22-year longitudinal study of repetitive colonoscopy in patients with a family history of colorectal cancer.

INTRODUCTION: We report the outcomes of a long-term surveillance programme for individuals with a family history of colorectal cancer. METHODS: The details of patients undergoing a colonoscopy having been referred on the basis of family history of colorectal cancer were entered prospectively into a database. Further colonoscopy was arranged on the basis of the findings. The outcomes assessed included incidence of cancer and adenoma identification at initial and subsequent colonoscopy. RESULTS: The records of 2,293 patients (917 men; median patient age: 51 years) were entered over 22 years, giving data on 3,982 colonoscopies. Eight adverse events (0.2%) were recorded. Twenty-seven cancers were found at first colonoscopy and thirteen developed during the follow-up period. There were significantly more cancers identified in those with more than one first-degree relative with cancer than in other groups (p=0.01). The number of adenomas identified at subsequent surveillance colonoscopies remained constant with between 9.3% and 12.0% of patients having adenomas that were removed. Two-thirds (68%) of patients with cancer and three-quarters (77%) with adenomas fell outside the British Society of Gastroenterology (BSG) 2006 guidelines. CONCLUSIONS: Repeated colonoscopy continues to yield significant pathology including new cancers. These continue to occur despite removal of adenomas at prior colonoscopies. The majority of patients with cancers and adenomas fell outside the BSG 2006 guidelines; more would have fallen outside the 2010 guidelines.

Impaired plasms immunoreactive insulin response to glucose in elderly hypertensive patients with abnormal clucose tolerance.

Oral glucose tolerance and the plasma immunoreactive insulin response to oral glucose were measured in 42 elderly hypertensive patients. Twenty-four of these patients showed abnormal glucose tolerance curves an 18 had normal curves. Patients with abnormal glucose tolerance showed significantly lower plasms immunoreactive insulin concentrations at 30 min and 60 min after the glucose load compared with patients with normal glucose tolerance. The patients in the two groups did not appear to differ in any other clinical or biochemical characteristics.

Topical treatment of dermatophytoses and candidoses.

In a double-blind trial clotrimazole cream was compared with tolnaftate cream in the treatment of dermatophytoses and with nystatin cream in the treatment of candidoses. Clotrimazole was shown to be effective against both dermatophytoses and candidoses and was as effective and acceptable as tolnaftate and nystatin creams in each condition.