Tesis sobre el tema "Early colorectal Cancer"
Crea una cita precisa en los estilos APA, MLA, Chicago, Harvard y otros
Consulte los 46 mejores tesis para su investigación sobre el tema "Early colorectal Cancer".
Junto a cada fuente en la lista de referencias hay un botón "Agregar a la bibliografía". Pulsa este botón, y generaremos automáticamente la referencia bibliográfica para la obra elegida en el estilo de cita que necesites: APA, MLA, Harvard, Vancouver, Chicago, etc.
También puede descargar el texto completo de la publicación académica en formato pdf y leer en línea su resumen siempre que esté disponible en los metadatos.
Explore tesis sobre una amplia variedad de disciplinas y organice su bibliografía correctamente.
Olsson, Louise. "Early detection of colorectal cancer /". Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-841-6/.
Texto completoBodle, Sarah J. "Adhesion Based Early Detection of Colorectal Cancer". Ohio University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1503486302129822.
Texto completoFADDA, ANTONIO. "Early detection of colorectal cancer: biomarker discovery". Doctoral thesis, Università degli Studi di Cagliari, 2017. http://hdl.handle.net/11584/249571.
Texto completoCharnley, Richard Michael. "The early detection of recurrent and metastatic colorectal cancer". Thesis, University of Nottingham, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.277384.
Texto completoAndersson, Martina. "Local, intestinal biomarkers for early detection of colorectal cancer". Thesis, Uppsala universitet, Institutionen för farmaci, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-445701.
Texto completoHart, Andrew R. "The early detection of colorectal cancer and its prevention". Thesis, University of Leicester, 1996. http://hdl.handle.net/2381/34100.
Texto completoJones, Simon Keith. "Mathematical modelling for early detection and treatment of cancer". Thesis, University of Southampton, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.241869.
Texto completoSutton, Kate Marie. "Mutation detection in normal mucosa and early lesions of colorectal cancer". Thesis, University of Leeds, 2014. http://etheses.whiterose.ac.uk/6410/.
Texto completoTurner, Shirley. "Health protective behavior and the elderly: Hemoccult testing for early colorectal cancer detection". Thesis, The University of Arizona, 1989. http://hdl.handle.net/10150/291436.
Texto completoHammoudi, Abeer T. "Proteomic dissection of the early genetic changes in a colorectal cancer model". Thesis, University of Liverpool, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.569126.
Texto completoPelstring, Keith R. "Determining the Proportion of Early-Onset Colorectal Cancer That is Potentially Preventable". The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1555584218954266.
Texto completoSeufferlein, Thomas y Jürgen Weitz. "Novel Concepts in the Management of Colorectal Cancer". Karger, 2019. https://tud.qucosa.de/id/qucosa%3A71648.
Texto completoWallin, Ulrik. "Cancer of the Colon and Rectum : Prognostic Factors and Early Detection". Doctoral thesis, Uppsala universitet, Kolorektalkirurgi, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-159142.
Texto completoBelthier, Guillaume. "Etude de la dissémination du cancer colorectal". Thesis, Montpellier, 2020. http://www.theses.fr/2020MONTT061.
Texto completoThe colorectal cancer (CRC) dissemination is an extremely inefficient multistep, but despite this, metastasis can be successfully formed. Dissemination starts by few cells that leave the primary tumor and use different type of migration individually or collectively. Once they enter into blood vessels, cancer cells become circulating tumors cells (CTCs). CTCs use the blood stream circulation to disseminate to distant organs. However, in each of the dissemination step, CTCs can face a new microenvironment that can give them advantages or disadvantages. Some of these disseminated tumor cells (DTCs) transform the microenvironment to a pro-tumoral microenvironment. If not, they can enter in dormancy and wait until that the microenvironment changes and became permissive. Each of these steps could be used to develop a targeted therapeutic strategy in order to impede the colorectal cancer dissemination. We face thus an urgent need to better understand the tumoral heterogeneity and their microenvironmental interactions. Furthermore, the dissemination process is a dynamic phenomenon and it must be considered earlier in order to integrate the early dissemination of the colorectal cancer
Silva, Ana Luísa Brás Dos Santos Ribeiro. "Identification of differentially methylated genes as potential biomarkers for the early detection of colorectal neoplasia". Thesis, University of Cambridge, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.610752.
Texto completoCiniselli, C. M. "IDENTIFICATION OF CIRCULATING BIOMARKERS FOR THE EARLY DIAGNOSIS OF COLORECTAL CANCER: METHODOLOGICAL ASPECTS". Doctoral thesis, Università degli Studi di Milano, 2017. http://hdl.handle.net/2434/486530.
Texto completoKünnemann, Kathi 1982. "Expression and role of cyclin O in colorectal cancer". Doctoral thesis, Universitat Pompeu Fabra, 2013. http://hdl.handle.net/10803/120756.
Texto completoLa Ciclina O, una ciclina que ha estat identificada recentment i que s'uneix amb Cdk1 i Cdk2, s'ha demostrat ser necessària per a l'apoptosis induïda per estímuls intrinsecs. Donat que les proteïnes implicades en apoptosis solen estar desregulades en el càncer, nosaltres hem volgut estudiar l'expressió i la implicació de la Ciclina O en carcinomes colorectals (CRC). Hem demostrat que la Ciclina O es sobreexpressa en estadis prematurs de CRC. L'expressió de la Ciclina O correlaciona amb una millor pronòstic en pacients amb CRC. A més, hem demostrat que la pèrdua d'un al·lel de la Ciclina O comporta l'aparició d'un major nombre d'adenomes en un model de ratolí de CRC, els ratolin s APCmin/+. Això ens indica que la Ciclina O funciona com un gen supressor de tumors. També hem observat expressió de la Ciclina O en teixits no tumorals de l'epitel·li intestinal dels ratolins APCmin/+ i en teixit peritumorals de pacients amb CRC. Amb aquestes observacions hem arribat a formular la hipòtesi de que la Ciclina O podria ser útil com a indicador precoç de la transformació de cèl·lula epitel·lial a tumoral en los pacientes de CRC.
Lindberg, Jan. "Ulcerative colitis : colorectal cancer risk and surveillance in an unselected population". Doctoral thesis, Umeå : Kirurgisk och perioperativ vetenskap Surgical and Perioperative Sciences, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1097.
Texto completoO'Neil, Donna. "The use of proteomics techniques to identify potential markers of early stage colorectal cancer". Thesis, University of Birmingham, 2011. http://etheses.bham.ac.uk//id/eprint/2960/.
Texto completoByström, Per. "Colorectal cancer treatment and early response evaluation how do we best evaluate treatment response? /". Stockholm, 2010. http://diss.kib.ki.se/2010/978-91-7409-766-5/.
Texto completoMASSOBRIO, ANDREA. "EARLY HEPATIC RECURRENCE AFTER COLORECTAL CANCER LIVER METASTASES SURGERY: A SINGLE PROSPECTIVE CENTRE STUDY". Doctoral thesis, Università degli studi di Genova, 2020. http://hdl.handle.net/11567/1011221.
Texto completoQuintanilla, Leo Isabel. "New insights into the colorectal carcinogenesis: from early precursor lesions to the role of aneuploidy". Doctoral thesis, Universitat de Barcelona, 2017. http://hdl.handle.net/10803/461912.
Texto completoEl cáncer colorrectal (CCR) representa un destacado problema para la salud, ya que es uno de los tumores más frecuentes a nivel mundial. La carcinogénesis colorrectal se desarrolla de forma progresiva a través de una lesión precursora conocida, el adenoma, lo que proporciona el escenario ideal para su prevención y la identificación de biomarcadores. En este sentido, el objetivo de esta tesis doctoral fue profundizar el conocimiento sobre la progresión de CCR a través de la evaluación de tanto lesiones precursoras como cambios moleculares que promueven la transformación maligna. Los focos de criptas aberrantes (FCA) son las primeras lesiones visibles del colón y recto, y los niveles de metilación de los elementos móviles LINE-1 han sido propuestos como posibles biomarcadores predictivos de CCR. Sin embargo, el papel de ambos en la carcinogénesis colorrectal aún guarda varias incógnitas. Por lo tanto, se utilizó una amplia cohorte de muestras FCA procedentes de pacientes con diferente riesgo de CCR (control, adenoma y CCR) para evaluar el estado mutacional de los principales genes asociados con CCR, la inestabilidad de microsatélites, y patrones de metilación aberrantes. Como resultado, no se observó ninguna asociación entre las alteraciones evaluadas en FCA y el riesgo de desarrollar CCR, indicando que estas lesiones no son buenos biomarcadores predictivos para esta enfermedad. Comprender la transición de adenoma a adenocarcinoma es un paso decisivo cuando se investiga la naturaleza del CCR. Así, lesiones de adenoma con adenocarcinoma in situ fueron utilizadas para realizar FISH multi-color a nivel de célula única y poder evaluar la heterogeneidad cromosómica y identificar drivers de transición y progresión. Curiosamente, las ganancias de los cromosomas 7p, 13q y 20q, así como la duplicación del genoma completo, demostraron que conducen a la evolución del CCR. Finalmente, se estudiaron los efectos de la duplicación del genoma completo sobre el comportamiento de las células de cáncer en dos líneas celulares de CCR, DLD1 y RKO. El perfil transcriptómico reveló la desregulación de los genes relacionados con la replicación en células de cáncer tetraploides, es decir, aquellas con el genoma duplicado. Además, estas células mostraron estrés replicativo, lo que desencadenaba en inestabilidad genómica y aberraciones cromosómicas. La duplicación del genoma también se asoció con una mayor capacidad de movilidad, de hecho, se demostró la presencia de células tetraploides en los frentes invasivos de los adenocarcinomas de colon.
Ehdode, Abdlrzag Muftah. "Circulating free DNA : a tumour biomarker for early detection and follow-up in colorectal cancer". Thesis, University of Leicester, 2017. http://hdl.handle.net/2381/40875.
Texto completoKongkanuntn, Rungtiva. "Early events in tumour development : a study based on mouse models of human colorectal cancer". Thesis, University of Edinburgh, 2000. http://hdl.handle.net/1842/22385.
Texto completoGernon, Grainne Mary. "Investigation into Early Growth Response 1 in colorectal disease : a study of EGR1 expression in colorectal tissue and novel protein interactions in cancer cells". Thesis, University of Edinburgh, 2012. http://hdl.handle.net/1842/9899.
Texto completoMalagón, Rodríguez Marta. "Development of new, non-invasive tools based on faecal bacterial signatures for the early detection of colorectal cancer". Doctoral thesis, Universitat de Girona, 2019. http://hdl.handle.net/10803/669281.
Texto completoAquesta tesi té l’objectiu principal de desenvolupar una nova eina no invasiva basada en marcadors bacterians fecals per a la detecció precoç del càncer colorectal, que sigui capaç també de detectar lesions precanceroses abans que apareguin signes clínics. En aquest treball s’ha aconseguit desenvolupar tres eines: (1) RAID-CRC, basada en la combinació de quatre espècies bacterianes amb el TSOF, capaç de reduir el nombre de falsos positius del TSOF en un 50% en una població amb símptomes compatibles amb el CCR; (2) RAID-CRC Screen, basada en la combinació de sis espècies bacterianes, capaç de reduir en un 20% els falsos positius del TSOF en una població sense símptomes d’entre 50 i 69 anys d’edat (població actual de cribratge de CCR); i per últim, (3) RAID-LS, basada en la combinació de tres espècies bacterianes, capaç de detectar l’absència de lesions neoplàsiques colorectals en portadors de la síndrome de Lynch (persones amb predisposició genètica a patir CCR) amb una sensibilitat del 100%.
Moe, Myint Ni Ni. "Assessing circulating cell-free tumour DNA as a potential biomarker for early detection and chemoprevention of colorectal cancer". Thesis, University of Leicester, 2017. http://hdl.handle.net/2381/40625.
Texto completoMiyake, Kanae. "Dual-time-point 18F-FDG PET/CT in patients with colorectal cancer: clinical value of early delayed scanning". Kyoto University, 2013. http://hdl.handle.net/2433/174796.
Texto completoJeong, K. "Cost-effective strategies in the follow-up of people with confirmed colorectal adenomas for the prevention and early detection of colorectal cancer in the National Health Insurance, South Korea". Thesis, London School of Hygiene and Tropical Medicine (University of London), 2017. http://researchonline.lshtm.ac.uk/3894604/.
Texto completoStrohkamp, Sarah [Verfasser]. "Identification of protein markers in tissue & liquid biopsies for improving early diagnosis & prognosis of sporadic colorectal cancer / Sarah Strohkamp". Lübeck : Zentrale Hochschulbibliothek Lübeck, 2017. http://d-nb.info/1137193573/34.
Texto completoIbrahim, Shahram. "Proteins, which are upregulated at early time points following Apc deletion, are involved in intestinal tumourigenesis and represent potential colorectal cancer biomarkers". Thesis, University of Liverpool, 2014. http://livrepository.liverpool.ac.uk/2002939/.
Texto completoMcWhirter, Derek. "Defining the role of microRNA-122 in the early detection of chemotherapy-induced hepatotoxicity in the neo-adjuvant treatment of advanced colorectal cancer". Thesis, University of Liverpool, 2014. http://livrepository.liverpool.ac.uk/2007526/.
Texto completoScholtka, Bettina, Mandy Schneider, Ralph Melcher, Tiemo Katzenberger, Daniela Friedrich, Kornelia Berghof-Jäger, Wolfgang Scheppach y Pablo Steinberg. "A gene marker panel covering the Wnt and the Ras-Raf-MEK-MAPK signalling pathways allows to detect gene mutations in 80% of early (UICC I) colon cancer stages in humans". Universität Potsdam, 2009. http://opus.kobv.de/ubp/volltexte/2010/4458/.
Texto completoToh, Eu-Wing. "Phenotype and biology of early colorectal cancers". Thesis, University of Leeds, 2016. http://etheses.whiterose.ac.uk/15738/.
Texto completoEusebi, Leonardo Henry Umberto <1979>. "Clinicopathological and molecular features of sporadic early onset colorectal cancers". Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2016. http://amsdottorato.unibo.it/7300/1/Eusebi_Leonardo_Tesi.pdf.
Texto completoEusebi, Leonardo Henry Umberto <1979>. "Clinicopathological and molecular features of sporadic early onset colorectal cancers". Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2016. http://amsdottorato.unibo.it/7300/.
Texto completoPetitprez, Florent. "Integrated analysis and clinical impact of immune and stromal microenvironments in solid tumors Quantitative analyses of the tumor microenvironment composition and orientation in the era of precision medicine Transcriptomic analysis of the tumor microenvironment to guide prognosis and immunotherapies Tumor microenvironment quantification tool draws a comprehensive map of the tumor microenvironment of non-hematologic human cancers The mMCP-counter method to estimate abundance of tissue-infiltrating immune and stromal cell populations using gene expression in murine samples Immune sub-classes in sarcoma predict survival and immunotherapy response Intra-tumoral tertiary lymphoid structures are associated with a low risk of hepatocellular carcinoma early recurrence Association of IL-36γ with tertiary lymphoid structures and inflammatory immune infiltrates in human colorectal cancer Immune-based identification of cancer patients at high risk of progression Tumor-infiltrating and peripheral blood T-cell immunophenotypes predict early relapse in localized clear cell renal cell carcinoma PD-L1 expression and CD8+ T-cell infiltrate are associated with clinical progression in patients with node-positive prostate cancer Intratumoral classical complement pathway activation promotes cancer progression". Thesis, Sorbonne Paris Cité, 2018. http://www.theses.fr/2018USPCB104.
Texto completoTumors are composed not only of malignant cells but also contain a vast variety of non-malignant cells, notably immune cells forming the tumor microenvironment (TME). The composition of the TME was shown to be associated with clinical outcome for cancer patients, in terms of survival and therapeutic responses. With the relatively recent development of immunotherapies targeting specific elements of the TME, tumor immunology has risen a strong interest and holds a strong therapeutic potential. Several methodologies have been developed to study the composition of the TME with an increased precision. Notably, some methods such as MCP-counter enable the use of the tumor bulk transcriptome to quantify cell populations composing the TME. The methodological aspect of this PhD project consisted in setting up an enhanced version of MCP-counter that can be readily applied to RNA-Seq data, as well as propose an adaptation of the method for mouse models. Using MCP-counter, the TME of large series of tumors can be easily analyzed. The application part of this PhD work consisted of applying MCP-counter to establish an immune-based classification of soft-tissue sarcoma, a rare, aggressive and heterogeneous cancer type. The immune classification notably allowed to identify immune low and high groups, and a group characterized by a strong vasculature. Interestingly, the classification was notably found to be predictive of the patients' response to immunotherapies. It also highlighted an important role of tertiary lymphoid structures (TLS). TLS are lymph-node-like structures composed of T and B cells that form within the tumor or in close proximity. They are a site of formation and maturation of antitumoral immune responses. TLS are raising a growing interest in many malignancies. In most cancer types, a strong infiltration by T cells, in particular CD8+ T cells, is associated with a favorable clinical outcome. However, clear-cell renal cell carcinoma and prostate cancer are exceptions to this general rule. Indeed, in these urological cancers, an increased infiltration by T cells is associated with a decreased patient survival and with earlier relapse and disease progression. In a third part of this thesis, these exceptions are investigated with more details by scrutinizing the TME, and questioning the implication of the complement system. Overall, this thesis presents how the combination of several analysis methods, in silico, in situ and in vivo, can help achieve an extremely precise description of the TME. Knowing accurately what cell populations and what their functional orientation can help guide patients care and improve clinical outcome. Complete description of the TME opens the way towards personalized medicine for cancer patients
Ferreira, Inês Rodrigues Borges. "Identification of biomarkers of colorectal cancer risk and metastasis: Targeting early onset cancer". Master's thesis, 2019. http://hdl.handle.net/10362/90975.
Texto completoYou, Yu-Jyun y 游宇君. "Correlation Between Postoperative Early Ambulation and Postoperative Recovery in Patients with Colorectal Cancer". Thesis, 2015. http://ndltd.ncl.edu.tw/handle/13897798903733050315.
Texto completo國立臺灣大學
護理學研究所
103
The patients with colorectal cancer usually suffer from multiple symptoms after surgery. Pain, nausea, vomit, abdominal fullness, low appetite, anxiety, depression and various postoperative complications are experienced by the patients . The symptoms not only cause the discomfort, prolong the postoperative recovery and hospitalization period, but also worsen the psychological condition. Early postoperative ambulation is thought to be a useful treatment to improve the postoperative recovery. But how it really works and how to apply on clinical condition remain unclear. The study aims to understand the correlation between postoperative ambulation and the recovery of patients with colorectal cancer. We conducted a longitudinal correlation study with a set of structured questionnaire survey with consecutive sampling in a medical center in Northern Taiwan. The population was postoperative patients with colorectal cancer. The questionnaire included: (1) Preoperative part: demographic profiles, Taiwan International Physical Activity Questionnaire (IPAQ), Hospital Anxiety & Depression Rating Scale (HADS); (2) Postoperative part: walking diary, physical symptoms scale and the heart-rate sensor ring were applied every day. HADS was recorded on the day before discharge. Data were analyzed by descriptive statistics and generalized estimating equation (GEE). Finally, 150 patients were recruited in 13 months. The results indicated that: (1) the higher the frequency of postoperative ambulation is, the time of flatus and tolerating to solid food is earlier, and the degree of physical symptoms and anxiety are lower; (2) the longer the distance of postoperative ambulation is, the time of tolerating to solid food is earlier, the hospitalization period is shorter, the degree of physical symptoms and anxiety are lower. In conclusion, the increase of frequency and distance of postoperative ambulation certainly lead to a better postoperative recovery. Further studies on the exact amount of ambulation are recommended for developing the clinical guidelines for this population.
Park, Mina. "Search for DNA Methylation Biomarkers in the Circulating DNA of Prostate and Colorectal Cancer". Thesis, 2012. http://hdl.handle.net/1807/32617.
Texto completoCourtney, Ryan James. "Colorectal cancer screening participation and medical advice seeking for symptoms in Australia". Thesis, 2012. http://hdl.handle.net/1959.13/932034.
Texto completoThe contents of this thesis by publication include an introduction, a critical review, five data-based manuscripts and a general discussion providing implications and conclusions. The papers examined the early detection and prevention of colorectal cancer (CRC) in the community-based setting and among first-degree relatives of CRC patients. At timing of thesis submission, three papers (two data-based and one review paper) had been accepted for publication. The remaining three are under editorial review. The burden of disease, early detection and prevention of colorectal cancer (CRC) is presented in the Introduction. It provides a general overview of CRC-related global burden of disease, its aetiology and the efficacy of screening in reducing incidence and mortality. It also examines current levels of CRC screening uptake and the populations currently experiencing inequality in CRC screening. This chapter also provides an overview of the current state of medical consultation and delay in seeking medical advice for primary symptoms of CRC (i.e. rectal bleeding and change in bowel habit). Paper One provides a critical review of methodically sound community-based approaches to increasing CRC screening levels. Paper Two is a cross-sectional study which identified the current levels of CRC screening uptake and screening in accordance with National Health and Medical Research Council (NHMRC) screening guidelines among an at-risk community cohort of persons aged 56-88 years. Paper Three is a cross-sectional cohort study using the aforementioned sampled population which assessed the socio-demographic and provider-level factors associated with ever receiving CRC testing and CRC screening in accordance with guideline recommendations. A secondary analysis was conducted to examine National Bowel Cancer Screening Program eligibility on each aforementioned outcome. Paper Four is a population-based study among first-degree relatives (FDRs) of CRC patients examining across varying levels of risk, the proportion of FDRs (i) ever receiving any CRC testing in their lifetime and (ii) screened in accordance with NHMRC screening guidelines. Socio-demographic and provider-level predictors of (i) and (ii) were also evaluated. Paper Five reports on a cross-sectional study examining, for two primary symptoms of colorectal cancer (i.e. rectal bleeding and change in bowel habit), rates of (i) non-consultation and (ii) delay in seeking medical advice for both symptoms. Additionally, the reasons for non-consultation and delay in seeking medical advice for each symptom as well as the triggers for consulting a doctor following symptom episode were investigated. Paper Six: The purpose of this study using the aforementioned Hunter Community Study cohort was to identify the socio-demographic and provider-related characteristics associated with (i) ever seeking medical advice for primary symptoms of CRC and (ii) early medical-advice-seeking behaviour for primary symptoms of CRC. Discussion and implications for future research and practice: In conclusion, this dissertation has provided insight into the current levels of CRC screening in compliance with NHMRC screening guideline recommendations at a community level and among an increased-risk population (i.e. first-degree relatives of CRC patients). Previously, little was known about community CRC screening levels across varying levels of risk. The low rates of screening in accordance with guidelines and the identified screening inequalities across individual and socio-demographic characteristics highlights the need for systematic population-based approaches to increase the rate of risk-appropriate CRC screening. This thesis also highlighted the poor receptivity of community members to prompt medical advice seeking for potential symptoms of CRC. Both high rates of delay and non-consultation for primary symptoms were evident, with little appreciable improvements indicated through a direct comparison with an earlier at-risk community data set. The current work highlights the need for systematic population-based approaches that are tested in methodically rigorous interventions, if improvements in the earlier presentation of primary symptoms and the level of risk-appropriate CRC screening are to occur. The direction of future research stemming from this dissertation and the possible pathways for future research initiatives are discussed.
Wang, Wen-Yin y 王文吟. "Outcomes of Early Enteral Feeding in Patients after Curative Colorectal Cancer Surgery: A Case-Control Study". Thesis, 2019. http://ndltd.ncl.edu.tw/handle/awgq87.
Texto completo國立臺北護理健康大學
護理研究所
107
Colorectal cancer is the most prevalent cancer and the third leading cause of cancer-related death in Taiwan. Surgical resection is the most common treatment for colorectal cancer. Postoperative early enteral nutrition can promote recovery, reduce the risk of complications and ease the medical burden. However, there remains a substantial reluctance to utilize early enteral feedings due to the fear of the increased risk of anastomotic dehiscence and complications. The purpose of this study is to evaluate the safety and tolerability of early enteral feeding after colorectal anastomosis surgeries and postoperative outcomes. This is a retrospective, propensity score-matched case-control study. We retrospectively reviewed the medical records of 708 adult patients undergoing colorectal surgery with GI anastomosis from January 2013 to June 2018 in a medical center of North Taiwan. Among them, 249 cases received early enteral feeding. Another propensity score 1:1 matched 227 patients who did not receive early enteral feeding were also include. Data were collected from patients’ medical records, including gastrointestinal symptoms, the timing of first flatus, timing of passaging the first face, feeding interruption, anastomotic leakages, infection rate, reoperation rate, calorie intake, length of hospital stay and unplanned seven-day readmissions. Chi-square and T-tests were used to compare between-group differences in outcome variables. Results of this study show that early enteral feeding can shorten the length of postoperative hospital stay for 1.53 days (10.94 ± 5.27 vs 12.48 ± 6.75, p < .01) and shorten the time to achieve energy goals for 1.26 days (7.90 ± 2,98 vs. 9.16 ± 3.63, p < .001), compared with the non-early enteral feeding group. There were no significant difference in post-operative complications, including most concerned issue: anastomotic leakage. It is recommended that colorectal surgeons can start enteral nutrition as soon as possible within two days after regular surgery without special concerns. This will not only bring better medical quality but also reduce hospital cost. Because this is a case-control study, it is recommended that randomized controlled trials can be conducted in the future. Take Enhanced recovery after surgery (ERAS) guidelines for colorectal cancer operation as a reference, including perioperative nutrition supplement, management of postoperative ileus and the use of mechanical bowel preparation, it is helpful for postoperative recovery and treatment.
Kuo, Chia-Yu y 郭嘉于. "The Impacts of Early Helicobacter Pylori Eradication on the Risk of Colorectal Cancer and Health Resource Utilizations". Thesis, 2018. http://ndltd.ncl.edu.tw/handle/8h49y7.
Texto completo國立中山大學
企業管理學系醫務管理碩士班
107
Objectives: Helicobacter pylori (H.p) infection is common in Taiwan, with approximately 50% of Taiwanese nationals infected. H.p causes gastric ulcer, gastritis, duodenal ulcer, gastric cancer, and gastric lymphoma. The main objective of this study was to address the research gap in Taiwan on medical resource utilization for early and late antibacterial treatments. In addition, cancer has consistently been the leading cause of death in Taiwan for numerous years. Therefore, this study also aimed to determine the correlation between the early antibacterial treatment for H.p and the risk of developing colorectal cancer based on the relationship between this bacterium and cancer. Methodology: This study employed a retrospective cohort design and secondary data analysis of outpatient and admission records from the 2000 Longitudinal Health Insurance Database obtained from the National Health Insurance (NHI) Research Database of the National Health Research Institutes, Taiwan. Patients that were newly diagnosed with gastric ulcer between 2000 and 2005 and were receiving treatment for H.p were selected. Patients receiving treatments within a year of diagnosis was defined as receiving early antibacterial treatment whereas those receiving treatment later than 1 year after diagnosis were considered as receiving late antibacterial treatment. An analysis was conducted on the mean number of clinical visits and medical expenses of patients in short and long term (1, 2, and 4 years) periods. A 10-year cumulative risk chart of both early and late antibacterial treatment groups was generated using a Kaplan–Meier survival curve, and then the variables of age, sex, comorbidity, and severity of illness were controlled for by applying Cox proportional hazard regression to determine the differences in risk between early and late antibacterial treatment on developing colorectal cancer. In terms of medical resource utilization and the number of return visits, multiple linear regression was applied to control for comorbidities (other confounders such as age, sex, and comorbidities) in order to determine if early and late antibacterial treatments caused statistically significant differences. Results: For patients that received early antibacterial treatment for H.p, the number of return visits within the first and second year was significantly lower than for those who received late treatment. In terms of mean medical expenses, the patients that received early antibacterial treatment spent considerably less on return visits within the first and second year than those who received late antibacterial treatment. Regarding the mean admission expenses, significant differences were observed within the period of 2–4 years. No significant differences were noted regarding the mean number of return visits within 4 years and the mean outpatient and admission expenses within 4 years and 1 year, respectively. Moreover, early or late antibacterial treatment for H.p was not significantly correlated with a risk of developing colorectal cancer. Conclusion: This study revealed that early antibacterial treatment for H.p resulted in fewer return visits compared with late antibacterial treatment, which proved to be effective in lowering medical resource utilization, thus decreasing registration fees and copayments for the NHI. Additionally, in contrast to other studies, the results of this study did not indicate any significant correlation between early antibacterial treatment for H.p and the development of colorectal cancer. This inconsistency in results might have been caused by the use of different diagnostic tools for H.p, research design differences, research bias, and different confounders. According to this study, on the basis of applying preventive health care to reduce NHI expenses and ensuring its sustainability, encouraging patients to receive early antibacterial treatment for H.p is recommended. This measure can lower medical resource utilization and reduce NHI expenses, which will bring substantial health benefits to the Taiwanese population. Key Word: Helicobacter pylori、Colorectal Cancer、Helicobacter pylori eradication、Resources utilization
Tsai, Yang-Ming y 蔡揚明. "Using DNA Methylation Status from Microarray to Establish Biomarkers for Early Stage of Colorectal Cancer by Animal Model". Thesis, 2013. http://ndltd.ncl.edu.tw/handle/18537400882956074677.
Texto completo國防醫學院
公共衛生學研究所
101
Background: Colorectal cancer is the most increased frequency of new cases among all cancer patients in Taiwan and ranks second incidence rate of all cancer. Recently, due to well prognosis in early stage but no high compliance and accurate colorectal cancer screening tool, the concept through use of epigenetic inheritance of DNA promoter methylation status in feces to predict the progress of colorectal cancer is necessary. However, existing data is not sufficient to assess temporal association between the progression of CRC and aberrant DNA methylation. Therefore, it is necessary to develop new genes as biomarkers. Methods: 20 male SD rats enrolled in our animal studied which collected the stools and given saline injections of either DMH in a dosage of 20 mg/kg body weight (n = 10), and the same volume of saline (n = 10) every week. Collecting feces and isolating the DNA, we use DNA microarray to choose target genes, and the DNA methylation status of colon tissue (tumor/normal) within the target genes was analyzed using methylation-specific PCR. Result: Nr5a2, Pomt1, Hes1 have been choose, but only Nr5a2 has well predictable power. The average sensitivity of the methylated Nr5a2 gene detected in stools in ACF phase, adenoma phase and tumor phase are 5%, 29%, 93%, respectively. Conclusion: Our result shows that Nr5a2 has well prediction on progress of adenoma phase and tumor phase for colorectal cancer, and also confirm that DAN microarray can be used as a more consummate colorectal cancer screening tool.
Jen, Hsiao-Hsuan y 任小萱. "Queue, Hurdle, and Coxian Phase-type Model for Time Distributions Related to Early Detection and Hospitalization of Colorectal Cancer". Thesis, 2015. http://ndltd.ncl.edu.tw/handle/90023214285973387246.
Texto completo國立臺灣大學
流行病學與預防醫學研究所
103
Background As the incidence rate of colorectal cancer (CRC) has been increasing in Taiwan, early detection of CRC through fecal immunochemical test (FIT) screening first and then colonoscopy examination and hospitalization of CRCs cannot be overemphasized. However, the arrival rate of screenees, the non-compliers of undergoing colonoscopy, the waiting time (WT) for undergoing colonoscopy, and the length of stay (LOS) for CRCs has rendered the conventional queue model infeasible. Aims The objective was to integrate the queue process, hurdle model, and Coxian phase-type model into a unifying framework that was applied to two empirical datasets, one relating to the WT of undergoing colonoscopy from Taiwanese nationwide screening program, and the other pertaining to the LOS on hospitalized CRCs enrolled from one medical centre. Methods The hurdle model was developed in combination with a mixture of the logistic regression model that dealt with the non-compliance part and the truncated Poisson regression model pertaining to the WT distribution. The Coxian phase-type was further developed to identify the optimal hidden phase of WT. To further consider the arrival rate of screenees, we developed the queue hurdle Coxian phase-type model which is the combination of the Poisson process, hurdle model and Coxian phase-type model. Data on the LOS of 178 CRCs were modelled by the Coxian phase-type model to identify the optimal number of hidden phases. Results Part I : From 2004 to 2009, the results of the hurdle model indicate the factors associated with non-compliance for colonoscopy included female, older age group, eastern Taiwan or offshore islands area, rural area, hospital screening unit and prevalent screening rounds, and the factors associated with shorter WT for colonoscopy included middle Taiwan area, main urban area, public health centers screening unit and subsequent screening rounds. Part II : The queue hurdle 2-phase Coxian phase-type model was classified as short- and long waiting phase. The arrival rate was 0.00021 per person-days and the probability of non-compliance with colonoscopy was 0.26. Annually, around 15% subjects were so hesitant to be referred to undergo colonoscopy that they were trapped in long waiting phase. The mean WT of short waiting phase and long waiting phase were 32 days and 169 days, respectively. Further to consider the effect of risk score on the model, the queue hurdle 2-phase Coxian phase-type model indicates the mean WT in short waiting phase were 36 days and 30 days for the low score group and the high score group, separately and 167 days in longer waiting phase among these two groups. Part III : For hospitalization, the LOS with 178 CRCs was modelled by the 3-phase Coxian phase-type model classified as short-stay, medium-stay and longer-stay phase. In the short-stay phase, the expected LOS was 10 days whereas both the medium- and longer-stay phases were 49 days. When gender was taken into account, the LOS was modelled as a 2-phase Coxian phase-type model, short- and long-stay care. It shows that male would discharge or die earlier than female. Regarding age, it shows the elderly would discharge or die earlier than the young. Conclusions A new queue hurdle Coxian phase-type model was developed to solve the queue process, the hurdle issue in relation to the problem of non-compliance with the referral of positive results of screenees to have confirmatory diagnosis, and to identify hidden phases during the WT for undergoing colonoscopy among the referrals and LOS in hospitalization for the treated CRCs.
Blair, Alexandra. "Addressing gaps in colorectal cancer screening in Canada : multilevel determinants of screening, pathways to screening inequalities, and program evaluation". Thèse, 2018. http://hdl.handle.net/1866/22576.
Texto completo