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The Epidemiology and Etiology of Right-Sided Colonic Diverticulosis: A Review
Greg A. Turner,Michael J. O’Grady,Rachel V. Purcell,Frank A. Frizelle 대한대장항문학회 2021 Annals of Coloproctolgy Vol.37 No.4
Diverticulosis of the colon is a common condition in Western countries and most patients will remain asymptomatic, but some will present with symptoms of acute diverticulitis or bleeding. Our understanding of diverticulosis is evolving but is mostly derived from diverticulosis affecting the left-sided colon. In contrast, right-sided colonic diverticulosis (RCD) is more commonly seen in Asian countries but is much less common overall. Based on the marked differences in epidemiology, it is commonly thought that these are 2 distinct disease processes. A review of the literature describing the epidemiology and etiology of RCD was performed, with a comparison to the current understanding of left-sided diverticulosis. RCD is becoming increasingly common. The epidemiology of RCD shows it to be a mostly acquired condition, and not congenital as previously thought. Many factors in the etiology of RCD are similar to that seen in left-sided diverticulosis, with a few variations. It is therefore likely that most cases of RCD represent the same disease process that is seen in the left colon.
A Review of the Role of Carcinoembryonic Antigen in Clinical Practice
Claire Hall,Louise Clarke,Atanu Pal,Pamela Buchwald,Tim Eglinton,Chris Wakeman,Frank Frizelle 대한대장항문학회 2019 Annals of Coloproctolgy Vol.35 No.6
Carcinoembryonic antigen (CEA) is not normally produced in significant quantities after birth but is elevated in colorectal cancer. The aim of this review was to define the current role of CEA and how best to investigate patients with elevated CEA levels. A systematic review of CEA was performed, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were identified from PubMed, Cochrane library, and controlled trials registers. We identified 2,712 papers of which 34 were relevant. Analysis of these papers found higher preoperative CEA levels were associated with advanced or metastatic disease and thus poorer prognosis. Postoperatively, failure of CEA to return to normal was found to be indicative of residual or recurrent disease. However, measurement of CEA levels alone was not sufficient to improve survival rates. Two algorithms are proposed to guide investigation of patients with elevated CEA: one for patients with elevated CEA after CRC resection, and another for patients with de novo elevated CEA. CEA measurement has an important role in the investigation, management and follow-up of patients with colorectal cancer.
Darren B. Taichman,Joyce Backus,Christopher Baethge,Howard Bauchner,Annette Flanagin,Fernando Florenzano,Frank A. Frizelle,Fiona Godlee,Laragh Gollogly,Abraham Haileamlak,Sung-Tae Hong,Richard Horton 대한의학회 2020 Journal of Korean medical science Vol.35 No.4
Many factors, including professional and personal relationships and activities, can influence the design, conduct, and reporting of the clinical science that informs health care decision. The potential for conflict of interest exists when these relationships and activities may bias judgement.1 Many stakeholders—editors, peer reviewers, clinicians, educators, policymakers, patients, and the public—rely on the disclosure of authors' relationships and activities to inform their assessments. Trust in the transparency, consistency, and completeness of these disclosures is essential.