- MeSH
- Dyslipidemias drug therapy MeSH
- Cardiovascular Diseases drug therapy MeSH
- Fatty Acids, Nonesterified analysis blood adverse effects MeSH
- Humans MeSH
- Niacin * administration & dosage history pharmacokinetics pharmacology adverse effects therapeutic use MeSH
- Pilot Projects MeSH
- Randomized Controlled Trials as Topic MeSH
- Flushing chemically induced MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- MeSH
- Time Factors MeSH
- Dimethyl Fumarate administration & dosage pharmacology adverse effects MeSH
- Adult MeSH
- Humans MeSH
- Magnetic Resonance Imaging MeSH
- Drug Substitution MeSH
- Multiple Sclerosis, Relapsing-Remitting * diagnostic imaging drug therapy immunology MeSH
- Treatment Outcome MeSH
- Flushing epidemiology chemically induced MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Aspirin administration & dosage adverse effects MeSH
- Dimethyl Fumarate administration & dosage adverse effects MeSH
- Adult MeSH
- Fingolimod Hydrochloride administration & dosage MeSH
- Humans MeSH
- Magnetic Resonance Imaging MeSH
- Methylprednisolone administration & dosage MeSH
- Multiple Sclerosis, Relapsing-Remitting * diagnosis drug therapy MeSH
- Treatment Outcome MeSH
- Flushing drug therapy prevention & control MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Time Factors MeSH
- Dimethyl Fumarate administration & dosage adverse effects MeSH
- Adult MeSH
- Fingolimod Hydrochloride administration & dosage adverse effects MeSH
- Immunosuppressive Agents therapeutic use MeSH
- Humans MeSH
- Drug Substitution MeSH
- Natalizumab adverse effects therapeutic use MeSH
- Disability Evaluation MeSH
- Recurrence MeSH
- Risk Factors MeSH
- Multiple Sclerosis * diagnostic imaging drug therapy MeSH
- Treatment Outcome MeSH
- Flushing MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Dimethyl Fumarate administration & dosage adverse effects MeSH
- Adult MeSH
- Fingolimod Hydrochloride administration & dosage MeSH
- Interferon beta-1a administration & dosage MeSH
- Interferon-beta administration & dosage MeSH
- Humans MeSH
- Magnetic Resonance Imaging MeSH
- Methylprednisolone administration & dosage MeSH
- Drug Resistance, Multiple MeSH
- Natalizumab administration & dosage adverse effects MeSH
- Disability Evaluation MeSH
- Recurrence MeSH
- Multiple Sclerosis diagnostic imaging drug therapy MeSH
- Treatment Outcome MeSH
- Flushing prevention & control MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Anaphylaxis chemically induced MeSH
- Depressive Disorder diagnosis drug therapy MeSH
- Dimethyl Fumarate administration & dosage adverse effects MeSH
- Dyspepsia drug therapy MeSH
- Glatiramer Acetate administration & dosage adverse effects MeSH
- Leflunomide analogs & derivatives adverse effects MeSH
- Middle Aged MeSH
- Humans MeSH
- Methylprednisolone administration & dosage adverse effects MeSH
- Drug Substitution MeSH
- Disability Evaluation MeSH
- Recurrence MeSH
- Multiple Sclerosis * diagnostic imaging drug therapy MeSH
- Treatment Outcome MeSH
- Flushing drug therapy MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Výraz „flush” je označenie začervenania pokožky pri rozličných fyziologických a patologických zdravotných stavoch. Flush však môže byť spôsobený aj závažnými príčinami. Veľké množstvo pacientov s nekarcinoidovým flushom bolo odoslaných na našu kliniku pre podozrenie na karcinoid. Väčšina z pacientov už v tom čase podstúpila mnohé biochemické a rádiologické vyšetrenia, bez praktického prínosu a finančne zaťažujúce. Sme si vedomí, že rozdiel medzi karcinoidovým a nekarcinoidovým flushom je stále viac zastretý. Ciele: V našom prehľade sme sa zamerali na diferenciáciu karcinoidového flushu a jeho odlíšenie od iných príčin, ktoré môžu imitovať karcinoidový syndróm, najmä rosacea a menopauzálny flush. Zameriavame sa stručne na základnú patofyziológiu flushu. Cieľom prehľadu je pomôcť lekárom stretávajúcim sa s flushom. Vymyslieť užitočný diagnostický algoritmus, ktorý pomôže objasniť jeho etiológiu a určiť nutnosť použitia multidisciplinárneho postupu. Zdôrazňujeme však, že lekár by mal vždy posudzovať každého pacienta individuálne. Výsledky: Na odlíšenie karcinoidového a nonkarcinoidového flushu sme sa pokúsili zaviesť diagnostický algoritmus za účelom zjednodušenia manažmentu týchto pacientov. Liečba je nad rozsah tejto práce.
The term “flush” is a misnomer for diverse physiological and pathological medical conditions; however, simple flush can signify the presence of a serious underlying medical condition. Many patients with non-carcinoid facial flush have been referred to our department as cases of carcinoid flush. Most of these patients had already undergone many biochemical and radiological workups, which were neither practical nor cost-effective. We acknowledge that the line between carcinoid and non-carcinoid flush is ever more blurred. Aim: In this review, we highlight the definition of carcinoid flush, and distinguish it from other conditions resembling those of carcinoid syndrome, mainly rosacea flush and menopausal flush. We briefly explore the basic pathophysiology of flush. Finally, in order to help guide referring physicians dealing with this condition, we have tried to devise a clinically useful algorithm for the diagnosis of carcinoid flush that takes into account the need for a multidisciplinary approach; nonetheless, physicians should always examine patients on a case-by-case basis. Results: To distinguish carcinoid flush from non-carcinoid flush, we designed an algorithm to help guide referring physicians dealing with these conditions. Treatment is beyond the scope of this review.
- MeSH
- Algorithms MeSH
- Diagnosis, Differential MeSH
- Carcinoid Tumor complications physiopathology MeSH
- Humans MeSH
- Malignant Carcinoid Syndrome complications physiopathology MeSH
- Menopause MeSH
- Decision Support Techniques MeSH
- Hot Flashes * diagnosis etiology physiopathology MeSH
- Rosacea * diagnosis physiopathology MeSH
- Body Temperature Regulation physiology MeSH
- Flushing * diagnosis etiology physiopathology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
BACKGROUND: Lanreotide Autogel/Depot effectively controls symptoms in patients with carcinoid syndrome associated with neuroendocrine tumours. Data on patient-reported outcomes are sparse. AIM: To evaluate the effect of lanreotide on patient-reported outcomes (PROs) with carcinoid syndrome. METHODS: This was an international, open-label, observational study of adults with neuroendocrine tumours and history of diarrhoea, receiving lanreotide for >3 months for relief of carcinoid syndrome symptoms. The primary PRO measure was satisfaction with diarrhoea control. Secondary PRO measures included severity, change in symptoms and impact on daily life of diarrhoea; and patient satisfaction with flushing control. RESULTS: Of 273 patients enrolled, 76% were 'completely' or 'rather' satisfied with diarrhoea control; 79% reported improvement in diarrhoea with lanreotide. The proportion of patients with 'mild', 'minimal', or 'no diarrhoea' increased from 33% before treatment to 75% during treatment; 75% were unconcerned about the impact of diarrhoea on daily life. Satisfaction with flushing control amongst patients with significant flushing at treatment initiation was 73%. CONCLUSIONS: Lanreotide treatment was associated with improvements in symptoms as well as a range of PROs in patients with neuroendocrine tumours and carcinoid syndrome (ClinicalTrials.gov: NCT01234168).
- MeSH
- Peptides, Cyclic administration & dosage MeSH
- Adult MeSH
- Patient Reported Outcome Measures * MeSH
- Internationality MeSH
- Delayed-Action Preparations MeSH
- Middle Aged MeSH
- Humans MeSH
- Malignant Carcinoid Syndrome complications drug therapy MeSH
- Prospective Studies MeSH
- Antineoplastic Agents administration & dosage MeSH
- Diarrhea etiology MeSH
- Aged MeSH
- Somatostatin administration & dosage analogs & derivatives MeSH
- Patient Satisfaction MeSH
- Flushing etiology MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Observational Study MeSH
- Research Support, Non-U.S. Gov't MeSH
Neuroendokrinné nádory (NEN) vychádzajú z buniek difúzneho neuroendokrinného systému. Produkujú peptidy alebo amíny, ktoré účinkujú ako hormóny alebo neurotransmitery. Incidencia NEN je pomerne nízka. Diagnostika a liečba týchto tumorov je multidisciplinárna. Cieľom práce bola analýza súboru pacientov s dobre diferencovaným neuroendokrinným nádorom tráviaceho traktu. Zaradení boli pacienti sledovaní od roku 1998 do roku 2013, ktorí mali histologicky potvrdený dobre diferencovaný, nízko alebo stredne malígny neuroendokrinný nádor gastrointestinálneho traktu. Do súboru bolo zaradených 97 pacientov. Z toho 34 (35,1 %) mužov a 63 (64,9 %) žien. Zistili sme, že v liečbe pacientov so stanovením diagnózy po roku 2005 sa signifikantne menej využíva interferón a signifikantne častejšie sa využíva endoskopická a PRRT liečba. Identifikovali sme najvhodnejší diskriminant pre rozdelenie pacientov z hľadiska výskytu metastáz v čase stanovenia diagnózy podľa hladiny 5-HIAA na 6,8 mg/24 hod, podľa hladiny CgA na 70 ng/ml. Identifikovali sme nasledovné rizikové faktory pre celkovú mortalitu: pečeňové metastázy, hnačky, flush, lokalizácia primárneho tumoru v tenkom čreve, vysoké hodnoty CgA a 5-HIAA v čase stanovenia diagnózy (5-HIAA > 520,52 mg/24 hod, CgA > 174,5 ng/ml). Ako pozitívny prognostický faktor sme identifikovali chirurgickú liečbu. Kľúčové slová: chromogranín A – kyselina 5-hydroxyindoloctová – neuroendokrinný nádor
Neuroendocrine neoplasmas are a form of cancer arising from cells of diffuse neuroendocrine system. They produce peptides or amines that act as hormones or neurotransmitters. Incidence of NENs is relatively low. Diagnostic work-up and treatment requires a multidisciplinary team approach. The aim of this study was an analysis of data from patients with well-differentiated neuroendocrine neoplasmas of gastrointestinal tract. The study included patients followed up from 1998 to 2013 with histologically confirmed well-differentiated digestive neuroendocrine neoplasm with low or intermediate malignant potential. 97 patients were included; 34 men (35.1 %) and 63 women (64.9 %). In patients being diagnosed after 2005 interferon treatment is significantly less used than endoscopic and peptide receptor radionuclide therapy. We have identified more appropriate discriminant values of 5-HIAA and chromogranin A (6.8 mg/24 hours; 70 ng/ml) for predicting the presence of metastases at the time of diagnosis. We have identified following risk factors for overall mortality: liver metastases, presence of diarrhea, flush, small bowel primary tumor, high values of CgA and 5-HIAA at the time of diagnosis (5-HIAA > 520.52 mg/24 hours, CgA > 174.5 ng/ml). Surgical treatment was found to be a positive prognostic factor. Key words: chromogranin A – 5-hydroxyindoleacetic acid – neuroendocrine neoplasm
- MeSH
- Time Factors MeSH
- Chromogranin A analysis MeSH
- Adult MeSH
- Kaplan-Meier Estimate MeSH
- Hydroxyindoleacetic Acid analysis MeSH
- Middle Aged MeSH
- Humans MeSH
- Disease Management * MeSH
- Neoplasm Metastasis diagnosis MeSH
- Digestive System Neoplasms * diagnosis mortality therapy MeSH
- Neuroendocrine Tumors * diagnosis mortality therapy MeSH
- Diarrhea epidemiology MeSH
- Radioisotopes therapeutic use MeSH
- Receptors, Peptide metabolism MeSH
- Retrospective Studies MeSH
- Risk Factors * MeSH
- Sex Distribution MeSH
- Aged MeSH
- Somatostatin analogs & derivatives therapeutic use MeSH
- Statistics as Topic MeSH
- Age Factors MeSH
- Flushing epidemiology MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Comparative Study MeSH
- MeSH
- Dyslipidemias drug therapy blood MeSH
- Drug Combinations MeSH
- Cholesterol, HDL blood MeSH
- Drug Evaluation MeSH
- Hypercholesterolemia drug therapy MeSH
- Hypolipidemic Agents therapeutic use MeSH
- Indoles therapeutic use MeSH
- Congresses as Topic MeSH
- Cholesterol, LDL blood MeSH
- Humans MeSH
- Niacin adverse effects therapeutic use MeSH
- Receptors, Immunologic antagonists & inhibitors MeSH
- Receptors, Prostaglandin antagonists & inhibitors MeSH
- Flushing chemically induced MeSH
- Check Tag
- Humans MeSH
