Current Quality of Videos on Colorectal Cancer Screening for General Public.

BACKGROUND: One-third of American adults encompassed by current colorectal cancer screening guidelines fail to obtain recommended screening evaluations. Educational videos are a valuable medium through which to educate and encourage recommended health behaviors in patients. METHODS: A cross-sectional study reviewing the quality of patient education videos addressing colorectal cancer screening. Video quality was assessed in 3 domains: accountability, content, and production. RESULTS: Forty-four videos met inclusion criteria. Out of 33 possible points, videos scored a median of 15.0 (interquartile range 12.9-16.6). Videos scored 1.0 (interquartile range .8-1.0) out of 4.0 for accountability, 6.0 (interquartile range 4.4-8.0) out of 20 for content, and 8.0 (interquartile range 7.4-8.0) out of 9.0 for production. Colonoscopy was the most frequently discussed method of screening (38, 86%). While 13 (34%) videos discussed the risk of colorectal cancer in the general population and 15 (32%) discussed the risk in those with a family history, few videos addressed those with other risk factors. Most (31, 70%) videos discussed the medical consequences of not receiving screening, but only 1 (2%) video discussed the social consequences. Similarly, medical benefits were discussed in 34 (77%) videos while other benefits were not discussed by any video. Only one-fifth of the videos address three or more barriers to screening. CONCLUSIONS: Videos on colorectal cancer screening have excellent production quality but need improvement in the domains of accountability and content. The videos included in this analysis did not adequately address the concerns of viewers nor the benefits of colorectal cancer screening.

Critical Evaluation of the Efficiency of Colorectal Fellowship Websites: Cross-sectional Study.

BACKGROUND: Websites are an important source of information for fellowship applicants, as they can influence ongoing interest and potential program selection. OBJECTIVE: This study aims to evaluate the current state of colorectal fellowship websites. METHODS: This cross-sectional study evaluates the quantity and quality of information available on websites of colorectal fellowship programs verified by the Accreditation Council for Graduate Medical Education in 2019. RESULTS: A total of 63 colorectal fellowships were included for evaluation. Websites were surveyed for content items that previous studies have found to be influential to program applicants. The 58 (91%) programs with a functional website were evaluated using an information index (calculated as a function of availability of content items concerning education, application, personnel, and benefits) and an interactive index (calculated as a function of accessibility and usability of the webpage). Programs had a median total score of 27.8 (IQR 21.5-34.5) of 79. The median score for the interactive index was 7.5 of 15 and for the information index was 20 of 64. The median scores for website application, education, personnel, and benefits or life considerations were 5, 5.5, 3.3, and 4 of 13, 24, 13, and 14, respectively. There was no difference in total score between programs in different geographical regions (P=.46). CONCLUSIONS: Currently, colorectal surgery fellowship program websites do not provide enough content for applicants to make informed decisions. All training programs, regardless of specialty, should evaluate and improve their digital footprint to ensure their websites are accessible and provide the information desired by applicants.

Primary pancreatic cancer of the jejunum: a case report and brief review of literature.

The variable clinical presentation of heterotopic pancreatic (HP) tissue and its malignant transformation makes the diagnosis very challenging. These lesions are very rare, usually not suspected upon initial presentation and for the most part, are diagnosed incidentally on review of pathology following surgical resection. In this study, we are reporting an adenocarcinoma arising from jejunal heterotopic pancreatic tissue in a 59-year-old female and a brief review of previously reported cases.

Colon Trauma: Evidence-Based Practices.

Colon injury is not uncommon and occurs in about a half of patients with penetrating hollow viscus injuries. Despite major advances in the operative management of penetrating colon wounds, there remains discussion regarding the appropriate treatment of destructive colon injuries, with a significant amount of scientific evidence supporting segmental resection with primary anastomosis in most patients without comorbidities or large transfusion requirement. Although literature is sparse concerning the management of blunt colon injuries, some studies have shown operative decision based on an algorithm originally defined for penetrating wounds should be considered in blunt colon injuries. The optimal management of colonic injuries in patients requiring damage control surgery (DCS) also remains controversial. Studies have recently reported that there is no increased risk compared with patients treated without DCS if fascial closure is completed on the first reoperation, or that a management algorithm for penetrating colon wounds is probably efficacious for colon injuries in the setting of DCS as well.

Psychosocial Support of the Inflammatory Bowel Disease Patient.

Inflammatory bowel disease (IBD) is a chronic, debilitating disease whose effects spread far beyond the gut. IBD does not generally result in excess mortality; health care providers should thus focus their efforts on improving health-related quality of life and minimizing associated morbidity. A bidirectional relationship exists between IBD and psychiatric conditions; chronic inflammation can produce neuromodulatory effects with resultant mood disorders, and the course of IBD is worse in patients with anxiety and depression. Screening for the early signs of depression or anxiety and initiating appropriate treatment can lead to improved functioning and positively impact disease course.

Recurrent metachronous metastatic multifocal renal cell carcinoma to the pancreas.

Renal cell carcinoma (RCC) metastatic to the pancreas may present synchronously or years after the initial diagnosis. In the absence of more widespread disease, surgical extirpation is recommended and is often associated with long-term survival. Most patients present with isolated metastases, with the vast majority of the literature pertaining to this select group. Multifocal metastases and recurrent metastatic disease after previous surgical resection of the pancreas for RCC have been less well described. Most often, surgery has been performed in these latter populations, although data with respect to long-term survival remains incomplete. Despite the use of routine CT, multifocal disease is often discovered unexpectedly at the time of surgical exploration or on final pathologic analysis, and diagnostic strategies to improve recognition of this entity have been incompletely assessed. Management of recurrent metastatic and multifocal RCC to the pancreas within the context of the existing literature is suggested.