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Management of pancreatitis

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https://www.readbyqxmd.com/read/28644861/impact-of-ki67-re-assessment-at-time-of-disease-progression-in-patients-with-pancreatic-neuroendocrine-neoplasms
#1
Francesco Panzuto, Noemi Cicchese, Stefano Partelli, Maria Rinzivillo, Gabriele Capurso, Elettra Merola, Marco Manzoni, Eugenio Pucci, Elsa Iannicelli, Emanuela Pilozzi, Michele Rossi, Claudio Doglioni, Massimo Falconi, Gianfranco Delle Fave
BACKGROUND: Although re-assessment of proliferative activity by K67 evaluation during the course of neuroendocrine neoplasms (NENs) is recommended in selected patients, its impact on patients' management is not clear due to the lack of data supporting this practice. AIM: To investigate Ki67 change at time of progressive disease (PD) in entero-pancreatic NENs (EP-NENs). PATIENTS AND METHODS: Retrospective analysis of sporadic EP-NENs which received histological re-assessment after PD once radiologically documented...
2017: PloS One
https://www.readbyqxmd.com/read/28643979/-acute-pancreatitis-new-aspects-for-the-management
#2
Olivier Windisch, Toni Raffoul, Catrina Hansen, Jean-Louis Frossard, Philippe Morel, Léo Bühler
Acute pancreatitis is a frequent disease, with a simple course in 80 % of the cases but a high morbidity and mortality in its severe form. Biliary origin and alcohol represent 80 % of the etiologies. Except endoscopic removal of gallstone for biliary origin, treatment remains symptomatic and focuses on fluid resuscitation, effective antalgia and adapted management of nutrition. This article focuses on the novelties introduced by the revision of the Classification of Atlanta in 2012 and details current guidelines for the management of the disease...
June 14, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28643065/laparoscopic-distal-pancreatectomy-for-pancreatic-cancer-is-safe-and-effective
#3
Marita D Bauman, David G Becerra, E Molly Kilbane, Nicholas J Zyromski, C Max Schmidt, Henry A Pitt, Attila Nakeeb, Michael G House, Eugene P Ceppa
PURPOSE: To compare the short-term and oncologic outcomes of patients with pancreatic ductal adenocarcinoma (PDAC) undergoing laparoscopic distal pancreatectomy (LDP) and open distal pancreatectomy (ODP). METHODS: Consecutive cases of distal pancreatectomy (DP) (n = 422) were reviewed at a single high-volume institution over a 10-year period (2005-2014). Inclusion criteria consisted of any patient with PDAC by surgical pathology. Ninety-day outcomes were monitored through a prospectively maintained pancreatic resection database...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28642332/morphine-worsens-the-severity-and-prevents-pancreatic-regeneration-in-mouse-models-of-acute-pancreatitis
#4
Usman Barlass, Raini Dutta, Hassam Cheema, John George, Archana Sareen, Ajay Dixit, Zuobiao Yuan, Bhuwan Giri, Jingjing Meng, Santanu Banerjee, Sulagna Banerjee, Vikas Dudeja, Rajinder K Dawra, Sabita Roy, Ashok K Saluja
BACKGROUND: Opioids such as morphine are widely used for the management of pain associated with acute pancreatitis. Interestingly, opioids are also known to affect the immune system and modulate inflammatory pathways in non-pancreatic diseases. However, the impact of morphine on the progression of acute pancreatitis has never been evaluated. In the current study, we evaluated the impact of morphine on the progression and severity of acute pancreatitis. METHODS: Effect of morphine treatment on acute pancreatitis in caerulein, L-arginine and ethanol-palmitoleic acid models was evaluated after induction of the disease...
June 22, 2017: Gut
https://www.readbyqxmd.com/read/28635562/nanoformulated-natural-therapeutics-for-management-of-streptozotocin-induced-diabetes-potential-use-of-curcumin-nanoformulation
#5
Yousra M El-Far, Mahmoud M Zakaria, Mahmoud M Gabr, Amal M El Gayar, Laila A Eissa, Ibrahim M El-Sherbiny
AIM: The goal of this study was to improve curcumin (CUR) aqueous solubility and bioavailability via nanoformulation, and then study its activity and mechanism of action as an antidiabetic agent. METHODS: CUR-loaded pluronic nanomicelles (CURnp) were prepared and characterized. Biochemical assessments were performed as well as histological, confocal and RTPCR studies on pancreatic target tissues. RESULTS: CURnp with a diameter of 333 ± 6 nm and ζ potential of -26...
June 21, 2017: Nanomedicine
https://www.readbyqxmd.com/read/28633652/spontaneous-rupture-of-the-common-hepatic-duct-associated-with-acute-pancreatitis-a-case-report
#6
Makram Moussa, Wissem Triki, Omar Karray, Ines Marzouk, Bouchoucha Sami
BACKGROUND: Rupture of the common bile duct is a life-threatening condition, usually observed after a trauma or in association with choledocholithiasis or an obstructive tumor of the bile duct. However, a spontaneous rupture of the common bile duct is a rare entity. CASE PRESENTATION: We report a new observation of a spontaneous rupture of the common bile duct, associated with biliary peritonitis and pancreatitis, in a 15-year-old North African girl. Etiological aspects, specificities of clinical presentation, means of diagnosis, as well as surgical and perioperative management are discussed...
June 21, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28627323/perspective-of-%C3%AE-v%C3%AE-6-integrin-imaging-for-clinical-management-of-pancreatic-carcinoma-and-its-precursor-lesions
#7
Katja Steiger, Anna-Melissa Schlitter, Wilko Weichert, Irene Esposito, Hans-Jürgen Wester, Johannes Notni
ß6-integrin immunohistochemistry analysis of a large number of pancreatic ductal adenocarcinoma (PDAC, 383 primary tumors, 7 lymph node, and 8 distant metastases) and 34 pancreatic intraepithelial neoplasia (PanIN) specimens revealed a high prevalence of αvß6-integrin expression in PDAC primaries (88%) and in almost all metastases, as well as in PanIN (57%). These findings underscore the high potential of a novel αvß6-integrin targeting positron emission tomography (PET) radiopharmaceutical, Ga-68-Avebehexin, for early diagnosis of pancreatic cancer...
January 1, 2017: Molecular Imaging
https://www.readbyqxmd.com/read/28626429/the-potential-for-circulating-tumor-cells-in-pancreatic-cancer-management
#8
REVIEW
Michael Pimienta, Mouad Edderkaoui, Ruoxiang Wang, Stephen Pandol
Pancreatic cancer is one the most lethal malignancies. Only a small proportion of patients with this disease benefit from surgery. Chemotherapy provides only a transient benefit. Though much effort has gone into finding new ways for early diagnosis and treatment, average patient survival has only been improved in the order of months. Circulating tumor cells (CTCs) are shed from primary tumors, including pre-malignant phases. These cells possess information about the genomic characteristics of their tumor source in situ, and their detection and characterization holds potential in early cancer diagnosis, prognosis, and treatment...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28625958/pain-management-of-pancreatic-cancer-patients-with-high-intensity-focused-ultrasound-therapy
#9
Yulan Shi, Xiao Ying, Xiaoye Hu, Hong Shen
This study was performed to evaluate cancer pain control of high-Intensity focused ultrasound ablation (HIFU) and to manage the HIFU treatment pain in advanced pancreatic cancer patients with analgesics. We collected 71 locally advanced pancreatic cancer patients treated with HIFU from 2013 March to 2014 January in our hospital. The cancer pain (pre-HIFU and two weeks after HIFU) and HIFU treatment pain were evaluated respectively. The numeric rating scale (NRS) was used as the tool of pain evaluation. The related factors with pains were analyzed...
January 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28625083/spinal-cord-ischemia-after-endoscopic-ultrasound-guided-celiac-plexus-neurolysis-case-report-and-review-of-the-literature
#10
Ibrahim Hakkı Köker, Ayşe Aralaşmak, Nurcan Ünver, Talip Asil, Hakan Şentürk
INTRODUCTION: Endosonography guided celiac plexus neurolysis is efficacious in the management of severe pain due to advanced pancreatic cancer. Although endoscopic ultrasound (EUS) guided celiac neurolysis (CN) is mostly a safer procedure than the percutaneous posterior approach, severe complications such as paraplegia have been reported. CASE REPORT: We describe a patient with advanced adenocarcinoma of the pancreas and severe pain who developed irreversible paraplegia after EUS guided CN...
June 18, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28625071/adult-gastric-duplication-an-unknown-condition-within-the-spectrum-of-gastric-submucosal-lesions
#11
Yurena Caballero Díaz, Macarena Centeno Haro, Ángel Turégano García, Juan Ramón Hernández Hernández
Gastric duplication is an uncommon condition in adults representing only 4-8% of all gastrointestinal duplications. It develops as a cystic growth within the thick gastric wall that is surrounded by a layer of smooth muscle and lined with gastric mucosa. It is usually asymptomatic but may present with nonspecific abdominal symptoms as well as cyst-related complications such as gastrointestinal (GI) bleeding, ulceration and even pancreatitis. They are difficult to distinguish from other gastric submucosal lesions and may also mimic a gastrointestinal tumor (GIST) or mucinous cyst of the pancreas...
June 19, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28621297/endoscopic-ultrasound-with-or-without-fine-needle-aspiration-has-a-meaningful-impact-on-clinical-care-in-the-pediatric-population
#12
Amit Raina, Maire A Conrad, Benjamin Sahn, Alireza Sedarat, Gregory G Ginsberg, Nuzhat A Ahmad, Vinay Chandrasekhara, Petar Mamula, Michael L Kochman
BACKGROUND AND OBJECTIVES: The safety and utility of endoscopic ultrasound (EUS) for the evaluation and management of gastrointestinal (GI) tract disorders among adults has been established. The literature on safety and efficacy in a pediatric referral population (under 21 years of age) is limited. We hypothesized that EUS is safe and useful in the pediatric population. We reviewed the pediatric EUS experience at a single tertiary-care system. We describe the indications, findings, safety, technical success rate, and impact on clinical outcomes...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28621290/efficacy-of-laparoscopic-ultrasonography-in-laparoscopic-resection-of-insulinoma
#13
REVIEW
Mengwei Wu, Huaitao Wang, Xiaobo Zhang, Feng Gao, Peng Liu, Boqiang Yu, Huanbing Qiu, Guanlong Huang, Xiaodong Tan
Insulinoma is the most common functioning islet cell tumor of the pancreas, with an annual incidence of 4 cases/1 million individuals. It is treated by surgical methods. Open surgery was once considered the standard approach for the treatment of insulinoma. However, the procedure is traumatic and requires a large incision, which does not satisfy the growing expectations of minimally invasive management of small-sized tumors. Insulinomas are usually benign solitary tumors and mostly occur sporadically, which makes them suitable candidates for laparoscopic management...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28620900/new-treatment-options-and-management-considerations-in-borderline-resectable-pancreatic-cancer
#14
REVIEW
Zeljka Jutric, Laleh G Melstrom
In the United States, cancer of the pancreas accounts for nearly 40,000 deaths annually and is the fourth leading cause of cancer-related mortality. The vast majority of patients present with metastatic or unresectable disease. Only 20% of patients are candidates for surgery, and therefore curable. The 5-year survival rate for patients with pancreatic adenocarcinoma is only 6%, with surgical resection being essential for long-term survival. Recent research has identified a precise subset of patients with borderline resectable pancreatic cancer for whom resection yielding durable survival is possible...
June 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28617885/the-role-of-wireless-capsule-endoscopy-wce-in-the-detection-of-occult-primary-neuroendocrine-tumors
#15
Manuele Furnari, Andrea Buda, Gabriele Delconte, Davide Citterio, Theodor Voiosu, Giovanni Ballardini, Flaminia Cavallaro, Edoardo Savarino, Vincenzo Mazzaferro, Emanuele Meroni
BACKGROUND AND AIMS: Neuroendocrine tumors (NETs) are a heterogeneous group of neoplasms with unclear etiology that may show functioning or non-functioning features. Primary tumor localization often requires integrated imaging. The European Neuroendocrine Tumors Society (ENETS) guidelines proposed wireless-capsule endoscopy (WCE) as a possible diagnostic tool for NETs, if intestinal origin is suspected. However, its impact on therapeutic management is debated. We aimed to evaluate the yield of WCE in detecting intestinal primary tumors in patients showing liver NET metastases when first-line investigations are inconclusive...
June 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28616721/biomarkers-in-pancreatic-ductal-adenocarcinoma
#16
REVIEW
J Gallego, C López, R Pazo-Cid, F López-Ríos, A Carrato
Pancreatic ductal adenocarcinoma (PDAC) is currently the third most frequent form of malignancy. The role of biomarkers in the diagnostic and therapeutic strategy of cancer is constantly expanding. Translational research is already changing paradigms in tumours encompassing from early diagnosis to precision medicine in advanced disease. Nomenclature for molecular subtypes of tumours is gradually gaining acceptance and there are growing expectations it will further go from the bench to the bedside. However, the clinical relevance of biomarkers in PDAC is still far behind the relevance of biomarkers in other solid tumours...
June 14, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28615966/acute-physiological-and-electrical-accentuation-of-vagal-tone-has-no-effect-on-pain-or-gastrointestinal-motility-in-chronic-pancreatitis
#17
Jacob Juel, Christina Brock, Søren S Olesen, Adnan Madzak, Adam D Farmer, Qasim Aziz, Jens B Frøkjær, Asbjørn Mohr Drewes
BACKGROUND: The effective management of pain in chronic pancreatitis (CP) remains a therapeutic challenge. Analgesic drugs, such as opioids, and the underlying pathology can impair gut function. The autonomic nervous system influences hormone secretion and gut motility. In healthy volunteers, electrical (using noninvasive transcutaneous vagal nerve stimulation [t-VNS]) and physiological (using deep slow breathing [DSB]) modulation of parasympathetic tone results in pain attenuation and enhanced gut motility...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28615506/modified-protocol-for-enhanced-recovery-after-surgery-is-beneficial-for-chinese-cancer-patients-undergoing-pancreaticoduodenectomy
#18
Xiaxing Deng, Xi Cheng, Zhen Huo, Yuan Shi, Zhijian Jin, Haoran Feng, Yue Wang, Chenlei Wen, Hao Qian, Ren Zhao, Weihua Qiu, Baiyong Shen, Chenghong Peng
Radical surgical resection remains the only effective treatment for advanced pancreatic cancer. Effective protocols for recovery from post-operative complications that result in high rates of morbidity and mortality are therefore essential. The enhanced recovery after surgery (ERAS) protocol is an interdisciplinary multimodal concept based on modern anesthesia and analgesia combined with other fast rehabilitation parameters. It was first applied in the field of elective colorectal surgery, and eventually extended to several surgical diseases...
May 23, 2017: Oncotarget
https://www.readbyqxmd.com/read/28614627/a-randomized-phase-ii-feasibility-trial-of-a-multimodal-intervention-for-the-management-of-cachexia-in-lung-and-pancreatic-cancer
#19
Tora S Solheim, Barry J A Laird, Trude Rakel Balstad, Guro B Stene, Asta Bye, Neil Johns, Caroline H Pettersen, Marie Fallon, Peter Fayers, Kenneth Fearon, Stein Kaasa
BACKGROUND: Cancer cachexia is a syndrome of weight loss (including muscle and fat), anorexia, and decreased physical function. It has been suggested that the optimal treatment for cachexia should be a multimodal intervention. The primary aim of this study was to examine the feasibility and safety of a multimodal intervention (n-3 polyunsaturated fatty acid nutritional supplements, exercise, and anti-inflammatory medication: celecoxib) for cancer cachexia in patients with incurable lung or pancreatic cancer, undergoing chemotherapy...
June 14, 2017: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/28614007/ectopic-cushing-s-syndrome-a-ten-year-experience-from-a-tertiary-care-centre-in-southern-india
#20
Samantha Sathyakumar, Thomas Vizhalil Paul, Hesargatta Shyamsunder Asha, Birla Roy Gnanamuthu, M J Paul, Deepak Thomas Abraham, Simon Rajaratnam, Nihal Thomas
OBJECTIVE: Ectopic ACTH secretion is a less common cause of Cushing's syndrome, and is seen in 5 to 10% of cases with endogenous hypercortisolemia. We hereby describe our experience of patients with ectopic ACTH syndrome, who have been managed over the past 10 years at a tertiary care centre in Southern India. METHODS: The inpatient and outpatient records of patients from 2006 to 2015 were retrospectively reviewed. The clinical features, clinical history, biochemical values, imaging features which included radiological findings and PET scans, management, details of follow-up and outcomes were documented...
June 14, 2017: Endocrine Practice
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