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https://www.readbyqxmd.com/read/28922207/sweet-sixteen-the-prospective-clinical-trials-of-john-l-cameron-md-the-clinician-scientist-from-alternate-allocation-to-randomized-controlled-trials
#1
Charles J Yeo
: The era of randomized controlled trials was ushered in by the British epidemiologist-statistician Austin Bradford Hill, with his work on the use of streptomycin in patients with tuberculosis. John L. Cameron, can be linked to 16 prospective clinical trials over his career thus far, starting with alternate-allocation trials and transitioning to prospective, randomized, placebo-controlled trials. These trials studied various topics in surgery-from pancreatitis to surgical site infections, to drain trials, a trial in Crohn disease and multiple trials in pancreatic surgery and cancer...
September 15, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28921102/pancreatic-acinar-cell-carcinoma-with-extensive-tumor-embolism-at-the-trunk-of-portal-vein-and-pancreatic-intraductal-infiltration
#2
Akihiko Kida, Koichiro Matsuda, Kai Takegoshi, Mitsuru Matsuda, Akito Sakai, Yatsugi Noda
A 59-year-old man was admitted to the hospital with acute pancreatitis. The cause was suggested to be a pancreatic tumor based on computed tomography (CT). The pancreatic tumor was 45 mm with an extensive tumor embolism at the trunk of the portal vein and intraductal infiltration of the main pancreatic duct (MPD). The pancreatic tumor was diagnosed as acinar cell carcinoma (ACC) by endoscopic ultrasound guided fine needle aspiration. Therefore, the cause of acute pancreatitis was diagnosed to be intraductal infiltration of ACC in the MPD...
September 18, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28919050/disease-and-treatment-factors-associated-with-lower-quality-of-life-scores-in-adults-with-multiple-endocrine-neoplasia-type-i
#3
Sneha Goswami, Benjamin J Peipert, Irene Helenowski, Susan E Yount, Cord Sturgeon
BACKGROUND: Physical and psychosocial morbidity of multiple endocrine neoplasia type-1 is ill-defined. How disease and treatment-related factors relate to patient-reported outcomes including health-related quality of life is unknown. We hypothesized that disease and treatment burden negatively impacts health-related quality of life in adults with multiple endocrine neoplasia type-1. METHODS: Adults (≥18 years) with multiple endocrine neoplasia type-1 completed an online survey of demographics, disease features, treatments, and Patient-Reported Outcomes Measurement Information System 29-item profile measure, and scores were compared with normative US data...
September 14, 2017: Surgery
https://www.readbyqxmd.com/read/28915662/cbl-b-predicts-postoperative-survival-in-patients-with-resectable-pancreatic-ductal-adenocarcinoma
#4
Qian Dong, Yuteng Ma, Yao Zhang, Xiujuan Qu, Zhi Li, Yafei Qi, Yunpeng Liu, Ce Li, Kai Li, Xianghong Yang, Xiaofang Che
Casitas B-lineage lymphoma b (Cbl-b) is a ubiquitin-protein ligase and a signal transducing adaptor protein involved in immune regulation, and it may be involved in the development and progression of cancer. We investigated the association between Cbl-b expression and prognosis in patients with resectable pancreatic ductal adenocarcinoma (PDAC). The clinicopathological characteristics and survival data of 134 patients with surgery for PDAC between January 2009 and February 2012 were retrospectively evaluated, and Cbl-b expression was assayed by immunohistochemical staining...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28915633/selection-of-optimal-molecular-targets-for-tumor-specific-imaging-in-pancreatic-ductal-adenocarcinoma
#5
Willemieke S Tummers, Arantza Farina-Sarasqueta, Martin C Boonstra, Hendrica A Prevoo, Cornelis F Sier, Jan S Mieog, Johannes Morreau, Casper H van Eijck, Peter J Kuppen, Cornelis J van de Velde, Bert A Bonsing, Alexander L Vahrmeijer, Rutger-Jan Swijnenburg
Discrimination of pancreatic ductal adenocarcinoma (PDAC) from chronic pancreatitis (CP) or peritumoral inflammation is challenging, both at preoperative imaging and during surgery, but it is crucial for proper therapy selection. Tumor-specific molecular imaging aims to enhance this discrimination and to help select and stratify patients for resection. We evaluated various biomarkers for the specific identification of PDAC and associated lymph node metastases. Using immunohistochemistry (IHC), expression levels and patterns were investigated of integrin αvβ6, carcinoembryonic antigen-related cell adhesion molecule 5 (CEACAM5), Cathepsin E (Cath E), epidermal growth factor receptor (EGFR), hepatocyte growth factor receptor (c-MET), thymocyte differentiation antigen 1 (Thy1), and urokinase-type plasminogen activator receptor (uPAR)...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28915575/hexokinase-2-promotes-tumor-growth-and-metastasis-by-regulating-lactate-production-in-pancreatic-cancer
#6
Marybeth Anderson, Raoud Marayati, Richard Moffitt, Jen Jen Yeh
Pancreatic ductal adenocarcinoma (PDAC) is a KRAS-driven cancer with a high incidence of metastasis and an overall poor prognosis. Previous work in a genetically engineered mouse model of PDAC showed glucose metabolism to be important for maintaining tumor growth. Multiple glycolytic enzymes, including hexokinase 2 (HK2), were upregulated in primary PDAC patient tumors, supporting a role for glycolysis in promoting human disease. HK2 was most highly expressed in PDAC metastases, suggesting a link between HK2 and aggressive tumor biology...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28914984/hypercalcemic-disorders-in-children
#7
REVIEW
Victoria J Stokes, Morten F Nielsen, Fadil M Hannan, Rajesh V Thakker
Hypercalcemia is defined as a serum calcium concentration that is greater than 2 standard deviations above the normal mean, which in children may vary with age and sex, reflecting changes in the normal physiology at each developmental stage. Hypercalcemic disorders in children may present with hypotonia, poor feeding, vomiting, constipation, abdominal pain, lethargy, polyuria, dehydration, failure to thrive and seizures. In severe cases renal failure, pancreatitis and reduced consciousness may also occur and older children and adolescents may present with psychiatric symptoms...
September 15, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28911286/the-effect-of-a-surgery-specific-cardiac-output-guided-haemodynamic-algorithm-on-outcomes-in-patients-undergoing-pancreaticoduodenectomy-in-a-high-volume-centre-a-retrospective-comparative-study
#8
L Weinberg, J Banting, L Churilov, R L McLeod, K Fernandes, I Chao, T Ho, D Ianno, V Liang, V Muralidharan, C Christophi, M Nikfarjam
In this retrospective observational study performed in a high-volume hepatobiliary-pancreatic unit, we evaluated the effect of a surgery-specific goal-directed therapy (GDT) physiologic algorithm on complications and length of hospital stay. We compared patients who underwent pancreaticoduodenectomy with either a standardised Enhanced Recovery After Surgery program (usual care group), or a standardised Enhanced Recovery After Surgery program in combination with a surgery-specific cardiac output-guided algorithm (GDT group)...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28905804/large-pancreatic-pseudocyst-penetrating-into-posterior-mediastinum
#9
Adam Roman Markowski, Elżbieta Brodalka, Katarzyna Guzinska-Ustymowicz, Konrad Zaręba, Dariusz Cepowicz, Bogusław Kędra
We report a rare case of a large mediastinal pancreatic pseudocyst compressing the left atrium and the esophagus and causing dyspnea, palpitations, and emesis. Chest radiograph was non-diagnostic, esophagogastroduodenoscopy showed diffuse extrinsic compression of the distal esophagus and gastric corpus, but a definitive diagnosis was confirmed by computed tomography. We decided to perform surgery due to the recurrence of the pancreatic pseudocyst, a history of unsuccessful radiologically guided external drainage a few years earlier, and a very large diameter of the pseudocyst causing acute cardio-pulmonary distress syndrome...
August 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28903837/impact-of-different-treatment-modalities-on-the-outcome-of-pancreatic-cancer
#10
Misbah Khan, Muhammad Ijaz Ashraf, Aamir Ali Syed, Faisal Hanif
OBJECTIVE: To analyze overall survival patterns of our pancreatic cancer patient population managed with a curative or palliative intent. STUDY DESIGN: Analytical study. PLACE AND DURATION OF STUDY: Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, from January 2000 till February 2015. METHODOLOGY: Aretrospective review of the data of all of our pancreatic cancer patients was performed, using the hospital information system...
August 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28902796/carcinosarcoma-of-the-pancreas-case-report-with-comprehensive-literature-review
#11
Dietrich A Ruess, Claudia Kayser, Jakob Neubauer, Stefan Fichtner-Feigl, Ulrich T Hopt, Uwe A Wittel
Carcinosarcomas are rare biphasic neoplasms with distinct malignant epithelial and mesenchymal components. Most commonly, carcinosarcomas arise in the uterus as malignant mixed müllerian tumors, but also infrequently appear in other organs such as the ovaries and breast, the prostate and urinary tract, the lungs, or in the gastrointestinal system, among others. Pancreatic carcinosarcomas are exceedingly rare; only a few cases are reported in the English literature. Their pathogenesis remains to be fully clarified...
October 2017: Pancreas
https://www.readbyqxmd.com/read/28902791/initial-features-of-hepatic-metastases-from-pancreatic-cancer-histological-and-radiolographical-appraisal-of-hepatic-micrometastases-detected-by-real-time-fluorescent-imaging
#12
Tomohiro Katada, Hideki Hashidate, Naoyuki Yokoyama, Natsuru Sudo, Koko Mitsuma, Tetsuya Otani
OBJECTIVE: The pathophysiology of primary-stage hepatic metastases from gastrointestinal cancers may provide clues to their formation. We investigated initial features of hepatic metastases from pancreatic cancer by examining the histologies of radiographically occult hepatic micrometastases. METHODS: We examined 133 consecutive pancreatic cancer patients with no evident hepatic metastases on preoperative imaging. An indocyanine green near-infrared camera system was used to detect hepatic metastases during surgery; preoperatively acquired images of patients were then retrospectively reviewed...
October 2017: Pancreas
https://www.readbyqxmd.com/read/28902777/operative-versus-nonoperative-management-of-blunt-pancreatic-trauma-in-children-a-systematic-review
#13
Ezra Y Koh, Daan van Poll, J Carel Goslings, Olivier R Busch, Erik A Rauws, Matthijs W Oomen, Marc G Besselink
The aim of this study was to compare operative versus nonoperative management of blunt pancreatic trauma in children. A systematic literature search was performed. Studies including children with blunt pancreatic injuries classified according to the American Association for the Surgery of Trauma classification were included. The primary outcome was pseudocyst formation. After screening 526 studies, 23 studies with 928 patients were included. Sufficient data were available for 674 patients (73%). Of 309 patients with grade I or II injuries, 258 (83%) were initially managed nonoperatively with a 96% success rate...
October 2017: Pancreas
https://www.readbyqxmd.com/read/28902473/preoperative-biliary-drainage-for-malignant-biliary-obstruction-results-from-a-national-database
#14
Yasser Shaib, Mahmoud A Rahal, Mohammad O Rammal, Aurelie Mailhac, Hani Tamim
INTRODUCTION: The impact of preoperative biliary drainage (PBD) on postoperative morbidity and mortality in patients with malignant biliary obstruction is still unclear. We examined short-term surgical outcomes among drained and non-drained patients. METHODS: We identified patients who underwent surgical resection for their malignancies with biliary obstruction using the American College of Surgeons National Surgical Quality Improvement Program Participant Use Files, from 2014 to 2015...
September 13, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28901935/partial-pancreatoduodenectomy-versus-duodenum-preserving-pancreatic-head-resection-in-chronic-pancreatitis-the-multicentre-randomised-controlled-double-blind-chropac-trial
#15
Markus K Diener, Felix J Hüttner, Meinhard Kieser, Phillip Knebel, Colette Dörr-Harim, Marius Distler, Robert Grützmann, Uwe A Wittel, Rebekka Schirren, Hans-Michael Hau, Axel Kleespies, Claus-Dieter Heidecke, Ales Tomazic, Christopher M Halloran, Torsten J Wilhelm, Marcus Bahra, Tobias Beckurts, Thomas Börner, Matthias Glanemann, Ulrich Steger, Frank Treitschke, Ludger Staib, Karsten Thelen, Thomas Bruckner, André L Mihaljevic, Jens Werner, Alexis Ulrich, Thilo Hackert, Markus W Büchler
BACKGROUND: There is substantial uncertainty regarding the optimal surgical treatment for chronic pancreatitis. Short-term outcomes have been found to be better after duodenum-preserving pancreatic head resection (DPPHR) than after partial pancreatoduodenectomy. Therefore, we designed the multicentre ChroPac trial to investigate the long-term outcomes of patients with chronic pancreatitis within 24 months after surgery. METHODS: This randomised, controlled, double-blind, parallel-group, superiority trial was done in 18 hospitals across Europe...
September 9, 2017: Lancet
https://www.readbyqxmd.com/read/28900703/utility-of-18-f-fdg-pet-ct-and-cect-in-conjunction-with-serum-ca-19-9-for-detecting-recurrent-pancreatic-adenocarcinoma
#16
Sampanna Rayamajhi, Aparna Balachandran, Mathew Katz, Arun Reddy, Eric Rohren, Priya Bhosale
PURPOSE: The roles of different cross-sectional imaging in evaluating the recurrence of pancreatic adenocarcinoma are not well established. We evaluated the utility of (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) and contrast-enhanced computed tomography (CECT) in the diagnosis of recurrent pancreatic adenocarcinoma in conjunction with the tumor marker CA 19-9. METHODS: We retrospectively reviewed the records of patients who underwent CECT and FDG PET/CT along with serum CA 19-9 measurement as a follow-up or on a clinical suspicion of recurrent disease after initial surgery for pancreatic adenocarcinoma...
September 12, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28900126/a-new-mild-hyperthermia-device-to-treat-vascular-involvement-in-cancer-surgery
#17
Matthew J Ware, Lam P Nguyen, Justin J Law, Martyna Krzykawska-Serda, Kimberly M Taylor, Hop S Tran Cao, Andrew O Anderson, Merlyn Pulikkathara, Jared M Newton, Jason C Ho, Rosa Hwang, Kimal Rajapakshe, Cristian Coarfa, Shixia Huang, Dean Edwards, Steven A Curley, Stuart J Corr
Surgical margin status in cancer surgery represents an important oncologic parameter affecting overall prognosis. The risk of disease recurrence is minimized and survival often prolonged if margin-negative resection can be accomplished during cancer surgery. Unfortunately, negative margins are not always surgically achievable due to tumor invasion into adjacent tissues or involvement of critical vasculature. Herein, we present a novel intra-operative device created to facilitate a uniform and mild heating profile to cause hyperthermic destruction of vessel-encasing tumors while safeguarding the encased vessel...
September 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28898495/clinical-features-of-cystatin-a-expression-in-patients-with-pancreatic-ductal-adenocarcinoma
#18
Takuya Komura, Hisashi Takabatake, Kenichi Harada, Masatoshi Yamato, Masaki Miyazawa, Keiko Yoshida, Masao Honda, Takashi Wada, Hirohisa Kitagawa, Tetsuo Ohta, Shuichi Kaneko, Yoshio Sakai
Pancreatic ductal adenocarcinoma (PDAC) is the most lethal malignancy known, with an extremely poor prognosis due to the lack of an efficient diagnostic scheme and no radical treatment option, except surgery. Therefore, understanding the pathophysiology of, and finding a novel biomarker to detect, PDAC should be prioritized. We observed an increase in mRNA expression of the cysteine protease inhibitor cystatin A (CSTA) in CD4+T cells in peripheral blood cells of 9 patients with PDAC, compared with the expression in 7 healthy volunteers...
September 12, 2017: Cancer Science
https://www.readbyqxmd.com/read/28895920/emt-and-treatment-resistance-in-pancreatic-cancer
#19
REVIEW
Nicola Gaianigo, Davide Melisi, Carmine Carbone
Pancreatic cancer (PC) is the third leading cause of adult cancer mortality in the United States. The poor prognosis for patients with PC is mainly due to its aggressive course, the limited efficacy of active systemic treatments, and a metastatic behavior, demonstrated throughout the evolution of the disease. On average, 80% of patients with PC are diagnosed with metastatic disease, and the half of those who undergo surgery and adjuvant therapy develop liver metastasis within two years. Metastatic dissemination is an early event in PC and is mainly attributed to an evolutionary biological process called epithelial-to-mesenchymal transition (EMT)...
September 12, 2017: Cancers
https://www.readbyqxmd.com/read/28895142/randomized-clinical-trial-of-laparoscopic-versus-open-pancreatoduodenectomy-for-periampullary-tumours
#20
C Palanivelu, P Senthilnathan, S C Sabnis, N S Babu, S Srivatsan Gurumurthy, N Anand Vijai, V P Nalankilli, P Praveen Raj, R Parthasarathy, S Rajapandian
BACKGROUND: Laparoscopic resection as an alternative to open pancreatoduodenectomy may yield short-term benefits, but has not been investigated in a randomized trial. The aim of this study was to compare laparoscopic and open pancreatoduodenectomy for short-term outcomes in a randomized trial. METHODS: Patients with periampullary cancers were randomized to either laparoscopic or open pancreatoduodenectomy. The outcomes evaluated were hospital stay (primary outcome), and blood loss, radicality of surgery, duration of operation and complication rate (secondary outcomes)...
October 2017: British Journal of Surgery
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