One hundred and thirty unrelated patients with recurrent deep venous thrombosis were studied over a period of 4 years (1986-1990) in order to determine the possible etiology. Protein C levels were estimated in plasma both by chromogenic substrate assay and by immunoassay. Protein S levels in plasma was determined by immunoassay using antisera to human protein S. Antithrombin III (AT-III) was assayed using monospecific rabbit antiserum to human AT-III. Fifteen patients were found to have hereditary protein C deficiency (11.52%). Family studies revealed autosomal recessive inheritance in one patient and a dominant pattern in the remaining 14 patients. Protein S deficiency was found in eight cases (6.1%), AT-III deficiency was established in five cases (3.8%) and a fibrinolytic defect in 33 cases (25.4%). Thrombosis of visceral and cerebral vessels and a positive family history were more frequently found among patients who had hereditary deficiency of one or the other antithrombotic factor. Thrombophlebitis of superficial veins was found to be very common in patients with protein C and protein S deficiency and virtually absent in AT-III deficiency. The high frequency of protein C and protein S deficiency in this ethnic group is attributed to the high frequency of consanguinity.
Colon polyps might originate from the submucosa including lymphoid aggregates, carcinoids and lipomas. On the other hand, most polyps usually arise from the mucosa and include various types, whether neoplastic or not. The prognosis and treatment of these lesions depend on establishing an adequate diagnosis to rule out the presence of malignancy. Therefore, clinicians should be aware of each subclassification's different types and presentations to achieve the best outcomes. When conducting colonoscopy screening for colorectal cancer, colorectal polyps are commonly discovered. The prevalence of these lesions is high. However, most of them do not have any clinical significance. On the other hand, evidence shows that some polyps might have premalignant characteristics, which are usually challenging to manage in clinical practice. Therefore, evidence shows that the most appropriate approach to managing these lesions and achieving the best prognosis would be identifying and treating them as early as possible before complications appear to intervene against potential morbidities and mortality. Clinicians should consider the wide variations of colorectal cancer to establish the most appropriate diagnosis. A histological diagnosis is essential in these events to exclude malignancy and decide the most appropriate treatment plan.
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