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C Mangham

Publications and source records attributed to C Mangham.

11 recordsLinked to original sources
PubMed2001

Risks, costs, and compliance limit colorectal adenoma surveillance: lessons from a randomised trial.

BACKGROUND AND AIMS: In the USA and many other countries, endoscopic surveillance of colorectal adenoma patients is now widely practised. However, the optimal frequency and mode of such surveillance are not yet established. The aim of this trial was to compare surveillance at one, two, or five year intervals using either flexible sigmoidoscopy or colonoscopy. METHODS: Analysis of a randomised trial of flexible sigmoidoscopy and colonoscopy over one, two, or five years after stratification for "high" or "low" risk of recurrent adenomas. The trial started in 1984. RESULTS: A total of 776 patients were stratified into "high" (n=307) and "low" (n=469) recurrence risk groups and randomised to flexible sigmoidoscopy or colonoscopy at varying intervals. Only 81 recurrent adenomas (30/81 were >1 cm in diameter) were detected in the 2307 person years of follow up within the surveillance study. Adenoma recurrence was significantly higher in the high risk group (relative rate 1.82; 95% confidence interval 1.2-2.9) but recurrence rates per 1000 person years were low and not significantly different in those surveyed by colonoscopy or flexible sigmoidoscopy. Loss to follow up was greatest in those having an annual examination compared with two or five yearly surveillance examinations. Despite surveillance, invasive cancer developed in four patients compared with an expected value of 9.12 for the general population in England (p=0.10); of these four patients who developed cancers, only one was detected by surveillance examination. CONCLUSIONS: Adenoma recurrence rates were much lower than expected in both high and low risk groups. This suggests that endoscopic surveillance should be targeted at high risk groups. A surveillance interval of five years was as effective as shorter intervals in terms of cancer prevention, and was associated with similar compliance to two yearly examinations.

Adenoma↗
PubMed2000

Juvenile ossifying fibroma. An analysis of eight cases and a comparison with other fibro-osseous lesions.

Juvenile ossifying fibroma (JOF) is a well-defined clinical and histological entity that has recently been separated from other fibro-osseous lesions, including cemento-ossifying fibromas. Its biological behaviour is well defined, but unexplained. Its behaviour, clinical and histological appearance, however, bears resemblance to osteofibrous dysplasia of long bones, a lesion that in some cases has been reported to be part of a spectrum of diseases associated with adamantinoma, thus accounting for its variable biological behaviour. Eight cases of JOF were examined for islands of epithelium or single epithelial cells using immunocytochemistry. While these cases of JOF could clearly be separated from other fibro-osseous lesions, and were histologically similar to osteofibrous dysplasia, the absence of cytokeratin-positive cells in all cases suggests that another reason for its biological behaviour has still to be found.

Adolescent↗
PubMed1997

Fostering children's resilience.

Resilience is relevant to nurses because of its implications for health. Research on the resilience of children and adolescents has proliferated over the past five years. However, the specific processes underlying resilience and outcome variables require further study. Furthermore, few intervention studies have been conducted. This article describes resilience and factors that influence resilience of children, examines the relationship between resilience and health, identifies interventions that foster children's resilience and health, reviews research focusing on children's resilience, and suggests the relevance of resilience to nursing of children.

Adaptation, Psychological↗
PubMed1996

SV40-like sequences in human bone tumors.

Simian virus 40 (SV40) is a monkey virus that induces ependymomas, choroid plexus tumors, mesotheliomas, osteosarcomas, sarcomas and true histiocytic lymphomas when injected in hamsters. Recently, approximately 60% of human ependymomas, choroid plexus tumors and mesotheliomas were reported to contain and express SV40-like sequences (N. Engl. J. Med., 1992, 36, 988-993; Oncogene, 1994, 9, 1781-1790). In this study the presence of SV40-like sequences was investigated in additional types of human tumors. Initially, 200 tumor and normal tissue DNA samples were analysed by polymerase chain reaction (PCR) with primers that amplify a 574 base pair region of SV40 large T antigen (Tag), which includes the Rb-pocket binding domain and the intron of Tag. PCR amplification and Southern blot hybridization with a probe specific for SV40 Tag revealed that 18/200 samples contained SV40-like sequences and, unexpectedly, 11/18 were from patients with osteosarcomas. Additional DNA samples from bone tumors were then analysed. In 40/126 osteosarcomas, and 14/34 other bone-related tumors, Tag sequences could be amplified. Sequence analysis of the DNA amplified from seven different tumors confirmed that the amplified sequences corresponded to SV40 Tag, with some demonstrating deletions in the intron region but not in the Rb-pocket binding domain. The extent of SV40 genome sequences present in the DNA samples was further analysed in two osteosarcomas. PCR amplification, Southern blot hybridization, and sequence analysis revealed that these samples also contained sequences for the carboxy-terminal domain of Tag, the viral regulatory region, and the VP1 capsid protein. These results indicate that SV40-like sequences are present in human bone tumors.

Base Sequence↗
PubMed1989

Epidemiological study of asymptomatic inflammatory bowel disease: the identification of cases during a screening programme for colorectal cancer.

An asymptomatic population of 37,000 people in the Nottingham area were offered faecal occult blood tests in a screening study for colorectal cancer. Seventeen thousand nine hundred and thirty people completed the tests and 481 individuals with positive tests underwent full investigation of the colon. Eight people with previously undiagnosed inflammatory bowel disease were identified. In five cases there was total ulcerative colitis; in one a proctitis and in two Crohn's disease. Two further patients with ulcerative colitis were identified; they had been lost to follow up for 25 and 45 years respectively. The combined prevalence of inflammatory bowel disease was 56/10(5) and it is likely that current studies of the epidemiology of these conditions may underestimate the true prevalence by between 27% and 38%.

Aged↗
PubMedDate not supplied

Malignant cervical teratomas.

A case of malignant cervical teratomas is presented. Treatment based on chemotherapy protocols for testicular teratoma may improve the outcome of this rapidly progressive disease.

Head and Neck Neoplasms↗