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https://www.readbyqxmd.com/read/29350062/telotristat-ethyl-a-novel-agent-for-the-therapy-of-carcinoid-syndrome-diarrhea
#1
Joseph S Dillon, Chandrikha Chandrasekharan
Carcinoid syndrome (CS), characterized by diarrhea and flushing, is present in 20% of patients with neuroendocrine tumors at diagnosis and becomes more frequent with progression. The diarrhea of CS is caused mainly by tumoral secretion of serotonin. It may not be fully controlled by somatostatin analogs, the currently indicated drugs for symptomatic relief. Telotristat ethyl is a novel inhibitor of tryptophan hydroxylase, the rate-limiting enzyme in serotonin biosynthesis. Administration of the drug decreases diarrhea in patients with CS...
January 19, 2018: Future Oncology
https://www.readbyqxmd.com/read/29330194/telotristat-ethyl-in-carcinoid-syndrome-safety-and-efficacy-in-the-telecast-phase-3-trial
#2
Marianne E Pavel, David J Gross, Marta Benavent, Petros Perros, Raj Srirajaskanthan, Richard R P Warner, Matthew H Kulke, Lowell Anthony, Pamela Kunz, Dieter Hörsch, Martin O Weickert, Pablo Lapuerta, Wenjun Jiang, Kenneth Kassler-Taub, Suman Wason, Rosanna Fleming, Douglas Fleming, Rocio García-Carbonero
Telotristat ethyl, a tryptophan hydroxylase inhibitor, was efficacious and well tolerated in the Phase 3 TELESTAR study in patients with carcinoid syndrome (CS) experiencing ≥4 bowel movements per day (BMs/day) while on somatostatin analogs (SSAs). TELECAST, a Phase 3 companion study, assessed safety and efficacy of telotristat ethyl in patients with CS (diarrhea, flushing, abdominal pain, nausea, or elevated urinary 5-hydroxyindoleacetic acid [u5-HIAA]) with <4 BMs/day on SSAs (or ≥1 symptom or ≥4 BMs/day if not on SSAs) during a 12-week double-blind treatment period followed by a 36-week open-label extension (OLE)...
January 12, 2018: Endocrine-related Cancer
https://www.readbyqxmd.com/read/29273478/anesthetic-management-of-patients-with-carcinoid-syndrome-and-carcinoid-heart-disease-the-mount-sinai-algorithm
#3
REVIEW
Javier Castillo, George Silvay, Menachem Weiner
No abstract text is available yet for this article.
November 20, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29233841/small-intestinal-neuroendocrine-tumours-and-fibrosis-an-entangled-conundrum
#4
Anela Blazevic, Johannes Hofland, Leo Hofland, R A Feelders, Wouter W de Herder
Small intestinal neuroendocrine tumours (SI-NETs) are neoplasms characterized by their ability to secrete biogenic amines and peptides. These cause distinct clinical pathology including carcinoid syndrome, marked by diarrhoea and flushing, as well as fibrosis, notably mesenteric fibrosis. Mesenteric fibrosis often results in significant morbidity by causing intestinal obstruction, oedema and ischemia. Although advancements have been made to alleviate symptoms of carcinoid syndrome and prolong the survival of patients with SI-NETs, therapeutic options for patients with mesenteric fibrosis are still limited...
December 12, 2017: Endocrine-related Cancer
https://www.readbyqxmd.com/read/29232344/telotristat-ethyl-for-patients-with-carcinoid-syndrome-associated-with-chest-pain-and-hypertension
#5
Pashtoon Murtaza Kasi
No abstract text is available yet for this article.
January 2018: Pancreas
https://www.readbyqxmd.com/read/29217649/an-unusual-cause-of-hypoxia-getting-to-the-heart-of-the-matter
#6
Daniel Hammersley, Aamire Shamsi, Mohammad Murtaza Zaman, Phillip Berry, Lydia Sturridge
A 63 year old female presented to hospital with progressive exertional dyspnoea over a 6 month period. In the year preceding her admission, she reported an intercurrent history of abdominal pain, diarrhoea and weight loss. She was found to be hypoxic, the cause for which was initially unclear. A ventilation-perfusion scan identified a right-to-left shunt. Transoesophageal echocardiography (TOE) demonstrated a significant right-to-left intracardiac shunt through a patent foramen ovale (PFO); additionally severe tricuspid regurgitation was noted through a highly abnormal tricuspid valve...
December 7, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/29203758/-diffuse-idiopathic-pulmonary-neuroendocrine-cell-hyperplasia-dipnech-an-overview-of-the-cases-diagnosed-at-the-department-of-thoracic-surgery-in-the-years-2010-2014
#7
Mariusz Stefański, Krzysztof Bruliński, Marianna Stefańska
INTRODUCTION: Pulmonary neuroendocrine cells (PNEC) are present in the normal lungs with the incidence of 1 in 2500 epithelial cells. They usually proliferate in the presence of reactive processes related to inflammation and fibrosis of the lung parenchyma. The division of pulmonary neuroendocrine cell hyperplasia proposed by Travis et al. additionally distinguished diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) or proliferation that occurs in people without reactive hyperplasia risk factors...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29202350/case-report-ectopic-cushing-s-syndrome-in-a-young-male-with-hidden-lung-carcinoid-tumor
#8
Ghanem Aljassem, Hazem Aljasem
INTRODUCTION: Ectopic Cushing syndrome is a form of Cushing's in which a tumor outside the pituitary gland produces adrenocorticotropic hormone (ACTH). Small cell carcinoma and carcinoid of the lung comprises half of its cases. The main purpose of this study is to present a case of ectopic Cushing syndrome caused by a hidden lung carcinoid and how to manage it. PRESENTATION OF CASE: Here we present a case of a 26year old young male complains of increased weight and appetite, proximal muscle weakness, easy bruising and appearing of purple striae on his abdomen, with a final diagnosis of ACTH secreting lung carcinoid...
November 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29194046/updates-on-the-biology-of-serotonin-and-tryptophan-hydroxylase
#9
Tara Swami, H Christian Weber
PURPOSE OF REVIEW: To summarize the most recent findings relevant to the biology of serotonin (5-hydroxytryptamine; 5-HT) and the enzyme tryptophan hydroxylase (TPH) in human gastrointestinal disease. RECENT FINDINGS: Serotonin is synthesized in the central nervous system (CNS) and the gastrointestinal tract where it is secreted from enteroendocrine cells. Its biosynthesis is regulated by two isoforms of the enzyme TPH of which TPH1 is localized predominantly in gastrointestinal enteroendocrine cells...
February 2018: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/29176078/one-stage-surgery-for-synchronous-liver-metastasis-from-a-neuroendocrine-tumor-of-the-colon-a-case-report
#10
Nicola Tartaglia, Alessandra Di Lascia, Pasquale Cianci, Alberto Fersini, Francesca Sanguedolce, Roberta Iadarola, Sabino Capuzzolo, Vincenzo Neri, Antonio Ambrosi
INTRODUCTION: Neuroendocrine tumors (NETs) are a heterogeneous group of tumors. NET of colon represent less than 1% of colonic tumors. Synchronous liver metastases, present in 75-80%, are considered significant adverse prognostic indicators. Liver is the second commonest site for metastasis in patients with colorectal neuroendocrine tumors. Available treatment options include surgical resection, chemotherapy, biotherapy. Surgery is the gold standard for curative therapy and it is strictly related to the localization, the grade of tumor, and the stage of disease...
November 20, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29175096/budgetary-impact-of-telotristat-ethyl-a-novel-treatment-for-patients-with-carcinoid-syndrome-diarrhea-a-us-health-plan-perspective
#11
Vijay N Joish, Feride Frech, Pablo Lapuerta
PURPOSE: Telotristat ethyl (TE) was recently approved for carcinoid syndrome diarrhea (CSD) in patients not adequately controlled with somatostatin analog long-acting release (SSA LAR) therapy alone. A budget impact model was developed to determine the short-term affordability of reimbursing TE in a US health plan. METHODS: A budget impact model compared health care costs when CSD is managed per current treatment patterns (SSA LAR, reference drug scenario) versus when TE is incorporated in the treatment algorithm (SSA LAR + TE, new drug scenario)...
November 23, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/29173655/management-of-well-differentiated-gastroenteropancreatic-neuroendocrine-tumors-gepnets-a-review
#12
REVIEW
Gurleen Pasricha, Parikshit Padhi, Nour Daboul, Dulabh K Monga
PURPOSE: Neuroendocrine tumors (NETs) are heterogeneous tumors that arise from the neuroendocrine cells of the digestive tract and other organs, such as the lung, ovary, and thyroid glands. They can be well differentiated or poorly differentiated, and management of these tumors differs for each histologic subtype. We have performed a review of NETs and focused on management of well-differentiated gastroenteropancreatic neuroendocrine tumors (GEPNETs) and carcinoid syndrome. METHODS: A PubMed search was performed to obtain articles on the management of well-differentiated NETs...
November 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/29142475/predictive-factors-associated-with-carcinoid-syndrome-in-patients-with-gastrointestinal-neuroendocrine-tumors
#13
Beilei Cai, Michael S Broder, Eunice Chang, Tingjian Yan, David C Metz
AIM: To discover unknown factors associated with carcinoid syndrome (CS) with the goal of earlier diagnosis of CS. METHODS: In this retrospective case-control study using United States administrative claims, patients (≥ 18 years) newly-diagnosed with gastrointestinal neuroendocrine tumors (GI NETs) without CS (controls) were exactly matched to patients with CS (cases) based on NET diagnosis date at a 3-to-1 ratio. Study index date was first CS diagnosis (controls: same distance from NET diagnosis as cases)...
October 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29138755/paraneoplastic-hepatopathy-associated-with-gastrointestinal-carcinoid
#14
Dhruv Mehta, Priyanka Chugh, Lavneet Chawla, Daniela Jodorkovsky
Paraneoplastic hepatopathy has been reported with various malignancies, most commonly with renal cell cancer. This non-metastatic hepatic dysfunction in such malignancies is known as Stauffer syndrome. We describe a 61-year-old man who presented with symptoms of bowel obstruction with marked cholestasis and high levels of alkaline phosphatase and bilirubin. Imaging revealed an unremarkable liver and a mass in the ileocecal valve with mesenteric lymphadenopathy. Biopsies were consistent with a carcinoid tumor...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29120923/carcinoid-syndrome-recent-advances-current-status-and-controversies
#15
Tetsuhide Ito, Lingaku Lee, Robert T Jensen
PURPOSE OF REVIEW: To review recent advances and controversies in all aspects of carcinoid-syndrome. RECENT FINDINGS: Over the last few years there have been a number of advances in all aspects of carcinoid syndrome as well as new therapies. These include new studies on its epidemiology which demonstrate it is increasing in frequency; increasing insights into the pathogenesis of its various clinical manifestations and into its natural history: definition of prognostic factors; new methods to verify its presence; the development of new drugs to treat its various manifestations, both initially and in somatostatin-refractory cases; and an increased understanding of the pathogenesis, natural history and management of carcinoid heart disease...
February 2018: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/29109490/lower-extremity-vasospasm-caused-by-carcinoid-syndrome
#16
Wala Ben Kridis, Zeinab Guermazi, Héla Mnif, Nabil Toumi, Afef Khanfir, Tahia Boudawara, Mounir Frikha
No abstract text is available yet for this article.
November 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29092118/carcinoid-valve-disease-a-case-report-and-review
#17
Daniel Heikali, Nelson Chang, Ramin Tabibiazar
In patients with carcinoid syndrome, the development of carcinoid valve disease typically carries an unfavorable prognosis. We present the case of a patient with significant valvular dysfunction secondary to carcinoid valve disease. Valve replacement surgery was complicated by the development of prosthetic valve degeneration, ultimately requiring percutaneous valve implantation in a valve-in-valve fashion. The technical details of the case, as well as a review of carcinoid valve disease, including its pathophysiology, clinical manifestations, diagnostic features and management considerations, are presented...
May 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29080935/echocardiography-in-functional-midgut-neuroendocrine-tumors-when-and-how-often
#18
REVIEW
Javier G Castillo, Tara Naib, Jerome S Zacks, David H Adams
The management of patients with midgut neuroendocrine tumors (MNET) is rapidly evolving. Current preoperative detection rates of primary tumor sites are higher than ever and progression-free survival in patients with already advanced disease is expanding due to the implementation of novel efficacious treatment strategies. This survival benefit may potentially translate into a need for a multidisciplinary approach to an even more heterogenous variety of clinical conditions, among these, carcinoid syndrome (CS) and carcinoid heart disease (CHD)...
October 28, 2017: Reviews in Endocrine & Metabolic Disorders
https://www.readbyqxmd.com/read/29074312/understanding-the-patient-experience-with-carcinoid-syndrome-exit-interviews-from-a-randomized-placebo-controlled-study-of-telotristat-ethyl
#19
Lowell Anthony, Claire Ervin, Pablo Lapuerta, Matthew H Kulke, Pamela Kunz, Emily Bergsland, Dieter Hörsch, David C Metz, Janice Pasieka, Nick Pavlakis, Marianne Pavel, Martyn Caplin, Kjell Öberg, John Ramage, Emily Evans, Qi Melissa Yang, Shanna Jackson, Karie Arnold, Linda Law, Dana B DiBenedetti
PURPOSE: Telotristat ethyl, an oral tryptophan hydroxylase inhibitor, is intended to treat carcinoid syndrome by reducing serotonin production. Telotristat ethyl was evaluated in TELESTAR, a Phase III study for patients who had carcinoid syndrome with at least 4 bowel movements (BMs) per day and who were receiving somatostatin analogue therapy. This interview substudy was conducted to provide insight into the patient experience in TELESTAR and to help understand whether reductions in BM frequency (the primary end point) and other symptoms were clinically meaningful...
October 23, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/29071265/freezing-fort-knox-mesenteric-carcinoid-cryoablation
#20
Erik Soule, Arya Bagherpour, Jerry Matteo
BACKGROUND: Neuroendocrine malignancy is indolent, yet relentless in its propensity to metastasize to the liver, where it may cause bizarre paraneoplastic syndromes. The pathophysiologic mechanism behind this predilection for hepatic metastasis is twofold: the portal venous system drains the most likely primary sites for neuroendocrine tumors, and the relatively immunosuppressed environment within the hepatic parenchyma is permissive for tumor growth. The standard of care for patients with metastatic neuroendocrine tumor is surgical resection of at least 90% of the tumor burden...
September 2017: Gastrointestinal Tumors
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