Background: Somatostatin and its long-acting analogues are effective in symptom control in patients with functionally active neuroendocrine GEP tumours. Several in vitro and in vivo reports suggest that they are also able to control tumour growth. Methods: Critical review of published data on the effect of long-acting somatostatin analogues on symptom and growth control in patients with metastatic neuroendocrine GEP tumours. Results: With the exception of insulinoma and gastrinoma, octreotide acetate and other long-acting somatostatin formulations are currently the therapeutic principle of first choice to control hormone-mediated symptoms. The consequences of gastric acid hypersecretion in patients with Zollinger-Ellison syndrome are best controlled by proton pump inhibitors. Available data on growth control indicate that stabilization of tumour growth seems to be the most beneficial antiproliferative effect occurring in up to 50% of patients. This effect is limited. However, it is unknown which tumour entity responds best to long- acting somatostatin analogues. Conclusion: Additional studies in patients with known spontaneous tumour growth and avoiding a mix-up of different entities of neuroendocrine malignancies are necessary to identify subpopulations of neuroendocrine tumours which respond to long-acting somatostatin analogues in terms of longer lasting growth inhibition.

Treatment of neuroendocrine GEP tumours with somatostatin analogues: a review.

https://www.amjmed.com/article/0002-9343(90)90467-R/pdf

Management of severe hyponatremia: rapid or slow correction?

Clinical utility of copper, ceruloplasmin, and metallothionein plasma determinations in human neurodegenerative patients and their first-degree relatives.

The biology and practice of surgical drains part I

Hyponatraemia is common among the elderly, and may be caused by physiological changes, disease processes or drugs. About half of elderly patients with hyponatraemia have features typical of the syndrome of inappropriate antidiuretic hormone secretion (SIADH). It is important to establish whether drugs are the cause, as this is easily remediable. The clinical manifestations of SIADH are predominantly attributable to hyponatraemia and serum hypo-osmolality. The severity of the signs and symptoms depends on the degree of hyponatraemia and the rapidity with which the syndrome develops. Although a growing number of drugs have been reported to produce SIADH, most published reports concern vasopressin and its analogues, thiazide and thiazide-like diuretics, chlorpropamide, carbamazepine, antipsychotics, antidepressants and nonsteroidal anti-inflammatory drugs. Old age is a risk factor for SIADH following the use of many of these drugs. The use of these drugs in combination, excessive fluid intake and other underlying conditions that limit free water excretion increase the risk. Drug-induced SIADH usually resolves following cessation of the offending agent(s). Additional measures are required in patients with symptomatic hyponatraemia, including fluid restriction and intravenous sodium chloride and/or furosemide (frusemide) therapy. Careful monitoring is essential, with particular attention paid to the rate and extent of correction of the hyponatraemia.

Drug-Induced Syndrome of Inappropriate Antidiuretic Hormone Secretion. Causes, Diagnosis and Management.

Clinical value of serum bilirubin subfractionation by high-performance liquid chromatography and conventional methods in patients with primary biliary cirrhosis

Excerpt Short-term infusion (2 hours) of somatostatin has been shown to reduce urinary volume and free-water clearance in healthy persons (1). Although somatostatin is being widely used (2), water ...

Life-Threatening Water Intoxication During Somatostatin Therapy

Plasma glutathione S-transferase alpha 1-1 levels in patients with chronic liver disorders.

https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.1840020614

Kinetics of 64copper in primary biliary cirrhosis

https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.1840140610

A. Roelof Janssens

Papers

Clinical value of serum bilirubin subfractionation by high-performance liquid chromatography and conventional methods in patients with primary biliary cirrhosis

Life-Threatening Water Intoxication During Somatostatin Therapy

Plasma glutathione S-transferase alpha 1-1 levels in patients with chronic liver disorders.

Kinetics of 64copper in primary biliary cirrhosis

Plasma metallothionein concentration in patients with liver disorders: special emphasis on the relation with primary biliary cirrhosis.