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pancreatitis guideline

Nathan H Parker, An Ngo-Huang, Rebecca E Lee, Daniel P O'Connor, Karen M Basen-Engquist, Maria Q B Petzel, Xuemei Wang, Lianchun Xiao, David R Fogelman, Keri L Schadler, Richard J Simpson, Jason B Fleming, Jeffrey E Lee, Gauri R Varadhachary, Sunil K Sahai, Matthew H G Katz
PURPOSE: Guidelines recommend exercise to cancer survivors, but limited data exists regarding exercise among patients undergoing preoperative cancer treatment. We examined differences in weekly self-reported exercise and accelerometer-measured physical activity among participants in a home-based exercise program administered during preoperative treatment for pancreatic cancer. METHODS: Participants were encouraged to perform at least 60 min/week of moderate-intensity aerobic exercise and at least 60 min/week of full-body strengthening exercises concurrent with chemotherapy, chemoradiation therapy or both sequentially and received resistance equipment, program instruction, and biweekly follow-up calls to encourage adherence...
October 17, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Aliye Uc, Dana K Andersen, Drucy Borowitz, Marshall J Glesby, Julia Mayerle, Robert Sutton, Stephen J Pandol
A workshop was sponsored by the Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, on July 25, 2018, in Pittsburgh, Penn. The workshop was designed to bring together a multidisciplinary group of experts to accelerate the development of therapeutics for clinical application in inflammatory diseases of the exocrine pancreas. Three separate working groups (acute pancreatitis, recurrent acute pancreatitis, and chronic pancreatitis) were formed to address the needs, gaps, and opportunities...
November 2018: Pancreas
Jennifer L Olson, Richard J Bold
Pancreatic adenocarcinoma is the 9th most common cancer in the United States and the 4th most common cause of cancer-related death given its poor prognosis. Areas covered: The authors have performed a literature search for pertinent published clinical trials, ongoing Phase 3 clinical trials, and current treatment guidelines using PubMed,, and NCCN, ASCO, ESMO, and JPS websites. The review itself discusses landmark studies and ongoing research into the chemotherapy regimens recommended by each oncologic society...
October 16, 2018: Expert Opinion on Pharmacotherapy
Qinghai Chen, Peng Jin, Xiaoyan Ji, Haiwei Du, Junhua Lu
Selective bile duct cannulation is the prerequisite for all endoscopic biliary therapeutic interventions, but this cannot always be achieved easily. Despite advances and new developments in endoscopic accessories, selective biliary access fails in 5%-15% of cases, even in expert high volume centers. Various techniques - such as double-guidewire induced cannulation, pre-cut papillotomy or transpancreatic sphincterotomy with or without placement of a pancreatic stent - have been used to improve cannulation success rates...
October 9, 2018: Clinics and Research in Hepatology and Gastroenterology
Matteo Tacelli, Ciro Celsa, Bianca Magro, Luca Barresi, Salvatore Guastella, Gabriele Capurso, Luca Frulloni, Giuseppe Cabibbo, Calogero Cammà
BACKGROUND AND AIMS: Risk for relapse after induction of remission with steroid therapy has been extensively studied in patients with autoimmune pancreatitis (AIP), but findings are equivocal. We performed a systematic review and meta-analysis were to estimate the rate of rate of AIP following initial remission after steroid treatment and to identify factors associated with relapse. METHODS: Three reviewers searched MEDLINE, SCOPUS and EMBASE until July 2018 to identify studies of rate of relapse of AIP rate after induction of remission with steroid therapy...
October 9, 2018: Clinical Gastroenterology and Hepatology
Jesse Lachter, Carly Rosenberg, Tomer Hananiya, Iyad Khamaysi, Amir Klein, Kamel Yassin, Elizabeth Half
OBJECTIVE OF THE WORK: Pancreatic cancer (PC) is a deadly disease that is most commonly diagnosed at an incurable stage. Early diagnosis is the most important factor for improving prognosis. Evidence is beginning to accumulate that screening and surveillance may lead to the early detection of precursor lesions and/or pancreatic cancer in asymptomatic individuals. Proper screening methods and identification of such precursor lesions may enable effective pre-emptive interventions to prevent further fatalities...
October 4, 2018: Rambam Maimonides Medical Journal
Eun Kyoung Chung, Ji Hyun Lee, Dong Kee Jang, Sang Hyub Lee, Jin Ho Lee, Byung-Joo Park, Kyenghee Kwon, Jun Kyu Lee
OBJECTIVES: The aim of this study was to analyze causes of drug-induced acute pancreatitis (DIAP) in Korea and factors associated with serious DIAP. METHODS: Case records of DIAP voluntarily reported to the Korea Adverse Event Reporting System from 2004 to 2013 were reviewed. When a patient took 2 or more drugs, each drug was identified as a potential cause. The seriousness of each case was determined based on the International Conference on Harmonization E2D Guideline...
November 2018: Pancreas
Savio G Barreto, Ilse Dirkzwager, John A Windsor, Sanjay Pandanaboyana
BACKGROUND: Post-operative pancreatic fistulae (POPF) remain a major contributor to morbidity and mortality following pancreatic resection. Evidence for preoperative prediction of POPF based on cross-sectional imaging has not been systemically reviewed. This review aimed to determine whether preoperative imaging modalities can accurately predict the development of POPF. METHODS: A systematic review of major reference databases was undertaken, according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, up to May 2018...
October 10, 2018: ANZ Journal of Surgery
(no author information available yet)
Neuroendocrine neoplasias (NEN) comprise a rare tumor entity with heterogeneous biology, prognosis and therapeutic options. Together with the recent publication of the first German guidelines on diagnostics and therapy of NEN, an analysis of the German NET-registry cohort of the German Society of Endocrinology (DGE) was performed. For this purpose, 2686 cases were extracted and their patient characteristics (e. g., age, sex, histopathological characterization, grading and staging) were displayed and outcomes were calculated...
October 2018: Zeitschrift Für Gastroenterologie
Rachel E Simpson, Nathan J Cockerill, Michele T Yip-Schneider, Eugene P Ceppa, Michael G House, Nicholas J Zyromski, Attila Nakeeb, Mohammad A Al-Haddad, C M Schmidt
BACKGROUND: For pancreatic cysts with negative cytology, Integrated Molecular Pathology (IMP) is a malignancy risk score integrating clinical criteria with pancreatic cyst fluid DNA profiling. Aside from main pancreatic duct (MPD) diameter, integrated clinical criteria are not International Consensus Guidelines High-Risk Stigmata. We predicted exclusion of clinical criteria except MPD diameter could simplify the IMP and better distinguish invasive/malignant disease. METHODS: Records of >1100 patients with IPMN were reviewed retrospectively...
October 4, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Mahendran Jayaraj, Babu P Mohan, Banreet S Dhindsa, Harmeet S Mashiana, Gowri Radhakrishnan, Vinay Dhir, Arvind J Trindade, Douglas G Adler
INTRODUCTION: Periampullary diverticulum (PAD) is most often asymptomatically found in elderly population. ERCP in the presence of PAD is technically challenging since the location and orientation of the ampulla could be altered. Various studies have reported differing results on the technical success and safety outcomes of ERCP in the presence of PAD. We aimed at a meta-analysis of such studies to assess the technical success and the occurrence of complications during ERCP in patients with PAD...
October 6, 2018: Digestive Diseases and Sciences
Derek O'Reilly, Linyun Fou, Elise Hasler, James Hawkins, Susan O'Connell, Ferruccio Pelone, Mark Callaway, Fiona Campbell, Margred Capel, Richard Charnley, Pippa Corrie, Dawn Elliot, Lesley Goodburn, Anna Jewell, Suzanne Joharchi, Laura McGeeney, Somnath Mukherjee, Kofi Oppong, Phil Whelan, John Primrose, John Neoptolemos
To enable standardisation of care of pancreatic cancer patients and facilitate improvement in outcome, the United Kingdom's National Institute for Health and Care Excellence (NICE) developed a clinical guideline for the diagnosis and management of pancreatic cancer in adults. Systematic literature searches, systematic review and meta-analyses were undertaken. Recommendations were drafted on the basis of the group's interpretation of the best available evidence of clinical and cost effectiveness. There was patient involvement and public consultation...
September 28, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Chathura Bb Ratnayake, Benjamin Pt Loveday, Shailesh V Shrikhande, John A Windsor, Sanjay Pandanaboyana
BACKGROUND: Morphometric analysis of sarcopenia has garnered interest due to its putative role in predicting outcomes following surgery for a variety of pathologies, including resection for pancreatic disease. However, there are no standard recommendations on whether sarcopenia is a clinically relevant predictor of outcomes in this setting. The aim of this study was to review the prognostic impact of preoperatively diagnosed sarcopenia on postoperative outcomes following pancreatic resection...
September 27, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Guru Trikudanathan, Pierre Tawfik, Stuart K Amateau, Satish Munigala Mbbs, Mustafa Arain, Rajeev Attam, Gregory Beilman, Siobhan Flanagan, Martin L Freeman, Shawn Mallery
OBJECTIVES: Current guidelines for necrotizing pancreatitis (NP) recommend delay in drainage ± necrosectomy until 4 or more weeks after initial presentation to allow collections to wall off. However, evidence of infection with clinical deterioration despite maximum support may mandate earlier (<4 weeks) intervention. There are concerns, but scant data regarding risk of complications and outcomes with early endoscopic intervention. Our aim was to compare the results of an endoscopic centered step-up approach to NP when initiated before versus 4 or more weeks...
October 2, 2018: American Journal of Gastroenterology
Mohammed E Al-Sofiani, Michael Quartuccio, Erica Hall, Rita Rastogi Kalyani
PURPOSE OF REVIEW: While there has been a growing utilization of total pancreatectomy with islet autotransplantation (TPIAT) for patients with medically refractory chronic pancreatitis over the past few decades, there remains a lack of consensus clinical guidelines to inform the counseling and management of patients undergoing TPIAT. In this article, we review the current clinical practice and published experience of several TPIAT centers, outline key aspects in managing patients undergoing TPIAT, and discuss the glycemic outcomes of this procedure...
September 28, 2018: Current Diabetes Reports
Marta Kramer Mikkelsen, Cecilia Margareta Lund, Anders Vinther, Anders Tolver, Anne-Mette Ragle, Julia Sidenius Johansen, Inna Chen, Lotte Engell-Noerregaard, Finn Ole Larsen, Bo Zerahn, Dorte Lisbet Nielsen, Mary Jarden
BACKGROUND: Several intervention studies have demonstrated that exercise training has beneficial effects among cancer patients. However, older cancer patients are underrepresented in clinical trials, and only few exercise-based studies have focused specifically on older patients with cancer. In particular, research investigating the effects of exercise training among older patients with advanced cancer is lacking. The purpose of the current study is to investigate the effect of a 12-week multimodal and exercise-based intervention among older patients (≥65 years) with advanced pancreatic, biliary tract or lung cancer, who are treated with first-line palliative chemotherapy, immunotherapy or targeted therapy...
September 27, 2018: BMC Cancer
Raza S Hoda, Ree Lu, Ronald N Arpin, Matthew W Rosenbaum, Martha B Pitman
BACKGROUND: The risk of malignancy is weighed against the attendant risks of surgery in the clinical management of pancreatic cysts. The latter are a group of histologically diverse and prognostically variable entities, and the risk of malignancy therein is primarily based on imaging characteristics-with or without high-grade atypia. Cytologic criteria for high-grade atypia in intraductal papillary mucinous neoplasms have recently been defined, and its recognition in all pancreatic cysts may help to guide management...
September 26, 2018: Cancer Cytopathology
Bhavyaa Bahl, Rohith Vadlamudi, Parekha Yedla, Roger D Smalligan
Periampullary malignancies arise in the vicinity of the ampulla of Vater, a common passage for biliary and pancreatic secretions. Determining the anatomical origin of these tumors represents a diagnostic challenge. This is especially true for large tumors due to the transitional nature of this region, proximity to different structures, anatomical variations, and overlapping features among constituting structures. This determination has significant prognostic and therapeutic implications. Among them, primary ampullary adenocarcinoma is a rare malignancy that has the best overall prognosis with high rates of potentially curative resection and possible survival even in advanced disease...
July 23, 2018: Curēus
Jeyakumar R Apollos, Sharukh Sami, Manju Nadh Prasanth, Jerusha Jeyakumar, Angus K McFadyen
Background: Pancreatic ductal adenocarcinomas are poor prognostic cancers accounting for 3% of all cancer cases in the UK. They often present late in the course of the disease process with non-specific symptoms, including gastro-intestinal(GI) symptoms. Delays in diagnosis occur when investigations are carried out in a primary care setting for GI symptoms. The aim of this study was to assess delays in pancreatic cancer diagnosis when patients were referred for GI investigations and evaluate its effect on survival...
October 2018: Annals of Medicine and Surgery
Katherine A Baugh, Hop S Tran Cao, George van Buren, Eric J Silberfein, Cary Hsu, Christy Chai, Omar Barakat, William E Fisher, Nader N Massarweh
BACKGROUND: Although current guidelines recommend multimodal therapy for all patients with pancreatic ductal adenocarcinoma, it is unclear the extent to which clinical stage I patients are accurately staged and how this may affect management. METHODS: In this retrospective cohort study of 4,404 patients aged 18-79 years with clinical stage 1 (ie, T1N0 or T2N0) pancreatic ductal adenocarcinoma treated with upfront resection in the National Cancer Database (2004-2014), understaging was ascertained by comparing pretreatment clinical stage with pathologic stage...
September 19, 2018: Surgery
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