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pancreatitis guideline

Safiya Karim, Ingrid Harle, Jennifer O'Donnell, Shirley Li, Christopher M Booth
PURPOSE: Guidelines recommend that oncologists discuss goals of care (GOC) with patients who have advanced cancer and that these patients be referred for early palliative care (PC). An audit of practice between 2010 and 2015 at the Cancer Centre of Southeastern Ontario suggested that these rates were suboptimal. We sought to improve the rate of documentation of GOC and referral to PC through the implementation of a quality improvement (QI) initiative. METHODS: Patients receiving palliative systemic treatment of lung, pancreatic, colorectal, and breast cancer were identified via electronic pharmacy records and the electronic patient care system...
August 16, 2018: Journal of Oncology Practice
Ioannis Mintziras, Tobias Keck, Jens Werner, Stefan Fichtner-Feigl, Uwe Wittel, Norbert Senninger, Thorsten Vowinkel, Jörg Köninger, Matthias Anthuber, Bernd Geißler, Detlef Klaus Bartsch
BACKGROUND: ENETS guidelines recommend parenchyma-sparing procedures without formal lymphadenectomy, ideally with a minimally invasive laparoscopic approach for sporadic small pNENs (≤2 cm). Non-functioning (NF) small pNENs can also be observed. The aim of the study was to evaluate how these recommendations are implemented in the German surgical community. METHODS: Data from the prospective StuDoQ|Pancreas registry of the German Society of General and Visceral Surgery were analyzed regarding patient's demographics, tumor characteristics, surgical procedures, histology and perioperative outcomes...
August 10, 2018: World Journal of Surgery
Jorrit Jv de Vries, Anne B Chang, Catherine M Bonifant, Elizabeth Shevill, Julie M Marchant
BACKGROUND: People with cystic fibrosis (CF) and pancreatic insufficiency are at risk of a deficiency in fat-soluble vitamins, including vitamin A. Vitamin A deficiency predominantly causes eye and skin problems, while excessive levels of vitamin A can harm the respiratory and skeletal systems in children and interfere with the metabolism of other fat-soluble vitamins. Most CF centres administer vitamin A as supplements to reduce the frequency of vitamin A deficiency in people with CF and to improve clinical outcomes such as growth, although the recommended dose varies between different guidelines...
August 9, 2018: Cochrane Database of Systematic Reviews
Andrea Palermo, Ettore Capoluongo, Rossella Del Toro, Silvia Manfrini, Paolo Pozzilli, Daria Maggi, Giuseppe Defeudis, Francesco Pantano, Roberto Coppola, Francesco Maria Di Matteo, Marco Raffaelli, Paola Concolino, Alberto Falchetti
CONTEXT: Clinical phenotype variability in MEN1 syndrome exists and evidence for an established genotype-phenotype is lacking. However, a higher aggressiveness of MEN1-associated gastro-entero-pancreatic (GEP) (neuro)endocrine tumours (NETs) tumours has been reported when MEN1 gene truncating mutations are detected. We found a novel germline truncating mutation of MEN1 gene at exon 10 in a subject with an aggressive clinical behavior of GEP-NETs. Successively, other two mutant-affected familial members have been identified...
August 6, 2018: Hormones: International Journal of Endocrinology and Metabolism
Iman Khaoudy, Olivier Farges, Emmanuel Boleslawski, Eric Vibert, Olivier Soubrane, Mustapha Adham, Jean Yves Mabrut, Laurent Christophe, Philippe Bachellier, Olivier Scatton, Yves-Patrice Le Treut, Jean Marc Regimbeau
OBJECTIVE: To perform a retrospective root-cause analysis of the causes of postoperative mortality after hepatectomy. BACKGROUND: Mortality after liver resection has not decreased over the past decade. METHODS: The study population was a prospective cohort of hepatectomies performed at hepatic, pancreatic, and biliary (HPB) centers between October 2012 and December 2014. Of the 1906 included patients, 90 (5%) died within 90 days of surgery...
August 3, 2018: Annals of Surgery
Jenifer Barrie, Saurabh Jamdar, Neil Smith, Simon J McPherson, Ajith K Siriwardena, Derek A O'Reilly
BACKGROUND: International guidelines for the management of acute pancreatitis state that antibiotics should only be used to treat infectious complications. Antibiotic prophylaxis is not recommended. The aim of this study was to analyse antibiotic use, and its appropriateness, from a national review of acute pancreatitis. METHODS: Data were collected from The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) study into the management of acute pancreatitis...
May 24, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Randall Brand, Erkut Borazanci, Virginia Speare, Beth Dudley, Eve Karloski, Mary Linton B Peters, Lindsey Stobie, Nathan Bahary, Herbert Zeh, Amer Zureikat, Melissa Hogg, Kenneth Lee, Allan Tsung, John Rhee, James Ohr, Weijing Sun, James Lee, A James Moser, Kim DeLeonardis, Jill Krejdovsky, Emily Dalton, Holly LaDuca, Jill Dolinsky, Arlene Colvin, Cynthia Lim, Mary Helen Black, Nadine Tung
BACKGROUND: The objective of this study was to investigate the prevalence of pathogenic germline variants (PGVs) in 32 cancer susceptibility genes in individuals with newly diagnosed pancreatic ductal adenocarcinoma (PDAC). A key secondary objective was to evaluate how often PGVs would have been undetected with existing genetic testing criteria. METHODS: From May 2016 through May 2017, this multicenter cohort study enrolled consecutive patients aged 18 to 89 years with histologically confirmed PDAC diagnosed within the previous 12 weeks...
August 1, 2018: Cancer
A D Hintaran, M N Chenault, B P M Verhaegh, P L M Reijven, A A M Masclee, Y C A Keulemans
INTRODUCTION: Chronic pancreatitis (CP) is a progressive inflammatory disorder causing irreversible destruction of pancreatic tissue, leading to malnutrition. A previous study has found that currently used screening methods (periodic recording of body weight and faecal and serological markers) fall short in identifying and curbing malnutrition. Moreover, data is lacking regarding change in nutritional status over time. The aim of our study is to investigate changes in nutritional status in CP patients over time and to determine whether a more extensive set of measurements would be beneficial for nutritional screening of these patients...
August 30, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Linus Aronsson, Daniel Ansari, Bodil Andersson, Ulf Persson, Adam Fridhammar, Roland Andersson
BACKGROUND: Branch-duct intraductal papillary mucinous neoplasm (BD-IPMN) presents a clinical conundrum. Rigorous long-term surveillance or surgical resection is recommended. The economic consequences of the management have not been fully investigated. METHODS: A Markov decision model compared 4 strategies for low-risk BD-IPMN: I = upfront total pancreatectomy, II = upfront partial pancreatectomy, III = initial surveillance, IV = watchful waiting. Surveillance was based on the Swedish Guidelines for Pancreatic Cancer...
July 28, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Simron Singh, Lesley Moody, David L Chan, David C Metz, Jonathan Strosberg, Timothy Asmis, Dale L Bailey, Emily Bergsland, Kari Brendtro, Richard Carroll, Sean Cleary, Michelle Kim, Grace Kong, Calvin Law, Ben Lawrence, Alexander McEwan, Caitlin McGregor, Michael Michael, Janice Pasieka, Nick Pavlakis, Rodney Pommier, Michael Soulen, David Wyld, Eva Segelov
There is no consensus on optimal follow-up for completely resected gastroenteropancreatic neuroendocrine tumors. Published guidelines for follow-up are complex and emphasize closer surveillance in the first 3 years after resection. Neuroendocrine tumors have a different pattern and timescale of recurrence, and thus require more practical and tailored follow-up. The Commonwealth Neuroendocrine Tumour Collaboration convened an international multidisciplinary expert panel, in collaboration with the North American Neuroendocrine Tumor Society, to create patient-centered follow-up recommendations for completely resected gastroenteropancreatic neuroendocrine tumors...
July 26, 2018: JAMA Oncology
Wen-Quan Wang, Liang Liu, Quan-Xing Ni, Xian-Jun Yu
No abstract text is available yet for this article.
July 24, 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Xinyue Hu, Lipeng Zhang
Severe acute pancreatitis (SAP) is still with a high incidence and mortality. Early onset is usually non-infectious inflammation caused by systemic inflammatory response syndrome (SIRS), with the further progress into pancreatic necrosis, which is the main cause of death. The occurrence of infection can induce or aggravate multiple organ failure (MOF), leading to death. Therefore, whether early use of antibiotics to prevent the occurrence of pancreatic infection and how to identify early pancreatic infection, how to choose the start of antibiotic therapy is the hot and difficult point of current study...
July 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Vivian L Weiss, Colleen Kiernan, Jesse Wright, Nipun B Merchant, Alice C Coogan, Chanjuan Shi
Introduction: The World Health Organization (WHO) has provided grading guidelines for pancreatic neuroendocrine neoplasms (PanNENs) based on mitotic count and Ki-67 proliferation index. Due to the desire to provide earlier tumor grading for clinical management decisions, some groups have proposed grading PanNENs at the time of fine needle aspiration (FNA) using Ki-67 proliferation rates. While a Ki-67 can be performed on FNA cell blocks, there are potential sampling limitations with this technique that may affect the reliability of the Ki-67 result...
May 2018: Journal of the American Society of Cytopathology
Chiara Citterio, Michela Baccini, Elena Orlandi, Camilla Di Nunzio, Luigi Cavanna
Guidelines for treatment of metastatic pancreatic cancer recommend a second line based on Fluoropyrimidine (FP) alone or in combination with Oxaliplatin (OXA) or Irinotecan (IRI) after a first line treatment based on Gemcitabine (GEM). We conducted a Bayesian network meta-analysis to compare currently available therapies to treat metastatic pancreatic cancer in the second line, considering as efficacy measures overall survival (OS) and progression free survival (PFS). Published randomized trials were identified using electronic databases (MEDLINE, PubMed, https://clinicaltrials...
July 3, 2018: Oncotarget
Malte Weinrich, Johanna Bochow, Anna-Lisa Kutsch, Guido Alsfasser, Christel Weiss, Ernst Klar, Bettina M Rau
Background: Adjuvant chemotherapy (adCx) is an integral part of multimodal treatment in resected pancreatic ductal adenocarcinoma (PDAC) and is recommended by the German S3 guideline since 2007 in all patients. We aimed to investigate the impact of this guideline at our institution. Methods: In 151 of 403 pancreatic resections performed histopathology revealed PDAC. Follow-up data were available from 143 patients (95%) representing our study group. The rate of recommended, initiated and fully completed adCx was analyzed for period 1 (09/2003-07/2007) and period 2 (08/2007-08/2014)...
August 2018: Annals of Medicine and Surgery
(no author information available yet)
Pancreatic cancer ranks the fifth leading cause of cancer-related death, while the incidence has increased in the recent years.Although available diagnosis and treatment have failed to significantly improve patients' outcome, some advances have been made along with the understanding of the new concepts from oncology over the past several years.Pancreatic Cancer Committee of Chinese Anti-Cancer Association worked out this latest edition of "The Clinical Practice Guidelines for Pancreatic Cancer(version 2018)" based on current situation to standardize and improve the diagnosis and treatment of pancreatic cancer in China...
July 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Somashekar G Krishna, Andrew J Kruger, Nishi Patel, Alice Hinton, Dhiraj Yadav, Darwin L Conwell
OBJECTIVES: Few studies have evaluated national readmission rates after acute pancreatitis (AP) in the United States. We sought to evaluate modifiable factors impacting 30-day readmissions after AP hospitalizations. METHODS: We used the Nationwide Readmission Database (2013) involving all adults with a primary discharge diagnosis of AP. Multivariable logistic regression models assessed independent predictors for specific outcomes. RESULTS: Among 180,480 patients with AP index admissions, 41,094 (23%) had biliary AP, of which 10...
July 19, 2018: Pancreas
Amar Mandalia, Erik-Jan Wamsteker, Matthew DiMagno
This review highlights advances made in recent years in the diagnosis and management of acute pancreatitis (AP). We focus on epidemiological, clinical, and management aspects of AP. Additionally, we discuss the role of using risk stratification tools to guide clinical decision making. The majority of patients suffer from mild AP, and only a subset develop moderately severe AP, defined as a pancreatic local complication, or severe AP, defined as persistent organ failure. In mild AP, management typically involves diagnostic evaluation and supportive care resulting usually in a short hospital length of stay (LOS)...
2018: F1000Research
Claudia Della Corte, Simona Faraci, Fabio Majo, Vincenzina Lucidi, Douglas S Fishman, Valerio Nobili
Pancreatic disorders in children represent a growing health problem in pediatric patients. In the past two decades, several advances have been made in the knowledge of pediatric pancreatic disorders, with better understanding of different etiologies and clinical manifestations of these disorders. Moreover, many efforts have been made in pancreatology, aiming to define guidelines in the management of pancreatitis in children, initially based on the available information in adults. A multidisciplinary and multicenter approach is necessary to better determine pancreatic disease pathways and treatment options in children...
June 27, 2018: Digestive and Liver Disease
C Frère, B Bournet, I Benzidia, M Jamelot, P Debourdeau, A Hij, H Rafii-Elayoubi, L Buscail, D Farge
Pancreatic cancer (PC) is a devastating malignancy with an overall 5-year survival of 8% for all stages combined. Most of the PC patients diagnosed have an advanced disease (40%) or metastatic stage (40%), which eliminates surgery as a potentially curative treatment. The disease course is often complicated by venous thromboembolism (VTE) events, which per se account for significant morbidity and mortality, with significantly worsen survival. PC is associated with the highest risk of VTE among all cancer patients...
July 2018: Journal de Médecine Vasculaire
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