scholarly journals Radionuclide imaging and therapy in patients with neuroendocrine tumors

2018 ◽  
Vol 11 (4) ◽  
pp. 178-190 ◽  
Author(s):  
Olga D. Baranova ◽  
Pavel O. Roumiantsev ◽  
Konstantin Y. Slashchuk ◽  
Leonid O. Petrov
Keyword(s):  
Neuroendocrine Tumors ◽  
Molecular Mechanisms ◽  
Advanced Disease ◽  
Somatostatin Analogues ◽  
Heterogeneous Group ◽  
Diagnostic Methods ◽  
Diffuse Neuroendocrine System ◽  
Medical Control ◽  
Associated Symptoms ◽  
The Right

Neuroendocrine tumors (NETs) are heterogeneous group of the tumors that arise from the enterochromaffin cells of the diffuse neuroendocrine system and occurr in 0.5% of all neoplasms. Recently there has been a significant increase in the incidence of neuroendocrine tumors, which is undoubtedly associated with the improvement of diagnostic methods. However, despite significant success in studying the biological and molecular mechanisms of its behavior, a single algorithm for the diagnosis and treatment of neuroendocrine tumors remains unclear today. Treatment of neuroendocrine tumors largely depends on their functional status and the stage of the disease. While the treatment of localized NETs is surgical resection, varieties of therapeutic options are available for patients with advanced NETs. These include medical control of excess hormone levels and associated symptoms, cytoreductive surgery for patients with advanced disease, systemic chemotherapy, somatostatin analogues, and peptide receptor-targeted radionuclide therapy. However, the right choice of the therapeutic approach in current clinical practice in heterogeneous group of patients with neuroendocrine tumors requires further discussion.

scholarly journals The state of PRRT and its sequencing amongst current therapeutic options for gastroenteropancreatic neuroendocrine tumors

2021 ◽  
Author(s):  
Lauren M Raymond ◽  
Tetiana Korzun ◽  
Adel Kardosh ◽  
Kenneth J. Kolbeck ◽  
Rodney Pommier ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Standard Dose ◽  
Peptide Receptor Radionuclide Therapy ◽  
Somatostatin Analogues ◽  
Tumor Burden ◽  
Treatment Modalities ◽  
Its Sequencing ◽  
Gastroenteropancreatic Neuroendocrine Tumors ◽  
Reduce Tumor Burden ◽  
Spectrum Of Patients

Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are the most common form of neuroendocrine neoplasia, but there is no current consensus for the sequencing of approved therapies, particularly with respect to peptide receptor radionuclide therapy (PRRT). This comprehensive review evaluates the data supporting approved therapies for GEP-NETs and recommendations for therapeutic sequencing with a focus on how PRRT currently fits within sequencing algorithms. The current recommendations for PRRT sequencing restrict its use to metastatic, inoperable, progressive midgut NETs, however, this may change with emerging data to suggest PRRT might be beneficial as neoadjuvant therapy for inoperable tumors, is more tolerable than other treatment modalities following first-line standard dose somatostatin analogues, and can be used as salvage therapy after disease relapse following prior successful cycles of PRRT. PRRT has also been shown to reduce tumor burden, improve quality of life, and prolong the time to disease progression in a broad spectrum of patients with GEP-NETs. As the various potential benefits of PRRT in GEP-NET therapy continues to expand, it is necessary to review and critically evaluate our treatment algorithms for GEP-NETs.

scholarly journals Clostridioides difficile Infection, Still a Long Way to Go

2021 ◽  
Vol 10 (3) ◽  
pp. 389
Author(s):  
Eleftheria Kampouri ◽  
Antony Croxatto ◽  
Guy Prod’hom ◽  
Benoit Guery
Keyword(s):  
Fecal Microbiota Transplantation ◽  
Diagnostic Algorithm ◽  
Fecal Microbiota ◽  
Diagnostic Methods ◽  
Special Focus ◽  
Surveillance Systems ◽  
Main Question ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
The Right

Clostridioides difficile is an increasingly common pathogen both within and outside the hospital and is responsible for a large clinical spectrum from asymptomatic carriage to complicated infection associated with a high mortality. While diagnostic methods have considerably progressed over the years, the optimal diagnostic algorithm is still debated and there is no single diagnostic test that can be used as a standalone test. More importantly, the heterogeneity in diagnostic practices between centers along with the lack of robust surveillance systems in all countries and an important degree of underdiagnosis due to lack of clinical suspicion in the community, hinder a more accurate evaluation of the burden of disease. Our improved understanding of the physiopathology of CDI has allowed some significant progress in the treatment of CDI, including a broader use of fidaxomicine, the use of fecal microbiota transplantation for multiples recurrences and newer approaches including antibodies, vaccines and new molecules, already developed or in the pipeline. However, the management of CDI recurrences and severe infections remain challenging and the main question remains: how to best target these often expensive treatments to the right population. In this review we discuss current diagnostic approaches, treatment and potential prevention strategies, with a special focus on recent advances in the field as well as areas of uncertainty and unmet needs and how to address them.

Dual Role of Caveolin-1 in β-Catenin Signaling During Fracture Healing Induced by Low-Intensity Pulsed Ultrasound in Rabbits

2021 ◽  
Vol 11 (2) ◽  
pp. 229-239
Author(s):  
Yun Li ◽  
Guanghua Liu ◽  
Feng Xiao ◽  
Wenqin Gu ◽  
Zhengdong Gao ◽  
...  
Keyword(s):  
Fracture Healing ◽  
Molecular Mechanisms ◽  
Dual Role ◽  
Fracture Repair ◽  
Long Bone ◽  
Pulsed Ultrasound ◽  
Mineral Density ◽  
X Ray ◽  
Caveolin 1 ◽  
The Right

We did this research to observe the effect of LIPUS on long bone fracture repair and caveolin-1, β-catenin signaling expression in the radius defects of rabbits, to explore its possible molecular mechanisms. 24 male New Zealand rabbits with bilateral radial bone defects were divided into 4 groups randomly, n = 6. The right side had daily LIPUS exposure for 20 minutes, while the left received sham treatment. After 7, 14, 21, 28 days, respectively, fracture healing was observed by X-ray imaging and Dual Energy X-ray Absorptiometry (DXA) scan, specimens were harvested for histology, immunohistochemistry, and gene expression analysis. We found that LIPUS brought forward endochondral ossification, increased the bone callus size without changes in Bone Mineral Density (BMD). The caveolin-1 expression increased first then decreased, while the β-catenin kept growing during the process. These demonstrated that caveolin-1 participated in fracture healing accelerated by LIPUS, which was speculated to play a dual role in β-catenin signaling expression.

scholarly journals Diagnostic difficulties and features of endovideosurgical treatment of a patient with mucocele of the appendix

2020 ◽  
Vol 12 (2) ◽  
pp. 85-90
Author(s):  
Badri V. Sigua ◽  
Vyacheslav P. Zemlyanoy ◽  
Elguja L. Lataria ◽  
Alexey A. Kurkov ◽  
Vyacheslav A. Melnikov ◽  
...  
Keyword(s):  
Benign Tumor ◽  
Abdominal Cavity ◽  
Clinical Manifestations ◽  
Vermiform Appendix ◽  
Diagnostic Methods ◽  
Number Of Patients ◽  
Mucocele Of The Appendix ◽  
Diagnostic Difficulties ◽  
Life Threatening ◽  
The Right

The mucocele of the appendix is the expansion of the appendix with the accumulation of a large amount of mucus. The mechanism and causes of mucocele are not fully understood. According to some authors, such changes in the appendix can occur due to cicatricial narrowing of the lumen of the appendix, compression or blockage of its base. Other authors believe that the mucocele of the appendix is a benign tumor that develops from the remnants of primitive mesenchyme and is sometimes prone to malignancy. Clinical manifestations of mucocele of the appendix are nonspecific. In a number of patients, this disease causes pain in the right abdomen, more often pulling, intermittent. However, the disease is often asymptomatic. In this regard, diagnosis is established only during performing an operation, most often, regarding acute appendicitis. Nevertheless, instrumental diagnostic methods such as ultrasound and computed tomography of the abdominal and pelvic organs make it possible to suspect mucocele. Despite the frequent asymptomatic, non-aggressive course, a number of life-threatening complications can become the outcome of the mucocele of the vermiform appendix. The most formidable complication is the rupture of the appendix with mucus entering free abdominal cavity, followed by the development of peritoneal pseudomyxoma due to implantation of mucus-forming cells. The only option for radical treatment of the mucocele of the appendix is a surgical intervention. A presented clinical case demonstrates the difficulties of diagnosis, as well as the features of surgical treatment of a patient with a mucocele of the appendix.

scholarly journals Dynamic neuropathy of the common peroneal nerve at the level of the fibular head (literature review and case report)

2019 ◽  
Vol 21 (1) ◽  
pp. 54-59
Author(s):  
M. G. Bashlachev ◽  
G. Yu. Evzikov ◽  
V. A. Parfenov ◽  
N. B. Vuitsyk ◽  
F. V. Grebenev
Keyword(s):  
Ankle Joint ◽  
Peroneal Nerve ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Common Peroneal Nerve ◽  
Diagnostic Methods ◽  
Fibular Head ◽  
Study Objective ◽  
The Common ◽  
The Right

The study objective is to report a case of dynamic neuropathy of the common peroneal nerve at the level of the fibular head and to discuss diagnostic methods and neurosurgical treatment. Materials and methods. We report a case of dynamic neuropathy of the common peroneal nerve at the level of the fibular head in a female patient. The patient was treated in the Neurology Clinic of I.M. Sechenov First Moscow State Medical University. We analyzed clinical manifestations and compared them with the data described in research literature. Results. Upon admission, the patient complained of pain in the anterolateral surface of the right shin and in the dorsum of the foot during walking. At rest, the patient experienced no pain. We observed no motor or sensory disorders typical of nerve root disorders at the level of L5. Lasegue’s test was negative. The patient had a positive Tinel’s sign in the area of the right fibular head. In order to clarify the diagnosis, we performed a repeated extension test in the right ankle joint and it was positive. The patient underwent surgery that included peroneal nerve decompression and neurolysis at the level of the fibular head. In the postoperative period, the patient had complete pain relief. Conclusion. Due to the difficulties in the diagnostics of dynamic neuropathy of the common peroneal nerve, this disease is often mistaken for radiculopathy at the level of L5. Thorough clinical examination, testing for Tinel’s sign in the area of the fibular head, and repeated extension test in the ankle joint ensure the correct diagnosis and reduce the frequency of ineffective surgeries on the lumbar spine. Surgical decompression of the common peroneal nerve at the level of the fibular head with obligatory opening of the entrance to the nerve canal is an effective method of treatment in such patients.

scholarly journals Hepatic Venous Duplex as an Alternative Non- invasive Diagnostic Tool for Diagnosis of Pulmonary Hypertension

2020 ◽  
Vol 16 (2) ◽  
pp. 86-91
Author(s):  
Md Harisul Hoque ◽  
SM Mustafa Zaman ◽  
Khurshid Ahmed ◽  
Sajal Krisna Banerjee ◽  
Md Faisal Ibne Kabir ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Diagnostic Tool ◽  
Right Heart Catheterization ◽  
Diagnostic Methods ◽  
Heart Catheterization ◽  
Right Heart ◽  
Non Invasive ◽  
Close Proximity ◽  
The Right ◽  
Practical Demonstration

Pulmonary hypertension is a hemodynamic disorder defined by abnormally high pulmonary artery pressure that affects the arteries in your lungs and the right side of your heart. In this study, hepatic venous duplex will be done to diagnose and quantify the PH. So that Patients can avoid unnecessary invasive right heart catheterization. This practical demonstration is the key to enrich our experience and knowledge in the field of PH. Objectives of this study was to assess PH status by Hepatic venous Duplex (HVD) as well by right heart catheterization and to compare them. This study was conducted in the Department of Cardiology, BSMMU, Shahbagh, Dhaka extending from July 2018 to December 2019. Total 100 (One hundred) subjects were enrolled in this study. It was an Observational study and includes the subjects between 18 years to 45 years of age. Results of this study shows very close proximity to that of Right heart catheterization. Hemodynamic changes in Hepatic venous duplex study could be used as an alternative diagnostic tool for evaluating moderate to severe pulmonary hypertension. This method could counteract the weakness of the currently used diagnostic methods and improve the accuracy of assessing pulmonary hypertension when combined with other methods. University Heart Journal Vol. 16, No. 2, Jul 2020; 86-91

scholarly journals A rare cause of biliary obstruction – intraductal neuroendocrine tumor of the right hepatic biliary duct: a case report

2020 ◽  
Author(s):  
Mirela Danila ◽  
Roxana Sirli ◽  
Alina Popescu ◽  
Nicoleta Iacob ◽  
Ana-Maria Ghiuchici
Keyword(s):  
Neuroendocrine Tumors ◽  
Biliary Obstruction ◽  
Ultrasound Examination ◽  
Hepatic Duct ◽  
Biliary Duct ◽  
Presumptive Diagnosis ◽  
Additional Imaging ◽  
Biliary Ducts ◽  
Well Differentiated ◽  
The Right

Primary biliary tract neuroendocrine tumors (NETs) are extremely rare tumors that account for 0.2-2% of all gastrointestinal neuroendocrine tumors. The typical presentation is with jaundice and other symptoms related to biliary obstruction.We present a case of right hepatic duct NET in a 27-year-old female patient, asymptomatic, presented for a routine ultrasound examination that revealed moderate dilatation of the intrahepatic biliary ducts and a 20 mm hyperechoic lesion in the right hepatic biliary duct. Additional imaging was performed with the presumptive diagnosis of cholangiocarcinoma. After surgery, the histopathological and immunohistochemical report was conclusive for the diagnosis of G2 well-differentiated NET

scholarly journals Small Bowel and Colorectal Carcinoids

2018 ◽  
Vol 31 (05) ◽  
pp. 301-308 ◽  
Author(s):  
Raphael Byrne ◽  
Rodney Pommier
Keyword(s):  
Small Bowel ◽  
Neuroendocrine Tumors ◽  
Cytoreductive Surgery ◽  
Mammalian Target Of Rapamycin ◽  
Arterial Embolization ◽  
Angiogenesis Inhibitors ◽  
Somatostatin Analogues ◽  
Interferon Α ◽  
Peptide Receptor ◽  
Hepatic Arterial Embolization

AbstractNeuroendocrine tumors, or carcinoid tumors, of both the midgut and hindgut are quite rare, but their incidence is increasing. Surgery is the treatment of choice in patients who can tolerate an operation and have operable disease. Options for the treatment of metastatic disease include cytoreductive surgery, somatostatin analogues, interferon α, local liver therapies (hepatic arterial embolization, ablation), chemotherapy, Peptide-Receptor Radionucleotide Radiotherapy, angiogenesis inhibitors, and mammalian target of rapamycin inhibitors.

scholarly journals Rumpel-Leede Phenomenon: A Case Report

1970 ◽  
Vol 9 (4) ◽  
Author(s):  
Rehman HU, MBBS, FRCPC ◽  
Kambo J, MD
Keyword(s):  
Complete Blood Count ◽  
Vital Signs ◽  
Liver Function Tests ◽  
Left Hand ◽  
Lower Base ◽  
Associated Symptoms ◽  
Chest Auscultation ◽  
History Of ◽  
Artery Disease ◽  
The Right

A 72-year-old woman presented with a one-week history of fever, non-productive cough, and three unwitnessed syncopal episodes, with no other associated symptoms. She had poor recollection of the episodes, but denied urinary/fecal incontinence, tongue biting, numbness, parasthesias, or weakness. Her medical history was significant for hypertension, dyslipidemia, leg ulcers, psoriasis, stress incontinence, and gastroesophageal reflux disease. She did not have diabetes, coronary artery disease, or peripheral vascular disease. Her medications included Atorvastatin, Enalapril, Hydrochlorothiazide, Lansoprazole, and Calcium. She did not smoke or drink. On examination, her vital signs were stable and she was afebrile. Chest auscultation revealed crackles in the right lower base. She developed an erythematous, lacy sharply demarcated rash on her left hand that lasted for 3–4 hours after her blood pressure was taken on the same arm (Figures 1 and 2). Blood tests were unremarkable and included glucose, complete blood count, electrolytes, urea, creatinine, liver function tests, and coagulation studies.

Difficulties associated with the diagnosis of tuberculous osteomyelitis of the ribs in children

2021 ◽  
Vol 16 (2) ◽  
pp. 74-79
Author(s):  
M.D. Zvereva ◽  
◽  
S.S. Kanash ◽  
S.I. Petrova ◽  
V.A. Evseev ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Clinical Symptoms ◽  
Correct Diagnosis ◽  
Diagnostic Procedures ◽  
Diagnostic Methods ◽  
Mantoux Test ◽  
Comprehensive Treatment ◽  
Tuberculous Osteomyelitis ◽  
The Right ◽  
Tuberculosis In Children

Diagnosis of tuberculosis in children is challenging because of variable clinical symptoms and no specific signs. We report a case of tuberculous osteomyelitis of the ribs, which demonstrates difficulties associated with the diagnosis of generalized tuberculosis in an 8-year-old child (correct diagnosis was established after 1.3 years). Diagnostic procedures included: Mantoux test, skin test with recombinant tuberculosis allergen, computed tomography, pathomorphological and bacterioscopic testing. The patient presented with disease progression and lesions to the lung tissue, pleura, and ribs and did not respond to antibacterial therapy, hormones, and cytostatics. This required repeated diagnosis revision. The diagnosis of tuberculosis of the right 4th and 5th ribs was confirmed after surgery using bacterioscopic and immunohistochemical examinations. The child received comprehensive treatment in a specialized tuberculosis hospital and had positive dynamics. Despite the correct routing, low suspicion for tuberculosis in primary and secondary healthcare institutions has led to an insufficient use of currently available diagnostic methods and late diagnosis of tuberculosis in a child residing in a megapolis. Key words: generalized tuberculosis, children, tuberculosis of the rib, immunodiagnostics, diagnosis of tuberculosis, immunohistochemistry

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