Walter E Longo

..The VA will continue its leadership position in the healthcare arena if it can successfully address the challenges facing it...

....

..Among those with an area of specialization, their prize winning paper reflects on their current area of specialization today. Few have ever worked in a VA hospital and thus few have ever been members of the AVAS...

....

..difficile colitis are infrequently reported. This study was designed to identify risk factors, clinical characteristics, and outcome of patients who required colectomy for fulminant C. difficile colitis...

..To examine the epidemiology and clinical characteristics of small-bowel cancer...

..001). The risk indices presented provide an easy-to-use tool for clinicians to predict outcomes for patients undergoing surgery for SBO...

..Anal cancer affects women more often than men. Squamous cell carcinoma is the most common histological type...

..All significant differences are clinically rather modest, however. These data should be useful in the design of controlled trials on this topic...

..Undoubtedly, survival benefits can be shown with a well-designed evidence-based follow-up strategy. However, well-designed large prospective multi-institutional randomized studies are needed to establish a consensus for follow-up...

..This article summarizes those studies. The cost versus benefit of endoscopic simulators is also discussed, as well as the upcoming role of simulators in judging competence and as a tool in the credentialing process...

..Features predictive of malignant small bowel obstructions among patients with previous gynecologic malignancies remain undetermined...

..This report describes the first cohort study comparing pure transvaginal appendectomies (TVAs) to traditional 3-port laparoscopic appendectomies (LAs)...

..This article reviews the reported cases of Clostridium difficile with toxic megacolon in the literature and introduces an additional case that underscores the importance of early diagnosis in guiding appropriate therapy...

..Data are lacking to delineate the optimal surveillance strategy following resection. A large-scale multi-center European study is underway to address this issue (Gruppo Italiano di Lavoro per la Diagnosi Anticipata-GILDA)...

..The objective of this study was to identify risk factors for recurrent or complicated diverticulitis requiring colectomy...

..Furthermore, they provide a starting point for the design of similar models to evaluate non-VA patients with appendicitis using the data the National Surgical Quality Improvement Program is currently gathering from private hospitals...

..Undoubtedly, the use of novel cyclooxygenase inhibitors with less of a toxicity profile will allow more widespread use of nonsteroidal anti-inflammatory drugs for a variety of diseases. The future of this class of drugs is promising...

..The fate of residents who complete 2 years as NDPS residents remains ill defined...

..Ischemic colitis is a common disorder often without clear indications for surgical management. The aim of this study was to identify risk factors that predict the need for surgery...

....

..Other therapies involve non-operative techniques such as laser therapy, colonic stenting, emergency endoscopy, and comfort measures...

....

..Surgical emergencies are few and patients have a favorable stage of disease. This data supports aggressive detection of colorectal cancer in asymptomatic elderly patients who may harbor occult colorectal cancer...

....

..Prospective randomized trials are needed, but remain difficult owing to the uncertain natural history of the disease...

..Its role is more well-established in some areas than in others, and there are still significant limitations. As technology advances, MRI will shed more light on a complex anatomical area...

..Endoscopy is employed frequently; imaging tests are employed less often. The observed variation in the intensity of postoperative monitoring is of concern...

..Elderly patients diagnosed with acute cholecystitis (AC) may undergo both ultrasonography (US) and computed tomography (CT)...

..5, and a creatinine of >1.4, those patients at risk for postoperative morbidity and mortality can be identified and clinical decision making can be appropriately adjusted...

..Nevertheless, diverticulitis often remains a clinical diagnosis; thus communication between the clinician and the radiologist remains imperative to facilitate effective testing...

..Any unexplained abdominal illness after recent antibiotic administration should alert the physician to CDC and its potential as a fulminant, potentially fatal illness...

..To identify rapidly modifiable risk factors that would improve surgical outcomes in elderly patients undergoing emergent colorectal procedures who are at high risk for morbidity and mortality...

..Although still under development, novel techniques for the earlier detection of dysplastic lesions have moved to the forefront in an attempt to optimize surveillance strategies and decrease the risk of CRC development...

..Elderly patients who can tolerate a major operation, and have good preoperative sphincter function should undergo a resection with primary anastomosis...

..The absence of colonic infarction does not ensure a favorable outcome. Patients who are felt to be candidates for nonoperative therapy have significant mortality rates. Mortality rates remain high, despite treatment...

..The presentation, investigations performed, and management are variable. Our objectives were to assess the presentation, extent of disease, and treatment of a cohort of patients with colonic diverticulitis...

..At the time of laparotomy, the foreign body was found in the fistulous colonic segment. The presence of an ingested foreign body likely contributed to a rare fistula that was refractory to medical management...

..This novel exchanger is capable of modulating intracellular pH over a wide pH spectrum and may play an important role in maintaining cellular pH homeostasis...

..This article reviews the latest data about etiology and pathophysiology of bowel ischemia to explain the bases of diagnosis and treatment of this condition...

..Colovaginal fistulas require a multidisciplinary approach and focused diagnostics, successful treatment can dramatically improve the patient's quality of life...

..CONCLUSION: Correctly diagnosing pelvic floor disorders can be complex and challenging, and the various imaging modalities as well as clinical history and exam must be considered together in order to arrive at a diagnosis...

..Surgical intervention increases morbidity and should be chosen when absolutely necessary. Because of the high incidence of colorectal malignancies in patients with dermatomyositis, aggressive screening should be performed...

....

....

..We therefore studied the capacity of differentiated human intestinal epithelial and smooth muscle cell lines to produce IL-6 in response to various proinflammatory stimuli...

..With a multidisciplinary approach, morbidity can be reduced and patients can have a rapid return and improved quality of life...

..These anecdotal experiences, the unproven belief that follow-up is beneficial, and traditions imparted during training are among the likely motivating factors for most physicians caring for colorectal cancer patients...

..Assigning relative weights to factors associated with adverse outcomes may help improve patient care...

..Resident core competence can be improved by learning to accurately estimate the costs of postoperative complications...

..A main reason is grounded in unequal methodology. The aims of this study were to assess differences in perceived QoL over time among patients treated with AR or APR with a recommended study design and methodology...

..We observed elevated liver function tests (LFTs) after restorative proctocolectomy (RPC). This study was undertaken to determine the etiology and implications of elevated LFTs before RPC and postoperatively...

..If complications of cholecystectomy are indeed SCI-related, attention to perioperative SCI care could improve outcomes of cholecystectomy. Future research should continue to explore this important research topic...

..This paper reports on preliminary results and analysis from the ongoing study...