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Neuroendocrine tumors of the gastrointestinal tract: Case reports and literature review

World journal of Gastrointestinal Oncology 2014年第8期6卷 301-310页

作者： william j salyers Kenneth j Vega juan Carlos Munoz Bruce W Trotman Silvio S Tanev Division of Gastroenterology University of Florida College of Medicine/Jacksonville Jacksonville FL 32207 United States Division of Digestive Diseases and Nutrition University of Oklahoma Health Sciences Center Oklahoma City OK 73104 United States Department of Medicine University of Maryland School of Medicine Baltimore MD 21201 United States Department of Pathology Manatee Memorial Hospital Bradenton FL 34208 United States

Neuroendocrine tumors(NET)previously called carcinoid tumors are neoplasms of enterochromaffin/neuroendocrine cell origin which display neurosecretory capacity that may result in the carcinoid *** annual incidence of patients with NET is 8.4 per 100000;yet many NET remain asymptomatic and clinically undetected.A majority of NET follows a benign course;however,some will display malignant *** most commonly occur in the gastrointestinal tract(67%)and bronchopulmonary system(25%).Gastrointestinal NET occur within the stomach,small intestine,liver,and *** report a retrospective study of 11 subjects:Eight with benign carcinoid tumors:duodenal bulb(n=2),terminal ileum(n=1),sigmoid colon(n=2),and rectum(n=3);three with malignant carcinoid:liver(n=1)and intra-abdominal site(n=2).The diagnosis,endoscopic images,outcome,treatment and review of the literature are presented.

关键词： Neuroendocrine Carcinoid Gastrointestinal Tumors

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Under-diagnosing and under-treating iron deficiency in hospitalized patients with gastrointestinal bleeding

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World journal of Gastrointestinal Pharmacology and Therapeutics 2016年第1期7卷 139-144页

作者： Mustapha M El-Halabi Michael S Green Christopher jones william j salyers jr Department of Internal Medicine University of Kansas School of Medicine-Wichita Division of Gastroenterology University of Kansas School of Medicine-Wichita

AIM: To determine whether patients hospitalized with gastrointestinal(GI) blood loss anemia are being checked and treated for iron deficiency. METHODS: Retrospective chart review was conducted for all patients admitted to a single tertiary care hospital between 11/1/2011 and 1/31/2012 for any type of GI bleeding. The primary endpoint was the percentage of patients who had their iron studies checked during a hospitalization for GI blood loss anemia. Secondary outcomes included percentage of anemic GI bleeders who had adequate documentation of anemia and iron deficiency, and those who were treated for their iron deficiency. Then we tried to identify possible predictors of checking iron studies in an attempt to understand the thought process that physicians go through when managing these patients. Iron deficiency was defined as Iron saturation less than 15% or ferritin level less than 45 μg/L. Anemia was defined as hemoglobin level less than 13 g/dL for males and 12 g/dL for ***: Three hundred and seven GI bleeders were hospitalized during the study period, and 282 of those(91.9%) had anemia during their hospital stay. Ninetyfive patients(30.9%) had iron studies performed during hospitalization, and 45 of those(47.4%) were actually found to be iron deficient. Only 29 of those 45 iron deficient patients were discharged home on iron supplements. Of the 282 patients that had anemia during hospitalization, 50(17.7%) had no documentation of the anemia in their hospital chart. Of the 45 patients that had lab proven iron deficiency anemia(IDA), only 22(48.5%) had documentation of IDA in at least one note in their chart. Predictors of checking iron studies in anemic GI bleeders were lower mean corpuscular volume, documentation of anemia, having fecal occult blood testing, not having hematemesis or past history of GI bleeding. There were no significant differences between the teaching and non-teaching services in any patient characteristics or outcomes. CONCLUSION:

关键词： Gastrointestinal bleeding Iron deficiency anemia Acute blood loss anemia Iron supplements Documentation

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