Colorectal cancer surveillance in inflammatory bowel disease: The search continues

Ahmadi, Anis; Polyak, Steven; Draganov, Peter V.

doi:10.3748/wjg.15.61

Cited by 60 publications

(40 citation statements)

References 58 publications

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“…Colonoscopy is a procedure often performed for prevention, diagnosis, and treatment of a variety of symptoms and diseases of the lower digestive tract, 9,14 and sedation or anesthesia should be considered as an important tool to increase its effectiveness. 15 Sedation or anesthesia is intended to decrease anxiety and discomfort, increase tolerance and satisfaction with the procedure, reduce risks of complications, and promote satisfactory conditions for the examination.…”

Section: Discussionmentioning

confidence: 99%

Colonoscopy sedation: clinical trial comparing propofol and fentanyl with or without midazolam

Neves

Araújo²,

Araújo

et al. 2016

Brazilian Journal of Anesthesiology (English Edition)

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Colonoscopy is one of the most common procedures. Sedation and analgesia decrease anxiety and discomfort and minimize risks. Therefore, patients prefer to be sedated when undergoing examination, although the best combination of drugs has not been determined. The combination of opioids and benzodiazepines is used to relieve the patient's pain and discomfort. More recently, propofol has assumed a prominent position. This randomized prospective study is unique in medical literature that specifically compared the use of propofol and fentanyl with or without midazolam for colonoscopy sedation performed by anesthesiologists. The aim of this study was to evaluate the side effects of sedation, discharge conditions, quality of sedation, and propofol consumption during colonoscopy, with or without midazolam as preanesthetic. The study involved 140 patients who underwent colonoscopy at the University Hospital of the Federal University of Juiz de Fora. Patients were divided into two groups: Group I received intravenous midazolam as preanesthetic 5min before sedation, followed by fentanyl and propofol; Group II received intravenous anesthesia with fentanyl and propofol. Patients in Group II had a higher incidence of reaction (motor or verbal) to the colonoscope introduction, bradycardia, hypotension, and increased propofol consumption. Patient satisfaction was higher in Group I. According to the methodology used, the combination of midazolam, fentanyl, and propofol for colonoscopy sedation reduces propofol consumption and provides greater patient satisfaction.

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Section: Discussionmentioning

confidence: 99%

Colonoscopy sedation: clinical trial comparing propofol and fentanyl with or without midazolam

Neves

Araújo²,

Araújo

et al. 2016

Brazilian Journal of Anesthesiology (English Edition)

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“…The cell cycle machinery is a recognized target of resveratrol action (Ahmadi et al, 2009). Thus, we examined the effects of resveratrol on cell proliferation.…”

Section: Discussionmentioning

confidence: 99%

Role of microRNAs in Resveratrol-Mediated Mitigation of Colitis-Associated Tumorigenesis inApc^Min/+Mice

Altamemi

Murphy

Catroppo

et al. 2014

J Pharmacol Exp Ther

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The pleiotropic effects of resveratrol include anti-inflammatory, antioxidant, and anticancer activities, and thus unique possibilities exist to explore mechanistic pathways of chemoprevention. The aim of this study was to investigate the role of microRNA (miRNA) alterations induced by resveratrol in the context of chemopreventive mechanisms against dextran sodium sulfate (DSS)-induced colitis-associated tumorigenesis in the Apc Min/1 mouse. To that end, ApcMin/1 mice were exposed to 2% DSS to enhance intestinal inflammation and polyp development. Concurrently, mice received either vehicle or resveratrol treatment via oral gavage for 5 weeks. Interestingly, treatment of DSS-exposed mice with resveratrol resulted in decreased number and size of polyps, fewer histologic signs of cell damage, and decreased proliferating epithelial cells in intestinal mucosa compared with vehicle. Resveratrol treatment dramatically reversed the effects of DSS on the numbers of specific inflammatory CD4 1 T cells, CD8 1 T cells, B cells, natural killer T cells, and myeloid-derived suppressor cells in mesenteric lymph nodes. Resveratrol treatment also decreased interleukin-6 (IL-6) and tumor necrosis factor-a protein levels and reduced IL-6 and cyclooxygenase-2 mRNA expression. Microarray analysis revealed 104 miRNAs exhibiting .1.5-fold differences in expression in the intestinal tissue of resveratrol-treated mice. Among them, two miRNAs with anti-inflammatory properties, miRNA-101b and miRNA-455, were validated to be upregulated with resveratrol treatment by reverse-transcription polymerase chain reaction. Pathway analysis revealed that numerous differentially regulated miRNAs targeted mRNAs associated with inflammatory processes with known roles in intestinal tumorigenesis. These results suggest that resveratrol mediates anti-inflammatory properties and suppresses intestinal tumorigenesis through miRNA modulation.

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“…The reasons for this observed change in incidence may be the more widespread use of surveillance colonoscopy, a chemoprotective effect attributable to the more widespread use of maintenance therapies, more aggressive surgical intervention, and/or dietary or environmental factors [8] .…”

Section: Lukasmentioning

confidence: 99%

Inflammatory Bowel Disease as a Risk Factor for Colorectal Cancer

Lukáš¹

2010

Dig Dis

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Patients with long-term inflammatory bowel disease (IBD), ulcerative colitis (UC) and Crohn’s colonic disease (CD) have an increased risk of colorectal carcinoma (CRC). Eaden’s meta-analysis has shown that the risk for CRC in UC patients is 2% at 10 years, 8% at 20 years and 18% at 30 years of disease duration. It is now accepted that the risk of colorectal cancer is equivalent in both (UC and CD) conditions. Duration of disease is recognized to be the most important risk factor for CRC development. Extent of disease in another major risk factor. Most cancers arise in patients with extensive disease, which is generally defined as extension of inflammation beyond the hepatic flexure. It was demonstrated that proctitis and proctosigmoiditis posed no increased risk for patients with UC. Recent data from case control studies suggests that greater degrees of colonoscopic or histologically active inflammation are associated with an increased risk of CRC. Recently, it has been proven that shortened tubular colon, colonic stricture and postinflammatory polyps should be considered strong risk factors for CRC development. Primary sclerosing cholangitis (PSC) in patients with UC is associated with substantial risk of CRC. Screening colonoscopy should be performed in patients with UC after 8–10 years of disease. The interval between surveillance examinations is dependent on each individual’s personal risk factors. In patients with a previous history of PSC, ongoing active inflammation, previous history of dysplasia or strictures, and strong family history of bowel cancer, annual surveillance is recommended. Colectomy is strictly recommended for patients who were diagnosed with flat high-grade dysplasia (HGD) or CRC and where the diagnosis was confirmed by expert gastrointestinal pathologists. In patients with a biopsy specimen considered indefinite for dysplasia, guidelines suggest colonoscopy between 3 and 12 months. Multifocal low-grade dysplasia (LGD) is a stronger indication for colectomy. The optimal colonoscopic surveillance interval for patients who were diagnosed with a flat LGD is still unknown, but 3–6 months is often recommended. Chemopreventive agents should be used to minimize the risk of developing dysplasia or CRC in IBD patients. It has been shown that mesalazine has a preventive effect for CRC and dysplasia.

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Colorectal cancer surveillance in inflammatory bowel disease: The search continues

Cited by 60 publications

References 58 publications

Colonoscopy sedation: clinical trial comparing propofol and fentanyl with or without midazolam

Colonoscopy sedation: clinical trial comparing propofol and fentanyl with or without midazolam

Role of microRNAs in Resveratrol-Mediated Mitigation of Colitis-Associated Tumorigenesis inApc^Min/+Mice

Inflammatory Bowel Disease as a Risk Factor for Colorectal Cancer

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Colorectal cancer surveillance in inflammatory bowel disease: The search continues

Cited by 60 publications

References 58 publications

Colonoscopy sedation: clinical trial comparing propofol and fentanyl with or without midazolam

Colonoscopy sedation: clinical trial comparing propofol and fentanyl with or without midazolam

Role of microRNAs in Resveratrol-Mediated Mitigation of Colitis-Associated Tumorigenesis inApcMin/+Mice

Inflammatory Bowel Disease as a Risk Factor for Colorectal Cancer

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Product

Resources

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Role of microRNAs in Resveratrol-Mediated Mitigation of Colitis-Associated Tumorigenesis inApc^Min/+Mice