal incontinence is a common problem after anal sphincter-preserving operations. The intersphincteric autonomic nerves supplying the internal anal sphincter (IAS) are formed by the union of: (1) nerve fibers from Auerbach's nerve plexus of the most distal part of the rectum and (2) the inferior rectal branches of the pelvic plexus (IRB-PX) running along the conjoint longitudinal muscle coat. The aim of the present study is to identify the detailed morphology of nerves to the IAS. The study comprised histological and immunohistochemical evaluations of paraffin-embedded sections from a large block of anal canal from the preserved 10 cadavers. The IRB-PX came from the superior aspect of the levator ani and ran into the anal canal on the anterolateral side. These nerves contained both sympathetic and parasympathetic fibers, but the sympathetic content was much higher than in nerves from the distal rectum. All intramural ganglion cells in the distal rectum were neuronal nitric oxide synthase-positive and tyrosine hydroxylase-negative and were restricted to above the squamous-columnar epithelial junction. Parasympathetic nerves formed a lattice-like plexus in the circular smooth muscles of the distal rectum, whereas the IAS contained short, longitudinally running sympathetic and parasympathetic nerves, although sympathetic nerves were dominant. The major autonomic nerve input to the IAS seemed not to originate from the distal rectum but from the IRB-PX. Injury to the IRB-PX during surgery seemed to result in loss of innervation to the major part of the IAS.

  13. Menetlejate küsitlemistehnikad : alla 14-aastaste laste ülekuulamisprotokollide analüüs / Kristjan Kask

    Index Scriptorium Estoniae

    Kask, Kristjan, 1980-

    2010-01-01

    Alla 14-aastaste laste kohtueelse ülekuulamise videosalvestiste analüüsist. Ülevaade põhineb Justiitsministeeriumi poolt 2009. aastal läbi viidud uurimisprojektil "Alaealiste ülekuulamine kriminaalmenetluses". Tabelid

  14. Effect of subsequent vaginal delivery on bowel symptoms and anorectal function in women who sustained a previous obstetric anal sphincter injury.

    Science.gov (United States)

    Jordan, Polly A; Naidu, Madhu; Thakar, Ranee; Sultan, Abdul H

    2018-03-29

    Our primary objective was to prospectively evaluate anorectal symptoms, anal manometry and endoanal ultrasound (EAUS) in women who followed the recommended mode of subsequent delivery following index obstetric anal sphincter injuries (OASIs) using our unit's standardised protocol. Our secondary objectives were to evaluate the role of internal anal sphincter defects and also to compare outcomes in a subgroup of symptomatic women with normal anorectal physiology. This is a prospective follow-up study of pregnant women with previous OASIs who were counselled regarding subsequent mode of delivery between January 2003 and December 2014. Assessment involved the St Mark's Incontinence Score (SMIS), anal manometry and EAUS at both antepartum and 3-month postpartum visits. Data were analysed using Wilcoxon and Mann-Whitney U tests. Three hundred and fifty women attended the perineal clinic over the study period, of whom 122 met the inclusion criteria (99 vaginal delivery [VD], 23 caesarean section). No significant worsening of anorectal symptoms was observed following subsequent delivery in the VD group (p = 0.896), although a reduced squeeze pressure was observed at 3 months postpartum (p delivery. In the absence of a randomised study, use of this protocol can aid clinicians in their decision-making.

  15. Sequential Acquisition of Anal Human Papillomavirus (HPV) Infection Following Genital Infection Among Men Who Have Sex With Women: The HPV Infection in Men (HIM) Study.

    Science.gov (United States)

    Pamnani, Shitaldas J; Nyitray, Alan G; Abrahamsen, Martha; Rollison, Dana E; Villa, Luisa L; Lazcano-Ponce, Eduardo; Huang, Yangxin; Borenstein, Amy; Giuliano, Anna R

    2016-10-15

    The purpose of this study was to assess the risk of sequential acquisition of anal human papillomavirus (HPV) infection following a type-specific genital HPV infection for the 9-valent vaccine HPV types and investigate factors associated with sequential infection among men who have sex with women (MSW). Genital and anal specimens were available for 1348 MSW participants, and HPV genotypes were detected using the Roche Linear Array assay. Sequential risk of anal HPV infection was assessed using hazard ratios (HRs) among men with prior genital infection, compared with men with no prior genital infection, in individual HPV type and grouped HPV analyses. In individual analyses, men with prior HPV 16 genital infections had a significantly higher risk of subsequent anal HPV 16 infections (HR, 4.63; 95% confidence interval [CI], 1.41-15.23). In grouped analyses, a significantly higher risk of sequential type-specific anal HPV infections was observed for any of the 9 types (adjusted HR, 2.80; 95% CI, 1.32-5.99), high-risk types (adjusted HR, 2.65; 95% CI, 1.26, 5.55), and low-risk types (adjusted HR, 5.89; 95% CI, 1.29, 27.01). MSW with prior genital HPV infections had a higher risk of a subsequent type-specific anal infection. The higher risk was not explained by sexual intercourse with female partners. Autoinoculation is a possible mechanism for the observed association. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  16. Association between free testosterone levels and anal human papillomavirus types 16/18 infections in a cohort of men who have sex with men.

    Directory of Open Access Journals (Sweden)

    Hilary K Hsu

    Full Text Available Human papillomavirus (HPV types 16 and 18 cause invasive cervical cancer and most invasive anal cancers (IACs. Overall, IAC rates are highest among men who have sex with men (MSM, especially MSM with HIV infection. Testosterone is prescribed for men showing hypogonadism and HIV-related wasting. While there are direct and indirect physiological effects of testosterone in males, its role in anal HPV16/18 infections in men is unknown.Free testosterone (FT was measured in serum from 340 Multicenter AIDS Cohort Study (MACS participants who were tested for anal HPV16/18-DNA approximately 36 months later. The effect of log10-transformed current FT level on anal HPV16/18 prevalence was modeled using Poisson regression with robust error variance. Multivariate models controlled for other HPV types, cumulative years of exogenous testosterone use, race, age, lifetime number of receptive anal intercourse partnerships, body mass index, tobacco smoking, HIV-infection and CD4+ T-cell counts among HIV-infected, and blood draw timing.Participants were, on average, 60 (+5.4 years of age, White (86%, and HIV-uninfected (56%; Twenty-four percent tested positive for anal HPV16 and/or 18-DNA (HPV16 prevalence=17.1%, HPV18=9.1%. In adjusted analysis, each half-log10 increase of FT was associated with a 1.9-fold (95% Confidence Interval: 1.11, 3.24 higher HPV16/18 prevalence. Additionally, other Group 1 high-risk HPVs were associated with a 1.56-fold (1.03, 2.37 higher HPV16/18 prevalence. Traditional risk factors for HPV16/18 infection (age, tobacco smoking; lifetime number of sexual partners, including the number of receptive anal intercourse partnerships within 24 months preceding HPV testing were poorly correlated with one another and not statistically significantly associated with higher prevalence of HPV16/18 infection in unadjusted and adjusted analyses.Higher free testosterone was associated with increased HPV16/18 prevalence measured approximately three years

  17. Anal channel neoplasm: a neoplasm radio chemo curable

    International Nuclear Information System (INIS)

    Torres Lopez, M.; Avondet, I.; Vazquez, J.; Santini Blasco, A.

    1997-01-01

    Presently work is made an exhaustive revision of the anatomy of the region, the history of the treatments and of the current treatments of channel cancer anal. It makes emphasis in the importance of the conservative treatment with radiochemotherapy (RQT). The present is a prospective study,longitudinal and descriptive. Material and method: between January of 1989 and December of 1994 20 patients attended with cancer of anal channel with an illness metastasis. An average age it was of 62.4 years.The sex, 16 men and 4 women. The performance status 0,1 or 2 of the scale of the ECOQ. In the pathological anatomy: 15 patient epidermic neoplasm, 5 patient basal neoplasm. State I: 2 patients, II: 12 patients, III: 6 patients, IV: 0 patients.Treatment: the radiotherapy one carries out with cobalt 60 and it irradiates the primary tumour and the ganglion structures region, pelvic and inguinal. It surrendered to Gy/dia from Monday to Friday up to 50 Gy. The chemotherapy one carries out with mitomicine C 10 mg/ previous day to the radiotherapy and 5-UGH 1 intravenous g/my in infusion the days from 1 to 4 and from 29 to 32 after the radiotherapy.Results: to) control locorregional patient RC-16 (80%) ,RP 2 patients (10%) , without answer or with progression lesional a patient (5%) .b) State vital: living 15 patients, died 5 patients(continuation 12 to 60 months) .e)Tolerance: there were not deaths for the gastrointestinal treatment and haematological with toxicity moderate.To conclude:1) The radiochemotherapy is the treatment of elect.2)A feasible treatment of being carried out in our environment.3)Required of a good relationship predictable interdisciplinary.4)Toxicity and tolerable.5)Results of conservation of the sphincter in 80%(AU) [es

  18. Estudi de la variabilitat biològica en el posttrasplantament renal optimització del protocol analític assistencial /

    OpenAIRE

    Biosca i Adzet, Carme

    2002-01-01

    Consultable des del TDX Títol obtingut de la portada digitalitzada El motiu d'aquesta tesi ha estat trobar indicadors analítics capaços de senyalar canvis significatius en l'estat de salut dels pacients transplantats renals, abans de qualsevol manifestació clínica. En el seguiment de pacients es sol·liciten repetidament proves analítiques al llarg del temps, essent molt important determinar la diferència mínima entre resultats consecutius, d'una mateixa magnitud biològica, que expressen...

  19. Desarrollo de las nuevas metodologías analíticas que incorporan la nanotecnología en procesos (Bio)Químicos de medida.

    OpenAIRE

    Bouri, Mohamed

    2014-01-01

    El desarrollo de la Nanociencia y Nanotecnología (N&N) ha provocado un nuevo marco dentro de la ciencia y la tecnología. La Química Analítica ha experimentado, al igual que otras áreas de la ciencia, un gran cambio gracias a las necesidades y oportunidades que proporciona la Nanociencia y Nanotecnología Analíticas. La Nanotecnología se está demostrando cada vez más como un aliado poderoso de la Química Analítica para que alcance sus objetivos, así como para la simplificación de los procesos a...

  20. Avaliação da qualidade de vida na incontinência anal: validação do questionário FIQL (Fecal Incontinence Quality of Life Evaluation of quality of life in anal incontinence: validation of the questionnaire FIQL (Fecal Incontinence Quality of Life

    Directory of Open Access Journals (Sweden)

    Sonia Ahlaim Ibrahim Yusuf

    2004-09-01

    Full Text Available RACIONAL: A incontinência anal acarreta incapacitação física e psicológica, determinando impacto na qualidade de vida. Para quantificar esse impacto em nosso meio, não existem instrumentos específicos validados. OBJETIVOS: Avaliar a qualidade de vida na incontinência anal, através da validação do questionário "Fecal Incontinence Quality of Life" (FIQL, que é composto por 29 questões distribuídas em 4 domínios: estilo de vida, comportamento, depressão e constrangimento, sua escala de pontuação varia de 1 a 4 com exceção das questões 1 e 4 que variam de 1 a 5 e 1 a 6, respectivamente. MATERIAL E MÉTODO: Após tradução e adaptação cultural, estudou-se a validação do instrumento através das propriedades de medida de reprodutibilidade e validade. Para a avaliação da reprodutibilidade aplicou-se o questionário em 50 pacientes com incontinência anal por dois examinadores, sendo reaplicado por um dos examinadores após período de 7 a 10 dias. A validade construtiva foi testada através da comparação do FIQL e o SF-36, questionário genérico de qualidade de vida e entre o FIQL e um índice de incontinência anal. O índice de incontinência anal utilizado foi o de Jorge-Wexner, que varia de 0 (continência perfeita a 20 (incontinência total. A validade discriminativa foi avaliada através da aplicação do FIQL em dois grupos controle: indivíduos voluntários hígidos e portadores de constipação intestinal. RESULTADOS: Verificou-se que o FIQL apresentou correlação significativa com outros instrumentos (SF-36 e índice de incontinência e que a qualidade de vida no portador de incontinência anal está comprometida em todos os domínios: estilo de vida: 2,4 comportamento: 2,0, depressão: 2,5 e constrangimento: 1,9, quando comparado com os indivíduos voluntários hígidos (3,9, 3,9, 4,1 e 4,0, e pacientes com constipação intestinal (3,7, 3,8, 3,6 e 3,8, respectivamente. CONCLUSÃO: O FIQL é útil para a

  1. Chronic idiopathic anal pain. Results of a diagnostic-therapeutic protocol in a colorectal referral unit.

    Science.gov (United States)

    Armañanzas, Laura; Arroyo, Antonio; Ruiz-Tovar, Jaime; López, Alberto; Santos, Jair; Moya, Pedro; Gómez, María Amparo; Candela, Fernando; Calpena, Rafael

    2015-01-01

    Chronic idiopathic anal pain (CIAP) remains a diagnosis of exclusion. Its study and management still lack a standardized protocol. The aim of this study is to evaluate the results obtained with the diagnostic-therapeutic protocol established in our service. We performed a retrospective study of patients diagnosed with CIAP at the Colorectal Unit of the General University Hospital of Elche, between 2005 and 2011. We evaluated 57 patients with a diagnosis of chronic anal pain for functional anorectal disease (FAD). After the application of our diagnostic protocol, final diagnosis of chronic anal pain (CAP) was achieved in 43 cases (75%), including 22 cases of descending perineum syndrome, 12 of proctalgia fugax, 2 of pudendal neuritis and 7 of coccydynia. In 14 patients exclusion diagnosis of CIAP was established. Among the therapies used on patients with CIAP, biofeedback combined with conservative measures improved symptoms in 43% of the cases. Sacral nerve stimulation was assessed in patients who did not respond to other treatments. Through proper anamnesis, physical examination and complementary tests, a specific diagnosis of the cause of CAP by FAD can be achieved, reducing exclusion diagnosis of CIAP to 25% of cases. Conservative measures combined with biofeedback achieved an improvement in pain in more than 40% of the cases of CIAP in our study. Sacral nerve stimulation can be considered as a treatment option in refractory cases. Copyright © 2013 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. High-resolution magnetic resonance imaging of the anal sphincter using a dedicated endoanal receiver coil

    Energy Technology Data Exchange (ETDEWEB)

    DeSouza, N.M.; Williams, A.D.; Gilderdale, D.J. [Dept. of Radiology, Imperial College School of Medicine, London (United Kingdom)

    1999-04-01

    The use of a surface coil in MR imaging improves signal-to-noise ratio of adjacent tissues of interest. We therefore devised an endoanal receiver coil for imaging the anal sphincter. The probe is solid and re-usable: it comprises a saddle geometry receiver with integral tuning, matching and decoupling. It is placed in the anal canal and immobilised externally. Both in vitro and in vivo normal anatomy is identified. The mucosa is high signal intensity, the submucosa low signal intensity, the internal sphincter uniformly high signal intensity and the external sphincter low signal intensity on T1- and T2-weighted images. In females, the transverse perineal muscle bridges the inferior part of the external sphincter anteriorly. In perianal sepsis, collections and the site of the endoanal opening are identified. In early-onset fecal incontinence following obstetric trauma/surgery, focal sphincter defects are demonstrated; in late-onset fecal incontinence external sphincter atrophy is seen. In fecally incontinent patients with scleroderma, forward deviation of the anterior sphincter musculature with descent of rectal air and feces into the anal canal is noted. The extent of sphincter invasion is assessed in low rectal tumours. In children with congenital anorectal anomalies, abnormalities of the muscle components are defined using smaller-diameter coils. Such information is invaluable in the assessment and surgical planning of patients with a variety of anorectal pathologies. (orig.) With 15 figs., 26 refs.

  3. Cutting Whole Length or Partial Length of Internal Anal Sphincter in Managementof Fissure in Ano

    Directory of Open Access Journals (Sweden)

    Furat Shani Aoda

    2017-12-01

    Full Text Available A chronic anal fissure is a common painful perianal condition.The main operative procedure to treat this painful condition is a lateral internal sphincteretomy (LIS.The aim of study is to compare the outcome and complications of closed LIS up to the dentate line (whole length of internal sphincter or up to the fissure apex (partial length of internal sphincter in the treatment of anal fissure.It is a prospective comparativestudy including 100 patients with chronic fissure in ano. All patients assigned to undergo closed LIS. Those patients were randomly divided into two groups: 50 patients underwent LIS to the level of dentate line (whole length and other 50 patients underwent LIS to the level of fissure apex (partial length. Patients were followed up weekly in the 1st month, twice monthly in the second month then monthly   for next 2 months and finally after 1 year. There was satisfactory relief of pain in all patients in both groups & complete healing of the fissure occurred. Regarding post operative incontinence no major degree of incontinence occur in both group but minor degree of incontinence persists In 7 patients after whole length LIS after one year. In conclusion, both whole length & partial length LIS associated with improvement of pain, good chance of healing but whole length LIS associated with more chance of long term  flatus incontinence. Hence,we recommend partial length LIS as treatment forchronic anal fissure.

  4. Earlier anal sexarche and co-occurring sexual risk are associated with current HIV-related risk behaviors among an online sample of men who have sex with men in Asia

    Science.gov (United States)

    Cheung, Doug H.; Suharlim, Christian; Guadamuz, Thomas E.; Lim, Sin How; Koe, Stuart; Wei, Chongyi

    2014-01-01

    Studies of heterosexual populations across the globe and men who have sex with men (MSM) in a few developed countries showed that earlier sexual debut (sexarche) was associated with higher levels of co-occurring and subsequent HIV risk behaviors. We examined the relationships between earlier anal sexarche, unprotected earlier anal sexarche and current HIV risks among MSM from Asia. A cross-sectional online survey was conducted among MSM (N = 10,826) in Asia in 2010. Bivariate and multivariable logistic regressions were used to identify co-occurring (i.e., sexual experiences during sexarche) and current HIV-related risk factors (i.e., past six months) associated with earlier anal sexarche (before the age of 18) and unprotected earlier anal sexarche, respectively. Earlier anal sexarche was significantly associated with lack of condom use, being anal receptive or both receptive and insertive, and having a partner who were older during sexarche. It was also associated with current HIV-related risk behaviors including having multiple male sexual partners, having been paid for sex, and increased frequencies of recreational drug use. Unprotected earlier anal sexarche was significantly associated with inconsistent condom use in the past the six months. Improved and culturally sensitive sex education at schools should be included in national and regional HIV/AIDS prevention programming and policies in Asia. Such sex education programs should incorporate curriculum that address sexuality, sexual orientation, and sexual behaviors beyond those related to reproductive health. PMID:24920344

  5. Australasian Gastrointestinal Trials Group (AGITG) Contouring Atlas and Planning Guidelines for Intensity-Modulated Radiotherapy in Anal Cancer

    International Nuclear Information System (INIS)

    Ng, Michael; Leong, Trevor; Chander, Sarat; Chu, Julie; Kneebone, Andrew; Carroll, Susan; Wiltshire, Kirsty; Ngan, Samuel; Kachnic, Lisa

    2012-01-01

    Purpose: To develop a high-resolution target volume atlas with intensity-modulated radiotherapy (IMRT) planning guidelines for the conformal treatment of anal cancer. Methods and Materials: A draft contouring atlas and planning guidelines for anal cancer IMRT were prepared at the Australasian Gastrointestinal Trials Group (AGITG) annual meeting in September 2010. An expert panel of radiation oncologists contoured an anal cancer case to generate discussion on recommendations regarding target definition for gross disease, elective nodal volumes, and organs at risk (OARs). Clinical target volume (CTV) and planning target volume (PTV) margins, dose fractionation, and other IMRT-specific issues were also addressed. A steering committee produced the final consensus guidelines. Results: Detailed contouring and planning guidelines and a high-resolution atlas are provided. Gross tumor and elective target volumes are described and pictorially depicted. All elective regions should be routinely contoured for all disease stages, with the possible exception of the inguinal and high pelvic nodes for select, early-stage T1N0. A 20-mm CTV margin for the primary, 10- to 20-mm CTV margin for involved nodes and a 7-mm CTV margin for the elective pelvic nodal groups are recommended, while respecting anatomical boundaries. A 5- to 10-mm PTV margin is suggested. When using a simultaneous integrated boost technique, a dose of 54 Gy in 30 fractions to gross disease and 45 Gy to elective nodes with chemotherapy is appropriate. Guidelines are provided for OAR delineation. Conclusion: These consensus planning guidelines and high-resolution atlas complement the existing Radiation Therapy Oncology Group (RTOG) elective nodal ano-rectal atlas and provide additional anatomic, clinical, and technical instructions to guide radiation oncologists in the planning and delivery of IMRT for anal cancer.

  6. Audit of paired anal cytology and histopathology outcomes in patients referred to a public sexual health clinic.

    Science.gov (United States)

    Williams, Vincent M; Metcalf, Cecily; French, Martyn A; McCloskey, Jenny C

    2010-09-01

    The level of agreement between anal cytology and histopathology is not clear with only a few studies evaluating the reliability of anal specimen reporting. Australian data in relation to this are limited. The results of paired anal cytology and histopathology specimens received between 2002 and 2008 from patients who were referred within the sexual health clinic were retrieved from the anatomical pathology database. A total of 248 paired samples from 154 (21 females, 133 males) participants were extracted. Concurrent high risk human papilloma virus (hrHPV) DNA assay and HIV status for the study group were also collected. Data were tabulated according to reported grade of squamous abnormality based on the Bethesda system. Using the biopsy result as the gold standard the specificity, sensitivity, positive predictive value (PPV) and negative predictive value (NPV) for cytology were calculated and the association between grade of abnormality, HIV status and hrHPV infection estimated. Concordance between cytology and histology showed that in 204 (85%) paired samples both tests were categorised as abnormal (Kappa statistic 0.73, P = 0.013). The cytology result showed a sensitivity of 96%, specificity 14%, PPV 89% and NPV 31% when compared with histopathology. HrHPV assay was positive in 192 (80%) samples. High-grade squamous abnormalities were reported in biopsy specimens from 60% (n = 42/67) of HIV-positive subjects and 25% (n = 22/87) of HIV-negative subjects. HIV-positive individuals were more likely to be hrHPV positive, odds ratio (OR) 6.21 [95% confidence interval (CI) 2.69 to 14.34], when compared with HIV-negative subjects. Anal cytology is highly sensitive for the detection of abnormal squamous cells. While cytology has low specificity for predicting the grade of abnormality compared with biopsy outcome, its application as a screening method in asymptomatic at risk populations warrants further study.

  7. Velhice e espiritualidade na perspectiva da psicologia analítica

    OpenAIRE

    Mello, Maria Aparecida

    2012-01-01

    Esta Tese de Doutorado é resultado da pesquisa "Velhice e Espiritualidade na Perspectiva da Psicologia Analítica" realizada no Núcleo de Psicossomática e Psicologia Hospitalar da PUC-SP. Foi utilizado os métodos quantitativo e qualitativo na análise dos resultados. O objetivo geral do estudo foi compreender a percepção do idoso acerca do processo de envelhecimento e da vivência da espiritualidade nessa fase da vida. Esta pesquisa foi realizada com uma amostra de 100 idosos, a m...

  8. Radio(chemo)therapy of the anal carcinoma. A retrospective study

    International Nuclear Information System (INIS)

    Sauer, Thomas Albert

    2013-01-01

    In a retrospective study the data of a consecutive cohort of 138 patients with a locally advanced squamous cell anal cancer were analysed, who were treated with a radio(chemo)therapy in the period from 1988 to 2011. The 5-year overall survival rate was 82%±4%. T category, UICC clinical stage, histopathologic grading and the ECOG performance status were significantly associated with overall survival. Acute toxicity grade 3/4 and chronic side effects grade 3 were found in 58% and 37% of the patients, respectively.

  9. Endoanal MRI of the anal sphincter complex: correlation with cross-sectional anatomy and histology

    NARCIS (Netherlands)

    Hussain, S. M.; Stoker, J.; Zwamborn, A. W.; den Hollander, J. C.; Kuiper, J. W.; Entius, C. A.; Laméris, J. S.

    1996-01-01

    The purpose of this study was to correlate the in vivo endoanal MRI findings of the anal sphincter with the cross-sectional anatomy and histology. Fourteen patients with rectal tumours were examined with a rigid endoanal MR coil before undergoing abdominoperineal resection. In addition, 12 cadavers

  10. Primena SWOT analize na sistem integralnog transporta Vojske Srbije / SWOT analysis of the intermodal transportation system in the Army of Serbia

    Directory of Open Access Journals (Sweden)

    Dragan S. Pamučar

    2008-04-01

    Full Text Available U radu je prikazana primena SWOT analize na sistem integralnog transporta Vojske Srbije. Kao rezultat analize predstavljeni su ciljevi daljeg usavršavanja integralnog transporta, kao i mogući problemi generisani strateškim upravljanjem. / This work presents the SWOT analysis application to the intermodal transportation system in the Army of Serbia. The analysis resulted in defining goals for the future development of intermodal transportation, as well as possible problems generated by strategic management.

  11. FDG-PET/CT imaging for staging and target volume delineation in conformal radiotherapy of anal carcinoma

    International Nuclear Information System (INIS)

    Krengli, Marco; Inglese, Eugenio; Milia, Maria E; Turri, Lucia; Mones, Eleonora; Bassi, Maria C; Cannillo, Barbara; Deantonio, Letizia; Sacchetti, Gianmauro; Brambilla, Marco

    2010-01-01

    FDG-PET/CT imaging has an emerging role in staging and treatment planning of various tumor locations and a number of literature studies show that also the carcinoma of the anal canal may benefit from this diagnostic approach. We analyzed the potential impact of FDG-PET/CT in stage definition and target volume delineation of patients affected by carcinoma of the anal canal and candidates for curative radiotherapy. Twenty seven patients with biopsy proven anal carcinoma were enrolled. Pathology was squamous cell carcinoma in 20 cases, cloacogenic carcinoma in 3, adenocarcinoma in 2, and basal cell carcinoma in 2. Simulation was performed by PET/CT imaging with patient in treatment position. Gross Tumor Volume (GTV) and Clinical Target Volume (CTV) were drawn on CT and on PET/CT fused images. PET-GTV and PET-CTV were respectively compared to CT-GTV and CT-CTV by Wilcoxon rank test for paired data. PET/CT fused images led to change the stage in 5/27 cases (18.5%): 3 cases from N0 to N2 and 2 from M0 to M1 leading to change the treatment intent from curative to palliative in a case. Based on PET/CT imaging, GTV and CTV contours changed in 15/27 (55.6%) and in 10/27 cases (37.0%) respectively. PET-GTV and PET-CTV resulted significantly smaller than CT-GTV (p = 1.2 × 10 -4 ) and CT-CTV (p = 2.9 × 10 -4 ). PET/CT-GTV and PET/CT-CTV, that were used for clinical purposes, were significantly greater than CT-GTV (p = 6 × 10 -5 ) and CT-CTV (p = 6 × 10 -5 ). FDG-PET/CT has a potential relevant impact in staging and target volume delineation of the carcinoma of the anal canal. Clinical stage variation occurred in 18.5% of cases with change of treatment intent in 3.7%. The GTV and the CTV changed in shape and in size based on PET/CT imaging

  12. Twitter.com kā korporatīvo sabiedrisko attiecību instruments Latvijā: satura analīze

    OpenAIRE

    Lulle, Katrīna

    2010-01-01

    Bakalaura darba tēma ir „Twitter.com kā korporatīvo sabiedrisko attiecību instruments Latvijā: satura analīze”. Darba ietvaros analizēti 10 Latvijas uzľēmumu Twitter.com profilu ieraksti laika periodā no 2009. gada decembra līdz 2010. gada februārim, kopumā 2780 ieraksti. Darba mērķis ir veikt Latvijas uzľēmumu Twitter.com profilu satura analīzi, lai noteiktu, kā Twitter.com tiek izmantots kā korporatīvo sabiedrisko attiecību instruments. Darbā ir divas teorētiskās nodaļas par sabied...

  13. A comparative analysis of homosexual behaviors, sex role preferences, and anal sex proclivities in Latino and non-Latino men.

    Science.gov (United States)

    Jeffries, William L

    2009-10-01

    Machismo prescribes that homosexual encounters among Latino men are conducted along highly gendered lines: men tend to be anally insertive or receptive over the lifecourse, but not both. Some have argued that Latino men have more lifecourse homosexual behaviors in comparison to other racial/ethnic groups. This is often due to the perception that Latin America has quasi-institutionalized homosexuality, which sharply contrasts it with the United States. Although scholars suggest that sex role preferences and greater likelihoods for homosexual behaviors exist among Latino men in the United States, limited empirical data validate these claims. Latino/non-Latino differences in male homosexual behaviors and sex role preferences were analyzed by using the 2002 cycle of the National Survey of Family Growth, a nationally representative, probability sample of 4,928 men. Findings revealed that non-Mexican Latino, but not Mexican, men had increased likelihoods of ever having anal sex than non-Latino Whites and oral sex than non-Latino Blacks. These relationships remained after controlling for age, education, and foreign birth. Latino men preferred insertive or receptive sex in comparison to non-Latino Blacks and Whites, but this difference disappeared after education was controlled. In full and reduced models, Mexican men tended to be orifice-specific (oral or anal), while non-Mexican Latinos were more oriented to both oral and anal sex. Controlling for other factors, all Latinos were more likely than non-Latino Blacks and Whites to refuse to answer male homosexual behavior questions. The implications of race/ethnicity are discussed for homosexual behavior patterns among U.S. men.

  14. Fecal incontinence, sexual complaints, and anorectal function after third-degree obstetric anal sphincter injury (OASI): 5-year follow-up.

    Science.gov (United States)

    Visscher, A P; Lam, T J; Hart, N; Felt-Bersma, R J F

    2014-05-01

    Our aim was to evaluate alterations in anorectal function after anal sphincteroplasty for third-degree obstetric anal sphincter injury (OASI) in relation to clinical outcome. In this retrospective, descriptive, cross-sectional study conducted between 1998 and 2008, women with persisting fecal incontinence (FI) after 3a OASI and all women with grade 3b or 3c OASI were sent for anorectal function evaluation (AFE) consisting of anal manometry and endosonography 3 months after sphincteroplasty. In 2011, questionnaires regarding FI (Vaizey/Wexner), urinary incontinence (UI) [International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF)], sexual function [Female Sexual Function Index (FSFI)], and quality of life (QOL) (Rand-36) were sent and women were asked to undergo additional AFE. Sixty-six women underwent AFE. Mean follow-up was 5.0 years. Forty (61%) patients returned questionnaires regarding FI and UI. Prevalence of FI was 63% flatus, 50% liquid stool, and 20% solid stool. Thirty-two of 40 also reported on QOL and SF. Sexual dysfunction was present in the majority of women (cutoff value 26.55) and more pronounced in larger OASI. Sixteen of 40 women underwent additional AFE. Women with combined internal (IAS) and external (EAS) anal sphincter injury (n = 6) had worse FI (P 40) than women with isolated EAS injury (n = 10). Follow-up after third-degree OASI suggests poor anorectal and sexual function. Women with combined external and internal OASI show more deterioration in anorectal function and experience worse FI. Therefore, special attention should be paid to these women in order to mitigate these symptoms later in life.

  15. Trans-anal barotrauma by compressed air leading to sigmoid perforation due to a dangerous practical joke.

    Science.gov (United States)

    Pahwa, Harvinder Singh; Kumar, Awanish; Srivastava, Rohit; Rai, Anurag

    2012-08-01

    To present a case report of trans-anal barotrauma by high-pressure compressed air jet as a dangerous practical joke, that is, playful insufflation of high-pressure air jet through the anal orifice resulting in sigmoid perforation. The patient presented to emergency a day later with complaints of severe pain in the abdomen and abdominal distension following insufflation of high-pressure air jet through the anus. On examination, he had signs suggestive of perforation peritonitis and x-ray of the abdomen showed gas under the diaphragm. An emergency exploratory laparotomy was performed which revealed a 4-cm perforation in the sigmoid colon. Resection of the segment containing perforation along with the surrounding devitalised part was done with double-barrel colostomy. Reversal of colostomy was done after 8 weeks. Follow-up was uneventful.

  16. Anal cancer precursor lesions in HIV-positive and HIV-negative patients seen at a tertiary health institution in Brazil Lesões precursoras do câncer anal em pacientes HIV-positivos e HIV-negativos atendidos numa instituição de saúde terciária no Brasil

    Directory of Open Access Journals (Sweden)

    Ivan Tramujas da Costa e Silva

    2011-02-01

    Full Text Available Purpose: To investigate the prevalence of anal squamous intraepithelial lesions (ASIL or anal cancer in patients attended at the Tropical Medicine Foundation of Amazonas. Methods: 344 patients consecutively attended at the institution, in 2007/2008, were distributed in the following strata according to presence/abscense of at risk conditions for anal cancer: Group 1 _ HIV-positive men-who-have-sex-with-men (101; Group 2 _ HIV-positive females (49; Group 3 _ patients without any at risk condition for anal cancer (53; Group 4 _ HIV-positive heterosexual men (38; Group 5 _ HIV-negative patients, without anoreceptive sexual habits, but with other at risk conditions for anal cancer (45; Group 6 _ HIV-negative men-who-have-sex-with-men (26; and Group 7 _ HIV-negative anoreceptive females (32. The histopathological results of biopsies guided by high-resolution anoscopy were analyzed by frequentist and bayesian statistics in order to calculate the point-prevalence of ASIL/cancer and observe any eventual preponderance of one group over the other. Results: The point-prevalence of ASIL for all the patients studied was 93/344 (27%, the difference between HIV-positive and negative patients being statistically significant (38.3% versus 13.5%; p Objetivo: Investigar a prevalência de lesões intraepiteliais escamosas anais (ASIL ou câncer anal em pacientes atendidos na Fundação de Medicina Tropical do Amazonas. Métodos: 344 pacientes consecutivamente atendidos na instituição, em 2007/2008, foram distribuídos nos seguintes estratos conforme a presença/ausência de fatores de risco para o câncer anal: Grupo 1 _ homens-que-fazem-sexo-com-homens HIV-positivos (101; Grupo 2 _ mulheres HIV-positivas (49; Grupo 3 _ pacientes sem condição de risco para o câncer anal (53; Grupo 4 _ homens heterossexuais HIV-positivos (38; Grupo 5 _ pacientes HIV-negativos, sem hábitos sexuais anorreceptivos, mas com outras condições de risco para o câncer anal (45

  17. Psicoterapia Analítica Funcional feminista: possibilidades de um encontro

    OpenAIRE

    fideles, marcela nayara duarte; Vandenberghe, Luc

    2015-01-01

    O presente estudo reflete sobre o encontro dos posicionamentos da Terapia Feminista (TF) e da Psicoterapia Analítica Funcional (Functional Analytic Psychotherapy – FAP) na clínica. Um estudo de literatura foi feito para comparar seus estilos clínicos. Sua compatibilidade destacou-se quanto ao manejo da relação terapêutica, à inclusão de elementos sociais e culturais, à ênfase sobre a aquisição de habilidades para modificar o ambiente, ao fato de o terapeuta e o cliente assumirem seus valores ...

  18. Latvijas importa analīze un prognoze

    OpenAIRE

    Vasiļenko, Oļegs

    2010-01-01

    Viena no nozīmīgākām pazīmēm, kuras raksturo valsts ekonomikas stāvokli un attīstības līmeni, ir ārējās tirdzniecības bilance. Sakarā ar Latvijas ekonomikas situācijas pasliktināšanu, un, ar to saistītu, ārējās tirdzniecības negatīvās bilances strauju pieaugumu, importa analīzes un prognozes jautājuma nozīme vairāk kārt pieauga. Jau ilgāku laiku pieaug bezdarba līmenis Latvijā, līdz ar ko pasliktinās iedzīvotāju pirktspēja, kura, neapšaubāmi, ietekmē valsts ārējo tirdzniecību. ...

  19. Cervical, anal and oral HPV in an adolescent inner-city health clinic providing free vaccinations.

    Directory of Open Access Journals (Sweden)

    Nicolas F Schlecht

    Full Text Available Published human papillomavirus (HPV vaccine trials indicate efficacy is strongest for those naive to the vaccine-types. However, few high-risk young women have been followed and cervical HPV has been the predominant outcome measure.We collected cervical and anal swabs, as well as oral rinse specimens from 645 sexually active inner-city young females attending a large adolescent health-clinic in New York City that offers free care and HPV vaccination. Specimens were tested for HPV-DNA using a MY09/MY11-PCR system. Type-specific prevalence of HPV at each anatomic site was compared for individuals by vaccination dose using generalized estimating equation logistic regression models.The majority of subjects reported being of non-Caucasian (92% and/or Hispanic ethnicity (61%. Median age was 18 years (range:14-20. All had practiced vaginal sex, a third (33% practiced anal sex, and most (77% had also engaged in oral sex. At enrollment, 21% had not received the vaccine and 51% had received three doses. Prevalent HPV infection at enrollment was detected in 54% of cervical, 42% of anal and 20% of oral specimens, with vaccine types present in 7%, 6% and 1% of specimens, respectively. Comparing prevalence for vaccine types, the detection of HPV in the cervix of vaccinated compared to unvaccinated adolescents was significantly reduced: HPV6/11 (odds ratio [OR] = 0.19, 95%CI:0.06-0.75, HPV16 (OR = 0.31, 95%CI:0.11-0.88 and HPV18 (OR = 0.14, 95%CI:0.03-0.75. For anal HPV, the risk of detecting vaccine types HPV6/11 (OR = 0.27, 95%CI:0.10-0.72 and HPV18(OR = 0.12, 95%CI:0.01-1.16 were significantly reduced for vaccinated adolescents however, the risk for HPV16 was not significantly decreased (OR = 0.63, 95%CI:0.18-2.20.HPV Prevalence is extremely high in inner-city female adolescents. Administration of the HPV vaccine reduced the risk for cervical HPV; however continued follow-up is required to assess the protection for HPV at all sites

  20. Lymphatic mapping inguinal and sentinel lymph node biopsy in anal canal cancers to avoid prophylactic inguinal irradiation; Le marquage lymphatique et la biopsie du ganglion sentinelle inguinal dans les cancers du canal anal pour eviter l'irradiation inguinale prophylactique

    Energy Technology Data Exchange (ETDEWEB)

    Bobin, J.Y. [Centre Hospitalier Universitaire Lyon-Sud, Service de Chirurgie Oncoloque, 69 - Pierre-Benite (France); Gerard, J.P.; Chapet, O.; Romestaing, P. [Centre Hospitalier Universitaire Lyon-Sud, Dept. de Radiotherapie et Oncologie, 69 - Pierre-Benite (France); Isaac, S. [Centre Hospitalier Universitaire Lyon-Sud, Dept. d' Anatomopathologie, 69 - Pierre-Benite (France)

    2003-11-01

    Thirty-five patients with clinically N0 cancers of the canal anal, 33 epidermoid carcinomas et 2 melanomas were histologically staged with inguinal sentinel lymphode biopsy (ISN). With the combined technique, blue dye and radiocolloid the ISN was identified in 100 % of the cases. The ISN was invaded in 7 cases/33 for epidermoid tumors and 2/2 for melanomas. After 18 months of follow-up, no inguinal recurrence could be seen in ISN pN0 cases. In conclusion, ISN biopsy is a reliable procedure to stage anal,, canal cancers. It should prevent unnecessary prophylactic inguinal irradiation for pN0 ISN. Inguinal irradiation is only indicated in pN1 ISN. (author)

  1. Tulemuslikkuse hindamine : efektiivsuse analüüs Käru raamatukogu näitel / Ilme Säde

    Index Scriptorium Estoniae

    Säde, Ilme

    2011-01-01

    Ülevaade Ilme Säde uurimustööst "Raamatukogutöö efektiivsuse analüüs lugejate ja töötajate hinnangute ning kvantitatiivsete tulemusnäitajate abil Käru rahvaraamatukogus aastatel 2005-2010"

  2. [Anal sphincter injury caused by falling off a trampoline].

    Science.gov (United States)

    Pakarinen, Mikko

    2013-01-01

    A girl of preschool age fell off a trampoline in a sitting position onto an iron bar sticking up from the ground. In addition to a laceration of the terminal portion of the rectum, she was found to have a severe sphincter injury. The sphincters were repaired by a surgeon the next morning. After one month from the surgery the anal canal pressure was found to be symmetrical with good contractile force of the sphincters. No abnormalities were found in a contrast study or in rectoscopy. The protective stoma was closed after three months from the injury and fecal continence was normal after one and a half years.

  3. Penile Duplication and Two Anal Openings; Report of a Very Rare Case

    OpenAIRE

    Bakheet, Mohamed Abdel Al M.; Refaei, Mohammad

    2012-01-01

    Background Penile duplication (diphallus) is an extremely rare disorder. It is almost always associated with other malformations like double bladder, exstrophy of the cloacae, imperforate anus, duplication of the rectosigmoid and vertebral deformities. Meanwhile anal canal duplication, the most distal and least common duplication of the digestive tube and is a very rare congenital malformation. Case Presentation A 21 days old Egyptian neonate is reported with complete penile duplication and t...

  4. Finanční analýza společnosti Unilever ČR, spol. s r.o.

    OpenAIRE

    Richter, Martin

    2006-01-01

    Finanční analýza společnosti Unilever ČR, spol. s r.o. za období 2002 až 2005. Unilever ČR je česká pobočka nadnárodního koncernu produkujícího potravinářské a spotřební zboží. Metodologická část práce popisuje úlohu finanční analýzy a jednotlivé její metody a postupy. Praktická část analyzuje společnost Unilever ČR se zaměřením na celkovou hospodářskou situaci a výsledky podnikových programů a strategií.

  5. Influence of preoperative (hyperthermic) radiochemotherapy on manometric anal sphincter function in locally advanced rectal cancer

    International Nuclear Information System (INIS)

    Fritzmann, J.; Huenerbein, M.; Slisow, W.; Rau, B.; Gellermann, J.; Wust, P.

    2004-01-01

    Background and purpose: preoperative radiochemotherapy (RCT) followed by curative surgery is a well-accepted therapeutic option in the treatment of advanced rectal cancer. Usually, the anal sphincter is located in the irradiation area of a preoperative RCT regime. The aim of this study is to evaluate the influence of preoperative RCT on anal sphincter function. Patients and methods: between 1994 and 2000, 102 patients with rectal cancer stage uT3/uT4 were analyzed. All patients underwent radiotherapy with 45 Gy (5 x 1.8 Gy) including two cycles of 5-fluorouracil (5-FU)/leucovorin (folinic acid) chemotherapy. 46 patients were treated additionally with up to five sessions of locoregional hyperthermia. The sphincter function was analyzed by perfusion manometry before preoperative therapy and 4 weeks after pretreatment had been finished. For statistics, the Wilcoxon signed rank test and mann-whitney U-test were used (SPSS 9.0 for Windows trademark). Results: the mean value of all 102 patients showed a significant reduction of the mean maximum resting pressure from 97 to 89 mmHg (p = 0.02). For the mean maximal squeeze pressure no significant difference could be shown (178 vs. 176 mmHg). For patients with distal (≤ 7.5 cm from anal verge) tumors the difference was highly significant (92 vs. 79 mmHg). Locoregional hyperthermia had no additional influence on sphincter function. Conclusion: preoperative RCT impairs sphincter function especially in patients with distal tumors. In addition, RCT could have a negative influence on the continence of patients who received sphincter-preserving surgery. (orig.) [de

  6. Recto-anal junction (RAJ) microbiota composition in Escherichia coli O157:H7 shedding cattle

    Science.gov (United States)

    Introduction: Cattle are the asymptomatic reservoirs of Escherichia coli O157:H7 (O157) that tend to preferentially colonize the bovine recto-anal junction (RAJ). Therefore, understanding the taxonomic profile, microbial diversity, and microbiota-O157 interactions at the RAJ could give insights into...

  7. Elective Inguinal Node Irradiation in Early-Stage T2N0 Anal Cancer: Prognostic Impact on Locoregional Control

    Energy Technology Data Exchange (ETDEWEB)

    Zilli, Thomas, E-mail: Thomas.Zilli@hcuge.ch [Department of Radiation Oncology, Geneva University Hospital, Geneva (Switzerland); Betz, Michael [Department of Radiation Oncology, Geneva University Hospital, Geneva (Switzerland); Radiation Oncology Institute, Hirslanden Lausanne, Lausanne (Switzerland); Bieri, Sabine [Department of Radiation Oncology, Geneva University Hospital, Geneva (Switzerland); Ris, Frederic; Roche, Bruno [Department of Surgery, Geneva University Hospital, Geneva (Switzerland); Roth, Arnaud D. [Oncosurgery Unit, Geneva University Hospital, Geneva (Switzerland); Allal, Abdelkarim S. [Department of Radiation Oncology, Geneva University Hospital, Geneva (Switzerland); Department of Radiation Oncology,Hôpital Fribourgeois, Fribourg (Switzerland)

    2013-09-01

    Purpose: To evaluate the influence of elective inguinal node radiation therapy (INRT) on locoregional control (LRC) in patients with early-stage T2N0 anal cancer treated conservatively with primary RT. Methods and Materials: Between 1976 and 2008, 116 patients with T2 node-negative anal cancer were treated curatively with RT alone (n=48) or by combined chemoradiation therapy (CRT) (n=68) incorporating mitomycin C and 5-fluorouracil. Sixty-four percent of the patients (n=74) received elective INRT. Results: Over a median follow-up of 69 months (range, 4-243 months), 97 (84%) and 95 patients (82%) were locally and locoregionally controlled, respectively. Rates for 5-year actuarial local control, LRC, cancer-specific, and overall survival for the entire population were 81.7% ± 3.8%, 79.2% ± 4.1%, 91.1% ± 3.0%, and 72.1% ± 4.5%, respectively. The overall 5-year inguinal relapse-free survival was 92.3% ± 2.9%. Isolated inguinal recurrence occurred in 2 patients (4.7%) treated without INRT, whereas no groin relapse was observed in those treated with INRT. The 5-year LRC rates for patients treated with and without INRT and with RT alone versus combined CRT were 80.1% ± 5.0% versus 77.8% ± 7.0% (P=.967) and 71.0% ± 7.2% versus 85.4% ± 4.5% (P=.147), respectively. A trend toward a higher rate of grade ≥3 acute toxicity was observed in patients treated with INRT (53% vs 31%, P=.076). Conclusions: In cases of node-negative T2 anal cancer, the inguinal relapse rate remains relatively low with or without INRT. The role of INRT in the treatment of early-stage anal carcinoma needs to be investigated in future prospective trials.

  8. Anorectal pain and irritation: anal fissure, levator syndrome, proctalgia fugax, and pruritus ani.

    Science.gov (United States)

    Vincent, C

    1999-03-01

    Anal fissures, proctalgia fugax, levator ani syndrome, and pruritus ani are common causes of anorectal pain and irritation. The clinician who obtains a thorough history and performs a complete examination can accurately diagnose these disorders. Ancillary tests seldom are helpful and rarely are necessary. Most patients suffering from these conditions readily respond to conservative therapy provided in the primary care practitioner's office.

  9. Abordaje Analítico Versus Abordaje por Medios Tecnológicos

    Directory of Open Access Journals (Sweden)

    María Cecilia Municoy

    2007-12-01

    Full Text Available El presente artículo aborda la problemática de la conveniencia y/o ventajas que presenta el desarrollo analítico de un concepto matemático frente a la resolución por medios tecnológicos a través de un ejemplo concreto, como es el caso de la resolución de un sistema de ecuaciones diferenciales con solución en el campo complejo. Se focalizan las diferencias que presentan ambos abordajes.

  10. Parlamentide info- ja analüüsiteenistuste koostöövõrgud / Aare Kasemets

    Index Scriptorium Estoniae

    Kasemets, Aare, 1963-

    2003-01-01

    Euroopa parlamentide teabe- ja analüüsiteenistused ning raamatukogud teevad koostööd mitmes võrgustikus, millest kaks suuremat on Euroopa Parlamendiuuringute ja -dokumentatsiooni Keskus (ECPRD) ning Rahvusvaheline Raamatukoguühingute ja -institutsioonide Liidu (IFLA) parlamendisektsioon. Ülevaade koostöövõrgustikest. Tabel: ECPRD seminarid 2002. ja 2003. aastal

  11. Electromagnetic effects on the biological tissue surrounding a transcutaneous transformer for an artificial anal sphincter system*

    Science.gov (United States)

    Zan, Peng; Yang, Bang-hua; Shao, Yong; Yan, Guo-zheng; Liu, Hua

    2010-01-01

    This paper reports on the electromagnetic effects on the biological tissue surrounding a transcutaneous transformer for an artificial anal sphincter. The coupling coils and human tissues, including the skin, fat, muscle, liver, and blood, were considered. Specific absorption rate (SAR) and current density were analyzed by a finite-length solenoid model. First, SAR and current density as a function of frequency (10–107 Hz) for an emission current of 1.5 A were calculated under different tissue thickness. Then relations between SAR, current density, and five types of tissues under each frequency were deduced. As a result, both the SAR and current density were below the basic restrictions of the International Commission on Non-Ionizing Radiation Protection (ICNIRP). The results show that the analysis of these data is very important for developing the artificial anal sphincter system. PMID:21121071

  12. Limited Value of Staging Squamous Cell Carcinoma of the Anal Margin and Canal Using the Sentinel Lymph Node Procedure : A Prospective Study with Long-Term Follow-Up

    NARCIS (Netherlands)

    de Jong, Johannes S.; Beukema, Jannet C.; van Dam, Gooitzen M.; Slart, Riemer; Lemstra, Clara; Wiggers, Theo

    2010-01-01

    Background. Selection of patients with anal cancer for groin irradiation is based on tumor size, palpation, ultrasound, and fine needle cytology. Current staging of anal cancer may result in undertreatment in small tumors and overtreatment of large tumors. This study reports the feasibility of the

  13. Outcome of peri-anal surgeries without use of prophylactic antibiotics, in terms of post operative wound infection

    International Nuclear Information System (INIS)

    Asif, M.; Mirza, A.A.; Saeed, A.

    2017-01-01

    To determine the outcome of perianal surgeries without use of antibiotics in terms of post operative infection. Study Design: Descriptive study. Place and Duration of study: Department of general surgery, Pakistan Atomic Energy Commission General Hospital, from Jan 2014 to Jun 2015. Material and Methods: All patients, both male and female admitted for hemorrhoidectomy, fistulectomy and lateral internal sphincterotomy for Anal Fissure with minimum 02 months follow-up were included in the study through non probability consecutive sampling technique. The selected patients were not administered any antibiotics pre or postoperatively. All these patients were followed up for any post-operative surgical site infection up to 02 months. Patients were advised only to take pyodine sitz bath regularly. Results: One hundred and eighty two patients were selected for the study. Patients mean age was 48.0 +- 11.4 years. 68.68% were male and 31.3% were female patients. In our study most frequent clinical presentation was hemorrhoids (37.9.0%), followed by anal fissure (33.5%). Least frequent clinical presentation was of anal fistula (28.57%). None of the patients developed surgical site infection post operatively. Conclusions: In our study we found that there was no additional beneficial role of prophylactic antibiotics in perianal surgeries Perianal surgeries can safely be performed without the use pre or post-operative antibiotics there by significantly reducing health care expenses. (author)

  14. External validation of leukocytosis and neutrophilia as a prognostic marker in anal carcinoma treated with definitive chemoradiation.

    Science.gov (United States)

    Schernberg, Antoine; Huguet, Florence; Moureau-Zabotto, Laurence; Chargari, Cyrus; Rivin Del Campo, Eleonor; Schlienger, Michel; Escande, Alexandre; Touboul, Emmanuel; Deutsch, Eric

    2017-07-01

    To validate the prognostic value of leukocyte disorders in anal squamous cell carcinoma (SCC) patients receiving definitive concurrent chemoradiation. Bi-institutional clinical records from consecutive patients treated between 2001 and 2015 with definitive chemoradiation for anal SCC were retrospectively reviewed. Prognostic value of pretreatment leukocyte disorders was examined, with focus on patterns of relapse and survival. Leukocytosis and neutrophilia were defined as leukocyte or neutrophil count exceeding 10G/L and 7G/L, respectively. We identified 133 patients, treated in two institutions. Eight% and 7% displayed baseline leukocytosis and neutrophilia, respectively. Estimated 3-year overall survival (OS) and progression-free survival (PFS) were 88% and 77%, respectively. In univariate analysis, both leukocytosis and neutrophilia were associated with worse OS, PFS (p<0.01), locoregional control (LRC) and Distant Metastasis Control (DMC) (p<0.05), also after stratification by each institution. In multivariate analysis, leukocytosis and neutrophilia remained as independent risk factors associated with poorer OS, PFS, LRC and DMC (p<0.05). This study validates leukocytosis and neutrophilia as independent prognostic factors in anal SCC patients treated with definitive chemoradiation. Although prospective confirmation is warranted, it is suggested that the leukocyte and neutrophil count parameters are clinically relevant biomarkers to be considered for further clinical investigations. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Urethral dose sparing in squamous cell carcinoma of anal canal using proton therapy matching electrons with prior brachytherapy for prostate cancer: A case study

    Energy Technology Data Exchange (ETDEWEB)

    Apinorasethkul, Ontida, E-mail: ontida.a@gmail.com [Medical Dosimetry Graduate Program, University of Wisconsin, La Crosse, WI (United States); Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA (United States); Lenards, Nishele; Hunzeker, Ashley [Medical Dosimetry Graduate Program, University of Wisconsin, La Crosse, WI (United States)

    2016-10-01

    The purpose of this case study is to communicate a technique on treating the re-irradiation of squamous cell carcinoma (SCC) of anal canal with proton fields matched with electron fields to spare prostatic urethra. A 76-year old male presented with a secondary radiation-induced malignancy as a result of prostate brachytherapy seeds irradiation 10 years prior. A rectal examination revealed a bulky tumor at the top of the anal canal involving the left superior-most aspect of the anal canal extending superiorly into the rectum. The inferior extent was palpable approximately 3 cm from the anal verge and the superior extent of the mass measured greater than 5 cm in the superior-inferior dimension. Chemoradiation was suggested since the patient was opposed to abdominoperineal resection (APR) and colostomy. The use of proton therapy matching with electron fields in the re-irradiation setting could help reduce the complications. A 2 lateral proton beams were designed to treat the bulky tumor volume with 2 electron beams treating the nodal volumes. This complication of treatment fields helped spare the prostatic urethra and reduced the risk of urinary obstruction in the future.

  16. "It Takes a Man to Put Me on the Bottom": Gay Men's Experiences of Masculinity and Anal Intercourse.

    Science.gov (United States)

    Ravenhill, James P; de Visser, Richard O

    2017-12-08

    In anal intercourse between gay men, men who are typically insertive ("tops") are often perceived as, and may identify as, more masculine than those who are typically receptive ("bottoms"). "Versatile" men, who may adopt either position, may be perceived as more gender balanced and may transcend the gender-role stereotypes associated with self-labeling as top or bottom. The aim of this study was to explore how gay men's beliefs about masculinity were associated with their beliefs about the gendered nature of sexual self-labels and their behavior in anal intercourse. Individual semistructured interviews were undertaken with 17 UK-based gay men. Interpretative phenomenological analysis (IPA) identified that perceptions of tops and bottoms as gendered social identities varied depending on the extent to which gay men subscribed to the mandates of hegemonic masculinity, the dominant masculinity in Western society. The findings also suggested that some gay men differentiated between top and bottom as social identities and topping and bottoming as gendered behaviors. This had implications for gay men's behaviors in anal intercourse. It is suggested that future efforts to engage with gay men about their sexual behavior should account for their beliefs regarding the gender-role stereotypes associated with gay sexual self-labels.

  17. HPV seroconversion following anal and penile HPV infection in HIV-negative and HIV-infected MSM

    NARCIS (Netherlands)

    Mooij, Sofie H.; Landén, Olivia; van der Klis, Fiona R. M.; van der Sande, Marianne A. B.; de Melker, Hester E.; Xiridou, Maria; van Eeden, Arne; Heijman, Titia; Speksnijder, Arjen G. C. L.; Snijders, Peter J. F.; Schim van der Loeff, Maarten F.

    2014-01-01

    We assessed human papillomavirus (HPV) seroconversion following anal and penile HPV infection in HIV-negative and HIV-infected men who have sex with men (MSM). MSM aged ≥18 years were recruited in Amsterdam, the Netherlands (2010-2011), and followed up semiannually. Antibodies against 7 high-risk

  18. Anal and penile high-risk human papillomavirus prevalence in HIV-negative and HIV-infected MSM

    NARCIS (Netherlands)

    van Aar, Fleur; Mooij, Sofie H.; van der Sande, Marianne A. B.; Speksnijder, Arjen G. C. L.; Stolte, Ineke G.; Meijer, Chris J. L. M.; Verhagen, Dominique W. M.; King, Audrey J.; de Vries, Henry J. C.; Schim van der Loeff, Maarten F.

    2013-01-01

    Anal and penile high-risk human papillomavirus (HPV) infection is associated with anogenital cancer, which is especially common in HIV-infected MSM. We assessed HPV prevalence and determinants in MSM. Analysis of baseline data from a prospective cohort study. MSM aged 18 years or older were

  19. The condom imperative in anal sex - one size may not fit all: a qualitative descriptive study of men who have sex with men.

    Science.gov (United States)

    Neville, Stephen; Adams, Jeffery; Moorley, Calvin; Jackson, Debra

    2016-12-01

    To explore men who have sex with men's views about condom use when having anal intercourse. Internationally, health promotion campaigns use behavioural change strategies to support men who have sex with men to always use condoms when having anal sex with other men. The health promotion message given to this group is consistent and explicitly stated that 'use a condom every time for anal sex regardless of relationship status'. Qualitative analysis of data from a cohort of New Zealand men who have sex with men. A total of 960 useable questionnaires were completed: 571 online and 389 in hard copy. Qualitative data were analysed using a thematic data analytic process. Three themes relating to condom use in men who have sex with men were identified. These are as follows: 'Safer sex is good sex', 'Condom use is good but …' and 'I use condoms sometimes'. The range of responses towards condom use for anal sex in men who have sex with men in our sample reveal this as a complex public health issue, with not all men who have sex with men willing to consistently use condoms. It is important that nurses do not assume that all men who have sex with men are willing to use condoms for anal sex, and should create opportunities for men who have sex with men to raise any concerns about the use of condoms. In this way, nurses can assist in providing information that may help men who have sex with men to make decisions that will minimise risk of contracting infections associated with sexual activity. © 2016 John Wiley & Sons Ltd.

  20. Incidence, Trends and Ethnic Differences of Oropharyngeal, Anal and Cervical Cancers: Singapore, 1968-2012.

    Directory of Open Access Journals (Sweden)

    Jennifer O Lam

    Full Text Available In recent decades, several Western countries have reported an increase in oropharyngeal and anal cancers caused by human papillomavirus (HPV. Trends in HPV-associated cancers in Asia have not been as well described. We describe the epidemiology of potentially HPV-related cancers reported to the Singapore Cancer Registry from 1968-2012. Analysis included 998 oropharyngeal squamous cell carcinoma (OPSCC, 183 anal squamous cell carcinoma (ASCC and 8,019 invasive cervical cancer (ICC cases. Additionally, 368 anal non-squamous cell carcinoma (ANSCC and 2,018 non-oropharyngeal head and neck carcinoma (non-OP HNC cases were included as comparators. Age-standardized incidence rates (ASR were determined by gender and ethnicity (Chinese, Malay and Indian. Joinpoint regression was used to evaluate annual percentage change (APC in incidence. OPSCC incidence increased in both genders (men 1993-2012, APC = 1.9%, p<0.001; women 1968-2012, APC = 2.0%, p = 0.01 and was 5 times higher in men than women. In contrast, non-OP HNC incidence declined between 1968-2012 among men (APC = -1.6%, p<0.001 and women (APC = -0.4%, p = 0.06. ASCC and ANSCC were rare (ASR = 0.2 and 0.7 per 100,000 person-years, respectively and did not change significantly over time except for increasing ANSCCs in men (APC = 2.8%, p<0.001. ICC was the most common HPV-associated cancer (ASR = 19.9 per 100,000 person-years but declined significantly between 1968-2012 (APC = -2.4%. Incidence of each cancer varied across ethnicities. Similar to trends in Western countries, OPSCC incidence increased in recent years, while non-OP HNC decreased. ICC remains the most common HPV-related cancer in Singapore, but Pap screening programs have led to consistently decreasing incidence.

  1. Patterns of Vaginal, Oral, and Anal Sexual Intercourse in an Urban Seventh-Grade Population

    Science.gov (United States)

    Markham, Christine M.; Peskin, Melissa Fleschler; Addy, Robert C.; Baumler, Elizabeth R.; Tortolero, Susan R.

    2009-01-01

    Background: This study examines the prevalence of vaginal, oral, and anal intercourse among a population of urban, public middle school students, the characteristics of early sexual initiators, and the sequence of sexual initiation. Such data are limited for early adolescents. Methods: A total of 1279 seventh-grade students (57.3% female, 43.6%…

  2. Preoperative evaluation of the depth of anal canal invasion in very low rectal cancer by magnetic resonance imaging and surgical indications for intersphincteric resection

    International Nuclear Information System (INIS)

    Bamba, Yoshiko; Itabashi, Michio; Kameoka, Shingo

    2012-01-01

    The present study was performed to evaluate the depth of anal canal invasion (DACI), and determine whether magnetic resonance imaging (MRI) assessment of the conjoined longitudinal muscle (CLM) can be used to identify the surgical indication for intersphincteric resection. Sixty-six patients with T1 (n=2), T2 (n=20), T3 (n=39), and T4 (n=5) lower rectal cancer were included. Depth of anal canal invasion was defined as extension of the tumor to the anal canal. The outline of the CLM on MRI was assessed as clear, unclear, or absent (indicating invasion). A comparison of overall T-stage and DACI of 22 pT1-pT2 tumors revealed that none had a higher T-stage within the anal canal, and 16 of 39 pT3 tumors had only pT0-pT2 invasion within the anal canal. The CLM was clear in 30 cases of T0-T2 DACI, unclear in 5 cases of T0-T2 DACI, and 3 cases of T3-T4 DACI, and showed invasion in 3 cases of T2 DACI and 25 cases of T3-T4 DACI. The sensitivity, specificity, positive predictive value, and negative predictive value of using a clear CLM outline for determining T0-T2 DACI was 78.9, 91.9, 100, and 77.8%, respectively. Preoperative evaluation of DACI was compatible with the surgical indications. A clear CLM accurately indicates T0-T2 DACI. (author)

  3. Indicação da anuscopia de alta resolução e citologia anal na prevenção de HPV e câncer colorretal em pacientes portadores de HIV Indication of high resolution anoscopy and anal cytology for prevention of HPV and colorectal cancer in HIV patients

    Directory of Open Access Journals (Sweden)

    Hugo Leonardo Madeiro Arcanjo Silva

    2010-12-01

    Full Text Available OBJETIVO: Rastreamento do papilomavírus humano (HPV assim como sua correlação com a neoplasia anorretal nos pacientes portadores do vírus da imunodeficiência humana (HIV por meio da anuscopia de alta resolução (AAR e da citologia anal. MÉTODOS: Desenvolvemos um estudo observacional, transversal e duplo-cego em que participaram 31 pacientes portadores do HIV independente de queixas proctológicas. Os pacientes foram submetidos à AAR e citologia anal cujas lâminas foram enviadas ao setor de anatomia patológica para coloração e posterior análise. RESULTADOS: Verificamos 22 pacientes do sexo masculino e 9 do sexo feminino entre 20 e 67 anos. Dos 31 analisados, quatro encontravam-se em estágio de imunodepressão, 23 utilizavam terapia antirretroviral, 16 com passado de sexo anal receptivo e 12 com passado de condiloma acuminado. À AAR 11 pacientes tinham alterações e 7 foram confirmados pela citologia. Verificamos ainda oito pacientes com alterações à citologia os quais possuíam ausência de alterações à AAR. À citologia apresentaram três células escamosas atípicas de significância (Ascus, do inglês atypical squamous cells of undetermined significance, cinco com paraceratose e/ou hiperceratose, seis lesões intraepiteliais de baixo grau e uma lesão intraepitelial de alto grau. CONCLUSÃO: Sugerimos a utilização da AAR aliada à citologia anal para rastreamento nos pacientes portadores do HIV, visto que esses exames complementam-se para a detecção de lesões que estejam relacionadas ao câncer anorretal.OBJECTIVE: Screening for HPV as well as its correlation with anorectal cancer in patients carrying the human immuno deficiency virus (HIV through high-resolution anoscopy (HRA and anal cytology. METHODS: We developed an observational study, double-blind attended by 31 patients with HIV independent proctologic complaints. Patients underwent HRA and anal cytology slides were sent to which sector pathology staining and

  4. Aqueous exposure to the progestin, levonorgestrel, alters anal fin development and reproductive behavior in the eastern mosquitofish (Gambusia holbrooki)

    Science.gov (United States)

    Frankel, Tyler E.; Meyer, Michael T.; Orlando, Edward F.

    2016-01-01

    Endogenous progestogens are important regulators of vertebrate reproduction. Synthetic progestins are components of human contraceptive and hormone replacement pharmaceuticals. Both progestogens and progestins enter the environment through a number of sources, and have been shown to cause profound effects on reproductive health in various aquatic vertebrates. Progestins are designed to bind human progesterone receptors, but they also have been shown to strongly activate androgen receptors in fish. Levonorgestrel (LNG) activates fish androgen receptors and induces development of male secondary sex characteristics in females of other species. Although behavior has been postulated to be a sensitive early indicator of exposure to certain environmental contaminants, no such research on the reproductive behavior of gestagen-exposed fish has been conducted to date. The goal of our study was to examine the exposure effects of a human contraceptive progestin, LNG, on the reproductive development and behavior of the viviparous eastern mosquitofish (Gambusia holbrooki). Internal fertilization is a requisite characteristic of viviparous species, and is enabled by an androgen driven elongation of the anal fin into the male gonopodium (i.e., phallus). In this study, we exposed adult mosquitofish to ethanol (EtOH control), 10 ng/L, and 100 ng/L LNG for 8 d using a static replacement exposure design. After 8 d, a subset of males and females from each treatment were examined for differences in the 4:6 anal fin ratio. In addition, paired social interaction trials were performed using individual control males and control females or females treated 10 ng/L or 100 ng/L LNG. Female mosquitofish exposed to LNG were masculinized as evidenced by the elongation of the anal fin rays, a feature normal to males and abnormal to females. LNG caused significant increases in the 4:6 anal fin ratios of female mosquitofish in both the 10 ng/L and 100 ng/L treatments, although these

  5. Positron Emission Tomography/Computed Tomography in the Staging and Treatment of Anal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sveistrup, Joen, E-mail: joensveistrup@hotmail.com [Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark); Loft, Annika [PET and Cyclotron Unit, Department of Clinical Physiology and Nuclear Medicine, Centre of Diagnostic Investigations, Rigshospitalet, Copenhagen (Denmark); Berthelsen, Anne Kiil [Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark); PET and Cyclotron Unit, Department of Clinical Physiology and Nuclear Medicine, Centre of Diagnostic Investigations, Rigshospitalet, Copenhagen (Denmark); Henriksen, Birthe Merete; Nielsen, Michael Bachmann [Department of Radiology, Section of Ultrasound X4123, Rigshospitalet, Copenhagen (Denmark); Engelholm, Svend Aage [Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark)

    2012-05-01

    Purpose: This study was intended to determine the role of PET/CT in the staging of anal cancer as a supplement to three-dimensional transanal ultrasound (TAUS) and inguinal ultrasound (US). The impact of the PET/CT on the initial stage and treatment plan proposed by TAUS/US was assessed. Methods and Materials: Ninety-five (95) patients referred to our clinic between July 1, 2005, and December 31, 2009, were retrospectively reviewed. All patients had biopsy-proven primary squamous cell cancer of the anal canal. There were 65 females (68%) and 30 males (32%), and the median age was 58 years (range, 35-88 years). Six (6%) of the patients were HIV positive. All patients were staged with TAUS/US and PET/CT. Results: Twenty-eight (28) patients were diagnosed with suspicious perirectal node metastases. TAUS visualized 24 of these, whereas PET/CT detected 15. Suspicious inguinal nodes were visualized on either US or PET/CT in 41 patients. Seventeen (17) of these had confirmed malignant disease on biopsy, and 15 had confirmed benign disease. All 17 patients (100%) with malignant inguinal nodes were diagnosed by PET/CT, whereas US identified 16 (94%). Ten patients were diagnosed with suspicious inguinal nodes on PET/CT that had not been seen on US. One of these was malignant, three were benign, and six were not biopsied. PET/CT diagnosed eight metastatic sites, whereas TAUS/US diagnosed three. PET/CT discovered three of the five synchronous cancers seen in this study. PET/CT upstaged the disease in 14% of the cases and changed the treatment plan proposed by TAUS/US in 17%. Conclusion: PET/CT has great potential influence on the staging and treatment of anal cancer. TAUS is important in the staging of the primary tumor and N1-stage, whereas PET/CT seems necessary for the N2/3-stage, the M-stage and synchronous cancers.

  6. Tratamento com radio e quimioterapia do carcinoma epidermóide do canal anal: experiência do hospital Barão de Lucena Radiochemotherapy for squamous cell carcinoma of the anal canal: Barao de Lucena hospital experience

    Directory of Open Access Journals (Sweden)

    Maurilio Toscano de Lucena

    2010-06-01

    Full Text Available Objetivos: Apresentar os resultados e analisar as variáveis implicadas no tratamento e prognóstico do carcinoma epidermóide do canal anal tratado através da radio e quimioterapia no Hospital Barão de Lucena-SUS-PE. Metodologia: Análise dos prontuários de pacientes com diagnóstico de câncer do canal anal submetidos a tratamento radioquimioterápico. O período de acompanhamento foi de junho de 1989 a junho de 2005. Foram incluídos os pacientes com diagnóstico histológico de câncer de canal anal, enquadrados nos estadios I, II, IIIa e IIIb, submetidos a dois ciclos de quimioterapia com 5-fluorouracil (5-FU na dose de 1g/m²/dia em infusão contínua de 96 horas e cisplatino na dose de 100mg/m² administrado em 6 horas no segundo dia de infusão de cada ciclo, administrados na primeira e terceira semanas do esquema de tratamento radioterápico. Resultados: Avaliamos 108 prontuários de pacientes que preencheram os critérios do protocolo. O tempo médio de seguimento foi de 51 meses (1-182 meses. Houve predomínio do gênero feminino (81,5% dos pacientes. A idade variou de 33 a 83 anos (média de 59 anos. O tipo histológico mais freqüente foi o carcinoma de células escamosas (80,6% dos casos. Em 21 pacientes, foi diagnosticado carcinoma basalóide. Quanto ao grau de diferenciação, prevaleceu o tipo moderadamente diferenciado (61% dos pacientes com carcinoma de células escamosas. O índice de resposta inicial completa foi de 89,8%. Onze pacientes persistiram com tumor após o tratamento radio e quimioterápico. O índice de resposta inicial completa foi menor nos estadios IIIa e IIIb em relação aos estadios I e II com significância estatística (pObjectives: To present the results and analyze the variables involved in the treatment and prognosis of squamous cell carcinoma of the anal canal treated by radiotherapy and chemotherapy at the Hospital Barao de Lucena-SUS-PE. Methodology: Analysis of medical records of patients

  7. Topical sucralfate treatment of anal fistulotomy wounds: a randomized placebo-controlled trial.

    Science.gov (United States)

    Gupta, Pravin J; Heda, Purushottam S; Shrirao, Subhash A; Kalaskar, Surekha S

    2011-06-01

    Sucralfate is a cytoprotective agent which adheres to mucoproteins and forms a protective barrier at wound sites. In oral form it is a common ulcer medication, and as a topical preparation it has been used to treat a wide variety of wounds. The present study was designed to evaluate the effectiveness and safety of topical sucralfate in wound healing after anal fistulotomy. Double-blind, randomized controlled study comparing topical application of sucralfate or placebo. Private outpatient clinic specializing in anorectal disease in Nagpur, India. Patients with a wound length of at least 5 cm after low anal fistulotomy were eligible for the study. Patients were randomly assigned to receive ointment containing 7% sucralfate or a placebo ointment consisting of petroleum jelly. Patients were instructed to apply approximately 3 g of ointment to the wound twice daily after a sitz bath for 6 weeks or until the wound had healed. The wounds were examined by a blinded independent observer at 2, 4, and 6 weeks after the operation. The primary end point was the proportion of patients with wounds that had completely healed. Secondary end points included amount of mucosal covering (scored by the observer), adverse events, and postoperative pain (self-rated on a visual analog scale). Of 80 participants (29 women, 51 men; median age, 23 (range, 17-49) years), 76 participants completed the trial (sucralfate, 39; placebo, 37). At 6-week follow-up, complete wound healing was achieved in 37 patients (95%) in the sucralfate group and 27 patients (73%) in the placebo group (P = .009). Mucosal coverage of the wound was significantly greater with sucralfate than with placebo at each measurement point (P = .01). No adverse events were observed. Postoperative pain scores were significantly lower for sucralfate than for placebo at 2 and 4 weeks after the start of treatment. Wound tissue specimens were not available for morphological and ultrastructural analysis. The results of this study add

  8. Interstitial high-dose rate brachytherapy as boost for anal canal cancer

    International Nuclear Information System (INIS)

    Falk, Alexander Tuan; Claren, Audrey; Benezery, Karen; François, Eric; Gautier, Mathieu; Gerard, Jean-Pierre; Hannoun-Levi, Jean-Michel

    2014-01-01

    To assess clinical outcomes of patients treated with a high-dose rate brachytherapy boost for anal canal cancer (ACC). From August 2005 to February 2013, 28 patients presenting an ACC treated by split-course external beam radiotherapy (EBRT) and HDR brachytherapy with or without chemotherapy in a French regional cancer center in Nice were retrospectively analyzed. Median age was 60.6 years [34 – 83], 25 patients presented a squamous cell carcinoma and 3 an adenocarcinoma; 21 received chemotherapy. Median dose of EBRT was 45 Gy [43.2 – 52]. Median dose of HDR brachytherapy was 12 Gy [10 - 15] with a median duration of 2 days. Median overall treatment time was 63 days and median delay between EBRT and brachytherapy was 20 days. Two-year local relapse free, metastatic free, disease free and overall survivals were 83%, 81.9%, 71.8% and 87.7% respectively. Acute toxicities were frequent but not severe with mostly grade 1 toxicities: 37% of genito-urinary, 40.7% of gastro-intestinal and 3.7% of cutaneous toxicities. Late toxicities were mainly G1 (43.1%) and G2 (22%). Two-year colostomy-free survival was 75.1%, one patient had a definitive sphincter amputation. High-dose rate brachytherapy for anal canal carcinoma as boost represents a feasible technique compared to low or pulsed-dose rate brachytherapy. This technique remains an excellent approach to precisely boost the tumor in reducing the overall treatment time

  9. Internal Delorme's Procedure for Treating ODS Associated With Impaired Anal Continence.

    Science.gov (United States)

    Liu, Weicheng; Sturiale, Alessandro; Fabiani, Bernardina; Giani, Iacopo; Menconi, Claudia; Naldini, Gabriele

    2017-12-01

    The aim of this study was to evaluate the medium-term outcomes of internal Delorme's procedure for treating obstructed defecation syndrome (ODS) patients with impaired anal continence. In a retrospective study, 41 ODS patients who underwent internal Delorme's procedure between 2011 and 2015 were divided into 3 subgroups according to their associated symptoms of impaired continence, as urgency, passive fecal incontinence and both, before study. Then the patients' preoperative statuses, perioperative complications, and postoperative outcomes were investigated and collected from standardized questionnaires, including Altomare ODS score, Fecal Incontinence Severity Index (FISI), Patient Assessment of Constipation-Quality of Life Questionnaire (PAC-QoL), and Fecal Incontinence Quality of Life Scale (FIQLS). All results with a 2-tailed P ODS score, FISI, PAC-QoL, and FIQLS in all patients when comparing scores from before the operation with those at the final follow-up. Similar results were also observed in both the urgency subgroup and passive fecal incontinence subgroup, but there were no statistically significant improvements ( P > .05) in Altomare ODS score, FISI, PAC-QoL, or FIQLS in the urgency and passive fecal incontinence subgroups. Anorectal manometry showed the mean value of anal resting pressure increased 20%. Additionally, no major complications occurred. Internal Delorme's procedure is effective without major morbidity for treating ODS associated with urgency or passive fecal incontinence, but it may be less effective for treating ODS associated with both urgency and passive fecal incontinence.

  10. Uuringutest ja mõjude analüüsist kriminaalpoliitika näitel / Mari-Liis Sööt

    Index Scriptorium Estoniae

    Sööt, Mari-Liis

    2010-01-01

    Kriminaalpoliitikas kasutatavatest uuringutest (statistikaülevaated; retsidiivsus-, ohvri-, mõju- ja probleemiuuringud). Uuringute ja analüüside kasutamisest ja mõjust varguste, joobes juhtimise ja narkoraviga seotud seaduseelnõude väljatöötamisel

  11. The influence of smoking and other risk factors on the outcome after radiochemotherapy for anal cancer

    International Nuclear Information System (INIS)

    Mai, Sabine Kathrin; Welzel, Grit; Haegele, Verena; Wenz, Frederik

    2007-01-01

    Smoking is an important risk factor for the development of cancer. Smoking during radiochemotherapy therapy may have a negative influence on prognosis. We evaluated the effect of smoking during radiochemotherapy on the outcome for patients with anal cancer. Sixty-eight patients (34 smokers, 34 non-smokers) treated by radiochemotherapy for anal cancer were analysed. The effect of smoking during radiochemotherapy and other risk factors (gender, T- and N category, tumor site, dose, therapy protocol) on disease-specific survival (DSS), local control (LC) and colostomy free survival (CFS) was evaluated. There was a significant difference in age and male:female ratio between the two groups. With a median follow up of 22 months (max. 119) DSS, LC, and CFS were 88%, 84% and 84%. A significant difference in local control between smokers (S) and non-smokers (NS) was found (S 74% vs. NS 94%, p = .03). For DSS and CFS a difference in terms of outcome between smokers and non-smokers was seen (DSS: S 82% vs. NS 96%, p = .19, CFS: S 75% vs. 91%, p = .15), which did not reach statistical significance. In multivariate analyses only gender had a significant association with LC and T category with CFS. The other risk factors did not reach statistical significance. Even though our evaluation reached statistical significance only in univariate analysis, we suggest, that the role of smoking during radiochemotherapy for anal cancer should not be ignored. The potential negative effect on prognosis should be explained to patients before therapy

  12. The influence of smoking and other risk factors on the outcome after radiochemotherapy for anal cancer

    Directory of Open Access Journals (Sweden)

    Haegele Verena

    2007-08-01

    Full Text Available Abstract Background Smoking is an important risk factor for the development of cancer. Smoking during radiochemotherapy therapy may have a negative influence on prognosis. We evaluated the effect of smoking during radiochemotherapy on the outcome for patients with anal cancer. Methods Sixty-eight patients (34 smokers, 34 non-smokers treated by radiochemotherapy for anal cancer were analysed. The effect of smoking during radiochemotherapy and other risk factors (gender, T- and N category, tumor site, dose, therapy protocol on disease-specific survival (DSS, local control (LC and colostomy free survival (CFS was evaluated. Results There was a significant difference in age and male:female ratio between the two groups. With a median follow up of 22 months (max. 119 DSS, LC, and CFS were 88%, 84% and 84%. A significant difference in local control between smokers (S and non-smokers (NS was found (S 74% vs. NS 94%, p = .03. For DSS and CFS a difference in terms of outcome between smokers and non-smokers was seen (DSS: S 82% vs. NS 96%, p = .19, CFS: S 75% vs. 91%, p = .15, which did not reach statistical significance. In multivariate analyses only gender had a significant association with LC and T category with CFS. The other risk factors did not reach statistical significance. Conclusion Even though our evaluation reached statistical significance only in univariate analysis, we suggest, that the role of smoking during radiochemotherapy for anal cancer should not be ignored. The potential negative effect on prognosis should be explained to patients before therapy.

  13. A psicologia analítica de Carl Gustav Jung: apontamentos de aulaThe analytical psychology of Carl Gustav Jung: notes of lesson

    OpenAIRE

    Ramos, Luís Marcelo Alves

    2008-01-01

    O texto traz o conteúdo de uma aula sobre Teorias da Personalidade com foco nos fundamentos da Psicologia Analítica do psicólogo e psiquiatra suíço Carl Gustav Jung (1875-1961), cuja obra vem apresentando significativas contribuições para a Psicologia Educacional, Organizacional e Clínica. Palavras-chave Psicologia analítica; Teorias da personalidade Abstract The text brings the content of a lesson on Theories of Personality focused in the fundamentals of the Analytical Psychology of...

  14. Analýza nestrukturovaných dat z bankovních stránek na sociální síti Facebook

    Directory of Open Access Journals (Sweden)

    Lucie Šperková

    2014-12-01

    Full Text Available Sociální sítě jako novodobý kanál pro sdílení online Word of Mouth představuje pro bankovní společnosti příležitost, jak analyzovat komunikaci a názory svých zákazníků, které zde veřejně sdílejí. Článek ukazuje proces a výsledky pokročilé kontextové analýzy těchto nestrukturovaných dat vybraných veřejných bankovních stránek na sociální síti Facebook. Analýza zákaznických názorů, problémů a přání může hrát významnou roli pro pozici těchto společností na trhu a jejich orientaci na zákazníky. Využity byly metody shlukování a sentiment analýz, výsledky odrážejí stav chování zákazníků a bank na této síti. Článek zdůrazňuje důležitost problematiky Word of Mouth a jeho analýz informačními technologiemi. Zároveň diskutuje, jak analýza kontextu může přenést marketing na další úroveň identifikace zákazníkova chování a jeho vztahu ke společnosti.

  15. The effectiveness of electrocautery ablation for the treatment of high-grade anal intraepithelial neoplasia in HIV-infected men who have sex with men.

    Science.gov (United States)

    Burgos, J; Curran, A; Landolfi, S; Navarro, J; Tallada, N; Guelar, A; Crespo, M; Ocaña, I; Ribera, E; Falcó, V

    2016-08-01

    Electrocautery is one of the main treatment options for high-grade anal intraepithelial neoplasia (HGAIN). However, data regarding its efficacy are scarce. The aim of the study was to evaluate the effectiveness of electrocautery for the treatment of HGAIN. An observational study of HIV-infected men who have sex with men (MSM) who underwent screening for anal dysplasia was carried out. The on-treatment effectiveness of electrocautery was evaluated (according to biopsy findings measured 6-8 weeks after treatment) in patients with HGAIN. A complete response was defined as resolution of anal intraepithelial neoplasia (AIN), a partial response as regression to low-grade AIN and recurrence as biopsy-proven HGAIN during follow-up. From May 2009 to November 2014, 21.9% (126 of 576) of patients screened were found to have HGAIN. Electrocautery effectiveness was evaluated in 83 patients. A complete response was observed in 27 patients [32.5%; 95% confidence interval (CI) 23.4-53.2%], a partial response in 28 patients (33.7%; 95% CI 24.5-44.4%) and persistence in 28 patients (33.7%; 95% CI 24.5-44.4%). The patients with the most successful results (81.8%) required two to four sessions of electrocautery. After a mean follow-up of 12.1 months, 14 of 55 patients with a response (25.4%; 95% CI 15.8-38.3%) developed recurrent HGAIN within a mean time of 29.9 months (95% CI 22-37.7 months). No patient progressed to invasive cancer during the study or developed serious adverse events after treatment. No factors associated with poor response or recurrences were observed. Although electrocautery is the standard treatment for anal dysplasia, almost 50% of patients with HGAIN in our study did not respond or relapsed. New treatment strategies are necessary to optimize the management of anal dysplasia. © 2015 British HIV Association.

  16. Human papillomavirus in anal biopsy tissues and liquid-based cytology samples of HIV-positive and HIV-negative Thai men who have sex with men

    Directory of Open Access Journals (Sweden)

    Tippawan Pankam

    2017-06-01

    Full Text Available Background: Men who have sex with men (MSM are at high risk of developing human papillomavirus (HPV-related anal cancer. We compared HPV genotypes in anal tissues (Bx and anal liquid-based cytology fluid (LBC from HIV-positive and HIV-negative MSM. Methods: Bx (32 normal, 41 low-grade squamous intraepithelial lesions (LSIL and 22 high-grade squamous intraepithelial lesions (HSIL, along with LBC from the same visit, were selected from 61 HIV-positive and 34 HIV-negative MSM who enrolled into a prospective cohort in Bangkok, Thailand. HPV genotyping was performed on Bx and LBC. Results: Any HPV and high-risk HPV (HR-HPV prevalence were 63.2% and 60.0% in Bx and 71.6% and 62.1% in LBC, respectively. HIV-positive MSM had higher rates of HR-HPV genotypes detection (70.5% vs. 47.1%, p=0.03 in LBC than HIV-negative MSM. HPV16 (27% was the most common HR-HPV found in HSIL tissue. In HIV-positive MSM, the frequency of HR-HPV detection increased with histopathologic grading in both Bx and LBC samples. HSIL was associated with the presence of any HR-HPV(OR 7.6 (95%CI 1.8–31.9; P=0.006 in LBC and in Bx((OR 5.6 (95%CI 1.4–22.7; P=0.02. Conclusions: Our data strongly support the integration of HR-HPV screening on LBC samples, along with HPV vaccination, into an anal cancer prevention program. Keywords: Human papillomavirus, Anal tissues, Men who have sex with men, HIV, Thailand

  17. Randomized clinical trial assessing the side-effects of glyceryl trinitrate and diltiazem hydrochloride in the treatment of chronic anal fissure.

    Science.gov (United States)

    Kocher, H M; Steward, M; Leather, A J M; Cullen, P T

    2002-04-01

    Glyceryl trinitrate (GTN) ointment (0 small middle dot2 per cent) has an efficacy of up to 68 per cent in healing chronic anal fissure, but with headache as a major side-effect. Diltiazem hydrochloride (DTZ) cream (2 per cent) is expected to have fewer side-effects. A prospective double-blind randomized two-centre trial requiring at least 26 patients in each group (alpha = 0.05, beta = 0.9) was instituted after approval of the local ethics committee, to compare the incidence of side-effects (primary endpoint) with 0.2 per cent GTN ointment and 2 per cent DTZ cream in the treatment of chronic anal fissure. Treatments were applied perianally, twice daily for 6-8 weeks. All patients gave written informed consent. Both groups were comparable in patient demographics and clinical characteristics. Twelve patients violated the protocol, withdrew or did not attend follow-up. There were more side-effects with GTN (21 of 29 patients) than with DTZ (13 of 31) (relative risk (RR) 1.84 (95 per cent confidence interval (c.i.) 1.11 to 3.04), P = 0.01). In particular, more headaches occurred with GTN (17 of 29 patients) than with DTZ (eight of 31) (RR 2.06 (95 per cent c.i. 1.18 to 3.59), P = 0.01). There were no significant differences in healing and symptomatic improvement rates between patients receiving GTN (25 of 29) and DTZ (24 of 31). DTZ cream caused substantially fewer headaches than GTN ointment. There was no significant difference in the healing or improvement of chronic anal fissure between the treatments. DTZ may be the preferred first-line treatment for chronic anal fissure.

  18. Urethral dose sparing in squamous cell carcinoma of anal canal using proton therapy matching electrons with prior brachytherapy for prostate cancer: A case study.

    Science.gov (United States)

    Apinorasethkul, Ontida; Lenards, Nishele; Hunzeker, Ashley

    2016-01-01

    The purpose of this case study is to communicate a technique on treating the re-irradiation of squamous cell carcinoma (SCC) of anal canal with proton fields matched with electron fields to spare prostatic urethra. A 76-year old male presented with a secondary radiation-induced malignancy as a result of prostate brachytherapy seeds irradiation 10 years prior. A rectal examination revealed a bulky tumor at the top of the anal canal involving the left superior-most aspect of the anal canal extending superiorly into the rectum. The inferior extent was palpable approximately 3cm from the anal verge and the superior extent of the mass measured greater than 5cm in the superior-inferior dimension. Chemoradiation was suggested since the patient was opposed to abdominoperineal resection (APR) and colostomy. The use of proton therapy matching with electron fields in the re-irradiation setting could help reduce the complications. A 2 lateral proton beams were designed to treat the bulky tumor volume with 2 electron beams treating the nodal volumes. This complication of treatment fields helped spare the prostatic urethra and reduced the risk of urinary obstruction in the future. Copyright © 2016 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  19. Verificación analítica para las determinaciones de cromo hexavalente en aguas por espectrofotometría

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Severiche Sierra

    2013-06-01

    Full Text Available En la actualidad la prestación de servicios analíticos de laboratorios, toma de forma ascendente más auge y utilidad. El efecto de un análisis de aguas es forjar resultados correctos y confiables, siendo la verificación de ensayos uno de los aspectos más importantes y factor clave para conseguir este propósito. La determinación de cromo hexavalente en aguas por colorimetría con la difenilcarbazida es la metodología analítica más usada y útil que se conoce en el ámbito científico técnico, principalmente, por su alta selectividad y también debatida por su reacción a las interferencias. En el presente estudio se hizo la valoración analítica del método espectrofotométrico para la determinación de cromo hexavalente en aguas; el objetivo de este trabajo fue confirmar correctamente la aplicación del método para el análisis de aguas. Se trabajaron muestras de diferentes tipos de agua: potable, residual y superficial, siguiéndose estrictamente los protocolos de verificación. Se encontraron resultados satisfactorios en precisión y exactitud con el fin de emitir resultados confiables y reales de la muestra analizada.

  20. Epidermal Growth Factor Receptor Expression As Prognostic Marker in Patients With Anal Carcinoma Treated With Concurrent Chemoradiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Fraunholz, Ingeborg, E-mail: inge.fraunholz@kgu.de [Department of Radiotherapy and Oncology, Goethe University, Frankfurt/Main (Germany); Rödel, Franz; Kohler, Daniela [Department of Radiotherapy and Oncology, Goethe University, Frankfurt/Main (Germany); Diallo-Georgiopoulou, Margarita [Department of Radiotherapy and Oncology, Goethe University, Frankfurt/Main (Germany); Department of Radiation Oncology, Klinikum Offenbach, Offenbach/Main (Germany); Distel, Luitpold [Department of Radiation Oncology, Friedrich Alexander University, Erlangen (Germany); Falk, Stefan [Pathology Associates, Frankfurt/Main (Germany); Rödel, Claus [Department of Radiotherapy and Oncology, Goethe University, Frankfurt/Main (Germany)

    2013-08-01

    Purpose: To investigate the prognostic value of epidermal growth factor receptor (EGFR) expression in pretreatment tumor biopsy specimens of patients with anal cancer treated with concurrent 5-fluorouracil and mitomycin C-based chemoradiation therapy (CRT). Methods and Materials: Immunohistochemical staining for EGFR was performed in pretreatment biopsy specimens of 103 patients with anal carcinoma. EGFR expression was correlated with clinical and histopathologic characteristics and with clinical endpoints, including local failure-free survival (LFFS), colostomy-free survival (CFS), distant metastases-free survival (DMFS), cancer-specific survival (CSS), and overall survival (OS). Results: EGFR staining intensity was absent in 3%, weak in 23%, intermediate in 36% and intense in 38% of the patients. In univariate analysis, the level of EGFR staining was significantly correlated with CSS (absent/weak vs intermediate/intense expression: 5-year CSS, 70% vs 86%, P=.03). As a trend, this was also observed for DMFS (70% vs 86%, P=.06) and LFFS (70% vs 87%, P=.16). In multivariate analysis, N stage, tumor differentiation, and patients’ sex were independent prognostic factors for CSS, whereas EGFR expression only reached borderline significance (hazard ratio 2.75; P=.08). Conclusion: Our results suggest that elevated levels of pretreatment EGFR expression could be correlated with favorable clinical outcome in anal cancer patients treated with CRT. Further studies are warranted to elucidate how EGFR is involved in the response to CRT.

  1. A novel pre-clinical murine model to study the life cycle and progression of cervical and anal papillomavirus infections.

    Directory of Open Access Journals (Sweden)

    Nancy M Cladel

    Full Text Available Papillomavirus disease and associated cancers remain a significant health burden in much of the world. The current protective vaccines, Gardasil and Cervarix, are expensive and not readily available to the underprivileged. In addition, the vaccines have not gained wide acceptance in the United States nor do they provide therapeutic value. Papillomaviruses are strictly species specific and thus human viruses cannot be studied in an animal host. An appropriate model for mucosal disease has long been sought. We chose to investigate whether the newly discovered mouse papillomavirus, MmuPV1, could infect mucosal tissues in Foxn1nu/Foxn1nu mice.The vaginal and anal canals of Foxn1nu/Foxn1nu mice were gently abraded using Nonoxynol-9 and "Doctor's BrushPicks" and MmuPV1 was delivered into the vaginal tract or the anal canal.Productive vaginal, cervical and anal infections developed in all mice. Vaginal/cervical infections could be monitored by vaginal lavage. Dysplasias were evident in all animals.Anogenital tissues of a common laboratory mouse can be infected with a papillomavirus unique to that animal. This observation will pave the way for fundamental virological and immunological studies that have been challenging to carry out heretofore due to lack of a suitable model system.

  2. Mihaila Bulgakova Volands un Marijas Korelli Lučija (salīdzinošā analīze)

    OpenAIRE

    Suhackis, Aleksandrs

    2009-01-01

    Darbs ir veltīts sātana tēlu romānos «Sātana Sēras» Marijas Korelli un «Meistars un Margarita» Mihaila Bulgakova salidzinošās analīzei. Pētīšanas mērķis ir salīdzināt Lučio Rimanca un Volanda tēlus simvolisma un demonoloģijas tradīcijas aspektā. Īpaša uzmanība ir veltīta arī uz simvolisma tradicijas, dekadanca un romantīsma abskatiem, ar mērķi analīzēt, literārus darbus „Satana Sēras” un „Meistars un Margarita” šaja aspektā. Darbs ir dalīts uz divam daļām. Pirmā ir aprakstīti teoretiskie ...

  3. Vertebral defect, anal atresia, cardiac defect, tracheoesophageal fistula/esophageal atresia, renal defect, and limb defect association with Mayer-Rokitansky-Küster-Hauser syndrome in co-occurrence

    DEFF Research Database (Denmark)

    Bjørsum-Meyer, Thomas; Herlin, Morten; Qvist, Niels

    2016-01-01

    Background: The vertebral defect, anal atresia, cardiac defect, tracheoesophageal fistula/esophageal atresia, renal defect, and limb defect association and Mayer-Rokitansky-Küster-Hauser syndrome are rare conditions. We aimed to present two cases with the vertebral defect, anal atresia, cardiac...... defect, tracheoesophageal fistula/esophageal atresia, renal defect, and limb defect association and Mayer-Rokitansky-Küster-Hauser co-occurrence from our local surgical center and through a systematic literature search detect published cases. Furthermore, we aimed to collect existing knowledge...... in the embryopathogenesis and genetics in order to discuss a possible link between the vertebral defect, anal atresia, cardiac defect, tracheoesophageal fistula/esophageal atresia, renal defect, and limb defect association and Mayer-Rokitansky-Küster-Hauser syndrome. Case presentation: Our first case was a white girl...

  4. The prognostic value of HPV status and p16 expression in patients with carcinoma of the anal canal.

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    Gloria B Roldán Urgoiti

    Full Text Available BACKGROUND: In anal cancer studies, the detection frequency of high-risk HPV (human papillomavirus is variable, depending on the method used. There are limited data reporting results of different HPV detection techniques in the same clinical series, and very few correlating results with clinical outcome. OBJECTIVES: To evaluate tumor expression of p16/HPV16 using three different methods, and to determine their association with clinical outcome in patients with anal canal squamous cell carcinomas (SCC. DESIGN: This retrospective study included patients with anal canal SCC treated with definitive radiotherapy or chemoradiotherapy at a single institution between 1992 and 2005. Formalin-fixed paraffin-embedded tumor samples from 53 of the 89 (60% patient pre-treatment biopsies were adequate for tissue microarray construction. HPV status was determined using: p16 expression by conventional immunohistochemistry (IHC and quantitative IHC (AQUA, HPV genotype analysis by chromogenic in situ hybridization (CISH and HPV linear array sub-typing. Expression status was correlated with clinical outcome. RESULTS: 80% (28/35 of patient tumors had high p16 expression using conventional IHC. HPV16 CISH was positive in 81% (34/42 of tumors, and 78% (28/36 of tumors were HPV subtype 16. HPV16 CISH correlated with p16 evaluated by conventional IHC (correlation coefficient 0.46; p = 0.01 and by p16 AQUA score (correlation coefficient 0.49; p = 0.001. A subset of cases (15% had very high p16 quantitative IHC scores (>244 and were associated with a higher incidence of local or distant recurrence (p = 0.04. CONCLUSIONS: The vast majority (80% of anal canal SCC in our series were positive for HPV16/p16, regardless of the testing method used. The exploratory analysis of automated quantitative IHC scoring was the only technique to define a subset of patients with a worse prognosis by p16 expression status on univariate analysis. Further exploration of the molecular

  5. Intracavitary afterloading boost in anal canal carcinoma. Results, function and quality of life

    International Nuclear Information System (INIS)

    Vordermark, D.; Flentje, M.; Koelbl, O.; Sailer, M.

    2001-01-01

    Background: First clinical data on a new intracavitary afterloading boost method for anal canal carcinoma is reported. Patients and Methods: 20 consecutive patients (T1 5%, T2 70%, T3 20%, T4 5%; N0 75%, N1 10%, N2 15%; all M0) treated with external beam pelvic radiotherapy (median dose 56 Gy, range 46-64 Gy), simultaneous 5-FU and mitomycin (in 75%) and an intracavitary afterloading boost (one or two fractions of 5 Gy at 5 mm depth) were analyzed after a mean ±SD follow-up for living patients of 4.4±2.1 years. Quality of life (QoL) and anorectal manometry parameters were assessed in ten colostomy-free survivors. Results: Overall, recurrence-free and colostomy-free survival at 5 years were 84%, 79% and 69%, respectively. No death was tumorrelated. The only local failure was successfully salvaged by local excision. All three colostomies were performed for toxicity. Resting pressure and maximum squeeze pressure of the anal sphincter were reduced by 51% and 71%, as compared with control subjects, but quality of life was similar compared to healthy volunteers. Conclusion: the described regimen is highly effective but associated with increased toxicity. (orig.) [de

  6. Defecation mechanisms after anterior resection with J-pouch-anal and side-to-end anastomosis in dogs.

    Science.gov (United States)

    Willis, S; Hölzl, F; Wein, B; Tittel, A; Schumpelick, V

    2007-02-01

    Colonic J-pouch-anal anastomosis or colonic side-to-end anastomosis is the reconstruction of choice after low anterior resection. However, the mechanisms of defecation after both reconstruction forms are still speculative. Low anterior rectal resections were performed in 12 dogs with six colonic J-pouch-anal (pouch) and six coloanal side-to-end (SE) reconstructions. Four months postoperative stool frequency, intestinal transit time, and neorectal compliance were determined by radiography and barostat. Defecation mechanisms were evaluated radiographically during expulsion of artificial stool. One dog with pouch reconstruction could not be evaluated due to an anastomotic leak, while the others had uncomplicated course. Spontaneous stool frequency was significantly increased with both reconstruction methods (control 2.0+/-0.9, pouch 2.7+/-1.2, SE 3.3+/-0.9 day; panastomosis. Our results show that pouch evacuation is passive and independent from pouch motility. The functional principle of the colonic J-pouch is not its reservoir function but a delay of colonic motility.

  7. Effect of Suyuping combined with semiconductor laser irradiation on wound healing after anal fistula surgery

    Institute of Scientific and Technical Information of China (English)

    Min Zhao; Chang-Ye Sang; Zhen-Jun Wang; Yan-Chun Xu

    2016-01-01

    Objective:To explore the effect of Suyuping combined with semiconductor laser irradiation on the wound healing after anal fistula surgery.Methods:A total of 180 patients with anal fistula who were admitted in our hospital from October, 2013 to May, 2015 for surgery were included in the study and randomized into the treatment group and the control group with 90 cases in each group. The patients in the control group were given the conventional surgical debridement dressing, a time a day. On this basis, the patients in the treatment group were given Suyuping smearing on the wound sinus tract combined with semiconductor laser irradiation, a time a day for 10 min, continuous irradiation until wound healing. The postoperative wound swelling fading, wound surface secretion amount, and the clinical efficacy in the two groups were recorded.Results:The wound surface swelling degree and wound pain degree at each timing point after operation in the treatment group were significantly lower than those in the control group (P<0.05). The wound surface area at each timing point after operation in the treatment group was significantly lower than that in the control group (P<0.05). The wound surface secretion amount 6, 9, and 12 days after operation in the treatment group was significantly lower than that in the control group (P<0.05). The total effective rate in the treatment group was significantly higher than that in the control group (P<0.05). The average healing time in the treatment group was significantly faster than that in the control group (P<0.05). Conclusions: Suyuping combined with semiconductor laser irradiation in the treatment of patients after anal fistula can effectively improve the local blood and lymphatic circulation of wound surface, promote the growth of granulation tissues, and contribute the wound healing.

  8. Effect of Suyuping combined with semiconductor laser irradiation on wound healing after anal fistula surgery

    Directory of Open Access Journals (Sweden)

    Min Zhao

    2016-06-01

    Full Text Available Objective: To explore the effect of Suyuping combined with semiconductor laser irradiation on the wound healing after anal fistula surgery. Methods: A total of 180 patients with anal fistula who were admitted in our hospital from October, 2013 to May, 2015 for surgery were included in the study and randomized into the treatment group and the control group with 90 cases in each group. The patients in the control group were given the conventional surgical debridement dressing, a time a day. On this basis, the patients in the treatment group were given Suyuping smearing on the wound sinus tract combined with semiconductor laser irradiation, a time a day for 10 min, continuous irradiation until wound healing. The postoperative wound swelling fading, wound surface secretion amount, and the clinical efficacy in the two groups were recorded. Results: The wound surface swelling degree and wound pain degree at each timing point after operation in the treatment group were significantly lower than those in the control group (P<0.05. The wound surface area at each timing point after operation in the treatment group was significantly lower than that in the control group (P<0.05. The wound surface secretion amount 6, 9, and 12 days after operation in the treatment group was significantly lower than that in the control group (P<0.05. The total effective rate in the treatment group was significantly higher than that in the control group (P<0.05. The average healing time in the treatment group was significantly faster than that in the control group (P<0.05. Conclusions: Suyuping combined with semiconductor laser irradiation in the treatment of patients after anal fistula can effectively improve the local blood and lymphatic circulation of wound surface, promote the growth of granulation tissues, and contribute the wound healing.

  9. Comparison of imiquimod, topical fluorouracil, and electrocautery for the treatment of anal intraepithelial neoplasia in HIV-positive men who have sex with men: an open-label, randomised controlled trial

    NARCIS (Netherlands)

    Richel, Olivier; de Vries, Henry J. C.; van Noesel, Carel J. M.; Dijkgraaf, Marcel. G. W.; Prins, Jan M.

    2013-01-01

    Anal cancer is an increasing issue in HIV-positive men who have sex with men (MSM). Screening for its precursor, anal intraepithelial neoplasia (AIN), is subject of discussion. Current treatment options are suboptimum and have not been compared in a prospective trial. We compared efficacy and

  10. Retrospective study about 71 patients with anal carcinoma, treated with a uniform radiochemotherapy

    International Nuclear Information System (INIS)

    Wiesmeth, Alfred J.

    2013-01-01

    The aim of this retrospectively prospective study was to examine the outcome (over all survival, tumorspecific survival, local control, colostomy free survival as well as sideeffects of the tumorspecific treatment) on a roughly homogenous and compared to other studies appropriate large group of 71 patients with diagnosed anal carcinoma. All patients underwent primary radiochemotherapy during the period of 1991 to 2010 in a municipal hospital. The median follow-up consisted of 38 month.

  11. Extracción automática de definiciones analíticas y relaciones semánticas de hiponimia-hiperonimia con un sistema basado en patrones lingüísticos

    Directory of Open Access Journals (Sweden)

    Miguel Alejandro Dorantes

    2017-12-01

    Full Text Available En el presente trabajo se muestra parte de un proyecto en curso centrada en el diseño de un autómata lexicográfico. El objetivo principal de la investigación es la extracción de definiciones analíticas y relaciones semánticas de términos con datos tomados directamente de internet. Presentamos dos de las capacidades del sistema: la extracción de definiciones analíticas y de hiperónimos. La metodología consiste principalmente en la búsqueda automática de esta información con patrones construidos manualmente basados en la estructura léxica de definiciones analíticas en lenguaje natural. Con este desarrollo, ha sido posible mejorar la precisión reportada en el estado del arte. Se ha conseguido una precisión de 92.5% para la tarea de extracción de definiciones analíticas y de las relaciones de hiperonimia.

  12. Bacterial fermentation of fructo-oligosaccharides and resistant starch in patients with an ileal pouch-anal anastomosis.

    NARCIS (Netherlands)

    Alles, M.S.; Katan, M.B.; Salemans, J.M.J.I.; Laere, van K.M.J.; Gerichhausen, M.J.W.; Rozendaal, M.J.; Nagengast, F.M.

    1997-01-01

    Patients with large bowel disease may undergo ileal pouch-anal anastomosis, in which the colon is removed and part of the distal ileum is used to construct a pelvic reservoir. Competence of the ileal pouch to ferment carbohydrates is associated with the absence of pouchitis. However, the extent to

  13. 3D high-resolution anorectal manometry in patients with perianal fistulas: comparison with 3D-anal ultrasound.

    Science.gov (United States)

    Felt-Bersma, Richelle J F; Vlietstra, Maarten S; Vollebregt, Paul F; Han-Geurts, Ingrid J M; Rempe-Sorm, Vera; Vander Mijnsbrugge, Grietje J H; Molenaar, Charlotte B H

    2018-04-04

    Perianal fistula surgery can damage the anal sphincters which may cause faecal incontinence. By measuring regional pressures, 3D-HRAM potentially provides better guidance for surgical strategy in patients with perianal fistulas. The aim was to measure regional anal pressures with 3D-HRAM and to compare these with 3D-EUS findings in patients with perianal fistulas. Consecutive patients with active perianal fistulas who underwent both 3D-EUS and 3D-HRAM at a clinic specialised in proctology were included. A group of 30 patients without fistulas served as controls. Data regarding demographics, complaints, previous perianal surgical procedures and obstetric history were collected. The mean and regional anal pressures were measured with 3D-HRAM. Fistula tract areas detected with 3D-EUS were analysed with 3D-HRAM by visual coding and the regional pressures of the corresponding and surrounding area of the fistula tract areas were measured. The study was granted by the VUmc Medical Ethical Committee. Forty patients (21 males, mean age 47) were included. Four patients had a primary fistula, 19 were previously treated with a seton/abscess drainage and 17 had a recurrence after previously performed fistula surgery. On 3D-HRAM, 24 (60%) fistula tract areas were good and 8 (20%) moderately visible. All but 7 (18%) patients had normal mean resting pressures. The mean resting pressure of the fistula tract area was significantly lower compared to the surrounding area (47 vs. 76 mmHg; p < 0.0001). Only 2 (5%) patients had a regional mean resting pressure < 10 mmHg of the fistula tract area. Using a Δ mean resting pressure ≥ 30 mmHg difference between fistula tract area and non-fistula tract area as alternative cut-off, 21 (53%) patients were identified. In 6 patients 3D-HRAM was repeated after surgery: a local pressure drop was detected in one patient after fistulotomy with increased complaints of faecal incontinence. Profound local anal pressure drops are found

  14. Modelos esquemáticos para avaliação da qualidade analítica dos dados nacionais de fibra alimentar

    Directory of Open Access Journals (Sweden)

    CARUSO Lúcia

    1999-01-01

    Full Text Available O controle de qualidade de uma análise laboratorial é essencial para garantir a confiabilidade da informação. Os resultados analíticos serão considerados restritos se não houver um programa definido de controle de qualidade analítico. O presente trabalho propõe modelos esquemáticos para a avaliação da qualidade dos dados nacionais de fibra alimentar. A fibra alimentar foi escolhida, como um modelo, com o propósito de se aplicar os critérios do USDA (U.S. Department of Agriculture empregados na avaliação do selênio, cobre e de carotenóides. Esta escolha foi baseada na escassez de informações desse nutriente e pela importância da fibra alimentar na prevenção de doenças crônico-degenerativas. Para a avaliação da qualidade dos dados foram consideradas cinco categorias: número de amostras, plano de amostragem, tomada de amostra, método analítico e controle de qualidade analítica. Estes modelos foram utilizados na avaliação da qualidade das determinações de fibra alimentar de 180 alimentos. O resultado obtido foi de 29% com código A e B (considerável e razoável confiança e 68% com código C (reduzida confiança. Com a determinação da qualidade dos dados, foi possível estabelecer quais os alimentos que constituem prioridades de análise, que são aqueles nos quais ainda não foi determinada a fração fibra alimentar, e aqueles com código de confiança C.

  15. Aportaciones de la Hermenéutica analógica a la Enfermería: entrevista al prof. Mauricio Beuchot Puente

    Directory of Open Access Journals (Sweden)

    Anabel Paramá

    Full Text Available Entrevista realizada al Prof. Dr. D. Mauricio Beuchot, fundador de la propuesta teórica llamada Hermenéutica Analógica. Este tipo de hermenéutica es, hoy en día, reconocida como una propuesta original y novedosa en el campo de la hermenéutica filosófica. Ya el propio Jean Grondin, uno de los mayores conocedores de la hermenéutica actual, llegó a afirmar que los investigadores en hermenéutica deberían comenzar a conocer el español para leer de primera mano la propuesta de hermenéutica analógica de Beuchot; mostrando con ello la importancia de este autor mexicano. El profesor Mauricio Hardie Beuchot Puente (Torreón, Coahuila, México, 1950, está reconocido como uno de los principales filósofos de Iberoamérica. Sacerdote y fraile dominico, es autor de más de 50 libros sobre temas relacionados con la Filosofía medieval, Filosofía del lenguaje, Filosofía analítica, Estructuralismo y sobre todo, Hermenéutica. Además es Director de la revista Analogía Filosófica, Director de Honor de la revista Hermes Analógica, subdirector de la revista Anamnesis, así como miembro de una cantidad importante de publicaciones académicas. En su larga trayectoria ha conseguido ser desde 1985 investigado titular "C" a tiempo completo del Centro de Estudios Clásicos del Instituto de Investigación Filológicas (IIFL de la UNAM (Universidad Nacional de México. Desde 1997 es miembro de número en la Academia Mexicana de la Lengua, desde 1999 es miembro de la Academia Pontificia de Santo Tomás de Aquino. Así mismo el Doctor Honoris Causa por la Universidad Anáhuac del Sur.

  16. High Prevalence and Genotype Diversity of Anal HPV Infection among MSM in Northern Thailand.

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    Taweewat Supindham

    Full Text Available HPV infection is common and may cause cancer among men who have sex with men (MSM. Anal HPV infection (HPV+ was found in 85% of HIV-positive (HIV+ and 59% of HIV-negative (HIV- MSM in Bangkok, central Thailand. As little is known about HPV in this group in northern Thailand, we studied MSM subgroups comprised of gay men (GM, bisexual men (BM, and transgender women (TGW.From July 2012 through January 2013, 85 (42.5% of 200 GM, 30 (15% BM, and 85 (42.5% TGW who practiced receptive anal intercourse were recruited after informed consent, followed by self-assisted computer interview, HIV testing, and anal swabs for HPV genotyping.Of 197 adequate specimens, the overall prevalence of any HPV was 157 (80%. Prevalence was 89% (76/85 in GM, 48% (14/29 in BM, and 81% (67/83 in TGW. The most common high-risk types were HPV16 (27% of 197, HPV58 (23%, and HPV51 (18%. Prevalence of high-risk types was 74% in 85 GM, 35% in 29 BM, and 71% in 83 TGW. Prevalence of any HPV type, or high-risk type, was 100% and 94%, respectively, among 48 HIV+ MSM, 70% and 54% among 120 HIV- MSM. Of the 197 specimens, 36% (70 had HPV types 16 and/or 18 in the bivalent vaccine, compared to 48% (95 with ≥1 of types 16/18/06/11 in the quadrivalent, 56% (111 for 16/18/31/33/45/52/58 in the 7-valent, and 64% (126 for 16/18/31/33/45/52/58/06/11 in the 9-valent. HIV+, GM, and TGW were independently associated with HPV infection.We found higher rates of both any HPV and high-risk types than previous studies. Among the heretofore unstudied TGW, their equivalent HPV rates were comparable to GM. Current and investigational HPV vaccines could substantially protect GM, BM, and TGW from the serious consequences of HPV infection especially among HIV + MSM.

  17. Genito-anal injury patterns and associated factors in rape survivors in an urban province of South Africa: a cross-sectional study.

    Science.gov (United States)

    Jina, Ruxana; Jewkes, Rachel; Vetten, Lisa; Christofides, Nicola; Sigsworth, Romi; Loots, Lizle

    2015-03-27

    The prevalence of genito-anal injuries in rape survivors varies significantly and the factors associated with the absence of injuries are not well understood. This plays a major role in the conviction of cases as the absence of injury is equated with a lack of assault. In such cases, health care providers face major challenges in presenting and defending their findings. The aim of this paper is to describe the absence of genito-anal injuries by site in a group of rape survivors and to identify factors associated with the absence of these injuries. In a cross-sectional study rape cases reported to the police in one province in South Africa were randomly sampled using a two stage sampling procedure. Data were obtained on the survivor, the circumstances of the rape and the findings of the medicolegal examination. Descriptive statistics were conducted for the prevalence of genito-anal injuries by site and logistic regression models were built to identify factors associated with the absence of genito-anal injuries for all survivors and those reported to be virgins. In the sample of 1472 women injuries ranged from 1% to 36%. No significant injuries were reported for 749 (51%) survivors. In the multivariable model there was a significantly lower odds of having no injuries in survivors who were virgins, those raped by multiple perpetrators and those examined by a doctor with additional qualifications. In the model for survivors who were virgins, those with disabilities had a greater odds of having no injuries while those between the ages of 8 and 17 years had a lower odds of having no injuries compared to survivors below four years of age. This study found that being a virgin, multiple perpetration rape and the examiner's qualifications were significantly associated with the absence of genito-anal injuries. Health providers should thus be aware that in all other respects there was no difference in survivors who had injuries and those who did not. It is important to

  18. Pensamiento meta-analítico: educación estadística

    OpenAIRE

    Frías-Navarro, Dolores; Badenes-Ribera, Laura; Pascual-Soler, Marcos; Monterde-i-Bort, Hector

    2013-01-01

    El procedimiento de significación de la hipótesis nula ha sido la estrategia de análisis dominante en el área de las ciencias sociales y de la salud. Sin embargo, también han sido muchas las críticas que han atacado el pensamiento dicotómico que implica dicho procedimiento. El movimiento de la reforma estadística plantea un cambio de perspectiva desde la significación estadística a la estimación de efectos. Desde esta nueva perspectiva destaca el desarrollo del pensamiento meta-analítico como...

  19. La neuromodulación en el tratamiento de la incontinencia anal

    OpenAIRE

    Ortega López, Mario

    2016-01-01

    El manejo terapéutico de la incontinencia anal es uno de los problemas más complejos de la coloproctología y siempre debe ser individualizado en función de las peculiaridades de cada paciente. La variedad de los factores implicados exige un análisis meticuloso. A diferencia de lo que ocurre en otras patologías, el objetivo no siempre es la curación, sino mejorar la calidad de vida lo máximo posible. La esfinteroplastia hasta hace poco era la opción quirúrgica principal para pacientes con lesi...

  20. Dose escalation without split-course chemoradiation for anal cancer: results of a phase II RTOG study

    International Nuclear Information System (INIS)

    John, Madhu; Pajak, Thomas; Kreig, Richard; Pinover, Wayne H.; Myerson, Robert

    1997-01-01

    PURPOSE: An attempt at radiotherapy (RT) dose escalation (from 45 Gy to 59.6 Gy) in a Radiation Therapy Oncology Group (RTOG) chemoradiation protocol for advanced anal cancers had resulted in an unexpectedly high 1-year colostomy rate (23%) and local failure (The Cancer Journal from Scientific American 2 (4):205-211, 1996). This was felt to be probably secondary to the split course chemoradiation (CR) that was mandated in the protocol. A second phase of this dose escalation study was therefore undertaken without a mandatory split and with an identical RT dose (59.6 Gy) and chemotherapy. MATERIALS AND METHODS: Twenty patients with anal cancers ≥2 cms were treated with a concurrent combination of 59.6 Gy to the pelvis and perineum (1.8 Gy daily, 5 times per week in 33 fractions over 6 (1(2)) weeks) and two cycles of 5 fluorouracil infusion (1000 mg/m 2 over 24 hours for 4 days) and mitomycin C (10 mg/m 2 bolus). A 10 day rest period was allowed only for severe skin reactions. A comparative analysis was made with the 47 patients in the earlier phase of this study who were treated with the identical chemoradiation course but with a mandatory 2-week break at the 36.00 Gy level. RESULTS: Predominant Grade 3 and 4 toxicities in 18 evaluable patients with dermatitis ((14(18)) or 78%), hematologic ((14(18)) or 78%), infection ((3(18)) or 17%) and gastrointestinal ((5(18)) or 28%). There were no fatalities. Nine patients (50%) completed the planned course without a break; 9 others (50%) had their treatments interrupted for a median of 11 days (range 7-19 days) at a median dose of 41.4 Gy (range 32.4 to 48.6 Gy). This compared to (40(47)) patients (85%) who had a 12 day treatment interruption at 36 Gy total dose in a planned break group. One patient had an abdomino-perineal resection (APR) for persistent disease and another for an anal fissure for (2(18)) or 11% 1-year colostomy rate. This was again favorably comparable to 23% 1-year colostomy rate for the earlier group of