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Diverticulitis
Published in Charles Theisler, Adjuvant Medical Care, 2023
To understand diverticulitis, it is necessary to first understand diverticulosis. Diverticulosis is the development of small pouches in the wall at the last part of the large intestine (sigmoid colon). If a local pouch, or diverticulum, gets inflamed or infected, this is known as diverticulitis. Approximately 1%-10% of patients with diverticulosis may develop diverticulitis. Some literature states the number could be as high as 25%, but studies have not confirmed this.1 Typical symptoms include lower left-sided, crampy abdominal pain, bloating, tenderness, possible low grade fever, nausea with vomiting, and constipation or sometimes diarrhea.
Do I Have IBS?
Published in Melissa G. Hunt, Aaron T. Beck, Reclaim Your Life From IBS, 2022
Melissa G. Hunt, Aaron T. Beck
Diverticulosis is a condition in which the walls of the colon weaken in some spots and bulge out into little balloon-shaped sacks or pouches. It is uncommon in people under the age of 40, but about half of people over the age of 60 have at least some diverticula. When the pouches become inflamed or infected, the condition is called diverticulitis. The symptoms of diverticulitis are – wait for it – cramping pain or discomfort in the abdomen and a change in bowel habits – either diarrhea or constipation. Complications of diverticulitis may also include low-grade fever and bloody stools.
Epidemiology, Pathophysiology, Diagnosis and Treatment
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Susannah Clark, Patricia L. Roberts, Rocco Ricciardi
Some remain sceptical that SUDD is a true disease, questioning the premise that diverticulosis can be associated with chronic gastrointestinal symptoms. Kang et al.15 evaluated 784 patients, 281 of whom had the presence of diverticulosis (with or without a diagnosis of diverticulitis) confirmed on colonoscopy or barium enema. All patients were assessed with a Rome II questionnaire about colonic symptoms. The authors noted that the rate of abdominal pain, diarrhoea, constipation and IBS in patients with diverticulosis compared to patients without diverticular findings was not statistically different.10 They concluded that the presence of diverticulosis does not potentiate the gastrointestinal symptoms commonly seen with IBS.
The possible role of serum bactericidal titres in long-term suppressive antibiotic treatment for infective endocarditis: report of three cases
Published in Infectious Diseases, 2023
Pietro Valsecchi, Matteo Calia, Lea Nadia Marvulli, Enrica Bono, Vincenzina Monzillo, Raffaele Bruno, Elena Seminari
The third case is a 78-year-old male who previously underwent aorto-coronary bypass, aortic valve substitution (biological prosthesis) and cardiac pacemaker (PM) implantation due to severe coronary artery disease, severe aortic stenosis and sinus-atrial and left branch bundle block. Other relevant medical conditions included hypertension and colon diverticulosis. He had three subsequent bacteraemia episodes caused by E. faecalis in May 2020 (treated with ampicillin, negative transthoracic echocardiogram for endocarditis), August 2020 (treated with ampicillin/ceftriaxone, complicated by prosthetic endocarditis) and in October 2020 (treated with fosfomycin, ampicillin and ceftriaxone for PVE). During this last episode, surgical reintervention was excluded due to lack of prosthetic disfunction and high surgical risk. He presented in December 2020 for relapsing E. faecalis bacteraemia 20 d after antibiotic discontinuation: a TOE confirmed relapse of IE (vegetation size < 5 mm) and linezolid (600 mg bid) therapy was started. Soon after the patient was discharged on linezolid and amoxicillin (1 g tid) SAT. Four weeks later PET scan was negative for prosthetic valve or PM pathologic uptake and linezolid was stopped but oral amoxicillin was maintained as an attempt of preventing further relapses. SBT performed on oral amoxicillin showed suboptimal bactericidal activity (Table 1), but the patient remained afebrile, monthly blood cultures were negative and one year after SAT was discontinued. He is still going well.
Clinical and pharmacological characteristics of elderly patients admitted for bleeding: impact on in-hospital mortality
Published in Annals of Medicine, 2020
Arianna Pani, Daniele Pastori, Michele Senatore, Alessandra Romandini, Giulia Colombo, Francesca Agnelli, Francesco Scaglione, Fabrizio Colombo
The study cohort was identified from administrative medical billing codes of the International Classification of Diseases (ICD-9) from patient’s hospital discharge data. Codes considered for the identification of bleeding have been listed in Supplementary Table 1. Three independent investigators have analysed and collected data through electronic medical records. Information regarding medical history and medication exposure of selected patient were recorded. Medication exposure was defined as the therapy assumed by the patient at the moment of admission. We also recorded data about intra-hospital mortality and laboratory values as follows: haemoglobin (Hb, g/dl), platelet count, glomerular filtration rate by the MDRD formula, and alanine transaminase (U/l). Anaemia was defined as an Hb <13 g/dl in men and <12 g/dl in women. Inflammatory bowel disease and diverticulosis are grouped under “gastrointestinal disease”.
Complete polypectomy and early detection and management of residual disease to reduce the risk of interval colorectal cancers
Published in Acta Oncologica, 2019
Neil O’Morain, Deirdre McNamara
Interval cancer refers to the occurrence of colorectal cancer following a colonoscopy prior to the next scheduled surveillance procedure. While some interval cancers represent rapid neoplastic development through alternate neoplastic pathways from the traditional, normal mucosa - polyp – dysplasia - cancer sequence, the majority (up to 70%) are thought to arise from “missed” or “incompletely excised” precancerous polyps at the time of index colonoscopy [3]. The rate of interval cancers is therefore considered to reflect the general quality of colonoscopy within screening programs, at an institution and for individual Endoscopists. A meta –analysis from 2014 reported post colonoscopy interval cancers rates of 2–9% [4]. More recent studies have reported lower interval cancer rates, 0.07%, or 1 in 1,400 colonoscopies, which may indicate improved colonoscopy quality overtime [5,6]. Older age, female gender, proximal polyp location and the presence of diverticulosis at the time of index colonoscopy have all been associated with increased interval cancer risk.