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Chronic pancreatitis

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https://www.readbyqxmd.com/read/28819358/surgical-treatment-for-chronic-pancreatitis-past-present-and-future
#1
REVIEW
Stephanie Plagemann, Maria Welte, Jakob R Izbicki, Kai Bachmann
The pancreas was one of the last explored organs in the human body. The first surgical experiences were made before fully understanding the function of the gland. Surgical procedures remained less successful until the discovery of insulin, blood groups, and finally the possibility of blood donation. Throughout the centuries, the surgical approach went from radical resections to minimal resections or only drainage of the gland in comparison to an adequate resection combined with drainage procedures. Today, the well-known and standardized procedures are considered as safe due to the high experience of operating surgeons, the centering of pancreatic surgery in specialized centers, and optimized perioperative treatment...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28814218/diagnosis-and-management-of-pancreatic-exocrine-insufficiency
#2
Mehrdad Nikfarjam, Jeremy S Wilson, Ross C Smith
In 2015, the Australasian Pancreatic Club (APC) published the Australasian guidelines for the management of pancreatic exocrine insufficiency (http://pancreas.org.au/2016/01/pancreatic-exocrine-insufficiency-guidelines). Pancreatic exocrine insufficiency (PEI) occurs when normal digestion cannot be sustained due to insufficient pancreatic digestive enzyme activity. This may be related to a breakdown, at any point, in the pancreatic digestive chain: pancreatic stimulation; synthesis, release or transportation of pancreatic enzymes; or synchronisation of secretions to mix with ingested food...
August 21, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28811674/regenerative-medicine-and-cell-based-approaches-to-restore-pancreatic-function
#3
REVIEW
Cara Ellis, Adam Ramzy, Timothy J Kieffer
The pancreas is a complex organ with exocrine and endocrine components. Many pathologies impair exocrine function, including chronic pancreatitis, cystic fibrosis and pancreatic ductal adenocarcinoma. Conversely, when the endocrine pancreas fails to secrete sufficient insulin, patients develop diabetes mellitus. Pathology in either the endocrine or exocrine pancreas results in devastating economic and personal consequences. The current standard therapy for treating patients with type 1 diabetes mellitus is daily exogenous insulin injections, but cell sources of insulin provide superior glycaemic regulation and research is now focused on the goal of regenerating or replacing β cells...
August 16, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28808857/the-surgeon-s-role-in-treating-chronic-pancreatitis-and-incidentally-discovered-pancreatic-lesions
#4
Vikrom K Dhar, Brent T Xia, Syed A Ahmad
Chronic pancreatitis and incidentally discovered pancreatic lesions present significant diagnostic and therapeutic challenges for surgeons. While both decompressive and resection procedures have been described for treatment of chronic pancreatitis, optimal management must be tailored to each patient's individual disease characteristics, parenchymal morphology, and ductal anatomy. Surgeons should strive to achieve long-lasting pain relief while preserving native pancreatic function. For patients with incidentally discovered pancreatic lesions, differentiating benign, pre-malignant, and malignant lesions is critical as earlier treatment is thought to result in improved survival...
August 14, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28797566/palmitate-induced-fetuin-a-secretion-from-pancreatic-%C3%AE-cells-adversely-affects-its-function-and-elicits-inflammation
#5
Alpana Mukhuty, Chandrani Fouzder, Sandip Mukherjee, Chandan Malick, Satinath Mukhopadhyay, Samir Bhattacharya, Rakesh Kundu
Islets of type 2 diabetes patients display inflammation, elevated levels of cytokines and macrophages. The master regulator of inflammation in the islets is free fatty acids (FFA). It has already been reported that FFA and TLR4 stimulation induces pro-inflammatory factors in the islets. In this report we demonstrate that excess lipid triggers Fetuin-A (FetA) secretion from the pancreatic β-cells. Palmitate treatment to MIN6 cells showed significantly elevated FetA levels in respect to their controls. Fatty acid induces the FetA gene and protein expression in the pancreatic β-cells via TLR4 and over-expression of NF-κB...
August 7, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28797012/risk-of-pancreatic-cancer-after-a-primary-episode-of-acute-pancreatitis
#6
Anton P Rijkers, Olaf J Bakker, Usama Ahmed Ali, Julia C J P Hagenaars, Hjalmar C van Santvoort, Marc G Besselink, Thomas L Bollen, Casper H van Eijck
OBJECTIVE: Acute pancreatitis may be the first manifestation of pancreatic cancer. The aim of this study was to assess the risk of pancreatic cancer after a first episode of acute pancreatitis. METHODS: Between March 2004 and March 2007, all consecutive patients with a first episode of acute pancreatitis were prospectively registered. Follow-up was based on hospital records audit, radiological imaging, and patient questionnaires. Outcome was stratified based on the development of chronic pancreatitis...
September 2017: Pancreas
https://www.readbyqxmd.com/read/28796139/longer-leukocyte-telomere-length-is-associated-with-an-increased-risk-of-chronic-pancreatitis
#7
Hao Wu, Wen-Bin Zou, Dai-Zhan Zhou, Yuan-Ting Gu, Zhuan Liao, Zhao-Shen Li
No abstract text is available yet for this article.
September 2017: Pancreas
https://www.readbyqxmd.com/read/28796138/predictive-value-of-computed-tomography-scans-and-clinical-findings-for-the-need-of-endoscopic-necrosectomy-in-walled-off-necrosis-from-pancreatitis
#8
Fabian Finkelmeier, Christian Sturm, Mireen Friedrich-Rust, Jörg Bojunga, Christoph Sarrazin, Andrea Tal, Johannes Hausmann, Stefan Zeuzem, Stephan Zangos, Jörg Albert, Harald Farnik
OBJECTIVES: Choosing the best treatment option at the optimal point of time for patients with walled-off necrosis (WON) is crucial. We aimed to identify imaging parameters and clinical findings predicting the need of necrosectomy in patients with WON. METHODS: All patients with endoscopically diagnosed WON and pseudocyst were retrospectively identified. Post hoc analysis of pre-interventional contrast-enhanced computed tomography was performed for factors predicting the need of necrosectomy...
September 2017: Pancreas
https://www.readbyqxmd.com/read/28796136/local-and-systemic-expression-of-immunomodulatory-factors-in-chronic-pancreatitis
#9
Hannah M Komar, Phil A Hart, Zobeida Cruz-Monserrate, Darwin L Conwell, Gregory B Lesinski
Inflammatory and fibrotic events that drive chronic pancreatitis (CP) are likely orchestrated via signaling of soluble cytokines and chemokines systemically and within the pancreas. However, a comprehensive summary of the expression of such factors during CP has not been reported to date. This information is important given continued interest in targeting cytokines that influence CP pathogenesis. Reported data on the expression change of soluble immunomodulatory factors in human CP patients were identified via a literature search using a single search term...
September 2017: Pancreas
https://www.readbyqxmd.com/read/28796135/inflammation-related-pancreatic-carcinogenesis-mechanisms-and-clinical-potentials-in-advances
#10
Juan-Juan Dai, Ming-Jie Jiang, Xing-Peng Wang, Ling Tian
Chronic inflammation has long been considered critical in pancreatic carcinogenesis, and recently studies showed that some anti-inflammatory agents such as aspirin could potentially be used to attenuate pancreatic carcinogenesis. Several inflammation-related critical transcription factors and pathways such as NF-κB (nuclear factor κ-light-chain enhancer of activated B cells) and reactive oxygen species have been confirmed to be involved in carcinogenesis. However, its underlying mechanisms are far from clear, which largely limits further development of potential anticarcinogenesis drugs...
September 2017: Pancreas
https://www.readbyqxmd.com/read/28796008/methicillin-resistant-staphylococcus-aureus-in-cystic-fibrosis-how-should-it-be-managed
#11
Marianne S Muhlebach
PURPOSE OF REVIEW: Methicillin-resistant Staphylococcus aureus (MRSA) remains prevalent in people with cystic fibrosis (CF). As chronic infection with worse pulmonary outcomes develops frequently, the organism is concerning to CF providers and patients. This review describes current epidemiology, our understanding of risk factors for MRSA infection, and relevant aspects of treatment with review of new and ongoing trials. RECENT FINDINGS: Prevalence ranges from a low of 3 to 4% in some European countries to a high of approximately 26% in the United States...
August 8, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28794173/glucose-potentiates-%C3%AE-cell-function-by-inducing-tph1-expression-in-rat-islets
#12
Yuqing Zhang, Ruyuan Deng, Xue Yang, Wan Xu, Yun Liu, Fengying Li, Juan Zhang, Hongju Tang, Xueying Ji, Yufang Bi, Xiao Wang, Libin Zhou, Guang Ning
Impaired pancreatic β-cell function is the primary defect in type 2 diabetes. Glucose is an important regulator of β-cell growth and function; however, the mechanisms that are involved in the chronic adaptation of β-cells to hyperglycemia remain largely unknown. In the present study, global gene expression patterns revealed that tryptophan hydroxylase 1 (Tph1) was the most profound of genes that are up-regulated in rat islets exposed to high glucose. Calcium and cAMP signals synergistically mediated glucose-stimulated Tph1 transcription in β-cells by activating cAMP-responsive element-binding protein and promoting its binding with a Tph1 promoter...
August 9, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/28791598/opioid-medications-in-the-management-of-chronic-abdominal-pain
#13
REVIEW
Dajie Wang
PURPOSE OF REVIEW: Chronic abdominal pain is a complex medical condition. The causes of chronic abdominal pain are extremely diverse ranging from chronic pancreatitis, Crohn's disease, to chronic pain with no clear etiology. Treatment of chronic abdominal pain remains a challenge in our clinical practice. While current interventions with celiac plexus blocks and pain medications provide some relief for these patients, but these treatments are typically less efficacious and limited by various adverse effects...
August 8, 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28791556/the-clinical-implications-of-fatty-pancreas-a-concise-review
#14
REVIEW
Tawfik Khoury, Akwi W Asombang, Tyler M Berzin, Jonah Cohen, Douglas K Pleskow, Meir Mizrahi
Fatty pancreas is a newly recognized condition which is poorly investigated until today as compared to nonalcoholic fatty liver disease. It is characterized by pancreatic fat accumulation and subsequent development of pancreatic and metabolic complications. Association of fatty pancreas have been described with type 2 diabetes mellitus, acute and chronic pancreatitis and even pancreatic carcinoma. In this review article, we provide an update on clinical implications, pathogenesis, diagnosis, treatment and outcomes...
August 8, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28789815/bioprinting-and-cellular-therapies-for-type-1-diabetes
#15
REVIEW
Dino J Ravnic, Ashley N Leberfinger, Ibrahim T Ozbolat
Type 1 diabetes mellitus is a chronic autoimmune disease that results from the destruction of beta (β) cells in the pancreatic islets, leading to loss of insulin production and resultant hyperglycemia. Recent developments in stem cell biology have generated much excitement for β-cell replacement strategies; β cells are one of many cell types in the complex islet environment and pancreas. In this Opinion, we discuss recent successful attempts to generate β cells and how this can be coupled with bioprinting technologies in order to fabricate pancreas tissues, which holds great potential for type 1 diabetes...
August 5, 2017: Trends in Biotechnology
https://www.readbyqxmd.com/read/28783521/paraduodenal-pancreatitis-as-an-uncommon-cause-of-gastric-outlet-obstruction-a-case-report-and-review-of-the-literature
#16
Soroush Larjani, Vanessa R Bruckschwaiger, Leslie A Stephens, Paul D James, Guillaume Martel, Richard Mimeault, Fady K Balaa, Kimberly A Bertens
INTRODUCTION: Paraduodenal pancreatitis (PP) is an under-recognized form of focal chronic or recurrent pancreatitis. Since PP presents with non-specific symptoms and shares radiological and histopathological features with other entities, it can be challenging to diagnose. PRESENTATION OF CASE REPORT: Herein, a case of a 64 year-old Caucasian male with PP presenting with recurrent gastric outlet obstruction (GOO) is detailed. Over the course of two years, he underwent multiple balloon dilatations for symptom management...
July 25, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28780079/antineutrophil-cytoplasmic-antibody-associated-vasculitides-and-igg4-related-disease-a-new-overlap-syndrome
#17
REVIEW
François-Xavier Danlos, Giovanni Maria Rossi, Daniel Blockmans, Giacomo Emmi, Andreas Kronbichler, Stéphane Durupt, Claire Maynard, Luminita Luca, Cyril Garrouste, Bertrand Lioger, Rachel Mourot-Cottet, Robin Dhote, Jean-Benoit Arlet, Thomas Hanslik, Philippe Rouvier, Mikael Ebbo, Xavier Puéchal, Dominique Nochy, Agnès Carlotti, Luc Mouthon, Loïc Guillevin, Augusto Vaglio, Benjamin Terrier
OBJECTIVE: Atypical manifestations have been described in patients with ANCA-associated vasculitides (AAV), such as pachymeningitis, orbital mass or chronic periaortitis. Because these manifestations have been associated to the spectrum of IgG4-related disease (IgG4-RD), we hypothesized that both diseases could overlap. METHODS: We conducted a European retrospective multicenter observational study including patients fulfilling ACR and Chapel Hill criteria for AAV and IgG4-RD Comprehensive Diagnostic Criteria...
August 2, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28780053/association-between-f508-deletion-in-cftr-and-chronic-pancreatitis-risk
#18
REVIEW
Dong Zhao, Yanzhen Xu, Jiatong Li, Shien Fu, Feifan Xiao, Xiaowei Song, Zhibin Xie, Min Jiang, Yan He, Chengwu Liu, Qiongxian Wen, Xiaoli Yang
BACKGROUND: The cystic fibrosis transmembrane conductance regulator (CFTR) has been reported to influence individual susceptibility to chronic pancreatitis (CP), but the results of previous studies are controversial. AIMS: We performed a study to demonstrate the relationship between CFTR and CP. METHODS: We searched PubMed, Scopus, and Embase for studies of patients with CP. Seven studies from 1995 to 2016 were identified, and included 64,832 patients...
July 1, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28775125/smad3-stat3-signaling-mediates-%C3%AE-cell-epithelial-mesenchymal-transition-in-chronic-pancreatitis-related-diabetes
#19
Xiangwei Xiao, Shane Fischbach, Tina Zhang, Congde Chen, Qingfeng Sheng, Ray Zimmerman, Sneha Patnaik, Joseph Fusco, Yungching Ming, Ping Guo, Chiyo Shiota, Krishna Prasadan, Nupur Gangopadhyay, Sohail Z Husain, Henry Dong, George K Gittes
Many patients with chronic pancreatitis develop diabetes (chronic pancreatitis-related diabetes; CPRD) through an undetermined mechanism. Here, we used long-term partial pancreatic duct ligation (PDL) as a model to study CPRD. We found that long-term PDL induced significant β-cell dedifferentiation, followed by a time-dependent decrease in functional β-cell mass, all specifically in the ligated tail portion of the pancreas (PDL-tail). High levels of transforming growth factor β1 (TGFβ1) were detected in the PDL-tail, mainly produced by M2 macrophages at the early stage, and by activated myofibroblasts at the later stage...
August 3, 2017: Diabetes
https://www.readbyqxmd.com/read/28774888/development-of-autoimmune-pancreatitis-is-independent-of-cdkn1a-p21-mediated-pancreatic-inflammation
#20
Gitta M Seleznik, Theresia Reding, Lukas Peter, Anurag Gupta, Sabrina G Steiner, Sabrina Sonda, Caroline S Verbeke, Emmanuel Dejardin, Igor Khatkov, Stephan Segerer, Mathias Heikenwalder, Rolf Graf
OBJECTIVE: Chronic pancreatitis (CP) and autoimmune pancreatitis (AIP) are characterised by different inflammatory processes. If pancreatic inflammation is a prerequisite for autoimmunity is still unclear. AIP is considered mostly a T cell-mediated disease; however, in induction of CP, macrophages play a pivotal role. p21-a member of cyclin-dependent kinase inhibitors-can influence inflammatory processes, in particular can regulate T cell activation and promote macrophage development...
August 3, 2017: Gut
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