Publications by authors named "Jack Winter"
Aim: The aim of this work was to quantify post-colonoscopy colorectal cancer (PCCRC) rates in National Health Service (NHS) Scotland using World Endoscopy Association guidelines, compare incidence between health boards and referral streams and explore comparisons in results with published data from other healthcare systems.
Method: This is a population-based cohort study using NHS Scotland data between 2012 and 2018. All people undergoing colonoscopy between 2012 and 2018 and subsequently diagnosed as having bowel cancer up to 3 years after their investigation were included.
Background: The faecal immunochemical test (FIT) has proven utility for colorectal cancer detection in symptomatic patients. However, most patients with a raised faecal haemoglobin (f-Hb) do not have colorectal cancer. We investigated alternative diagnoses and demographics associated with a raised f-Hb in symptomatic patients.
View Article and Find Full Text PDFPurpose: Faecal Immunochemical Test (FIT) has proven utility for Colorectal Cancer (CRC) detection in symptomatic patients. Most studies have examined FIT in symptomatic patients subsequently referred from primary care. We investigated associations between CRC and FIT in both referred and non-referred symptomatic patients.
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- Lower gastrointestinal symptoms are not very effective in predicting colorectal cancer (CRC), so this study evaluated how well faecal haemoglobin (f-Hb) levels predict CRC during colonoscopy for symptomatic patients.
- The study involved 4,841 patients in three Scottish NHS Boards, finding that only 0.6% of those with low f-Hb (<10 µg/g) were diagnosed with CRC, compared to 9.4% of those with f-Hb ≥10 µg/g and 22.4% with f-Hb ≥400 µg/g.
- The results suggest that patients with f-Hb ≥10 µg/g should be further investigated for CRC, while those with f-Hb <10 µ
Article Synopsis
- - The study aimed to determine the effectiveness of flexible sigmoidoscopy as an addition to traditional faecal occult blood test (FOBT) screening for colorectal cancer in individuals around age 60.
- - Conducted in Scotland with over 51,000 participants, the trial found that flexible sigmoidoscopy had a low uptake (17.8%), with higher rates in men and less in more deprived areas; however, it did detect more neoplasia compared to FOBT alone.
- - Results showed no difference in overall colorectal cancer detection between the two groups, but flexible sigmoidoscopy did significantly increase adenoma and total neoplasia detection rates, indicating it may be a beneficial complementary screening method.
Background: Up to 60% of patients with Crohn's disease need intestinal resection within the first 10 years of diagnosis, and postoperative recurrence is common. We investigated whether mercaptopurine can prevent or delay postoperative clinical recurrence of Crohn's disease.
Methods: We did a randomised, placebo-controlled, double-blind trial at 29 UK secondary and tertiary hospitals of patients (aged >16 years in Scotland or >18 years in England and Wales) who had a confirmed diagnosis of Crohn's disease and had undergone intestinal resection.
Background: Faecal calprotectin (FC) is a non-invasive marker of gastrointestinal inflammation.
Aim: To determine whether higher FC levels in individuals with quiescent Crohn's disease are associated with clinical relapse over the ensuing 12 months.
Methods: A single centre prospective study was undertaken in Crohn's disease patients in clinical remission.
The nonerosive reflux disease-gastroesophageal reflux disease controversy.
Curr Opin Gastroenterol
July 2008
Purpose Of Review: To analyse the concept of nonerosive reflux disease (NERD), examining its evolving definition and its relationship to reflux disease and functional gastrointestinal disorders.
Recent Findings: The advent of the Montreal definition of gastroesophageal reflux disease (GERD) and the Rome III definition of functional upper gastrointestinal disorders has refined the concept of NERD. The high prevalence of GERD symptoms and the strong overlap between GERD and irritable bowel syndrome is due to the influence of NERD.
Background & Aims: Nitrate ingestion leads to high luminal concentrations of nitric oxide being generated where saliva meets gastric acid. Nitric oxide generates N-nitrosative stress on reacting with oxygen at neutral pH. We aimed to ascertain if luminal nitric oxide exerts nitrosative stress in the human upper gastrointestinal tract, and to assess the influence of acid reflux on this phenomenon.
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