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Search on : Zollinger-Ellison and Syndrome [Words]
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[PMID]: 29517561
[Au] Autor:Norton JA; Krampitz GW; Poultsides GA; Visser BC; Fraker DL; Alexander HR; Jensen RT
[Ad] Address:Department of Surgery, Stanford University School of Medicine, Stanford, CA.
[Ti] Title:Prospective Evaluation of Results of Reoperation in Zollinger-Ellison Syndrome.
[So] Source:Ann Surg;267(4):782-788, 2018 Apr.
[Is] ISSN:1528-1140
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To determine the role of reoperation in patients with persistent or recurrent Zollinger-Ellison Syndrome (ZES). BACKGROUND: Approximately, 0% to 60% of ZES patients are disease-free (DF) after an initial operation, but the tumor may recur. METHODS: A prospective database was queried. RESULTS: A total of 223 patients had an initial operation for possible cure of ZES and then were subsequently evaluated serially with cross sectional imaging-computed tomography, magnetic resonance imaging, ultrasound, more recently octreoscan-and functional studies for ZES activity. The mean age at first surgery was 49 years and with an 11-year mean follow-up 52 patients (23%) underwent reoperation when ZES recurred with imageable disease. Results in this group are analyzed in the current report. Reoperation occurred on a mean of 6 years after the initial surgery with a mean number of reoperations of 1 (range 1-5). After reoperation 18/52 patients were initially DF (35%); and after a mean follow-up of 8 years, 13/52 remained DF (25%). During follow-up, 9/52 reoperated patients (17%) died, of whom 7 patients died a disease-related death (13%). The overall survival from first surgery was 84% at 20 years and 68% at 30 years. Multiple endocrine neoplasia type 1 status did not affect survival, but DF interval and liver metastases did. CONCLUSIONS: These results demonstrate that a significant proportion of patients with ZES will develop resectable persistent or recurrent disease after an initial operation. These patients generally have prolonged survival after reoperation and 25% can be cured with repeat surgery, suggesting all ZES patients postresection should have systematic imaging, and if tumor recurs, advise repeat operation.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Data-Review
[do] DOI:10.1097/SLA.0000000000002122

  2 / 3237 MEDLINE  
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[PMID]: 29405509
[Au] Autor:Othman MO; Harb D; Barkin JA
[Ad] Address:Division of Gastroenterology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
[Ti] Title:Introduction and practical approach to exocrine pancreatic insufficiency for the practicing clinician.
[So] Source:Int J Clin Pract;72(2), 2018 Feb.
[Is] ISSN:1742-1241
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:AIMS: In exocrine pancreatic insufficiency (EPI), the quantity and/or activity of pancreatic digestive enzymes are below the levels required for normal digestion, leading to maldigestion and malabsorption. Diagnosis of EPI is often challenging because the characteristic signs and symptoms overlap with those of other gastrointestinal conditions. Additionally, there is no single convenient, or specific diagnostic test for EPI. The aim of this review is to provide a framework for differential diagnosis of EPI vs other malabsorptive conditions. METHODS: This is a non-systematic narrative review summarising information pertaining to the aetiology, diagnosis and management of EPI. RESULTS: Exocrine pancreatic insufficiency may be caused by pancreatic disorders, including chronic pancreatitis, cystic fibrosis, pancreatic resection and pancreatic cancer. EPI may also result from extra-pancreatic conditions, including coeliac disease, Zollinger-Ellison syndrome and gastric surgery. Timely and accurate diagnosis of EPI is important, as delays in treatment prolong maldigestion and malabsorption, with potentially serious consequences for malnutrition, overall health and quality of life. Symptoms of EPI are non-specific; therefore, a high index of clinical suspicion is required to make a correct diagnosis.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:In-Process
[do] DOI:10.1111/ijcp.13066

  3 / 3237 MEDLINE  
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[PMID]: 29298151
[Au] Autor:Atri D; Furfaro D; Dhaliwal G; Feingold KR; Manesh R
[Ad] Address:From the Department of Medicine, Johns Hopkins Hospital and Johns Hopkins University School of Medicine, Baltimore (D.A., D.F., R.M.); and the Department of Medicine, University of California, San Francisco, and the Medical Service, San Francisco Veterans Affairs Medical Center - both in San Francis
[Ti] Title:Going from A to Z.
[So] Source:N Engl J Med;378(1):73-79, 2018 01 04.
[Is] ISSN:1533-4406
[Cp] Country of publication:United States
[La] Language:eng
[Mh] MeSH terms primary: Diarrhea/etiology
Gastrinoma/diagnosis
Liver Neoplasms/secondary
Liver/diagnostic imaging
Neoplasms, Unknown Primary/diagnosis
Zollinger-Ellison Syndrome/diagnosis
[Mh] MeSH terms secundary: Abdomen/diagnostic imaging
Abdominal Pain/etiology
Aged
Blood Chemical Analysis
Chronic Disease
Diagnosis, Differential
Gastrinoma/complications
Gastrinoma/diagnostic imaging
Humans
Liver/pathology
Liver Neoplasms/diagnosis
Liver Neoplasms/pathology
Magnetic Resonance Imaging
Male
Neoplasms, Unknown Primary/complications
Polycythemia/complications
Positron Emission Tomography Computed Tomography
Zollinger-Ellison Syndrome/complications
[Pt] Publication type:CASE REPORTS; CLINICAL CONFERENCE; JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180118
[Lr] Last revision date:180118
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180104
[St] Status:MEDLINE

  4 / 3237 MEDLINE  
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[PMID]: 29260252
[Au] Autor:Auernhammer CJ; Reincke M
[Ad] Address:Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland. christoph.auernhammer@med.uni-muenchen.de.
[Ti] Title:Funktionsdiagnostik in der Endokrinologie. [Functional diagnostics in endocrinology].
[So] Source:Internist (Berl);59(1):38-47, 2018 Jan.
[Is] ISSN:1432-1289
[Cp] Country of publication:Germany
[La] Language:ger
[Ab] Abstract:When investigating many endocrinological diseases, basal laboratory parameters are not sufficient to distinguish between physiological and pathological hormone secretion. Functional diagnostics plays a decisive role in this context. Stimulation and suppression tests are used depending on whether under- or over-function needs to be diagnosed. This review article discusses selected functional tests, each of which plays an important role in current guidelines. Indications and test principles, including their performance, reliability, and limitations, are discussed. Topics covered include the ACTH stimulation test for the diagnosis of adrenal cortex insufficiency and the dexamethasone inhibition test for suspected Cushing's syndrome, as well as functional tests for the diagnosis of primary hyperaldosteronism, pheochromocytoma, acromegaly, growth hormone deficiency, thyroid nodules and suspicion of medullary thyroid carcinoma, insulinoma, and Zollinger-Ellison syndrome. Functional tests that are explicitly not recommended are also addressed.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1712
[Cu] Class update date: 180119
[Lr] Last revision date:180119
[St] Status:In-Data-Review
[do] DOI:10.1007/s00108-017-0360-7

  5 / 3237 MEDLINE  
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[PMID]: 29019150
[Au] Autor:Guarnotta V; Martini C; Davì MV; Pizza G; Colao A; Faggiano A; NIKE group
[Ad] Address:Biomedical Department of Internal and Specialist Medicine (DIBIMIS), Section of Endocrine-Metabolic Diseases, University of Palermo, Palermo, Italy.
[Ti] Title:The Zollinger-Ellison syndrome: is there a role for somatostatin analogues in the treatment of the gastrinoma?
[So] Source:Endocrine;, 2017 Oct 10.
[Is] ISSN:1559-0100
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: Analyze the role of somatostatin analogues (SSAs) in the treatment of sporadic and MEN1-related gastrinomas, trying to define whether recent trials have changed the landscape of gastrinoma therapy. METHODS: We evaluate the rationale of SSA use in the treatment of gastrinomas, summarize the current literature concerning the effect of SSAs on the control of Zollinger-Ellison syndrome (ZES) and gastrinomas tumor progression and discuss their role in the most recent guidelines. RESULTS: The medical treatment of gastrinoma and related ZES is aimed at controlling acid hypersecretion and tumor progression, in inoperable patients. The use of proton pump inhibitors (PPIs) to control the syndrome is a cornerstone in the ZES therapy. SSAs are not usually indicated for antisecretory purpose, because PPIs are considered the treatment of choice, due to their long lasting high efficacy and oral availability. The antiproliferative effect of SSAs has been established by two placebo-controlled trials that have clearly demonstrated a significant increase in progression free survival in patients affected by non-functioning well-differentiated advanced neuroendocrine tumors (NETs). The recent ENETS guidelines recommend the use of SSAs in advanced well differentiated NETs as antiproliferative agents. CONCLUSIONS: The high sstr-expression in gastrinomas make them highly responsive to SSAs and support the use of such drugs to counteract the tumour growth in patients not amenable to surgical cure. Unfortunately, limited data, mainly case reports or small series, support the use of SSAs in advanced gastrinomas, therefore, it is difficult to quantify their ability to control tumour growth and disease progression.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1710
[Cu] Class update date: 171011
[Lr] Last revision date:171011
[St] Status:Publisher
[do] DOI:10.1007/s12020-017-1420-4

  6 / 3237 MEDLINE  
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[PMID]: 28949124
[Au] Autor:DE Angelis C; Cortegoso Valdivia P; Venezia L; Bruno M; Pellicano R
[Ad] Address:Department of Gastroenterology and Digestive Endoscopy, "AOU Città della Salute e della Scienza", University of Turin, Turin, Italy - eusdeang@hotmail.com.
[Ti] Title:Diagnosis and management of Zollinger-Ellison syndrome in 2017.
[So] Source:Minerva Endocrinol;, 2017 Sep 25.
[Is] ISSN:1827-1634
[Cp] Country of publication:Italy
[La] Language:eng
[Ab] Abstract:Zollinger-Ellison Syndrome (ZES) is a clinical syndrome characterized by gastric acid hypersecretion due to the ectopic secretion of gastrin by a gastrinoma, a neuroendocrine tumor (NET) which mostly develops in the duodenum and in the pancreas. This syndrome was first described by Zollinger and Ellison in 1964; if left untreated, ZES can lead to multiple complications mainly due to gastric hypersecretion and some patients can suffer from the complications of an advanced metastatic disease. Although its clinical features are considered typical, the diagnosis of ZES is often challenging for the clinician. A previous review was published in 2005 by our group, but in 12 years many things have changed: the diagnostic tools have been improved and many different therapeutical options are now available.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1709
[Cu] Class update date: 170926
[Lr] Last revision date:170926
[St] Status:Publisher
[do] DOI:10.23736/S0391-1977.17.02745-6

  7 / 3237 MEDLINE  
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[PMID]: 28776139
[Au] Autor:Mendelson AH; Donowitz M
[Ad] Address:Division of Gastroenterology and Hepatology, Department of Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. amendel5@jhmi.edu.
[Ti] Title:Catching the Zebra: Clinical Pearls and Pitfalls for the Successful Diagnosis of Zollinger-Ellison Syndrome.
[So] Source:Dig Dis Sci;, 2017 Aug 03.
[Is] ISSN:1573-2568
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Zollinger-Ellison syndrome (ZES) results from an ectopic gastrin-secreting tumor leading to peptic ulcer disease, reflux, and chronic diarrhea. While early recognition portends an excellent prognosis with >80% survival at 15 years, symptoms are often nonspecific making the diagnosis difficult to establish. Diagnosis involves a series of tests, including fasting gastrin, gastric pH, chromogranin A, and secretin stimulation. Performing these tests in the correct sequence and at the proper time is essential to avoid inaccurate results. Tumor localization is equally nuanced. Although providers have classically used indium-radiolabeled octreotide with somatostatin receptor scintigraphy to evaluate tumor size and metastases, recent studies have shown superior results with newer imaging modalities. In particular, gallium ( Ga)-labeled somatostatin radiotracers (i.e., Ga-DOTATOC, Ga-DOTANOC and Ga-DOTATATE) used with positron emission tomography/computed tomography can provide excellent results. Endoscopic ultrasound is another useful modality, particularly in patients with ZES in the setting of multiple endocrine neoplasia type 1. This review aims to provide clinicians with an overview of ZES with a focus on both clinical presentation and the proper utilization of the various biochemical and imaging tests available.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1708
[Cu] Class update date: 170818
[Lr] Last revision date:170818
[St] Status:Publisher
[do] DOI:10.1007/s10620-017-4695-7

  8 / 3237 MEDLINE  
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[PMID]: 28728310
[Au] Autor:Shim YK; Kim N
[Ad] Address:Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Korea.
[Ti] Title:The Effect of H Receptor Antagonist in Acid Inhibition and Its Clinical Efficacy.
[So] Source:Korean J Gastroenterol;70(1):4-12, 2017 Jul 25.
[Is] ISSN:2233-6869
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:The first histamine H receptor antagonists (H RAs) were developed in the early 1970s. They played a dominant role in treating peptic ulcer disease and gastroesophageal reflux disease (GERD). H RAs block the production of acid by H , K -ATPase at the parietal cells and produce gastric luminal anacidity for varying periods. H RAs are highly selective, and they do not affect H1 receptors. Moreover, they are not anticholinergic agents. Sequential development of H RAs, proton pump inhibitors (PPIs), and discovery of infection changed the paradigm of peptic ulcer disease with marked decrease of morbidity and mortality. PPIs are known to be the most effective drugs that are currently available for suppressing gastric acid secretion. Many studies have shown its superiority over H RAs as a treatment for acid-related disorders, such as peptic ulcer disease, GERD, and Zollinger-Ellison syndrome. However, other studies have reported that PPIs may not be able to render stomach achlorhydric and have identified a phenomenon of increasing gastric acidity at night in individuals receiving a PPI twice daily. These nocturnal acid breakthrough episodes can be eliminated with an addition of H RAs at night. The effectiveness of nighttime dose of H RA suggests a major role of histamine in nocturnal acid secretion. H RAs reduce secretion of gastric acid, and each H RA also has specific effects. For instance, nizitidine alleviates not only symptoms of GERD, but also provokes gastric emptying, resulting in clinical symptom improvement of functional dyspepsia. The aim of this paper was to review the characteristics and role of H RAs and assess the future strategy and treatment of upper gastrointestinal disease, including acid related disorders.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1707
[Cu] Class update date: 170721
[Lr] Last revision date:170721
[St] Status:In-Process
[do] DOI:10.4166/kjg.2017.70.1.4

  9 / 3237 MEDLINE  
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[PMID]: 28694576
[Au] Autor:Nath AL; Saxena NA; Kulkarni BK; Borwankar SS; Lahoti HN; Oak SN
[Ad] Address:Department of Pediatrics, Dr. D. Y. Patil Hospital and Research Centre, Navi Mumbai, Maharashtra, India.
[Ti] Title:Zollinger-Ellison Syndrome in a 12-year-old Child.
[So] Source:J Indian Assoc Pediatr Surg;22(3):168-169, 2017 Jul-Sep.
[Is] ISSN:0971-9261
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:The syndrome described by Zollinger and Ellison in 1955 is a rare clinical entity which is even rarer in children. This report describes a 12-year-old boy who presented with refractory peptic ulcer disease which was finally diagnosed to be due to a gastrinoma and was successfully treated.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1707
[Cu] Class update date: 170816
[Lr] Last revision date:170816
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.4103/0971-9261.207623

  10 / 3237 MEDLINE  
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[PMID]: 28639271
[Au] Autor:Anderson B; Sweetser S
[Ad] Address:Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN, USA.
[Ti] Title:Gastrointestinal: Zollinger-Ellison Syndrome: A rare cause of chronic diarrhea and abdominal pain.
[So] Source:J Gastroenterol Hepatol;32(7):1281, 2017 Jul.
[Is] ISSN:1440-1746
[Cp] Country of publication:Australia
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1706
[Cu] Class update date: 170622
[Lr] Last revision date:170622
[St] Status:In-Data-Review
[do] DOI:10.1111/jgh.13630


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