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Povilas Ignatavicius, Aiste Gulla, Karolis Cernauskis, Giedrius Barauskas, Zilvinas Dambrauskas
AIM: To explore the outcomes and the appropriate treatment for patients with moderately severe acute pancreatitis (AP). METHODS: Statistical analysis was performed on data from the prospectively collected database of 103 AP patients admitted to the Department of Surgery, Hospital of Lithuanian University of Health Sciences in 2008-2013. All patients were confirmed to have the diagnosis of AP during the first 24 h following admission. The severity of pancreatitis was assessed by MODS and APACHE II scale...
November 21, 2017: World Journal of Gastroenterology: WJG
Aparna Jakkampudi, Ramaiah Jangala, Ratnakar Reddy, Sasikala Mitnala, G Venkat Rao, Rebala Pradeep, D Nageshwar Reddy, Rupjyoti Talukdar
Clinical acute pancreatitis (AP) is marked by an early phase of systemic inflammatory response syndrome (SIRS) with multiorgan dysfunction (MODS), and a late phase characterized by sepsis with MODS. However, the mechanisms of acinar injury in human AP and the associated systemic inflammation are not clearly understood. This study, for the first time, evaluated the early interactions of bile acid induced human pancreatic acinar injury and the resulting cytokine response. We exposed freshly procured resected human pancreata to taurolithocolic acid (TLCS) and evaluated for acinar injury, cytokine release and interaction with peripheral blood mononuclear cells (PBMCs)...
November 10, 2017: Scientific Reports
Runkuan Yang, Jyrki Tenhunen, Tor Inge Tonnessen
Severe acute pancreatitis (SAP) starts as a local inflammation of pancreatic tissue that induces the development of multiple extrapancreatic organs dysfunction; however, the underlying mechanisms are still not clear. Ischemia-reperfusion, circulating inflammatory cytokines, and possible bile cytokines significantly contribute to gut mucosal injury and intestinal bacterial translocation (BT) during SAP. Circulating HMGB1 level is significantly increased in SAP patients and HMGB1 is an important factor that mediates (at least partly) gut BT during SAP...
2017: International Journal of Inflammation
Sebastian Rasch, Veit Phillip, Stephanie Reichel, Bettina Rau, Christian Zapf, Jonas Rosendahl, Ulrich Halm, Markus Zachäus, Martin Müller, Alexander Kleger, Albrecht Neesse, Jochen Hampe, Mark Ellrichmann, Felix Rückert, Peter Strauß, Alexander Arlt, Volker Ellenrieder, Thomas M Gress, Werner Hartwig, Ernst Klar, Joachim Mössner, Stefan Post, Roland M Schmid, Thomas Seufferlein, Marco Siech, Jens Werner, Uwe Will, Hana Algül
BACKGROUND: Necrotising pancreatitis, and particularly infected necrosis, are still associated with high morbidity and mortality. Since 2011, a step-up approach with lower morbidity rates compared to initial open necrosectomy has been established. However, mortality and complication rates of this complex treatment are hardly studied thereafter. METHODS: The German Pancreatitis Study Group performed a multicenter, retrospective study including 220 patients with necrotising pancreatitis requiring intervention, treated at 10 hospitals in Germany between January 2008 and June 2014...
2016: PloS One
(no author information available yet)
OBJECTIVE: To observe the occurrence rate of elevated serum amylase and lipase in critically ill children, to explore the relationship between elevated pancreatic enzymes and pancreatic injury, and the effect of elevated pancreatic enzymes on state of illness and the prognosis. METHOD: The data of cases treated in pediatric intensive care unit(ICU) of 17 children's hospitals were collected prospectively from January 2012 to March 2014 according to the inclusion and exclusion criteria...
September 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Wei-Ping Tai, Xiang-Chun Lin, Hong Liu, Cang-Hai Wang, Jing Wu, Neng-Wei Zhang, Wei Chen
Aim. To investigate the characteristic of hypertriglyceridemic- (HTG-) induced pancreatitis (HTG pancreatitis). Methods. We reviewed 126 cases of HTG pancreatitis and 168 cases of biliary pancreatitis as control. Results. The HTG group mean age was younger than biliary group. The number of females was a little higher than males in both groups. There were 18 cases that were recurrent in HTG group and 11 in billiary group. The mean hospitalization times were 13.7 ± 2.6 and 11.2 ± 2.3 days in two groups. Six patients received apheresis in HTG group...
2016: Gastroenterology Research and Practice
Sarjana S Atal, Shubham Atal
Despite significant improvements in medical and surgical management, multiple organ dysfunction syndrome (MODS) or multiple organ failure following conditions such as acute pancreatitis, severe sepsis, and traumatic, hemorrhagic, and endotoxin shocks is still accompanied with a high mortality rate. In light of the crucial role of immunologic derangement recently conceptualized in these conditions, ulinastatin, a urinary trypsin inhibitor, is considered as a potentially beneficial immunomodulator drug for MODS...
March 2016: Journal of Basic and Clinical Physiology and Pharmacology
Žurek Jiří, Michal Kýr, Martin Vavřina, Michal Fedora
Pancreatic stone protein (PSP)/regenerating protein 1-alpha (reg) is associated with inflammation, infection, and other disease-related stimuli. The prognostic value of PSP/reg among critically ill pediatric patients is unknown. The aim of this pilot study was to evaluate PSP/reg in children with systemic inflammatory response syndrome or sepsis. Prospective observational study, a five day evaluation period in children 0-19years old with systemic inflammatory response syndrome or septic state. Blood tests to determine levels of PSP/reg were obtained as long as the patient met the criteria for systemic inflammatory response syndrome or sepsis...
April 2014: Cytokine
Gang Zhao, Jun-Gang Zhang, He-Shui Wu, Jin Tao, Qi Qin, Shi-Chang Deng, Yang Liu, Lin Liu, Bo Wang, Kui Tian, Xiang Li, Shuai Zhu, Chun-You Wang
AIM: To compare effects of different resuscitation fluid on microcirculation, inflammation, intestinal barrier and clinical results in severe acute pancreatitis (SAP). METHODS: One hundred and twenty patients with SAP were enrolled at the Pancreatic Disease Institute between January 2007 and March 2010. The patients were randomly treated with normal saline (NS group), combination of normal saline and hydroxyethyl starch (HES) (SH group), combination of normal saline, hydroxyethyl starch and glutamine (SHG group) in resuscitation...
April 7, 2013: World Journal of Gastroenterology: WJG
Nayyar Iqbal, Stalin Viswanathan, Bhavith Remalayam, Vivekanandan Muthu, Tarun George
We report a 40 year old woman admitted with an acute abdomen. Investigations revealed pancreatitis, bilateral pleural effusion, renal failure, disseminated intravascular coagulation, and scrub IgM ELISA and dengue NS1 positivity. She improved with azithromycin and appropriate pain and fluid management. She also developed central venous catheter-related MRSA sepsis that was managed in the hospital.
April 2012: Tropical Medicine and Health
Yi Tang, Ling Zhang, Ping Fu, Yan Kang, Fang Liu
Severe acute pancreatitis is a common critical disease, which may cause severe complications such as sepsis and multiple organ dysfunction syndrome (MODS), and has a high mortality. A 31-year-old woman with 25-weeks pregnancy presented with hyperlipidemic pancreatitis, sepsis and MODS. Based on conventional treatment, 125 h of continuous veno-venous hemofiltration (CVVH) and 3 sessions of hemoperfusion (HP) were carried out. The treatment turned out to be very successful. We suggest that early intervention by blood purification therapy, and CVVH combined with HP could be effective in severe acute pancreatitis...
June 2012: International Urology and Nephrology
Pavle Gregoric, Gregoric Pavle, Ana Sijacki, Sijacki Ana, Sanja Stankovic, Stankovic Sanja, Dejan Radenkovic, Radenkovic Dejan, Nenad Ivancevic, Ivancevic Nenad, Aleksandar Karamarkovic, Karamarkovic Aleksandar, Nada Popovic, Popovic Nada, Borivoje Karadzic, Karadzic Borivoje, Lazar Stijak, Branislav Stefanovic, Stefanovic Branislav, Zoran Milosevic, Milosević Zoran, Djordje Bajec, Bajec Djordje
BACKGROUND/AIMS: Early recognition of severe form of acute pancreatitis is important because these patients need more agressive diagnostic and therapeutical approach an can develope systemic complications such as: sepsis, coagulopathy, Acute Lung Injury (ALI), Acute Respiratory Distress Syndrome (ARDS), Multiple Organ Dysfunction Syndrome (MODS), Multiple Organ Failure (MOF). To determine role of the combination of Systemic Inflammatory Response Syndrome (SIRS) score and serum Interleukin-6 (IL-6) level on admission as predictor of illness severity and outcome of Severe Acute Pancreatitis (SAP)...
March 2010: Hepato-gastroenterology
Matijs van Meurs, Philipp Kümpers, Jack J M Ligtenberg, John H J M Meertens, Grietje Molema, Jan G Zijlstra
Multiple organ dysfunction syndrome (MODS) occurs in response to major insults such as sepsis, severe haemorrhage, trauma, major surgery and pancreatitis. The mortality rate is high despite intensive supportive care. The pathophysiological mechanism underlying MODS are not entirely clear, although several have been proposed. Overwhelming inflammation, immunoparesis, occult oxygen debt and other mechanisms have been investigated, and - despite many unanswered questions - therapies targeting these mechanisms have been developed...
2009: Critical Care: the Official Journal of the Critical Care Forum
W Manzanares Castro
Selenium is an essential micronutrient for humans. Critically ill patients with Systemic Inflammatory Response Syndrome (SIRS) and Multiple Organ Dysfunction (MOD) -such as severe sepsis, trauma, severe pancreatitis and critical burns- are exposed to severe oxidative stress. These patients exhibit decreased serum Selenium and selenoenzymes like Glutathione Peroxidase and Selenoprotein P. Selenoenzymes play a major role in protecting cells against lipid peroxidation and they are involved in the inflammatory response regulation...
May 2007: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
Bettina M Rau, Esko A Kemppainen, Andrew A Gumbs, Markus W Büchler, Karl Wegscheider, Claudio Bassi, Pauli A Puolakkainen, Hans G Beger
BACKGROUND: Pancreatic infections and sepsis are major complications in severe acute pancreatitis (AP) with significant impact on management and outcome. We investigated the value of Procalcitonin (PCT) for identifying patients at risk to develop pancreatic infections in severe AP. METHODS: A total of 104 patients with predicted severe AP were enrolled in five European academic surgical centers within 96 hours of symptom onset. PCT was measured prospectively by a semi-automated immunoassay in each center, C-reactive protein (CRP) was routinely assessed...
May 2007: Annals of Surgery
Steven C Cunningham, Debra L Malone, Grant V Bochicchio, Thomas Genuit, Kaspar Keledjian, J Kathleen Tracy, Lena M Napolitano
BACKGROUND: In low concentrations, lipopolysaccharide-binding protein (LBP), an acute-phase protein recognizing lipopolysaccharide (LPS), catalyzes its transfer to the cellular receptor consisting of CD14 and Toll-like receptor-4. Previous studies have documented increased serum LBP concentrations in patients with sepsis, systemic inflammatory response syndrome (SIRS), or acute pancreatitis and after cardiopulmonary bypass. No prior studies have examined LBP expression in trauma victims...
June 2006: Surgical Infections
Naoyuki Matsuda, Yuichi Hattori
In recent years, extensive basic science research has led to a clear understanding of the molecular mechanisms contributing to the pathophysiology of sepsis. Sepsis is now defined as a systemic inflammatory response syndrome (SIRS) in which there is an identifiable focus of infection. SIRS can be also precipitated by non-infective events such as trauma, pancreatitis, and surgery. As a consequence of an overactive SIRS response, the function of various organ systems may be compromised, resulting in multiple organ dysfunction syndrome (MODS) and death...
July 2006: Journal of Pharmacological Sciences
Colleen R Walsh
Multiple organ dysfunction syndrome (MODS) is a serious, often fatal, sequel to multiple trauma. Prolonged shock states, severe sepsis, acute pancreatitis, acute renal failure, severe burns, ischemic conditions, and acute respiratory distress syndrome have been implicated in the development of MODS. Despite advances in critical care therapies and infection control practices, severe sepsis remains a major health problem, with an estimated mortality rate of 30-50% (Ely, Kleinpell, & Goyett, 2003). The purposes of this article are to describe the pathophysiologic changes that lead to the development of MODS and discuss strategies to prevent the development of MODS and to treat MODS if it develops...
September 2005: Orthopaedic Nursing
Avery B Nathens, J Randall Curtis, Richard J Beale, Deborah J Cook, Rui P Moreno, Jacques-Andre Romand, Shawn J Skerrett, Renee D Stapleton, Lorraine B Ware, Carl S Waldmann
OBJECTIVE: Acute pancreatitis represents a spectrum of disease ranging from a mild, self-limited course requiring only brief hospitalization to a rapidly progressive, fulminant illness resulting in the multiple organ dysfunction syndrome (MODS), with or without accompanying sepsis. The goal of this consensus statement is to provide recommendations regarding the management of the critically ill patient with severe acute pancreatitis (SAP). DATA SOURCES AND METHODS: An international consensus conference was held in April 2004 to develop recommendations for the management of the critically ill patient with SAP...
December 2004: Critical Care Medicine
Wen-Kui Yu, Wei-Qin Li, Ning Li, Jie-Shou Li
BACKGROUND: In acute pancreatitis (AP), several studies indicated that the balance between pro- and anti-inflammatory mediators is more important than the levels of proinflammatory response alone. This balance may be reflected by the expression of monocyte histocompatibility leukocyte antigen (HLA)-DR, with a low concentration indicating an excess of anti-inflammatory stimuli and relative immunodeficiency. We investigated the time course of HLA-DR expression in the early phase of AP and the relationship to markers of inflammation, severity of the disease, organ function, septic complications and outcome during AP...
2004: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
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