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Management of pancreatitis

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https://www.readbyqxmd.com/read/28087054/care-pathway-of-patients-with-metastatic-pancreatic-cancer-in-daily-practice-in-france-results-from-the-repere-national-survey
#1
Pascal Hammel, Romain Coriat, Gérard Lledo, Mariella de Bausset, Marion Selosse, Stéphane Obled, Franck Bonnetain
Data in the literature regarding the care pathway of pancreatic cancer patients are limited. The objective of the REPERE survey was to identify and describe the initial stages of the care pathway of pancreatic patients in the metastatic phase. From May to October 2015, 62 oncologists (ON) or gastroenterologists specialized in digestive oncology (GESDO) and 300 general practitioners (GP) completed an electronic questionnaire on the pathway of 728 patients recently diagnosed with metastatic pancreatic adenocarcinoma...
January 10, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28081546/advanced-pancreatic-adenocarcinoma-outcomes-with-transition-from-devolved-to-centralised-care-in-a-regional-cancer-centre
#2
Olusola O Faluyi, Joanna L Connor, Madhuchanda Chatterjee, Carl Ikin, Helen Wong, Daniel H Palmer
BACKGROUND: Previous observations suggest suboptimal 'real world' survival outcomes for advanced pancreatic adenocarcinoma. We hypothesized that centralisation of advanced pancreatic adenocarcinoma management would improve chemotherapy treatment and survival from the disease. METHODS: The data was prospectively collected on all cases of advanced pancreatic adenocarcinoma reviewed through Clatterbridge Cancer Centre according to two groups; 1 October 2009-31st Dec 2010 (devolved care) or 1 January 2013-31 March 2014 (centralised care)...
January 12, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28079795/pancreatic-groove-cancer
#3
Yuan-Hao Ku, Shih-Chin Chen, Bor-Uei Shyr, Rheun-Chuan Lee, Yi-Ming Shyr, Shin-E Wang
Pancreatic groove cancer is very rare and can be indistinguishable from groove pancreatitis. This study is to clarify the characteristics, clinical features, managements, and survival outcomes of this rare tumor.Brief descriptions were made for each case of pancreatic groove cancer encountered at our institute. Individualized data of pancreatic groove cancer cases described in the literature were extracted and added to our database to expand the study sample size for a more complete analysis.A total of 33 patients with pancreatic groove cancer were included for analysis, including 4 cases from our institute...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28078647/sitagliptin-a-review-in-type-2-diabetes
#4
Lesley J Scott
The dipeptidyl peptidase-4 inhibitor sitagliptin (Januvia(®); Glactiv(®); Tesavel(®); Xelevia™) is approved in more than 130 countries worldwide as monotherapy and in combination with other antihyperglycaemic drugs for the treatment of adult patients with type 2 diabetes (T2D). Extensive clinical experience has firmly established the glycaemic efficacy of oral sitagliptin (±other antihyperglycaemic drugs) in a broad spectrum of patients with T2D, including obese, elderly and renally impaired patients and those with established cardiovascular (CV) disease (CVD)...
January 11, 2017: Drugs
https://www.readbyqxmd.com/read/28078125/changing-paradigm-in-pancreatic-cancer-from-adjuvant-to-neoadjuvant-chemoradiation
#5
Justin D Anderson, Wen Wan, Brian J Kaplan, Jennifer Myers, Emma C Fields
BACKGROUND: Historically, management of pancreatic cancer has been determined based on whether the tumor was amenable to resection and all patients deemed resectable received curative intent surgery followed by adjuvant therapy with chemotherapy (CT) ± RT. However, patients who undergo resection with microscopic (R1) positive margins have inferior rates of survival. The purpose of this study is to identify patients who have undergone pancreatectomy for pancreatic cancer, determine the surgical margins, types of adjuvant therapies given and patterns of failure...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28077129/hypoglycemic-and-pancreatic-protective-effects-of-portulaca-oleracea-extract-in-alloxan-induced-diabetic-rats
#6
Basma K Ramadan, Mona F Schaalan, Amina M Tolba
BACKGROUND: Diabetes is a major public health concern. In spite of continuous new drug development to treat diabetes, herbal remedies remain a potential adjunct therapy to maintain better glycemic control while also imparting few side-effects. Portulaca oleracea has been traditionally used to manage several diseases due to the anti-oxidant and anti-atherogenic effects it imparts. To better understand the mechanisms associated with potential protective effect of P. oleracea extract against diabetes, alloxan-induced diabetic rats were used in this study...
January 11, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28075092/diabetes-mellitus-management-of-gastrointestinal-complications
#7
Beth Careyva, Brian Stello
Gastrointestinal disorders are common complications of diabetes mellitus and include gastroparesis, nonalcoholic fatty liver disease, gastroesophageal reflux disease, and chronic diarrhea. Symptoms of gastroparesis include early satiety, postprandial fullness, nausea, vomiting of undigested food, bloating, and abdominal pain. Gastroparesis is diagnosed based on clinical symptoms and a delay in gastric emptying in the absence of mechanical obstruction. Gastric emptying scintigraphy is the preferred diagnostic test...
December 15, 2016: American Family Physician
https://www.readbyqxmd.com/read/28074986/-recommendations-for-the-management-of-pancreatic-cancer-type-adenocarcinoma-a-consensus-statement-reached-during-the-2015-latin-american-symposium-on-gastroenterological-oncology
#8
Christian Caglevic, Jorge Gallardo, Marcela de la Torre, Mauricio Mahave, Bettina Müller, Sebastián Solé, Yuri Moscoso, Hernán De La Fuente, Juan Carlos Roa, Sebastián Hoefler, Jean M Butte, Pablo González M, Juan Manuel O'Connor, Javiera Torres, Verónica Pérez Encalada, Daniel Alarcón Cano, Luis Ubillos, Christian Rolfo, Alejo Lingua, Consuelo Díaz Romero, Alejandro Padilla Rosciano, Viviana Cuartero, Germán Calderillo Ruiz, Gilberto Schwartsmann, Xavier Kon Jara, Andrés Andrade G, Luis Mas López, Olga Barajas, Marcela Carballido, Hanns Lembach, Lena Morillas G, Enrique Roca, José Lobatón, Paola Montenegro B, Andrés Yepes, Hugo Marsiglia
Pancreatic cancer is a malignancy of great impact in developed countries and is having an increasing impact in Latin America. Incidence and mortality rates are similar for this cancer. This is an important reason to offer to the patients the best treatments available. During the Latin American Symposium of Gastroenterology Oncology (SLAGO) held in Viña del Mar, Chile, in April 2015, a multidisciplinary group of specialists in the field met to discuss about this disease. The main conclusions of this meeting, where practitioners from most of Latin American countries participated, are listed in this consensus that seek to serve as a guide for better decision making for patients with pancreatic cancer in Latin America...
October 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28074451/ercp-with-stenting-of-traumatic-pancreatic-duct-transection-a-case-report
#9
Deepa Prashant Makhija, Jayesh Desale, Charu Tiwari, Hemanshi Shah
Pancreatic injuries, though rare, are associated with high morbidity because of location of pancreas adjacent to the various hollow and solid organs. Difficulty in early diagnosis adds to morbidity. Condition of the pancreatic duct is an important factor in grading the injury and deciding upon course of management. Conservative management is the line of treatment in lower grade injuries. Higher grades of pancreatic injuries are usually managed surgically. Endoscopic retrograde cholangiopancreaticography (ERCP) has recently emerged as an effective diagnostic as well as therapeutic modality for hepatobiliary and pancreatic pathologies...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28072692/role-of-biochemistry-and-cytological-analysis-of-cyst-fluid-for-the-differential-diagnosis-of-pancreatic-cysts-a-retrospective-cohort-study
#10
Ozlem Mutluay Soyer, Bulent Baran, Asli Ciftcibasi Ormeci, Davut Sahin, Suut Gokturk, Sami Evirgen, Rafet Basar, Pinar Firat, Filiz Akyuz, Kadir Demir, Fatih Besisik, Sabahattin Kaymakoglu, Cetin Karaca
BACKGROUND: Management of pancreatic cysts is based on neoplastic-nonneoplastic discrimination. Endoscopic ultrasound (EUS) enables to differentiate neoplastic-nonneoplastic lesions and also allows fine-needle aspiration (FNA). In this study, we aim to assess feasibility and clinical relevance of cytological and biochemical analysis in differential diagnosis of cystic pancreatic lesions in patients who had undergone endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) due to pancreatic cysts...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28069018/intraoperative-radiation-therapy-iort-in-pancreatic-cancer
#11
REVIEW
Robert Krempien, Falk Roeder
Despite the important improvements made in the fields of surgery, chemotherapy and radiation therapy, pancreatic cancer remains one of the most lethal malignancies. Improved outcomes with novel chemotherapy regimes led again to increased attention on the role of localized radiotherapy, since local tumor progression causes significant morbidity and mortality in patients. Even after resection local failure rates are as high as 50-80%. The immediate proximity to critical structures (bone marrow, spinal cord, kidneys, liver, and intestine) limits the dose of radiation that can be administered to the tumor bed with conventional external beam radiation therapy (EBRT)...
January 10, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28068586/preliminary-investigation-of-whole-pancreas-3d-histogram-adc-metrics-for-predicting-progression-of-acute-pancreatitis
#12
Amir K Iranmahbook, Andrea S Kierans, Chenchan Huang, Justin M Ream, Andrew B Rosenkrantz
PURPOSE: To evaluate whole-pancreas 3D-histogram ADC metrics in acute pancreatitis. METHODS: In 41 patients with acute pancreatitis undergoing MRI/MRCP with DWI, 3D-volumes-of-interest encompassing the entire pancreas were placed to derive whole-pancreas histogram ADC metrics. RESULTS: There were trends toward higher 0-10th percentile ADC, higher 10-25th percentile ADC, lower skewness, and higher kurtosis in patients with new complications (p=0...
December 21, 2016: Clinical Imaging
https://www.readbyqxmd.com/read/28066983/endoscopic-ultrasound-guided-antegrade-biliary-stenting-for-unresectable-malignant-biliary-obstruction-in-patients-with-surgically-altered-anatomy-a-single-center-prospective-pilot-study
#13
Takuji Iwashita, Ichiro Yasuda, Tsuyoshi Mukai, Keisuke Iwata, Shinpei Doi, Shinya Uemura, Masatoshi Mabuchi, Mitsuru Okuno, Masahito Shimizu
BACKGROUND AND AIMS: Endoscopic retrograde cholangiography (ERCP) with biliary stenting for the treatment of unresectable malignant biliary obstruction (MBO) is challenging among patients with surgically altered anatomy. Endoscopic ultrasound-guided antegrade biliary stenting (EUS-ABS) was introduced as an alternative biliary drainage method, although it has not been well studied yet. In this single-center prospective pilot study, we aimed to evaluate the feasibility and safety of EUS-ABS for MBO in patients with surgically altered anatomy...
January 9, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28065242/advances-in-glycemic-characteristics-complications-and-treatment-for-patients-undergoing-total-pancreatectomy
#14
Ying Zhou, Wei-Gang Zhao
Total pancreatectomy has been mainly used to treat malignant diseases of the pancreas, di-ffuse ductal involvement, and severe chronic pancreatitis. Patients may develop pancreatic diabetes after the surgery, in whom the glucose levels fluctuate widely and are hard to control, which increases the incidence of recurrent hypoglycemia. Postoperative complications are closely associated with the glucose levels. Thus, tighter glycemic management is essential for increasing the survival of these patients. Few cases have been discribed in China...
December 20, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28062950/efficacy-and-safety-of-folfirinox-in-locally-advanced-pancreatic-cancer-a-single-center-experience
#15
G Lakatos, A Petranyi, A Szűcs, L Nehéz, L Harsanyi, P Hegyi, G Bodoky
The management of locally advanced pancreatic cancer (LAPC) is a major challenge. Although new drugs are available for the treatment of metastatic disease, the optimal treatment of non-metastatic cases remains controversial. The role of neoadjuvant therapy is still a question of debate in this setting. The aim of the study was to prospectively collect and analyse data on efficacy and safety of a modified FOLFIRINOX regimen in LAPC patients treated in a single institution. Another major objective was to assess the capability of FOLFIRINOX to render primary non-resectable cancer to resectable...
January 6, 2017: Pathology Oncology Research: POR
https://www.readbyqxmd.com/read/28062871/-chronic-diarrhea-in-the-diabetic-a-review-of-the-literature
#16
Juan Sebastián Frías Ordoñez, William Otero Regino
The association of diarrhea with diabetes mellitus has been known for more than 70 years. In diabetic patients its prevalence is around 20%.Its clinical manifestations are diverse, and represents a diagnostic and therapeutic challenge.There are certain diagnoses of higher prevalence in diabetic patients than in the general population.The different related etiologies can be adequately diagnosed through the clinical history and complementary diagnostic tests.The medications used by the diabetic patient to manage their disease often cause chronic diarrhea, so the pharmacological background should be studied at the time of the study of diarrhea...
October 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28062869/-large-balloon-dilation-for-removal-of-choledocholithiasis-difficult-to-extract-clinical-experience
#17
Luis Marin Calderón, Augusto Vera Calderón, Aldo Gómez Correa, Zenon Cervera Reyes, Milagros Dávalos Moscol, Edgar Alva Alva, Fernando Palacios Salas, Ramiro Díaz Ríos, Edson Guzmán Calderón, Grisley García Chihuan
OBJECTIVE: The aim of this study was to report the initial experience of the combined use of biliary sphincterotomy plus balloon dilatation of the papilla for management of large stones. MATERIALS AND METHODS: Design: Retrospective, descriptive. This study included 18 patients in whom a hydrostatic dilatation of the papilla with large balloons was performed between June 2012 and April 2014. Patients had multiple large stones, tapered distal common bile duct, previous sphincterotomy, or peri/ intradiverticular papilla...
October 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28060554/current-molecular-and-genetic-aspects-of-pancreatic-cancer-the-role-of-metastasis-associated-proteins-mta-a-review
#18
Efstathios T Pavlidis, Theodoros E Pavlidis
: Purpose/aim: To focus on current molecular and genetic aspects and MTA proteins, since pancreatic cancer is a lethal malignant with poor prognosis. Early diagnosis is essential step, contributing to potential curative resection. MATERIALS AND METHODS: A PubMed search of relevant articles published up to August 2016 was performed to identify current information about pancreatic cancer regarding molecular biomarkers, with emphasis on carcinogenesis, novel therapeutic targets, and MTA proteins...
January 6, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28060186/acupuncture-for-pain-in-chronic-pancreatitis-a-single-blinded-randomized-crossover-trial
#19
Jacob Juel, Stefano Liguori, Aldo Liguori, Jakob L Poulsen, Massimiliano Valeriani, Carina Graversen, Søren S Olesen, Asbjørn M Drewes
OBJECTIVES: Many patients with painful chronic pancreatitis (CP) have insufficient effect of treatment, and the prevalence of adverse effects is high. Consequently, alternatives to conventional management are needed. We aimed to study the effect of acupuncture in painful CP. METHODS: This was a prospective, single-blinded, randomized crossover trial. Fifteen patients with CP were assigned to a session of acupuncture followed by sham stimulation or vice versa. Patients rated clinical pain scores daily on a 0 to 10 visual analogue scale (VAS) and completed the Patient Global Impression of Change...
February 2017: Pancreas
https://www.readbyqxmd.com/read/28059943/efficacy-safety-and-outcomes-of-endoscopic-retrograde-cholangiopancreatography-with-per-oral-pancreatoscopy-a-multicenter-experience
#20
Sheeva K Parbhu, Ali A Siddiqui, Megan Murphy, Arish Noor, Linda J Taylor, Alyssa Mills, Douglas G Adler
INTRODUCTION: Per-oral pancreatoscopy can be used for both evaluation and treatment of pancreatic duct stones during endoscopic retrograde cholangiopancreatography, evaluating and treating pancreatic duct strictures of indeterminate etiology, and visual inspection and direct biopsy of pancreatic duct mucosa for diagnosis of intraductal papillary mucinous neoplasm (IPMN). We aim to describe the efficacy, safety, and outcomes of pancreatoscopy in a large, multicenter series of patients...
January 5, 2017: Journal of Clinical Gastroenterology
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