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Management of pancreatitis

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https://www.readbyqxmd.com/read/29934987/fibrin-sealants-for-the-prevention-of-postoperative-pancreatic-fistula-following-pancreatic-surgery
#1
REVIEW
Junhua Gong, Sirong He, Yao Cheng, Nansheng Cheng, Jianping Gong, Zhong Zeng
BACKGROUND: Postoperative pancreatic fistula is one of the most frequent and potentially life-threatening complications following pancreatic resections. Fibrin sealants are introduced to reduce postoperative pancreatic fistula by some surgeons. However, the use of fibrin sealants during pancreatic surgery is controversial. This is an update of a Cochrane Review last published in 2016. OBJECTIVES: To assess the safety, effectiveness, and potential adverse effects of fibrin sealants for the prevention of postoperative pancreatic fistula following pancreatic surgery...
June 23, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29933481/-outpatient-drain-management-in-patients-with-clinically-relevant-postoperative-pancreatic-fistula-cr-popf-current-status-in-germany
#2
Sebastian Hempel, Pamela Püttmann, Christoph Kahlert, Lena Seifert, Sören Torge Mees, Thilo Welsch, Jürgen Weitz, Marius Distler
INTRODUCTION: Postoperative pancreatic fistula (POPF) is a common complication after pancreatic surgery and is associated with extended hospitalisation, increased medical costs, and reduced quality of life. The aim of the present study was to assess the treatment of POPF in Germany, with a special focus on outpatient drain management in patients with clinically relevant POPF (CR-POPF). METHODS: A questionnaire evaluating postoperative management once a CR-POPF is diagnosed - especially focusing on ambulatory drain management - was developed and sent to 211 German hospitals performing > 12 pancreatic operations per year...
June 2018: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29932294/nab-paclitaxel-plus-gemcitabine-in-metastatic-pancreatic-adenocarcinoma-australian-subset-analyses-of-the-phase-iii-mpact-trial
#3
Rosemary Young, Paul Mainwaring, Philip Clingan, Francis Xavier Parnis, Gholamreza Asghari, Philip Beale, Abdalla Aly, Marc Botteman, Alfredo Romano, Stefano Ferrara, Sandra Margunato-Debay, Marion Harris
AIM: The phase III MPACT trial (N = 861) demonstrated superior overall survival (OS) with first-line nab-paclitaxel plus gemcitabine versus gemcitabine alone (median, 8.7 months vs 6.6 months; hazard ratio [HR], 0.72; 95% confidence interval [CI], 0.62-0.83; P < 0.001) in patients with metastatic pancreatic cancer. The efficacy benefit of the combination over gemcitabine alone was observed across patient subgroups, including those based on region. This subset analysis was designed to examine the safety and efficacy of nab-paclitaxel plus gemcitabine in patients treated in Australia to understand whether differences in patient population or regional variations in patient care had any impact on clinical outcomes...
June 22, 2018: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29931993/enzymatic-mediastinitis-as-a-fearsome-complication-of-pancreatic-necrosectomy
#4
Marta Paniagua García-Señoráns, María Reyes Meléndez Villar, Paula Senra Del Río, Eva María García Fontán, Fabio Ausania
Several types of thoracic complications can be associated with severe acute pancreatitis. Some are very common, such as pleural effusion, whilst some others are very rare although life threatening, such as enzymatic mediastinitis (EM). Only a few cases of EM (when related to acute pancreatitis) have been described in the literature. Here we describe the case of a 76-year-old female who developed acute respiratory failure and atrial fibrillation during the postoperative period after an open pancreatic necrosectomy, due to an EM episode...
June 22, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29930900/successful-management-of-necrotizing-pancreatitis-in-mixed-malaria-and-review-of-literature
#5
REVIEW
Jitendra Singh, Anju Dinkar, Rana Gopal Singh, Shishir Kapoor
Malaria is one of the very common causes of fever in the Indian subcontinent with significant morbidity and mortality. In endemic areas, malaria infection may manifest with a variety of systemic complications ranging from mild to the life-threatening condition including atypical presentations and sometimes a clinical dilemma. We herein report a case of 35-year-old male laborer with complaints of fever, headache, and altered consciousness whose presentation was as case of clinical meningitis, developed acute hepatitis, kidney injury, and necrotizing pancreatitis...
January 2018: Tropical Parasitology
https://www.readbyqxmd.com/read/29928755/prophylactic-abdominal-drainage-for-pancreatic-surgery
#6
REVIEW
Wei Zhang, Sirong He, Yao Cheng, Jie Xia, Mingliang Lai, Nansheng Cheng, Zuojin Liu
BACKGROUND: The use of surgical drains has been considered mandatory after pancreatic surgery. The role of prophylactic abdominal drainage to reduce postoperative complications after pancreatic surgery is controversial. OBJECTIVES: To assess the benefits and harms of routine abdominal drainage after pancreatic surgery, compare the effects of different types of surgical drains, and evaluate the optimal time for drain removal. SEARCH METHODS: For the last version of this review, we searched CENTRAL (2016, Issue 8), and MEDLINE, Embase, Science Citation Index Expanded, and Chinese Biomedical Literature Database (CBM) to 28 August 2016)...
June 21, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29928186/hypothermia-related-acute-pancreatitis
#7
Kyawzaw Lin, Emmanuel Ofori, Aung Naing Lin, Sithu Lin, Thinzar Lin, Ameer Rasheed, Viswanath Vasudevan, Madhavi Reddy
Acute pancreatitis (AP) is an inflammatory disease presenting from mild localized inflammation to severe infected necrotic pancreatic tissue. In the literature, there are a few cases of hypothermia-induced AP. However, the association between hypothermia and AP is still a myth. Generally, mortality from acute pancreatitis is nearly 3-6%. Here, we present a 40-year-old chronic alcoholic female who presented with acute pancreatitis induced by transient hypothermia. A 40-year-old chronic alcoholic female was hypothermic at 81°F on arrival which was improved to 91...
May 2018: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29927872/nutritional-considerations-in-pediatric-pancreatitis-a-position-paper-from-the-nasphan-pancreas-committee-and-esphan-cystic-fibrosis-pancreas-working-group
#8
Maisam Abu-El-Haija, Aliye Uc, Steven L Werlin, Alvin Jay Freeman, Miglena Georgieva, Danijela Jojkić-Pavkov, Daina Kalnins, Brigitte Kochavi, Bart G P Koot, Stephanie Van Biervliet, Jaroslaw Walkowiak, Michael Wilschanski, Veronique D Morinville
OBJECTIVES: Wide variations exist in how physicians manage the nutritional aspects of children affected by acute pancreatitis (AP), acute recurrent pancreatitis (ARP), and chronic (CP) pancreatitis. Better consensus for optimal management is needed. METHODS: This consensus statement on nutrition in pediatric pancreatic diseases was developed through a joint ESPGHAN-NASPGHAN working group that performed an evidence-based search of the literature on nutrition in AP, ARP, and CP with a focus on pediatrics...
July 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29924043/conservative-management-of-acute-calculous-cholecystitis-complicated-by-pancreatitis-in-an-elderly-woman-a-case-report
#9
Marta K Walczak-Galezewska, Damian Skrypnik, Monika Szulinska, Katarzyna Skrypnik, Pawel Bogdanski
RATIONALE: Acute calculous cholecystitis is a prevalent disease whose diagnosis and management still face significant debate. Although the overall incidence of gallstone disease is 18.8% in European women aged 30 to 69 years, there is little data and experience in managing acute calculous cholecystitis in populations over 80 years old. The incidence of acute cholecystitis among the elderly is probably increasing. For the reason, we here highlight the advantages and disadvantage of various treatment and management opens based on a 96-year-old patient...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29923163/hypertriglyceridemia-induced-pancreatitis-updated-review-of-current-treatment-and-preventive-strategies
#10
REVIEW
Prashanth Rawla, Tagore Sunkara, Krishna Chaitanya Thandra, Vinaya Gaduputi
Hypertriglyceridemia (HTG) is an uncommon but well-established cause of acute pancreatitis (AP) comprising up to 7% of the cases. The clinical course of HTG-induced pancreatitis (HTGP) is highly similar to that of AP of other etiologies with HTG being the only distinguishing clinical feature. However, HTGP is often correlated with higher severity and elevated complication rate. At present, no approved treatment guideline for the management of HTGP is available, although different treatment modalities such as insulin, heparin, fibric acids, and omega 3 fatty acids have been successfully implemented to reduce serum triglycerides (TG)...
June 19, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29920619/the-endorotor-a-novel-tool-for-the-endoscopic-management-of-pancreatic-necrosis
#11
Sophia E van der Wiel, Jan-Werner Poley, Marina J A L Grubben, Marco J Bruno, Arjun D Koch
No abstract text is available yet for this article.
June 19, 2018: Endoscopy
https://www.readbyqxmd.com/read/29917026/endoscopic-management-of-pancreatic-duct-disruption-with-large-mediastinal-pseudocyst
#12
Vivian Ortiz, Muhammad Nadeem Yousaf, Thiruvengadam Muniraj, Priya Jamidar, Harry R Aslanian
No abstract text is available yet for this article.
May 2018: VideoGIE: an official video journal of the American Society for Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29916850/sphincter-of-oddi-dysfunction-sphincter-of-oddi-dysfunction-or-discordance-what-is-the-state-of-the-art-in-2018
#13
Jong Jin Hyun, Richard A Kozarek
PURPOSE OF REVIEW: To review important manuscripts published over the previous 2 years relative to sphincter of Oddi dysfunction (SOD). RECENT FINDINGS: The long-term outcomes of the Evaluating Predictors and Interventions of SOD (EPISOD) trial further substantiated results from the initial EPISOD study, reinforcing that neither endoscopic retrograde cholangiopancreatography-manometry nor endoscopic sphincterotomy are appropriate for SOD type III. Pain management in the latter patients has reverted to neuromodulating agents, and recent studies have suggested a role for duloxetine and potentially acupuncture...
June 16, 2018: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/29914168/association-of-low-fecal-elastase-1-and-non-ulcer-dyspepsia
#14
Mustafa Tahtaci, Huseyin Koseoglu, Murat Alisik, Oyku Tayfur Yurekli, Gozde Tahtaci, Ozcan Erel, Osman Ersoy
Non-ulcer dyspepsia (NUD) is a term used to define a set of symptoms that are believed to originate from the gastroduodenal region, and no underlying organic, systemic, or metabolic reason can be found. The majority of patients suffer from chronic symptoms although half of the patients report improvement in symptoms with time. The potential role exocrine pancreatic insufficiency in NUD patients has not been clarified yet. We aimed to identify exocrine pancreas function with pancreatic fecal elastase-1 in patients diagnosed with non-ulcer dyspepsia and no typical exocrine pancreatic insufficiency (EPI) symptoms...
June 16, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29913182/the-genetic-architecture-of-type-1-diabetes-mellitus
#15
REVIEW
Denis M Nyaga, Mark H Vickers, Craig Jefferies, Jo K Perry, Justin M O'Sullivan
Type 1 diabetes mellitus (T1D) is a complex autoimmune disorder characterised by loss of the insulin-producing pancreatic beta cells in genetically predisposed individuals, ultimately resulting in insulin deficiency and hyperglycaemia. T1D is most common among children and young adults, and the incidence is on the rise across the world. The aetiology of T1D is hypothesized to involve genetic and environmental factors that result in the T-cell mediated destruction of pancreatic beta cells. There is a strong genetic risk to T1D; with genome-wide association studies (GWAS) identifying over 60 susceptibility regions within the human genome which are marked by single nucleotide polymorphisms (SNPs)...
June 15, 2018: Molecular and Cellular Endocrinology
https://www.readbyqxmd.com/read/29912758/role-of-cholecystectomy-after-endoscopic-sphincterotomy-in-the-management-of-choledocholithiasis-in-high-risk-patients-a-systematic-review-and-meta-analysis
#16
Muhammad Ali Khan, Zubair Khan, Claudio R Tombazzi, Chiranjeevi Gadiparthi, Wade Lee, C Mel Wilcox
BACKGROUND: Endoscopic retrograde cholangiography and endoscopic sphincterotomy (ES) with subsequent cholecystectomy is the standard of care for the management of patients with choledocholithiasis. There is conflicting evidence in terms of mortality reduction, prevention of complications specifically biliary pancreatitis and cholangitis with the use of early cholecystectomy particularly in high-risk surgical and elderly patients. AIMS: We conducted this systematic review and meta-analysis of randomized controlled trials to compare the early cholecystectomy versus wait and watch strategy after ES...
June 16, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29912020/to-resect-or-not-to-resect-a-review-of-pancreatic-cyst-disease-management
#17
Jon M Harrison, Carlos Fernandez-Del Castillo
PURPOSE OF REVIEW: With recent advances in radiographic testing, there have been increases in the incidental identification of pancreatic cysts. Determining management, specifically, which cysts can be watched versus intervened upon has significant impact on at the patient-physician level as well as globally on resource allocation and healthcare expenditures. This review focuses on the three main guidelines (Fukuoka guidelines, European consensus, and American Gastroenterological Association recommendations) for management of pancreatic cystic disease after incidental identification...
June 13, 2018: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/29912000/neoplasms-of-the-neuroendocrine-pancreas-an-update-in-the-classification-definition-and-molecular-genetic-advances
#18
Julie M Guilmette, Vania Nosé
This review focuses on discussing the main modifications of the recently published 2017 WHO Classification of Neoplasms of the Neuroendocrine Pancreas (panNEN). Recent updates separate pancreatic neuroendocrine tumors into 2 broad categories: well-differentiated pancreatic neuroendocrine tumors (panNET) and poorly differentiated pancreatic neuroendocrine carcinoma (panNEC), and incorporates a new subcategory of "well-differentiated high-grade NET (G3)" to the well-differentiated NET category. This new classification algorithm aims to improve the prediction of clinical outcomes and survival and help clinicians select better therapeutic strategies for patient care and management...
June 14, 2018: Advances in Anatomic Pathology
https://www.readbyqxmd.com/read/29910463/autoimmune-pancreatitis
#19
REVIEW
Sajan Jiv Singh Nagpal, Ayush Sharma, Suresh T Chari
Over the course of the last 2 decades our knowledge of autoimmune pancreatitis has increased exponentially. In this review, we summarize the clinical presentation, diagnosis and treatment of AIP, to better allow general gastroenterologists and primary care providers to consider AIP as a as a rare but important cause of painless obstructive jaundice and recurrent acute pancreatitis. While steroids remain the mainstay of first line therapy, a number of patients with type 1 AIP require immunomodulators or rituximab to maintain remission; recommendations on the management of relapses continue to evolve...
June 18, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29910159/nivolumab-induced-thyroid-dysfunction-in-patients-with-lung-cancer
#20
Ana M Ramos-Levi, Jacobo Rogado, Jose Miguel Sanchez-Torres, Ramón Colomer, Mónica Marazuela
BACKGROUND: Nivolumab is an anti-cancer monoclonal antibody that inhibits PD1 and modulates T-cell response. It has been shown to significantly improve survival in several types of cancer, but clinical trials have also reported an increased risk of developing immune-related adverse events (IRAEs). Endocrine IRAEs may be particularly relevant. OBJECTIVE: To comprehensively evaluate the clinical presentation of endocrine IRAEs in patients with lung cancer treated with nivolumab...
June 14, 2018: Endocrinología, Diabetes y Nutrición
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