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Query: UMLS:C0001430 (adenoma)
 21,222 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A critical determinant of successful neck exploration for primary hyperparathyroidism (HPT) is the experience of the surgeon. Results of 17 patients treated surgically for HPT were reviewed to compare results at our medical center with results of large series reported from established national centers. Preoperative laboratory evaluation of 15 patients with surgically proven HPT (solitary adenoma, 14; diffuse hyperplasia, 1) included: mean serum calcium (Ca) 10.9 mg/dl +/- 0.79 and mean serum chloride/phosphate ratio 39 mg/dl +/- 7.9. Serum parathyroid hormone (PTH) was elevated in all patients. Seven neck ultrasounds were performed with a positive predictive value of 42%. No significant operative complications occurred. Mean postoperative serum Ca was 8.34 mg/dl +/- 0.75. One patient had asymptomatic hypocalcemia (Ca = 6.5 mg/dl). Follow-up in 11 patients (65%) at a mean of 8.6 months revealed no evidence of recurrence in these patients. In our experience, proper patient selection and careful surgical technique within established principles for neck exploration and parathyroidectomy lead to excellent results despite the size of the medical center. Patient selection is based on serum Ca, PTH, and chloride/phosphate ratio. Preoperative imaging studies did not appear to be of benefit in the small study reported here.
Mil Med 1993 Dec
PMID:Surgical management of hyperparathyroidism at an Air Force medical center. 810 20

Dietary folate appears to be inversely related to colorectal cancer risk. This study investigated the effects of dietary intervention with folate or the development of intestinal polyps in Min (Apc +/-) mice. Weanling Mil mice were fed diets containing 0, 2 (basal requirement), 8, or 20 mg folate/kg diet. At 3 and 6 months of dietary intervention, 50% of the mice from each group were sacrificed, and the small intestine and colon were analyzed for polyps and aberrant crypt foci (ACF). Serum folate concentrations accurately reflected dietary folate levels (P < 0.001). At 3 months no significant difference in the average number of total small intestinal polyps was observed among the four groups. However, increasing dietary folate levels significantly reduced the number of ileal, but not duodenal or jejunal, polyps in a dose-dependent manner (P-trend = 0.001); folate supplementation at 20 mg/kg diet was associated with a 68-78% reduction in the number of ileal polyps compared with the other three diets (P < 0.007). The number of ileal polyps was inversely correlated with serum folate concentrations (P = 0.03). At 3 months, increasing dietary folate levels significantly decreased the number of colonic ACF in a dose-dependent manner (P = 0.05); the control and two folate supplemented diets significantly reduced the number of colonic ACF by 75 100% compared with the folate-deficient diet (P < 0.04). The number of colonic ACF was inversely correlated with serum folate concentration (P = 0.05). No significant difference in the number of colonic adenoma was observed among the four groups at 3 months. At 6 months, no significant differences in the average number of total small intestinal, duodenal, and jejunal polyps, colonic adenomas, and colonic ACF wer observed among the four groups. However, the folate-deficient diet had 62-76% lower number of ileal polyps compared with the control and two folate-supplemented diets (P < 0.003). Serum folate concentrations, but not dietary folate levels, were directly correlated with the number of ilea polyps (P = 0.006). These data suggest that dietary folate supplementation suppresses the development of ileal polyps and colonic ACF in this model However, at later time points, folate supplementation appears to have an opposite effect on ileal polyps. These data generally support the role of folate in intestinal tumorigenesis suggested in epidemiological studies and chemical carcinogen animal models. Notwithstanding the limitations associated with this model, these data suggest that the optimal timing and dose of folate intervention need to be determined for safe and effective folate chemoprevention.
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PMID:Effects of dietary folate on intestinal tumorigenesis in the apcMin mouse. 1103 85

This was a prospective study performed in a Department of Veterans Affairs Medical Center. The aim of this study was to use endoscopic and histological examinations to determine the potential diagnostic origins of chronic gastrointestinal symptoms among patients who were part of the deployment of troops to the Persian Gulf after August 1990. Twenty-four (8%) male patients (mean age, 42 years) of 308 patients in the Persian Gulf War Registry agreed to undergo endoscopic examination of chronic symptoms, including heartburn (29%), dyspepsia (33%), dysphagia (8%), diarrhea (63%), Hemoccult-positive stool (21%), and rectal bleeding (17%). There were 17 upper endoscopies, 18 colonoscopies, and 4 flexible sigmoidoscopies performed, all with biopsies. Five (33%) of 15 patients had positive serological findings for Helicobacter pylori. With upper endoscopy, major findings included esophagitis (12%), Schatzki's ring (12%), hiatal hernia (47%), antral erythema (59%), and duodenal erythema (29%). With lower endoscopy, major findings included ileitis (5%), lymphoid hyperplasia (9%), polyps (27%), diverticulosis (23%), and hemorrhoids (23%). Major histopathological findings included microscopic esophagitis (24%), gastritis with H. pylori (35%), gastritis without H. pylori (18%), Crohn's disease (5%), tubular adenoma (5%), hyperplastic polyps (18%), and melanosis coli (5%). Most patients with chronic heartburn or dyspepsia have evidence of esophagitis or H. pylori. Individuals with these chronic symptoms should undergo evaluation.
Mil Med 2005 Aug
PMID:Evaluation of chronic gastrointestinal symptoms following Persian Gulf War exposure. 1617 12

Growth Hormone (GH) excess is an uncommon cause of gynecomastia encountered in primary care. Adults with GH excess (acromegaly) have a 72% increase in mortality compared with the general population, which is reversible with early detection and intervention. Currently, however, the diagnosis of acromegaly is often delayed up to 12 years because of the subtle onset of symptoms. We present an active duty male diagnosed with acromegaly after presenting to his primary care provider with chronic gynecomastia. The most common cause of GH excess is a pituitary somatotroph adenoma; however, it is important to remember that magnetic resonance imaging of the pituitary does not distinguish between functioning and nonfunctioning tumors. Subsequently, the diagnosis of GH excess is based on biochemical studies, not imaging.
Mil Med 2015 Dec
PMID:6'6" United States Marine Seeks Treatment for Gynecomastia Only to Learn It Is All in His Head. 2663 78