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Carcinoid syndrome

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https://www.readbyqxmd.com/read/29142475/predictive-factors-associated-with-carcinoid-syndrome-in-patients-with-gastrointestinal-neuroendocrine-tumors
#1
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
#2
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
#3
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...
November 7, 2017: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/29109490/lower-extremity-vasospasm-caused-by-carcinoid-syndrome
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/29066637/transcatheter-valve-implantation-to-inferior-vena-cava-to-control-carcinoid-symptoms
#9
Vandana M Sagar, Richard P Steeds, Sagar N Doshi, Tahir Shah
Severe carcinoid syndrome and carcinoid heart disease in neuroendocrine tumours can have a significant impact on a patient's quality of life and are a major cause of morbidity and mortality. We present a novel approach to managing a patient with medically uncontrollable carcinoid syndrome. Inferior and superior vena cava placement of transcatheter heart valves has been used to treat patients with right heart failure due to severe tricuspid and pulmonary regurgitation. However, this procedure has not been attempted to specifically reduce hormone secretion, primarily from the liver, in order to control carcinoid syndrome symptoms...
October 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29051994/telotristat-ethyl-proof-of-principle-and-the-first-oral-agent-in-the-management-of-well-differentiated-metastatic-neuroendocrine-tumor-and-carcinoid-syndrome-diarrhea
#10
REVIEW
Muhammad Masab, Muhammad Wasif Saif
INTRODUCTION: Metastatic neuroendocrine tumors (NETs) are associated with carcinoid syndrome that is typically characterized by diarrhea, cutaneous flushing and bronchospasm. Treatment with somatostatin analogues (SSA) improves the symptom burden but a significant proportion of patients stop responding to SSA therapy eventually. Novel agents with the potential to effectively control the symptoms are urgently needed. METHODS: This article reviews an in-depth analysis of the phase I-III clinical trials determining the clinical rationale for the use of tryptophan hydroxylase inhibitor, telotristat ethyl in patients with well-differentiated metastatic NETs and uncontrolled carcinoid syndrome...
October 19, 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/29051783/a-case-of-pulmonary-carcinoid-in-pregnancy-and-review-of-carcinoid-tumours-in-pregnancy
#11
D Kevat, M Chen, D Wyld, N Fagermo, K Lust
Carcinoid tumours are rare slow growing tumours which arise from primitive neuroendocrine cells. The effect of the pregnant state on carcinoid tumours and vice versa remains unclear, as does the optimal management of carcinoid tumours during the pregnancy including labour. We report the rare case of a 36 year old primigravida woman with large bilateral pulmonary carcinoid tumours. The patient's disease was minimally symptomatic with no clinical suspicion of carcinoid syndrome. Under close observation, the pregnancy progressed well and the patient proceeded to a spontaneous vaginal delivery of a healthy child...
September 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/29040196/carcinoid-syndrome-complicating-a-pancreatic-neuroendocrine-tumor-a-case-report
#12
James N Gerson, Ronald M Witteles, Daniel T Chang, Ramin E Beygui, Andrei H Iagaru, Pamela L Kunz
Neuroendocrine tumors (NETs) comprise a heterogeneous group of neoplasms. These tumors can produce a wide variety of hormones that can lead to syndromes of hormone excess, such as carcinoid syndrome. We present the case of a 47-year-old man who presented with right upper quadrant abdominal pain and emesis. He was found to have metastatic pancreatic NET and was treated with systemic chemotherapy. He subsequently developed dyspnea on exertion and was found to have severe right-sided heart disease secondary to elevated levels of serum serotonin...
November 2017: Pancreas
https://www.readbyqxmd.com/read/29039712/the-management-of-refractory-carcinoid-syndrome-challenges-and-opportunities-ahead
#13
Mauro Cives, Eleonora Pellè, Franco Silvestris
No abstract text is available yet for this article.
November 3, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/29038234/patient-reported-symptom-control-of-diarrhea-and-flushing-in-patients-with-neuroendocrine-tumors-treated-with-lanreotide-depot-autogel-results-from-a-randomized-placebo-controlled-double-blind-and-32-week-open-label-study
#14
George A Fisher, Edward M Wolin, Nilani Liyanage, Susan Pitman Lowenthal, Beloo Mirakhur, Rodney F Pommier, Montaser Shaheen, Aaron Vinik
BACKGROUND: In the double-blind (DB) ELECT study, lanreotide depot/autogel significantly reduced versus placebo the need for short-acting octreotide for symptomatic carcinoid syndrome (CS) control in neuroendocrine tumor (NET) patients. Here we present patient-reported symptom data during DB and initial open-label (IOL) treatment. MATERIALS AND METHODS: Adults with NETs and CS history, with/without prior somatostatin analog use, were randomized to 16 weeks' DB lanreotide 120 mg subcutaneous or placebo every 4 weeks, followed by 32 weeks' IOL lanreotide...
October 16, 2017: Oncologist
https://www.readbyqxmd.com/read/29019733/late-onset-myasthenia-gravis-and-carcinoid-tumour-paraneoplastic-syndrome
#15
L Fratalia, A J Larner
No abstract text is available yet for this article.
October 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28982960/management-of-endocrine-disease-flushing-current-concepts
#16
REVIEW
Isabel Huguet, Ashley Grossman
OBJECTIVE: Flushing can be defined as a sensation of warmth accompanied by erythema that most commonly is seen on the face and which occurs in episodic attacks. Such a problem can be clinically problematic, since many conditions and drugs can be related to flushing, and while often there appears to be no underlying organic disease, it is important to exclude disorders since they may be life-threatening conditions. DESIGN AND METHODS: We performed a search in MEDLINE using the terms 'flushing' in combination with 'carcinoid syndrome', 'pheochromocytoma', 'mastocytosis', 'menopausal hot flush' and 'treatment'...
November 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28971023/metastatic-primary-testicular-carcinoid-tumor-managed-with-radical-orchiectomy-retroperitoneal-lymph-node-dissection-and-inferior-vena-cava-excision-case-report
#17
H K Bangash, D Hayne, I A Thyer
Metastatic primary testicular carcinoid tumor remains a very rare condition. We report the first case of metastatic primary testicular carcinoid tumor where along retroperitoneal lymph node dissection excision of the Inferior Vena Cava was also performed. The rarity is further emphasised by the presence of a contralateral testicular dermoid cyst. Given the features of the tumor were not in keeping with the traditional predictors of metastases (primary tumor >7.3 cm, poor differentiation and the presence of carcinoid syndrome) this case adds valuable addition to the relatively limited literature available on this rare condition...
November 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28959913/cost-effectiveness-analysis-of-telotristat-ethyl-for-treatment-of-carcinoid-syndrome-diarrhea-inadequately-controlled-with-somatostatin-analogs
#18
V N Joish, F Frech, P Lapuerta
AIMS: This study evaluated the cost-effectiveness of telotristat ethyl (TE) added to somatostatin analog octreotide (SSA + TE) compared to octreotide alone (SSA) in patients with carcinoid syndrome diarrhea (CSD) whose symptoms remain uncontrolled with SSA alone. MATERIALS AND METHODS: A deterministic Markov model evaluated the costs and quality-adjusted life-years (QALY) gained with SSA + TE vs SSA per a third-party US payer perspective. The model reflected clinical practice and resource use estimates based on current standards of care, with utility estimates based on similar symptoms from ulcerative colitis...
October 9, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28923213/long-acting-somatostatin-analogues-in-the-treatment-of-unresectable-metastatic-neuroendocrine-tumors
#19
REVIEW
Thomas Enzler, Tito Fojo
Neuroendocrine tumors (NETs) are a relatively rare and heterogeneous group of neoplasms with an annual incidence of ~35 cases per 100,000 people in the United States. The updated World Health Organization (WHO) classification system of gastroenteropancreatic (GEP)-NETs categorizes these tumors according to site of origin, clinical syndrome, and degree of differentiation. Well-differentiated NETs arising from the gastrointestinal tract or lungs (formerly known as carcinoid tumors) are often indolent and slow-growing...
April 2017: Seminars in Oncology
https://www.readbyqxmd.com/read/28904734/a-17-year-old-male-with-a-small-bowel-neuroendocrine-tumor-flushing-differential-diagnosis
#20
Maria Alejandra Forero Molina, Elizabeth Garcia, Deyanira Gonzalez-Devia, Rafael García-Duperly, Alonso Vera
BACKGROUND: Neuroendocrine tumors (NETs) are heterogeneous neoplasms that originate from cells with a secretory function. Small bowel NETs (SB-NETs) are related to serotonin hypersecretion which causes: flushing, diarrhea, abdominal pain, bronchoconstriction and heart involvement, also known as carcinoid syndrome (CS). CS can be confused with an allergic reaction and thus should be considered as a differential diagnosis in the allergy consult. We present the case of a pediatric patient initially referred under the suspicion of food allergies...
2017: World Allergy Organization Journal
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