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Biomedical subjects

R G Norfleet

Publications and source records attributed to R G Norfleet.

At least 19 recordsLinked to original sources
PubMed1992

Screening sigmoidoscopy and colorectal cancer mortality.

BACKGROUND: Sigmoidoscopy may reduce colorectal cancer mortality by identifying both cancers and precursor lesions (including polyps) for treatment; however, evidence regarding the efficacy of this technique as a screening procedure is extremely limited. PURPOSE: In the absence of data from randomized controlled trials, we performed a retrospective case-control study to determine if sigmoidoscopy screening is associated with a reduction in colorectal cancer mortality. METHODS: The medical records of 66 members of the Greater Marshfield Community Health Plan (GMCHP) who died of large-bowel cancer from 1979 to 1988 were reviewed for history of screening for colorectal cancer (case subjects). For comparison, the records of 196 GMCHP members of similar gender, age, and enrollment duration were randomly selected for review (control subjects). RESULTS: History of screening sigmoidoscopy was much less common among case subjects (10%) than among control subjects (30%). Risk for death from colorectal cancer was reduced among individuals having had a single examination by screening sigmoidoscopy (odds ratio = 0.21; 95% confidence interval = 0.08-0.52), compared with the risk for those who never had one. The reduction in risk appeared to be limited to tumors in the rectum and distal colon. Neither fecal occult blood testing nor digital rectal examination was associated with a reduction in colorectal cancer mortality. CONCLUSIONS: These results suggest that screening sigmoidoscopy can substantially reduce mortality from cancers of the rectum and distal colon.

Aged↗
PubMed1991

Infectious endocarditis after fiberoptic sigmoidoscopy. With a literature review.

Infectious endocarditis is a feared complication of procedures causing bacteremia. Gastrointestinal procedures cause bacteremia, but are seldom followed by infectious endocarditis. Of nine cases found in the English literature, only five have convincing evidence that endocarditis resulted from the gastrointestinal procedure. I present a new case of endocarditis due to Streptococcus sanguis type II after fiberoptic sigmoidoscopy.

Endocarditis, Bacterial↗
PubMed1990

Mallory-Weiss syndrome after cardiopulmonary resuscitation.

We report hematemesis from Mallory-Weiss tears after successful cardiopulmonary resuscitation (CPR). A computer search of the English language literature disclosed only 3 similar cases, and we review them. This complication of CPR may occur more frequently than recognized and should be prevented by careful technique.

Aged↗
PubMed1989

Strange bedfellows: duodenal ulcer and cancer of the stomach.

We have found only 308 cases of gastric cancer in patients with unoperated duodenal ulcer. We present seven men whose duodenal ulcer disease obscured the diagnosis of gastric cancer. We review the theoretical reasons that those with duodenal ulcer may be protected from gastric cancer, along with the current literature.

Adenocarcinoma↗
PubMed1988

Adenomatous and hyperplastic polyps cannot be reliably distinguished by their appearance through the fiberoptic sigmoidoscope.

This prospective study is designed to determine if experienced sigmoidoscopists can, from gross appearance, differentiate adenomas and hyperplastic polyps. Six hundred eleven polyps discovered at fiberoptic sigmoidoscopy were removed completely or biopsied for histologic examination. The polyp's size, distance from the anal verge, color, and the endoscopist's diagnosis were analyzed. Hyperplastic polyps were significantly smaller, of lighter color, and located closer to the anus than adenomas. The sensitivity of the endoscopic diagnosis for adenomas is 0.80 and the specificity 0.71. We conclude the endoscopic diagnosis of polyps 1.0 cm and smaller is not accurate enough for decision making, and these should be biopsied to guide management. Since 97% of polyps larger than 1.0 cm are adenomas, their removal can be advised without biopsy.

Adenoma↗
PubMed1987

Barrett esophagus.

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Barrett Esophagus↗
PubMed1986

Effect of diet on fecal occult blood testing in patients with colorectal polyps.

To determine the effect of a red-meat-free, high-fiber diet, patients performed fecal blood testing before colonoscopy for suspected polyps. One hundred twenty-nine patients were allowed an unrestricted diet, and 159 consumed the special diet. Without dietary restrictions, 31 of 77 patients with adenomas, five of eight with cancer, one of seven with nonneoplastic polyps, and one of 37 with normal colonoscopy had positive tests. With the special diet, 30 of 97 patients with adenomas, eight of ten with cancer, one of six with nonneoplastic polyps, and one of 46 with normal colonoscopy had positive tests. There are no statistical differences between the groups. Comparing all patients with cancer to those with normal colonoscopy, the sensitivity of fecal blood testing is 72%, the specificity 98%, and the positive and negative predictive value 87% and 94%, respectively. The sensitivity for fecal blood testing in patients with adenomas (compared to those with normal endoscopy) is 35%, the specificity is 98%, and the positive and negative predictive values are 97% and 42%, respectively. Combining all patients with adenomas, those with multiple polyps, larger polyps, or polyps located distal to the splenic flexure had positive fecal blood tests more frequently. Fecal blood testing does not detect a large number of colorectal adenomas. This study does not indicate any benefit on the sensitivity or specificity of fecal blood tests from the red-meat-free, high-fiber diet currently recommended.

Adenoma↗
PubMed1985

High-dose cytosine arabinoside-associated pancreatitis.

Thirty patients with leukemia and lymphoma have been treated at our institution with high doses of cytosine arabinoside (Ara-C). Gastrointestinal symptoms were frequent after therapy, and 6 of the 30 patients had severe abdominal pain. Of the six, two had pancreatitis; two had normal amylase and lipase determinations; and in two, neither amylase nor lipase levels were determined. The two patients with pancreatitis are presented because this complication of high-dose Ara-C therapy has not been described. The authors conclude that pancreatitis can follow high-dose Ara-C chemotherapy and that patients with abdominal pain following this treatment be evaluated for pancreatitis.

Adult↗
PubMed1979

The bobbin' polyp.

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Colonic Neoplasms↗