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https://www.readbyqxmd.com/read/28918550/advance-care-planning-challenges-at-the-emergency-department-of-a-cancer-care-center
#1
Maria T Cruz-Carreras, Patrick Chaftari, Jayne Viets-Upchurch
INTRODUCTION: Code status discussions form an important part of advance care planning (ACP) as it enables physicians to respect the patient's wishes for end-of-life care. However, in some cases, code status discussions can be challenging causing the physician to go against the patient's wishes and the code of medical ethics. This is especially true in an emergency setting. In this paper, we will discuss three cases of advanced cancer patients, where code status discussions posed challenges to healthcare providers...
September 16, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28915970/a-new-proposed-mechanism-of-action-for-gastric-bypass-surgery-air-hypothesis
#2
Hasan Celiker
Roux-en-Y gastric bypass (RYGB) surgery is one of the most effective treatments for obesity and type II diabetes. RYGB was originally believed to work by mechanically restricting caloric intake or causing macronutrient malabsorption. However, such mechanical effects play no role in the remarkable efficacy of gastric bypass. Instead, mounting evidence shows that altered neuroendocrine signaling is responsible for the weight reducing effects of RYGB. The exact mechanism of this surgical response is still a mystery...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28915689/different-long-term-oncologic-outcomes-after-radical-surgical-resection-for-neuroendocrine-carcinoma-and-adenocarcinoma-of-the-stomach
#3
Jian-Wei Xie, Jun Lu, Jian-Xian Lin, Chao-Hui Zheng, Ping Li, Jia-Bin Wang, Qi-Yue Chen, Long-Long Cao, Mi Lin, Ru-Hong Tu, Chang-Ming Huang
PURPOSE: To explore differences in long-term outcomes between gastric neuroendocrine carcinoma (GNEC) and gastric adenocarcinoma (GAC). METHODS: One hundred GNEC patients and 3089 GAC patients were enrolled. Differences in long-term outcomes between the groups were analyzed by 1:2 propensity score matching. RESULTS: Statistically significant differences between the groups were noted in terms of gender, American Society of Anesthesiologists score, tumor size, T stage, N stage, TNM stage and surgical approach...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28912412/-a-case-of-advanced-neuroendocrine-cell-carcinoma-of-the-stomach-treated-with-s-1-and-cisplatin-chemotherapy
#4
Mikiko Sakuraya, Yoshimasa Shimizu, Nobuo Tachikawa, Hitoshi Hara, Masaki Ohashi, Tomoo Shatari, Masao Hori
A 69-year-old man presented to our hospital because of epigastric pain. A type 2 lesion was seen in the lesser curvature of the antrum of the stomach. A moderately differentiated adenocarcinoma(human epidermal growth factor receptor 2-negative) was diagnosed by biopsy. Abdominal computed tomography showed a mass shadow 52mm in diameter in the pyloric region invading the surrounding organs, but no evidence of distant metastasis. Chemotherapy with S-1 and cisplatin(SP therapy)was initiated because of a diagnosis of locally advanced gastric cancer...
September 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28902909/the-cytoprotective-protein-clusterin-is-overexpressed-in-hypergastrinemic-rodent-models-of-oxyntic-preneoplasia-and-promotes-gastric-cancer-cell-survival
#5
Pål Vange, Torunn Bruland, Berit Doseth, Reidar Fossmark, Mirta M L Sousa, Vidar Beisvag, Øystein Sørdal, Gunnar Qvigstad, Helge L Waldum, Arne K Sandvik, Ingunn Bakke
The cytoprotective protein clusterin is often dysregulated during tumorigenesis, and in the stomach, upregulation of clusterin marks emergence of the oxyntic atrophy (loss of acid-producing parietal cells)-associated spasmolytic polypeptide-expressing metaplasia (SPEM). The hormone gastrin is important for normal function and maturation of the gastric oxyntic mucosa and hypergastrinemia might be involved in gastric carcinogenesis. Gastrin induces expression of clusterin in adenocarcinoma cells. In the present study, we examined the expression patterns and gastrin-mediated regulation of clusterin in gastric tissue from: humans; rats treated with proton pump (H+/K+-ATPase) inhibitors and/or a gastrin receptor (CCK2R) antagonist; H+/K+-ATPase β-subunit knockout (H/K-β KO) mice; and Mongolian gerbils infected with Helicobacter pylori and given a CCK2R antagonist...
2017: PloS One
https://www.readbyqxmd.com/read/28900990/-prognostic-value-of-carcinoembryonic-antigen-alpha-fetoprotein-carbohydrate-antigen-125-and-carbohydrate-antigen-19-9-in-gastroenteropancreatic-neuroendocrine-neoplasms
#6
Luohai Chen, Yu Zhang, Minhu Chen, Jie Chen
OBJECTIVE: To study the rate of elevated common biomarkers of digestive tumors, including carcinoembryonic antigen (CEA), alpha fetoprotein (AFP), carbohydrate antigen 125 (CA125) and carbohydrate antigen 19-9 (CA19-9), in gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) and their prognostic values in GEP-NEN. METHODS: Clinicopathological data of patients with GEP-NEN treated in The First Affiliated Hospital, Sun Yat-sen University from January 2011 to December 2016 were retrospectively studied...
September 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28900986/-consensus-and-controversy-on-subtype-classification-of-gastric-neuroendocrine-neoplasms
#7
Huangying Tan
Gastric neuroendocrine neoplasms (g-NENs) are a heterogeneous group of tumors. Often silent, g-NENs may however be aggressive and sometimes mimic the course of gastric adenocarcinoma. Well-differentiated gastric neuroendocrine tumors (NET) can be subclassified into 3 distinct groups (type1, type 2 and type 3) according to Neuroendocrine Neoplasm Society (ENETS) guideline version 2006 as well as North America Neuroendocrine Tumor Society (NANETS) and National Comprehensive Cancer Network (NCCN) guidelines. However, since the publication of ENETS guideline version 2012, the subtype classification of g-NENs has been confusing due to the revised definition of type 3 g-NEN in versions 2012 and 2016...
September 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28887853/neuroendocrine-mechanisms-underlying-bariatric-surgery-insights-from-human-studies-and-animal-models
#8
REVIEW
Aneta Stefanidis, Brian J Oldfield
Obesity has reached epidemic proportions and to date, bariatric surgery remains the only effective treatment for morbid obesity in terms of its capacity to achieve durable weight loss. Bariatric surgery procedures, including Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB) and sleeve gastrectomy (SG) have been the primary procedures conducted over the past decade, with SG increasing in popularity over the past five years at the expense of both RYGB and AGB. Although these procedures were initially proposed to function via restrictive or malabsorptive mechanisms, it is now clear that profound physiological changes underlie the metabolic improvements in patients who undergo bariatric surgery...
September 8, 2017: Journal of Neuroendocrinology
https://www.readbyqxmd.com/read/28876642/outcome-of-liver-resection-for-carcinoid-neuroendocrine-metastases
#9
M D Polkinghorne, J E J Krige, E Jonas, U K Kotze, M M Bernon
BACKGROUND: Gastrointestinal carcinoid tumours, despite their low malignant potential, frequently metastasize to the liver. While liver resection improves survival and provides symptomatic relief, multifocal bilobar disease complicates surgical management. METHOD: All patients with carcinoid liver secondaries managed by resection from 1990-2015 were identified from a prospective departmental database. Demographic data, operative management, morbidity using the Accordion classification and mortality were analysed...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28859856/gastrin-induces-nuclear-export-and-proteasome-degradation-of-menin-in-enteric-glial-cells
#10
Sinju Sundaresan, Cameron A Meininger, Anthony J Kang, Amanda L Photenhauer, Michael M Hayes, Nirakar Sahoo, Jolanta Grembecka, Tomasz Cierpicki, Lin Ding, Thomas J Giordano, Tobias Else, David J Madrigal, Malcolm J Low, Fiona Campbell, Ann-Marie Baker, Haoxing Xu, Nicholas A Wright, Juanita L Merchant
BACKGROUND & AIMS: The multiple endocrine neoplasia, type 1 (MEN1) locus encodes the nuclear protein and tumor suppressor menin. MEN1 mutations frequently cause neuroendocrine tumors (NETs) such as gastrinomas, characterized by their predominant duodenal location and local metastasis at time of diagnosis. Diffuse gastrin cell hyperplasia precedes the appearance of MEN1 gastrinomas, which develop within submucosal Brunner's glands. We investigated how menin regulates expression of the gastrin gene and induces generation of submucosal gastrin-expressing cell hyperplasia...
August 28, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28855982/peritoneal-metastases-of-rare-carcinomas-treated-with-cytoreductive-surgery-and-hipec-a-single-center-case-series
#11
Andreas Brandl, Christina Barbara Zielinski, Wieland Raue, Johann Pratschke, Beate Rau
INTRODUCTION: In selected cases, cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is an established treatment for patients suffering from peritoneal metastases from colorectal, ovarian, gastric or appendiceal origin. The effectiveness of this extensive has not been elucidated within other rare diseases by now. METHODS: We conducted a retrospective analysis of patients treated with CRS for peritoneal carcinomatosis during the period between July 2010 and September 2015...
October 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28835367/fgfr2-amplification-in-colorectal-adenocarcinoma
#12
Jamal H Carter, Catherine E Cottrell, Samantha McNulty, Katinka A Vingh-Conrad, Stephen Lamp, Jonathan W Heusel, Eric J Duncavage
FGFR2 is recurrently amplified in 5% of gastric cancers and 1-4% of breast cancers; however, this molecular alteration has never been reported in a primary colorectal cancer specimen. Preclinical studies indicate that several FGFR tyrosine-kinase inhibitors (TKI), such as AZD4547, have in vitro activity against the FGFR2-amplified colorectal cell line, NCI-H716. The efficacy of these inhibitors is currently under investigation in clinical trials for breast and gastric cancer. Thus, better characterizing colorectal tumors for FGFR2 amplification could identify a subset of patients who may benefit from FGFR TKI therapies...
August 23, 2017: Cold Spring Harbor Molecular Case Studies
https://www.readbyqxmd.com/read/28808875/ssat-state-of-the-art-conference-current-surgical-management-of-gastric-tumors
#13
Jeffrey A Norton, Teresa Kim, Joseph Kim, Martin D McCarter, Kaitlyn J Kelly, Joyce Wong, Jason K Sicklick
INTRODUCTION: The current era of gastric surgery is marked by low morbidity and mortality rates, innovative strategies to approach resections with a minimally invasive fashion or hyperthermic intraperitoneal chemotherapy (HIPEC), as well as improved understanding of the biology of sporadic and hereditary stromal, neuroendocrine, and epithelial malignancies. METHODS: In 2017, the Society for Surgery of the Alimentary Tract convened a State-of-the-Art Conference on Current Surgical Management of Gastric Tumors with both international experts and emerging leaders in the field of gastric surgery...
August 14, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28710883/an-atypical-type-i-gastric-neuroendocrine-tumor
#14
Andrada-Viorela Gheorghe, Mihai Rimbas, Octav Ginghina, Andrada Spanu, Theodor Alexandru Voiosu
BACKGROUND: Gastric neuroendocrine tumors(GI-NETs) are rare lesions, usually discovered incidentally during endoscopy. Based on their pathology, there are 4 types of GI-NETs. Type I are multiple small polypoid lesions with central ulceration located in the gastric body or the fundus, associated with atrophic gastritis usually noninvasive and very rarely metastatic. We report on a rare case of a gastric NET arising from the muscularis propria layer of the pyloric ring. CASE REPORT: We present the case of a 65-year old woman with a history of alcoholic cirrhosis, investigated for melena...
July 14, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/28685792/digestive-neuroendocrine-tumors-reclassifying-of-26-cases-according-to-2010-who-classification
#15
Abir Chaabane, Issam M'sakni, Basma Laabidi, Fathi Bougrine, Ammar Bouziani
BACKGROUND: The classification of digestive neuroendocrine tumors is difficult due to their heterogeneity and rareness. AIMS: Reclassify the digestive neuroendocrine tumors according  to  the  WHO-2010 classification .  Methods: A retrospective study included   26 patients having digestive neuroendocrine     tumors ,  is achieved  in our  Pathology  Laboratory  of the Military Hospital of  Tunis between 2000 and 2013. RESULTS: The mean age of patients was 49...
October 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28685026/cholecystokinin-induced-satiety-a-key-gut-servomechanism-that-is-affected-by-the-membrane-microenvironment-of-this-receptor
#16
REVIEW
A J Desai, M Dong, K G Harikumar, L J Miller
The gastrointestinal (GI) tract has a central role in nutritional homeostasis, as location for food ingestion, digestion and absorption, with the gut endocrine system responding to and regulating these events, as well as influencing appetite. One key GI hormone with the full spectrum of these activities is cholecystokinin (CCK), a peptide released from neuroendocrine I cells scattered through the proximal intestine in response to fat and protein, with effects to stimulate gall bladder contraction and pancreatic exocrine secretion, to regulate gastric emptying and intestinal transit, and to induce satiety...
December 2016: International Journal of Obesity Supplements
https://www.readbyqxmd.com/read/28664383/the-slow-progressive-nature-of-duodenal-neuroendocrine-tumor-a-case-report-of-long-term-observation-over-14%C3%A2-years
#17
Kiichi Takahashi, Waku Hatta, Tomoyuki Koike, Takeshi Kanno, Nobuyuki Ara, Kiyotaka Asanuma, Naoki Asano, Akira Imatani, Fumiyoshi Fujishima, Hironobu Sasano, Tooru Shimosegawa
The number of duodenal neuroendocrine tumors has recently increased, but their natural history has not been well characterized. Here we report the case of a 59-year-old female undergoing complete resection by endoscopic mucosal resection after monitoring endoscopic morphologic changes and the size increment of a duodenal neuroendocrine tumor over the longest follow-up duration. An elevated lesion was initially detected on the duodenal bulb. Endoscopic biopsy from this lesion was performed three times during the follow-up, but all of the specimens simply demonstrated the presence of gastric metaplasia...
June 29, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28649475/solid-pseudopapillary-tumor-of-the-pancreas-an-unusual-cause-of-abdominal-pain
#18
Talal El Imad, Fady G Haddad, Mayurathan Kesavan, Liliane Deeb, Sherif Andrawes
Solid-pseudopapillary neoplasm (SPN) of the pancreas is a rare tumor that accounts for less than one percent of pancreatic tumors. The diagnosis could be challenging as SPN tend to manifest with nonspecific abdominal symptoms, variable radiological features, and inconsistent morphology. The cellular origin of SPN is unclear and might involve ductal, acinar and endocrine stem cells.  We report a rare case of a 27-year-old female who presented with intermittent abdominal pain for two years, associated with a decrease in appetite...
May 16, 2017: Curēus
https://www.readbyqxmd.com/read/28626594/a-case-report-gastric-mixed-neuroendocrine-nonneuroendocrine-neoplasm-with-aggressive-neuroendocrine-component
#19
Quang Duy Pham, Ichiro Mori, Robert Y Osamura
Mixed neuroendocrine-nonneuroendocrine neoplasm (MiNEN) is defined as mixed epithelial neoplasms composed of both neuroendocrine and nonneuroendocrine components with variable proportions for each component. Neuroendocrine component can show morphological features including well- or poorly differentiated neuroendocrine neoplasms and nonneuroendocrine component can present different tumor types depending on the site of origin. Recently, studies of tumors have shown that MiNENs are not as rare as our traditional belief, due to the wide application for immunohistochemistry...
2017: Case Reports in Pathology
https://www.readbyqxmd.com/read/28625066/a-rectal-neuroendocrine-neoplasm
#20
Modesto J Varas Lorenzo, Fernando Muñoz Agel
The incidence of gastric and rectal carcinoids is increasing. This is probably due to endoscopic screening. The prognosis is primarily dependent upon tumor size, aggressiveness (pathology, Ki-67), metastatic disease and stage. However, neuroendocrine carcinoma usually behaves as an adenocarcinoma.
June 19, 2017: Revista Española de Enfermedades Digestivas
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