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https://www.readbyqxmd.com/read/29157619/diagnosis-of-castleman-disease
#1
REVIEW
Raphaël Szalat, Nikhil C Munshi
Castleman disease (CD) is a rare and heterogenous group of disorders sharing in common an abnormal lymph node pathology. CD comprises distinct subtypes with different prognoses. Unicentric CD and multicentric CD are featured by specific systemic manifestations and may be associated with Kaposi sarcoma, non-Hodgkin and Hodgkin lymphoma, and POEMS syndrome. Multicentric CD is classically associated with systemic symptoms and poorer prognosis. In this article, the authors review how to diagnose the disease, keeping in context the clinical findings, biochemical changes and complications associated with CD...
February 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/29157616/the-peripheral-neuropathies-of-poems-syndrome-and-castleman-disease
#2
REVIEW
Michelle L Mauermann
Polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, skin changes (POEMS) syndrome is a rare paraneoplastic disorder. The polyneuropathy can be the presenting symptom and is typically a painful, motor-predominant polyradiculoneuropathy often mimicking chronic inflammatory demyelinating polyradiculoneuropathy. The presence of a lambda monoclonal protein, elevated vascular endothelial growth factor, systemic features, and treatment resistance are clues to the diagnosis. Castleman disease (CD) is seen in a subset of these patients, and when present the neuropathy is similar but less severe...
February 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/29157615/poems-syndrome-therapeutic-options
#3
REVIEW
Arnaud Jaccard
Treatment of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome should be directed at the underlying plasma cell clone with risk-adapted therapy based on the extent of the plasma cell disorder. Radiation therapy is effective for patients with a localized presentation, without bone marrow involvement, and 1 to 3 bone lesions. Patients with disseminated disease should receive, preferably, high-dose chemotherapy with peripheral blood transplantation. Low-dose melphalan and dexamethasone or new agents used in myeloma are also effective...
February 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/29157614/poems-syndrome-diagnosis-and-investigative-work-up
#4
REVIEW
Angela Dispenzieri, Taxiarchis Kourelis, Francis Buadi
POEMS syndrome is a rare paraneoplastic syndrome secondary to a plasma cell dyscrasia. Recognition of a combination of peripheral neuropathy, organomegaly, endocrinopathy, monoclonal plasmaproliferative disorder, skin changes, papilledema, extravascular volume overload, sclerotic bone lesions, thrombocytosis, and Castleman disease is the first step in managing the disease. Increased blood levels of vascular endothelial growth factor are usually confirmatory. This rare disorder should not be missed, especially if the patient has a putative diagnosis of chronic inflammatory polyradiculoneuropathy, a lambda restricted monoclonal gammopathy, and thrombocytosis, and is not responding as expected to immunomodulatory therapy commonly used for chronic inflammatory polyradiculoneuropathy...
February 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/29157613/castleman-disease-pathogenesis
#5
REVIEW
David C Fajgenbaum, Dustin Shilling
Castleman disease (CD) describes a group of heterogeneous disorders with common lymph node histopathologic features, including atrophic or hyperplastic germinal centers, prominent follicular dendritic cells, hypervascularization, polyclonal lymphoproliferation, and/or polytypic plasmacytosis. The cause and pathogenesis of the four subtypes of CD (unicentric CD; human herpesvirus-8-associated multicentric CD; polyradiculoneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, and skin changes [POEMS]-associated multicentric CD; and idiopathic multicentric CD) vary considerably...
February 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/29156013/a-novel-strategy-to-initiate-a-peroral-endoscopic-myotomy-program
#6
J Matthew Reinersman, Dennis A Wigle, Christopher J Gostout, Louis M Wong Kee Song, Shanda H Blackmon
OBJECTIVES: The standard of care for achalasia remains laparoscopic Heller myotomy with partial fundoplication. Peroral endoscopic myotomy (POEM) has been introduced as an alternative, but safety and long-term comparative efficacy are not yet established. We report our experience in developing a POEM program using a novel hybrid approach. METHODS: We developed a hybrid approach to POEM with a POEM followed by laparoscopic evaluation, extension of the myotomy, if necessary, and partial fundoplication...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29144018/navigated-retrograde-endoscopic-myotomy-rem-for-the-treatment-of-therapy-resistant-achalasia
#7
K D Pham, R F Havre, T Langø, E F Hofstad, G A Tangen, R Mårvik, T Pham, O H Gilja, J G Hatlebakk, A Viste
BACKGROUND: In achalasia, muscle spasm may involve the proximal esophagus. When the muscle spasm is located in the proximal esophagus, conventional per oral endoscopic myotomy (POEM) may not be sufficient to relieve symptoms. In this paper, we describe retrograde endoscopic myotomy (REM) as a novel approach to perform myotomy of the proximal esophagus, with the application of a navigation tool for anatomical guidance during REM. We aim to evaluate the feasibility and safety of REM and usefulness of the navigation during REM...
November 16, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29134329/esophageal-motility-disorders-new-perspectives-from-high-resolution-manometry-and-histopathology
#8
REVIEW
Hiroki Sato, Kazuya Takahashi, Ken-Ichi Mizuno, Satoru Hashimoto, Junji Yokoyama, Go Hasegawa, Shuji Terai
High-resolution manometry (HRM) and peroral endoscopic myotomy (POEM) have contributed significantly to the field of esophageal motility disorders in recent years. The development of HRM has categorized various esophageal motility disorders with a focus on a diverse range of manometric anomalies. Additionally, the Chicago classification criteria is widely used for manometric diagnosis. Moreover, POEM was introduced as a minimally invasive radical therapy for achalasia and shows promise for other spastic esophageal motility disorders as well...
November 13, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/29122601/per-oral-endoscopic-myotomy-in-patients-with-or-without-prior-heller-myotomy-comparing-long-term-outcomes-in-a-large-u-s-single-center-cohort-with-videos
#9
Xiaocen Zhang, Rani J Modayil, David Friedel, Krishna C Gurram, Collin E Brathwaite, Sharon I Taylor, Maria M Kollarus, Sony Modayil, Bhawna Halwan, James H Grendell, Stavros N Stavropoulos
BACKGROUND AND AIMS: Heller myotomy (HM) is one of the most effective treatments for esophageal achalasia. However, failures do exist and the success rate tends to decrease with time. The efficacy of rescue treatments for patients with failed Heller is limited. A few small-scale studies have reported outcomes of per-oral endoscopic myotomy (POEM) in these patients. We conducted this study to systematically assess feasibility, safety, and efficacy of POEM on post-Heller patients. METHODS: Patients at least 3 months out from their POEM were selected from our prospective database: 318 consecutive POEMs performed from October 2009 to October 2016...
November 6, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29113155/poems-syndrome-presentation-with-progressive-weakness-in-upper-and-lower-limbs-a-case-report
#10
Chuang-Jie Cao, Cheng-Yun Dou, Ke-Hua Zhou, Jin-Bo Liu, Hong Lai
Polyneuropathy, organomegaly, endocrinopathy, M proteins, and skin changes (POEMS) syndrome is a rare variant of plasma cell disorders with multiple systemic manifestations. A 50-year-old female patient presented with progressive weakness in her upper and lower limbs; tingling, numbness and burning in her feet; polyneuropathy (demyelinating in the majority of cases of POEMS syndrome); monoclonal plasma cell disorder (typicallyλ-restricted in cases of POEMS syndrome); sclerotic lesions on the spine and pelvis; organomegaly, including hepatomegaly, splenomegaly and lymphadenopathy; edema; pleural effusion; adrenal, thyroidal, pituitary, gonadal and pancreatic endocrinopathy; skin changes, including hyperpigmentation, dry skin and hypertrichosis; thrombocytosis; pulmonary hypertension; low vitamin B12 and weight loss...
November 2017: Oncology Letters
https://www.readbyqxmd.com/read/29113005/is-integrated-relaxation-pressure-a-promising-predictor-of%C3%A2-effectiveness-of-peroral-endoscopic-myotomy-for-achalasia
#11
Hong Jin, Wei Zhao, Lili Zhang, Zhongqing Zheng, Tao Wang, Lanlan Wu, Bangmao Wang
Background Peroral endoscopic myotomy (POEM), first introduced in 2010, appears to be an effective therapy with few complications. This study aimed to find an optimal predictor of POEM outcome in achalasia. Methods We retrospectively assessed 89 patients diagnosed with achalasia who underwent POEM in General Hospital of Tianjin Medical University, from September 2012 to March 2015. Associations of Eckardt score with symptom duration, lower esophageal resting pressure, 4-second integrated relaxation pressure (4s-IRP), and maximum esophageal diameter were assessed before POEM...
November 7, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29108981/outcomes-of-per-oral-endoscopic-myotomy-for-treatment-of-esophageal-achalasia-with-a-median-follow-up-of-49-months
#12
Quan-Lin Li, Qiu-Ning Wu, Xiao-Cen Zhang, Mei-Dong Xu, Wei Zhang, Shi-Yao Chen, Yun-Shi Zhong, Yi-Qun Zhang, Wei-Feng Chen, Wen-Zheng Qin, Jian-Wei Hu, Ming-Yan Cai, Li-Qing Yao, Ping-Hong Zhou
BACKGROUND AND AIMS: Per-oral endoscopic myotomy (POEM) has received wide acceptance as a highly effective and safe treatment for esophageal achalasia. Short-term and small-scale studies are ample but long-term large-scale studies are few. The aim of the study was to systematically analyze our long-term results of POEM, with particular emphasis on POEM failures and associated risk factors. METHODS: This is a single-center study. Consecutive POEM patients between August 2010 and December 2012 were included...
November 3, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29102729/gastroesophageal-reflux-disease-after-per-oral-endoscopic-myotomy-as-compared-with-heller-s-myotomy-with-fundoplication-a-systematic-review-with-meta-analysis
#13
REVIEW
Alessandro Repici, Lorenzo Fuccio, Roberta Maselli, Fabrizio Mazza, Loredana Correale, Daniele Mandolesi, Cristina Bellisario, Amrita Sethi, Mouen Kashab, Thomas Rösch, Cesare Hassan
BACKGROUND AND AIMS: Per-oral endoscopic myotomy (POEM) represents a less invasive alternative, as compared with conventional laparoscopic Heller's myotomy (LHM), for achalasia patients. It cannot be excluded, however, that the lack of fundoplication after POEM may result in a higher incidence of reflux disease, as compared with LHM. The aim was to conduct a systematic review of prospective studies reporting the incidence of reflux disease developed after POEM and LHM. METHODS: Literature search with electronic databases was performed (up to February 2017) to identify full articles on the incidence of gastro-esophageal reflux symptoms, endoscopic- and pH-monitoring-findings after POEM and LHM (with fundoplication)...
November 1, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29100675/skull-base-plasmacytoma-a-unique-case-of-poems-syndrome-with-a-plasmacytoma-causing-craniocervical-instability
#14
Hannah Gilder, Meghan E Murphy, Mohammed Ali Alvi, Panagiotis Kerezoudis, Daniel Shepherd, Patrick R Maloney, Michael J Yaszemski, Jonathan M Morris, Angela Dispenzieri, Jane M Matsumoto, Mohamad Bydon
INTRODUCTION: Plasmacytomas, considered to be the solitary counterparts of multiple myeloma, are neoplastic monoclonal plasma cell proliferations within soft tissue or bone. Plasmacytomas often present as a collection of findings known as POEMS-syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, M-Protein spike, and Skin changes). CASE DESCRIPTION: We present a report of a 47 yo male diagnosed with POEMS-syndrome secondary to a skull base plasmacytoma. The mass resulted in marked instability of the cranio-cervical junction due to bony erosion...
October 31, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29092839/the-clearing-poems-by-doctors
#15
Daniel Racey
No abstract text is available yet for this article.
November 2017: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/29089698/laparoscopic-heller-s-myotomy-for-achalasia-cardia-one-time-treatment-in-developing-countries
#16
Vishal Gupta, Hunaid Hatimi, Saket Kumar, Abhijit Chandra
Laparoscopic Heller's myotomy (LHM) and endoscopic balloon dilation are two main treatment modalities for achalasia cardia. The best treatment modality in Indian setting, however, is still unknown. Here, we present the early results of LHM in achalasia. Hospital data from January 2009 to October 2013 was analyzed. Preoperative assessment included Eckardt's scoring, esophagogastroduodenoscopy, barium swallow examination, and esophageal manometry. Thirty-five patients (19 males and 16 females, median age 31 years, range 12-65) underwent LHM with partial fundoplication (with intraoperative endoscopy)...
October 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29078682/the-current-state-of-per-oral-endoscopic-myotomy-for-achalasia
#17
REVIEW
Shane P Smith, Brian E Louie
Achalasia is an acquired neuromuscular disorder that has been treated using a variety of modalities throughout medical history. Recently, the technique of per oral endoscopic myotomy (POEM) was introduced to treat the disease using a truly minimally invasive, natural orifice technique that is rapidly being adopted across the world. This review outlines the development of POEM, the technique itself, and gives a comparison to other procedures, specifically laparoscopic Heller myotomy (LHM).
2017: J Vis Surg
https://www.readbyqxmd.com/read/29072527/william-osler-and-the-fixed-period-of-creativity
#18
Charles T Ambrose
In 1905, William Osler was the pre-eminent physician in American medical circles but was unknown to the general public. The latter suddenly learned of him through damning newspaper accounts of his address announcing his retirement from the Johns Hopkins Medical School. In it Osler mentioned two "fixed ideas" he held-(1) that most major advances in civilization have been made by men under age 40 (the "fixed period") and (2) that those over 60 should retire because they create little of significance and sometimes stifled the initiatives of younger colleagues...
January 1, 2017: Journal of Medical Biography
https://www.readbyqxmd.com/read/29056130/an-adult-with-polyneuropathy-and-hypogonadism-due-to-poems-syndrome
#19
Saba Zaidi, Sidra Sattar, Khealani Bhojo Asumal
POEMS (acronym for polyneuropathy, organomegaly, endocrinopathy, M protein myeloma and skin changes), is a rare disease which occurs in the setting of plasma cell dyscrasias. We describe a case of an adult lady who presented with gradual onset weakness of all four limbs and multisystem involvement characterized by pedal edema, ascites, hyperpigmentation and hypogonadism. Nerve conduction study showed severe sensorimotor polyneuropathy. Serum immunofixation showed lambda light chain restricted monoclonal gammopathy...
October 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29048751/severity-strata-for-five-patient-reported-outcomes-in-adults-with-atopic-dermatitis
#20
P P Vakharia, R Chopra, R Sacotte, N Patel, S Immaneni, T White, R Kantor, D Y Hsu, E L Simpson, J I Silverberg
BACKGROUND: Multiple patient-reported outcomes have been used to assess the burden of atopic dermatitis (AD). Some are disease specific, e.g. the Patient Oriented Eczema Measure (POEM). While others pertain to itch, e.g. Numerical Rating Scale (NRS)-itch, ItchyQoL and 5-D itch, or dermatologic disease in general, e.g. Dermatology Life Quality Index (DLQI). Development of severity strata is essential for proper interpretability of these assessments. We sought to confirm previously developed strata for POEM, DLQI and raw ItchyQoL, and develop strata for the NRS-itch, mean ItchyQOL and 5-D itch scale for use in adults with AD...
October 19, 2017: British Journal of Dermatology
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