scholarly journals Systematic review: management of localised low-grade upper gastrointestinal neuroendocrine tumours

2020 ◽  
Vol 51 (12) ◽  
pp. 1247-1267
Author(s):  
Klaire Exarchou ◽  
Nathan Howes ◽  
David Mark Pritchard
Keyword(s):  
Systematic Review ◽  
Neuroendocrine Tumours ◽  
Low Grade ◽  
Review Management ◽  
Gastrointestinal Neuroendocrine Tumours ◽  
Upper Gastrointestinal

scholarly journals Paraneoplastic Cushing Syndrome in Gastrointestinal Neuroendocrine Tumour

2021 ◽  
pp. 1407-1413
Author(s):  
Laurent Mineur ◽  
Rania Boustany ◽  
Léa Vazquez
Keyword(s):  
Neuroendocrine Tumours ◽  
Cushing Syndrome ◽  
Neuroendocrine Tumour ◽  
Low Grade ◽  
Effective Management ◽  
Ectopic Acth ◽  
Ectopic Acth Secretion ◽  
Ectopic Production ◽  
Gastrointestinal Neuroendocrine Tumours

Ectopic production of adrenocorticotropic hormone (ACTH) by gastrointestinal neuroendocrine tumours (NETs) is relatively uncommon. We report a rare case of a liver metastatic G1 low-grade NET of the intestine that induced hypercortisolism after surgical resection. A 50-year-old man was admitted for an intestinal obstruction caused by a tumour of the intestine. Paraneoplastic Cushing syndrome was diagnosed more than a year later following the appearance of cushingoid symptoms, despite stable disease according to RECIST criteria but chromogranin A increase. Ketoconazole and sandostatin medical treatment and liver chemoembolization never managed to control the hypercortisolism unlike the bilateral adrenalectomy. The identification and effective management of this uncommon statement of ectopic ACTH secretion is important to improve the patient’s prognosis and quality of life.

scholarly journals SARS-CoV-2 and Obesity: “CoVesity”—a Pandemic Within a Pandemic

2021 ◽  
Author(s):  
Kimberley Zakka ◽  
◽  
Swathikan Chidambaram ◽  
Sami Mansour ◽  
Kamal Mahawar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Viral Load ◽  
Respiratory Failure ◽  
Health Outcomes ◽  
Severe Disease ◽  
Vulnerable Population ◽  
Low Grade ◽  
Obesity Management ◽  
Low Grade Inflammation

AbstractIndividuals who are overweight or suffering from obesity are in a chronic state of low-grade inflammation, making them particularly susceptible to developing severe forms of respiratory failure. Studies conducted in past pandemics link obesity with worse health outcomes. This population is thus of particular concern within the context of the COVID-19 pandemic, considering the cessation of obesity management services. This systematic review highlights [1] the reciprocal link between the obesity and COVID-19 pandemics, [2] obesity as a risk factor for more severe disease in past pandemics, [3] potential mechanisms that make individual’s suffering from obesity more susceptible to severe disease and higher viral load, and [4] the need to safely resume bariatric services as recommended by expert guidelines, in order to mitigate the health outcomes of an already vulnerable population.

scholarly journals Treatment of asymptomatic blunt cerebrovascular injury (BCVI): a systematic review

2021 ◽  
Vol 6 (1) ◽  
pp. e000668
Author(s):  
Patrick B Murphy ◽  
Sarah Severance ◽  
Emma Holler ◽  
Laura Menard ◽  
Stephanie Savage ◽  
...  
Keyword(s):  
Systematic Review ◽  
Medical Management ◽  
Specific Treatment ◽  
Cochrane Library ◽  
Synthesis Methods ◽  
Low Grade ◽  
Significant Heterogeneity ◽  
Blunt Cerebrovascular Injury ◽  
Cerebrovascular Injury ◽  
Preventive Medication

BackgroundThe management of asymptomatic blunt cerebrovascular injury (BCVI) with respect to stroke prevention and vessel healing is challenging.ObjectivesThe aim of this systematic review was to determine if a specific treatment results in lower stroke rates and/or improved vessel healing in asymptomatic BCVI.Data sourcesAn electronic literature search of MEDLINE, EMBASE, Cochrane Library, CINAHL, SCOPUS, Web of Science, and ClinicalTrials.gov performed from inception to March 2020.Study eligibility criteriaStudies were included if they reported on a comparison of any treatment for BCVI and stroke and/or vessel healing rates.Participants and interventionsAdult patients diagnosed with asymptomatic BCVI(s) who were treated with any preventive medication or procedure.Study appraisal and synthesis methodsAll studies were systematically reviewed and bias was evaluated by the Newcastle-Ottawa Scale. No meta-analysis was performed secondary to significant heterogeneity across studies in patient population, screening protocols, and treatment selection. The main outcomes were stroke and healing rate.ResultsOf 8781 studies reviewed, 19 reported on treatment effects for asymptomatic BCVI and were included for review. Any choice of medical management was better than no treatment, but no specific differences between choice of medical management and stroke outcomes were found. Vessel healing was rare and the majority of healed vessels were following low-grade injuries.LimitationsMajority of the included studies were retrospective and at high risk of bias.Conclusions or implications of key findingsAsymptomatic BCVI should be treated medically using a consistent, local protocol. High-quality studies on the effect of individual antithrombotic agents on stroke rates and vessel healing for asymptomatic BCVI are required.

scholarly journals Seizure outcome after radiotherapy and chemotherapy in low-grade glioma patients: a systematic review

2015 ◽  
Vol 17 (7) ◽  
pp. 924-934 ◽  
Author(s):  
Johan A. F. Koekkoek ◽  
Melissa Kerkhof ◽  
Linda Dirven ◽  
Jan J. Heimans ◽  
Jaap C. Reijneveld ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Grade Glioma ◽  
Seizure Outcome ◽  
Low Grade

980 Technological Innovations in The Management of Pressure Ulcers: A Systematic Review and Discussion

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Srivastava ◽  
P Khanal ◽  
D Zargaran ◽  
F Zoller ◽  
A Zargaran ◽  
...  
Keyword(s):  
Systematic Review ◽  
Wound Healing ◽  
Wound Repair ◽  
Pressure Ulcers ◽  
Free Text ◽  
Low Grade ◽  
High Grade ◽  
Innovative Technologies ◽  
Fourfold Increase ◽  
Technological Intervention

Abstract Aim Pressure ulcers (PUs) affect over 700,000 patients per annum and are associated with an up to fourfold increase in mortality rate in older populations with complex pathologies. NICE guidelines for PU management involve a combination of low-grade technological interventions, including dressings and foam mattresses, while technology-centric therapies are not offered. The aim of this systematic review is to evaluate the effectiveness of any novel and high-grade technological PU interventions. Method The PubMed, Embase (via Ovid), Web of Science and CINAHL databases were electronically searched using free-text and MeSH search strings. Results evaluating the type of technological intervention, outcome measures and wound healing rates, duration of hospital stay, requirement for surgical debridement, infection and mortality rates were methodically assessed. Results An initial search identified 900 articles. Using the PRISMA guidance, 25 studies were included, encompassing 845 patients. 28 novel modalities of high-grade innovations were identified, with distinguished technologies including smart wireless bandages and 3D-printed wound repair scaffolds. Overall, 92.8% of devices demonstrated an improvement in wound healing (P < 0.05). A novel framework was created from the different innovations identified to approach adopting innovation in PU management. Conclusions The majority of high-technology innovations identified in this systematic review significantly improve PU healing, thus offering an additional pathway to standard care. Given the annual cost of PUs (£531 million), it is vital innovative technologies are considered as the NHS transitions into a digital age. Therefore, further studies are essential and recommended to evaluate the potential benefit of the promising, innovative technologies identified.

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