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Background: A treatment algorithm and screening examination have been developed to guide patient management and prospectively determine potential for highly active individuals to succeed with nonoperative care after anterior cruciate ligament rupture.

Objective: To prospectively characterize and classify the entire population of highly active individuals over a 10-year period and provide final outcomes for individuals who elected nonoperative care.

Methods: Inclusion criteria included presentation within 7 months of the index injury and an International Knee Documentation Committee level I or II activity level before injury. Concomitant injury, unresolved impairments, and a screening examination were used as criteria to guide management and classify individuals as noncopers (poor potential) or potential copers (good potential) for nonoperative care.

Results: A total of 832 highly active patients with subacute anterior cruciate ligament tears were seen over the 10-year period; 315 had concomitant injuries, 87 had unresolved impairments, and 85 did not participate in the classification algorithm. The remaining 345 patients (216 men, 129 women) participated in the screening examination a mean of 6 weeks after the index injury. There were 199 subjects classified as noncopers and 146 as potential copers. Sixty-three of 88 potential copers successfully returned to preinjury activities without surgery, with 25 of these patients not undergoing anterior cruciate ligament reconstruction at the time of follow-up.

Conclusion: The classification algorithm is an effective tool for prospectively identifying individuals early after anterior cruciate ligament injury who want to pursue nonoperative care or must delay surgical intervention and have good potential to do so.



NAVIGATION


         

 

Medicsight PLC, an industry leader in and principal developer of Computer-Aided Detection (CAD) and medical image analysis software today announced clinical results from a new study that demonstrated CAD significantly increased the sensitivity of readers in the detection of colorectal cancers in multi-row detector CT (MDCT) colonography (CTC).

 

DxS, a personalised medicine company, has signed an agreement with Amgen Inc. to provide a K-RAS companion diagnostic for Vectibix® (panitumumab) in the United States.

 

People are often reluctant to undergo a routine but painful colonoscopy - but the consequences can be fatal. According to the American Cancer Society, colon cancer is the third most common cancer found in American men and women and kills about 50,000 Americans every year. “85% of those who develop colon cancer have no symptoms or family history,” says Prof. Nadir Arber, a professor of medicine and gastroenterology, at Tel Aviv University’s Sackler Faculty of Medicine.

 

CTC (virtual colonoscopy) is a thin slice CT scan of the abdomen after adequate bowel preparation and colon insufflation in which data are reconstructed providing axial, multiplanar, and endoluminal views, in order to visualize internal colonic wall. Several studies have shown that CTC is a valuable tool to evaluate proximal colon after incomplete colonoscopy, and American Gastroenterologists Association (AGA) recognized that CTC is indicated for adults with failed colonoscopy.

 

Two studies presented at the American College of Gastroenterology’s 73rd Annual Scientific Meeting in Orlando highlight new technologies with the potential to improve the detection of colorectal polyps and flat lesions during colonoscopy. The American College of Gastroenterology endorses colonoscopy as the preferred strategy for colorectal cancer screening because of its remarkable sensitivity in detecting and removing polyps before they become cancerous.

 

Researchers at NorthShore University HealthSystem (NorthShore) and Northwestern University have discovered that fiber optic technology can for the very first time effectively measure blood levels in the colonic lining (mucosa) in humans, thus having potential applications for analyzing risk of colon cancer. The study appears in the October 2008 issue of Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute.

 

More patients stand to benefit from a comprehensive, less invasive method to accurately detect colorectal cancer and precancerous polyps, a multicenter study involving Brown University and institutions nationwide has found. The method, called computerized tomographic (CT) colonography, employs virtual reality technology to produce two- or three-dimensional visualizations that permit a thorough and minimally invasive evaluation of the entire colon and rectum.

 

A new study found that virtual colonoscopy using non invasive X-ray based computed tomography (CT scanning) was 90 per cent effective at finding large pre-cancerous and cancerous growths, but not very effective at finding much smaller growths. The study was the work of a large team of scientists from research centres in the US and Canada, including the Mayo Clinic Arizona, where first author Dr C. Daniel Johnson is based.

 

An effective new method of diagnosing bowel (also known as colorectal, or large bowel) cancer using ‘light’ may soon be available, according to research presented at the British Pharmaceutical Conference (BPC) in Manchester. The technique, known as ‘photodynamic diagnosis’, is already used to diagnose and treat other types of cancers, for example, certain skin cancers.

 

EXACT Sciences Corporation (NASDAQ: EXAS) announced the published results of a study in which stool and blood plasma were assessed, in a head-to-head comparison, for the detection of colorectal cancer (CRC). Using an improved BEAMing DNA detection technology from Johns Hopkins University, study results demonstrated 92 percent sensitivity for detecting CRC in stool samples.




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