scholarly journals Pancreatic and peripancreatic somatostatinomas

2011 ◽  
Vol 93 (5) ◽  
pp. 356-360 ◽  
Author(s):  
JML Williamson ◽  
CC Thorn ◽  
D Spalding ◽  
RCN Williamson
Keyword(s):  
Neuroendocrine Tumours ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Management Options ◽  
Term Survival ◽  
Medical Treatments ◽  
Pancreatic Neuroendocrine Tumours

BACKGROUND Somatostatinomas are rare neuroendocrine tumours with an annual incidence of 1 in 40 million. They arise in the pancreas or periampullary duodenum. Most are clinically non-secretory and do not cause the somatostatinoma syndrome. Many are metastatic at presentation and their management is typically multimodal. CASE HISTORIES Four cases of somatostatinoma are described. Two patients with periampullary disease presented with biliary obstruction, one with frank jaundice and one with incidental bile duct obstruction on investigation of hepatitis B. Each patient had type 1 neurofibromatosis and resection of the somatostatinoma by means of a pylorus-preserving proximal pancreaticoduodenectomy has resulted in long-term survival. Another two patients with metastatic pancreatic somatostatinomas presented with abdominal pain. Contrasting management illustrates current treatment strategies that are dependent in part on the distribution of the disease. DISCUSSION The pathophysiology, presentation, clinical associations and role of diagnostic imaging are discussed for periampullary and pancreatic neuroendocrine tumours. Operative treatment has an important role in both the curative and palliative settings in conjunction with appropriate medical treatments and these are described. Management options depend on the extent of the disease and the cases are used to illustrate the rationale of such strategies.

Antibody-Mediated Rejection and Lung Transplantation

2021 ◽  
Vol 42 (03) ◽  
pp. 428-435
Author(s):  
Laura P. Halverson ◽  
Ramsey R. Hachem
Keyword(s):  
Lung Transplantation ◽  
Diagnostic Criteria ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Solid Organ ◽  
Term Survival ◽  
Antibody Mediated Rejection ◽  
History Of ◽  
Active Research

AbstractAntibody-mediated rejection (AMR) is now a widely recognized form of lung allograft rejection, with mounting evidence for AMR as an important risk factor for the development of chronic lung allograft dysfunction and markedly decreased long-term survival. Despite the recent development of the consensus diagnostic criteria, it remains a challenging diagnosis of exclusion. Furthermore, even after diagnosis, treatment directed at pulmonary AMR has been nearly exclusively derived from practices with other solid-organ transplants and other areas of medicine, such that there is a significant lack of data regarding the efficacy for these in pulmonary AMR. Lastly, outcomes after AMR remain quite poor despite aggressive treatment. In this review, we revisit the history of AMR in lung transplantation, describe our current understanding of its pathophysiology, discuss the use and limitations of the consensus diagnostic criteria, review current treatment strategies, and summarize long-term outcomes. We conclude with a synopsis of our most pressing gaps in knowledge, introduce recommendations for future directions, and highlight promising areas of active research.

scholarly journals Peripartum cardiomyopathy

2011 ◽  
Vol 2 (3) ◽  
pp. 161
Author(s):  
Rodolfo Citro ◽  
Roberta Giudice ◽  
Marco Mirra ◽  
Rosa Paolillo ◽  
Chiara Paolillo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systolic Dysfunction ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Peripartum Cardiomyopathy ◽  
Multicenter Trials ◽  
Autoimmune Processes ◽  
Long Term Prognosis

Peripartum cardiomyopathy is an uncommon form of congestive heart failure associated with systolic dysfunction of left ventricle. The onset is characterised by symptoms of heart failure occurring between the last month of pregnancy and 5-6 months postpartum. The early diagnosis and the institution of medical treatment for this disease are essential because the inadequate management may affect the patient’s long-term prognosis and can lead to severe complications, including death.Currently its aetiology is not completely understood. Many aetiopathogenetic hypotheses have been formulated: inflammation, viral agents, autoimmune processes. In the last years, evidences aroused for a role of prolactin and its 16 kDa metabolite in reducing cardiomyocite metabolic activity and contraction. In this article we have reviewed the current literature with special emphasis on the role of prolactin and the related current treatment strategies. In particular, bromocriptine appears promising, even if women need to be informed that the drug stops the production of breastmilk. Further researchers, such as large multicenter trials, are needed to decide the best treatment for the women suffering of this disease.

scholarly journals Peripartum cardiomyopathy

2011 ◽  
Vol 2 (3) ◽  
pp. 161-170
Author(s):  
Rodolfo Citro ◽  
Roberta Giudice ◽  
Marco Mirra ◽  
Rosa Paolillo ◽  
Chiara Paolillo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systolic Dysfunction ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Peripartum Cardiomyopathy ◽  
Multicenter Trials ◽  
Autoimmune Processes ◽  
Long Term Prognosis

Peripartum cardiomyopathy is an uncommon form of congestive heart failure associated with systolic dysfunction of left ventricle. The onset is characterised by symptoms of heart failure occurring between the last month of pregnancy and 5-6 months postpartum. The early diagnosis and the institution of medical treatment for this disease are essential because the inadequate management may affect the patient’s long-term prognosis and can lead to severe complications, including death.Currently its aetiology is not completely understood. Many aetiopathogenetic hypotheses have been formulated: inflammation, viral agents, autoimmune processes. In the last years, evidences aroused for a role of prolactin and its 16 kDa metabolite in reducing cardiomyocite metabolic activity and contraction. In this article we have reviewed the current literature with special emphasis on the role of prolactin and the related current treatment strategies. In particular, bromocriptine appears promising, even if women need to be informed that the drug stops the production of breastmilk. Further researchers, such as large multicenter trials, are needed to decide the best treatment for the women suffering of this disease.

Novelties in Diabetes-Endocrine Development - Vol. 31

2017 ◽  
Vol 54 (2) ◽  
pp. 242
Author(s):  
G. P. Jeyanthi
Keyword(s):  
Weight Control ◽  
State Of The Art ◽  
Artificial Pancreas ◽  
Treatment Strategies ◽  
Comprehensive Overview ◽  
Beta Cell Replacement ◽  
Short And Long Term

The field of diabetes mellitus research is currently characterized by rapid and remarkable growth that has led to the development of significant diagnostic and therapeutic advances. The frequency of the disease continues to increase at alarming rates worldwide. This volume is a comprehensive overview of the contemporary state of the art in the field. Renowned experts in the field provide a comprehensive balanced overview of the most important related topics. Starting with a chapter on the individualization of treatment goals describing short and long term therapeutic targets in Type 1 and 2 diabetes the book then provides an overview of potential means to achieve this target. This encompasses chapters weighing the role of well known as opposed to novel therapeutic approaches, the latter including not only technical achievements like artificial pancreas, but also the state of the art in beta cell replacement. A focus is set on diabetic complications and the recently debated association between diabetes and cancer. Treatment strategies for blood pressure and weight control are discussed.

Imaging of Pancreatic-Neuroendocrine Tumours: An Outline of Conventional Radiological Techniques

2019 ◽  
Vol 12 (2) ◽  
pp. 135-155 ◽  
Author(s):  
Muhammad Affan Zamir ◽  
Wasim Hakim ◽  
Siraj Yusuf ◽  
Robert Thomas
Keyword(s):  
Neuroendocrine Tumours ◽  
Treatment Options ◽  
Advantages And Disadvantages ◽  
Imaging Characteristics ◽  
Fundamental Understanding ◽  
Pancreatic Neuroendocrine Tumours ◽  
Direct Management ◽  
Important Disease ◽  
Similar Imaging

IIntroduction: Pancreatic Neuroendocrine Tumours (p-NETs) are an important disease entity and comprise of peptide-secreting tumours often with a functional syndrome. : Accounting for a small percentage of all pancreatic tumours, they have a good overall survival rate when diagnosed early, with surgery being curative. The role of nuclear medicine in the diagnosis and treatment of these tumours is evident. However, the vast majority of patients will require extensive imaging in the form of conventional radiological techniques. It is important for clinicians to have a fundamental understanding of the p-NET appearances to aid prompt identification and to help direct management through neoplastic staging. Methods: This article will review the advantages and disadvantages of conventional radiological techniques in the context of p-NETs and highlight features that these tumours exhibit. Conclusion: Pancreatic neuroendocrine tumours are a unique collection of neoplasms that have markedly disparate clinical features but similar imaging characteristics. Most p-NETs are small and welldefined with homogenous enhancement following contrast administration, although larger and less welldifferentiated tumours can demonstrate areas of necrosis and cystic architecture with heterogeneous enhancement characteristics. : Prognosis is generally favourable for these tumours with various treatment options available. However, conventional radiological techniques will remain the foundation for the initial diagnosis and staging of these tumours, and a grasp of these modalities is extremely important for physicians.

The Role of SBA Loans in Small Business Survival after Disaster Events

2021 ◽  
pp. 0739456X2110282
Author(s):  
Maria Watson
Keyword(s):  
Small Business ◽  
Small Businesses ◽  
Conditional Logistic Regression ◽  
Small Business Administration ◽  
Confounding Factors ◽  
Term Survival ◽  
Business Survival ◽  
Quasi Experimental

Local businesses are important for recovering communities, yet program analyses of the effectiveness of Federal disaster loans—particularly for businesses—are limited and contradictory. This study looks at the role U.S. Small Business Administration (SBA) Disaster Loans played in the long-term survival of small businesses in Galveston County, Texas after the 2008 Hurricane Ike. This research uses quasi-experimental design, matching methods, and conditional logistic regression to tease out the effect of the loan from potential confounding factors. The results show that businesses that received a disaster loan were significantly more likely to survive than their controls, and businesses that moved were also more likely to survive.

scholarly journals The Potential Association between the Risk of Post-Surgical Adhesion and the Activated Local Angiotensin II Type 1 Receptors: Need for Novel Treatment Strategies

2021 ◽  
pp. 1-8
Author(s):  
Mahmood Tavakkoli ◽  
Saeed Aali ◽  
Borzoo Khaledifar ◽  
Gordon A. Ferns ◽  
Majid Khazaei ◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Molecular Mechanisms ◽  
Transforming Growth Factor ◽  
Therapeutic Potential ◽  
Angiotensin Receptor Blockers ◽  
Surgical Techniques ◽  
Treatment Strategies ◽  
Transforming Growth Factor Β

<b><i>Background:</i></b> Post-surgical adhesion bands (PSABs) are a common complication after abdominal or pelvic surgeries for different reasons like cancer treatment. Despite improvements in surgical techniques and the administration of drugs or the use of physical barriers, there has only been limited improvement in the frequency of postoperative adhesions. Complications of PSAB are pain, infertility, intestinal obstruction, and increased mortality. The most important molecular mechanisms for the development of PSAB are inflammatory response, oxidative stress, and overexpression of pro-fibrotic molecules such as transforming growth factor β. However, questions remain about the pathogenesis of this problem, for example, the causes for individual differences or why certain tissue sites are more prone to post-surgical adhesions. <b><i>Summary:</i></b> Addressing the pathological causes of PSAB, the potential role of local angiotensin II/angiotensin II type 1 receptors (AngII/AT1R), may help to prevent this problem. <b><i>Key Message:</i></b> The objective of this article was to explore the role of the AngII/AT1R axis potential to induce PSAB and the therapeutic potential of angiotensin receptor blockers in the prevention and treatment of PSAB.

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