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Rectal lymphogranuloma venereum in Jamaica
Ann R Coll Surg Engl ; 29(3): 141-59, Sept. 1961.
Artigo em Inglês | MedCarib | ID: med-14544
Biblioteca responsável: JM3.1
Localização: JM3.1; RD1.L6
ABSTRACT
Lymphogranuloma venereum is a major public health problem in Jamaica. With improvement in the standard of living, better housing, better general education, a healthier sex education, and a more active programme of venereal disease control, the incidence of rectal lymphogranuloma should diminish. The early diagnosis and treatment of the proctocolitis by drugs is effective and should reduce the incidence of stricture. Major operations should be reserved for cases in which the more conservative methods of treatment are unlikely to succeed or have failed. At present, in Jamaica, operation necessitating a permanent colostomy should be considered more carefully than in this country. Unfortunately our attempts to eradicate the disease by operation and leave the patient with a functioning anus have been attended with only very limited success. Some of the failures may be attributed to insufficent experience with these operations, but involvement of the sphincter in the dense fibrotic process is probably responsible for the majority. In these fibrotic sphincters functional control is impossible. In a small number of cases intra-sphincter proctectomy in one stage by the method described by Dimitrui and Gregoresco (1933) has given promising results where the sphincter is free. The disease appears to be self-limiting. There has been no evidence of reactivation after removal of the affected gut even though this is rarely a complete en bloc excision or indeed even after colostomy only. Our follow up has been short. I have deliberately avoided the term "cure" because rarely has the compliment fixation reaction been reversed to negative. The significance of a persistently positive serological reaction in the absence of clinical evidence of disease is yet to be assessed. We have come a long way since John Hunter described the bubo 175 years ago and Frei placed the study of the disease on a firm aetiological basis 140 years later. In the past 35 years our knowledge of the lympho-granuloma venereum virus has increased, but the problem of treatment of rectal stricture, the most disabling complication of the disease, awaits solution. Morte (1933) stated "The study of the stricture of the rectum is as fascinating as the treatment is discouraging. " In 1960 we can say "Treatment of rectal stricture is often disappointing, but the results are encouraging" (Summary)
Assuntos
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Coleções: Bases de dados internacionais Contexto em Saúde: ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis Problema de saúde: Neoplasias Colorretais / Doenças do Sistema Digestório Base de dados: MedCarib Assunto principal: Neoplasias Retais / Linfogranuloma Venéreo Tipo de estudo: Estudo de rastreamento Limite: Adolescente / Adulto / Idoso / Criança / Feminino / Humanos / Masculino País/Região como assunto: Caribe Inglês / Jamaica Idioma: Inglês Revista: Ann R Coll Surg Engl Ano de publicação: 1961 Tipo de documento: Artigo / Congresso e conferência
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Coleções: Bases de dados internacionais Contexto em Saúde: ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis Problema de saúde: Neoplasias Colorretais / Doenças do Sistema Digestório Base de dados: MedCarib Assunto principal: Neoplasias Retais / Linfogranuloma Venéreo Tipo de estudo: Estudo de rastreamento Limite: Adolescente / Adulto / Idoso / Criança / Feminino / Humanos / Masculino País/Região como assunto: Caribe Inglês / Jamaica Idioma: Inglês Revista: Ann R Coll Surg Engl Ano de publicação: 1961 Tipo de documento: Artigo / Congresso e conferência
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