1,720,981 research outputs found
Circulating Biochemical Markers of Gastro-Entero-Pancreatic (GEP) Neuroendocrine Neoplasms(NENs)
No full textNeuroendocrine neoplasms (NENs) are a heterogeneous group of neoplasms which represent a true challenge for clinicians. Their incidence and prevalence have been increasing over the past years partly due to increased awareness and improvements in instrumental diagnostic techniques so that a growing number of clinicians are facing this disease. Management of NEN represents a clinical challenge because of its late presentation, scarcity of standardized guidelines, and limitations in imaging modalities and biomarkers to guide management. The beginning of the diagnostic process of NENs is often based on the measurement of circulating markers, before planning expensive and invasive diagnostic tests; however up to 60–80% of NENs are metastatic at diagnosis, which highlights the frequent failure to identify symptoms or to establish a biochemical diagnosis. Classical available markers, which can be divided into general and specific biomarkers, often lack sensitivity and/or specificity and need to be interpreted in the diagnostic process. Therefore, it is very important to know the advantages and limitations of these diagnostic tools. On the other hand, new biomarkers are emerging in the scenario of molecular diagnostics. This chapter aims to review the different characteristics of the available biomarkers, exposing the strengths and limitations of each, for their best clinical use
Endoscopic Ultrasound Elastography in Pancreatic Diseases EUS-EG in Pancreatic Diseases
No full textElastography is a new ultrasound technique for tissue characterization, providing a noninvasive modality for the evaluation of tissue stiffness. Different pathologic processes such as cancerization and fibrosis alter tissue elasticity and therefore induce changes in elastographic appearance. The application of elastography to endoscopic ultrasound (EUS) technique allows a better characterization of lesions by the evaluation of tissue stiffness in sites only accessible from the gastrointestinal tract. In addition, the recent introduction of second-generation elastographic techniques (EUS-EG) allows an objective quantitative analysis of tissue strain. In the last years, EUS-EG has been increasingly used in the evaluation of several pancreatic diseases, including neoplasms, and inflammatory processes. Malignant pancreatic lesions are generally harder than adjacent pancreatic tissue, due to the presence of fibrosis and marked desmoplasia. In this setting, EUS-EG demonstrated high accuracy for the differential diagnosis of solid pancreatic tumors. Concerning parenchymal diseases, EUS-EG has been demonstrated to be a useful tool in the diagnosis of chronic pancreatitis and autoimmune pancreatitis. EUS-EG can provide an objective quantization of parenchymal stiffness, having a valuable role during the follow-up for monitoring possible disease progression and the need for medical treatment. We here aimed to review the main applications of EUS-EG in both focal and parenchymal pancreatic disease
Small Bowel Ultrasound beyond Inflammatory Bowel Disease: An Updated Review of the Recent Literature
No full textIs there still a role for the hepatic locoregional treatment of metastatic neuroendocrine tumors in the era of systemic targeted therapies?
No full textSomatostatin analogs in patients with Zollinger Ellison syndrome (ZES): an observational study
No full textPurpose: Zollinger Ellison syndrome (ZES) is a rare syndrome caused by gastrin hypersecretion from a gastrinoma. Gastrinoma treatment has two goals: the control of acid hypersecretion and the control of tumor growth. While therapy for the syndrome is univocally based on proton pump inhibitors, the one for disease control is still debated. We here aimed at evaluating the role of somatostatin analogs (SSAs) in the control of tumor progression in a series of ZES patients. Methods: A retrospective analysis of a prospectively collected database of ZES patients, followed and managed from 1990 to 2019, was performed. The patients’ clinical, pathological, treatment, and follow-up data were analyzed. Data regarding SSAs therapy start, dosage, duration, and side effects were collected. Results: 33 patients with ZES were diagnosed. Fourteen patients (42%) had a grade 1 (G1) neuroendocrine neoplasm (NEN), five had G2 (15%), none had G3. Fifteen patients (45%) had metastatic disease. Overall, 12 (36%) underwent SSAs therapy. The median treatment duration was 36 months. Eight patients (67%) had a sustained response to SSAs, four (33%) showed an early progression, with a significant difference in terms of PFS between the patients with early and late progression (84 vs 2 months, p = 0.004). No differences in terms of OS and PFS were observed between the treated and non-treated patients, despite the proportion of metastatic patients was greater in the SSAs-treated group (75% vs 29% in the non-treated group, p = 0.01). Conclusion: Present data support the use of SSAs in ZES, considering that gastrinoma is mainly a well-differentiated low-grade tumor (G1 or G2), with a high expression of somatostatin receptors
Micronutrient deficiencies in patients with chronic atrophic autoimmune gastritis: A review
No full textDeficiency of micronutrients in patients affected by chronic atrophic autoimmune gastritis: A single-institution observational study
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Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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