ABSTRACT
BACKGROUND AND STUDY AIMS: A screening program in first-degree relatives (FDRs) of colorectal cancer (CRC) patients (index patients) was started in Trentino, Italy, to analyze factors that influence uptake of CRC screening among invited FDRs (first objective) and to describe colorectal findings among those undergoing colonoscopy (secondary objective). PATIENTS AND METHODS: FDRs aged between 45 and 75 years were invited; exclusion criteria were: colonoscopy or barium enema in the preceding 5 years, a history of familial adenomatous polyposis, hereditary nonpolyposis colorectal cancer, inflammatory bowel diseases, and severe comorbidities. FDRs who were eligible but were not invited for screening because consent was not obtained from the index patients were considered as the control group. FDRs were invited by the education campaign targeted at the population at risk (both study and control groups); in the study group, interventions targeting individuals at risk (letters, phone calls, face-to-face counseling) were implemented. RESULTS: Starting from 626 new index cases of diagnosed CRC, 725 FDRs were invited to counseling; 77.6 % of these attended for colonoscopy in the study group vs. 8 % in the control group ( P < 0.0001). Predictors of colonoscopy uptake were FDR age above 60 years [odds ratio (OR) 2.50, 95 %CI 1.72 - 3.62], complex family history (simple family history: one CRC at age above 60 years; complex family history: one CRC at age below 60 or two or more CRC; OR 1.54; 95 %CI 1.04 - 2.33) and living in a rural area (OR 1.64, 95 %CI 1.12 - 2.44). Of the 560 FDRs in the study group, 186 (33.8 %) had adenomas, and 48 (8.8 %) had advanced adenomas or cancer. CONCLUSIONS: Interventions that target FDRs of patients with CRC, especially those younger than 60 years, with a complex family history of CRC and who live in a rural area, may improve uptake of CRC screening via colonoscopy.
Subject(s)
Colonoscopy , Colorectal Neoplasms/prevention & control , Aged , Colorectal Neoplasms/epidemiology , Family , Female , Humans , Italy/epidemiology , Male , Mass Screening , Middle Aged , Prevalence , Prospective Studies , Rural PopulationABSTRACT
This work studied the effect of different ethanol concentrations on the eicosanoid accumulation in human gastric incubates of healthy volunteers and chronic alcoholics, determining the in vitro eicosanoid release both in the basal condition and after different ethanol concentrations. The basal release of PGE2 and LTC4 in alcoholics is higher than in healthy volunteers. Various alcohol concentrations cause an increase in LTC4 and PGE2 in healthy volunteers; we observed no LTC4 increase in alcoholics and although PGE2 levels increased after 20% ethanol, they remained constant at higher ethanol concentrations.
Subject(s)
Alcoholism/metabolism , Eicosanoids/biosynthesis , Ethanol/pharmacology , Gastric Mucosa/drug effects , Adult , Female , Gastric Mucosa/metabolism , Humans , Male , Middle Aged , Reference ValuesSubject(s)
Fibrin Tissue Adhesive/therapeutic use , Rectal Diseases/therapy , Ulcer/therapy , Aged , Dietary Fiber/administration & dosage , Endoscopy , Female , Fibrin Tissue Adhesive/administration & dosage , Follow-Up Studies , Humans , Male , Middle Aged , Rectal Diseases/drug therapy , Syndrome , Ulcer/diet therapyABSTRACT
The aim of this work was to study the effect of 20% and 40% ethanol, administered acutely, on gastric PGE2 release in normal subjects and alcoholics. Ethanol 20% did not modify the release of PGE2 into the gastric juice, whereas 40% ethanol increased PGE2 release only in healthy subjects. The basal PGE2 levels were higher in alcoholic patients.
Subject(s)
Alcoholism/metabolism , Dinoprostone/metabolism , Ethanol/pharmacology , Gastric Mucosa/metabolism , Adult , Female , Gastric Juice/chemistry , Gastric Mucosa/drug effects , Humans , Male , Middle Aged , Stimulation, ChemicalABSTRACT
Human fibrin sealant (Tissucol) has been used in surgery for its haemostatic and sealing actions and stimulating effect on tissue regeneration. Recently it has been used in endoscopy, but controlled trials are not yet available. The aim of this study was to evaluate the efficacy of Tissucol on the healing rate of duodenal ulcers (DU). Thirty nine previously untreated DU patients received ranitidine 150 bid plus endoscopically applied either placebo (19 patients) or Tissucol (20 patients). Sixty-five percent of the patients in the Tissucol group and 21% in the control group healed after two weeks (p less than 0.02), 75 and 52.6% respectively after 4 weeks (NS). The endoscopic application of Tissucol seems to influence the healing of duodenal ulcer and its use could be suggested in selected patients with DU.
Subject(s)
Duodenal Ulcer/therapy , Fibrin Tissue Adhesive/administration & dosage , Ranitidine/therapeutic use , Combined Modality Therapy , Duodenal Ulcer/drug therapy , Duodenal Ulcer/pathology , Female , Gastroscopy , Humans , Male , Middle Aged , Single-Blind MethodSubject(s)
Dinoprostone/metabolism , Ethanol/toxicity , Gastric Mucosa/metabolism , Irritants , Adult , Alcoholism/metabolism , Female , Gastric Mucosa/drug effects , Humans , MaleABSTRACT
To study the mechanism(s) of action of metformin, fragments of human subcutaneous adipose tissue were incubated with therapeutic blood concentrations of metformin. In the absence of insulin no effect of metformin was seen on either lipolysis or glucose metabolism. When insulin was present, however, metformin stimulated glucose conversion into both triglycerides and CO2. In marked contrast, no effect of metformin was observed on the antilipolytic effect of insulin. In agreement with this selective effect no change in insulin binding was found. In conclusion, metformin seems to exert its effect on glucose metabolism by potentiating the action of insulin at a post-receptor level, possibly on the rate of glucose transport.
