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Management of pancreatitis

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https://www.readbyqxmd.com/read/29027110/predicting-the-cancer-burden-in-catalonia-between-2015-and-2025-the-challenge-of-cancer-management-in-the-elderly
#1
R Clèries, A Ameijide, R Marcos-Gragera, L Pareja, M Carulla, M-L Vilardell, L Esteban, M Buxó, J-A Espinàs, A Puigdefàbregas, J Ribes, A Izquierdo, J Galceran, J M Borrás
BACKGROUND: Developing effective cancer control programmes requires information on the future cancer burden in an ageing population. In our study we predicted the burden of cancer in Catalonia from 2015 to 2025. METHODS: Bayesian age-period-cohort models were used to predict the burden of cancer from 2015 to 2025 using incidence data from the Girona and Tarragona cancer registries and cancer mortality data from the Catalan mortality registry. Using the Bashir-Estève method, we divided the net change in the number of cases between 2015 and 2025 into changes due to population size (S), cancer risk (R) and age (A) distribution...
October 12, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/29026467/chromogranin-a-as-a-biochemical-marker-for-neuroendocrine-tumors-a-single-center-experience-at-royal-hospital-oman
#2
Elham S Al-Risi, Fatma S Al-Essry, Waad-Allah S Mula-Abed
OBJECTIVES: To evaluate the significance of serum chromogranin A (CgA) status in patients with and without different neuroendocrine tumors (NETs) by conducting a retrospective assessment of the diagnostic utility and limitations of CgA as a biomarker for NETs in a tertiary care hospital in Oman. METHODS: We conducted a retrospective analysis of CgA requests referred to the Clinical Biochemistry Laboratory, Royal Hospital, Oman over a 24-month period (April 2012 to March 2014)...
September 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/29024476/prevalence-and-outcomes-of-cystic-lesions-of-the-transplant-pancreas-the-university-of-wisconsin-experience
#3
Talal M Al-Qaoud, Eric J Martinez, Hans W Sollinger, Dixon B Kaufman, Robert R Redfield, Bridget Welch, Glen Leverson, Jon S Odorico
Literature on the behavior of cystic lesions in pancreas transplants is scarce, and hence a better understanding is warranted. Data on recipients and their respective donors that underwent simultaneous kidney and pancreas, pancreas transplant alone, and pancreas after kidney between 1994-2015 were reviewed (n=1185). Cystic lesions of the transplant pancreas developed in 22 patients (1.8%): 12 pseudocysts, 2 cysts/remnants, 4 intraductal papillary mucinous neoplasms (IPMN), 2 adenocarcinomas, 1 low grade intraepithelial pancreatic neoplasia, and 1 case of polycystic kidney disease...
October 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29022830/direct-costs-for-nonsurgical-management-of-chronic-pancreatitis-in-a-tertiary-care-teaching-hospital
#4
Nagesh Kamat, Ganesh Pai, Surulivel Rajan Mallayasamy, Asha Kamath, Rajasulochana S
BACKGROUND: Chronic pancreatitis (CP) is a leading cause of hospitalization among gastrointestinal diseases resulting in considerable financial burden to patients. However the direct costs for nonsurgical management in CP remains unexplored. METHODS: A cross sectional study was carried out (2011-14) in the Department of Gastroenterology, Kasturba Hospital, Manipal, India. Demographic and clinical data on laboratory investigations, interventions and follow up were obtained from the medical records department...
October 12, 2017: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/29022085/rare-pancreatic-tumors
#5
Jonathan Steinman, Atif Zaheer, Michael D Kluger, Helen Remotti, Elizabeth M Hecht
In this review, we will focus on rare pancreatic tumors. Most of these tumors do not have distinct characteristic appearances so the key to diagnosis requires a combination of imaging appearance, laboratory data, patient demographics, and associated medical syndromes in order to narrow the differential diagnosis. Nonetheless, imaging plays a vital role in narrowing the differential and guiding management. While there are many variant pathologic entities that cannot be encompassed by a single review, we aim to illustrate the imaging appearance of less common pancreatic tumors highlighting key distinctive diagnostic characteristics and discuss the implications for management...
October 11, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29019956/anti-diabetic-potential-of-ocimum-gratissimum-leaf-fractions-in-fortified-diet-fed-streptozotocin-treated-rat-model-of-type-2-diabetes
#6
Stanley I R Okoduwa, Isamila A Umar, Dorcas B James, Hajiya M Inuwa
Background: Ocimum gratissimum (OG) is used in the traditional management of diabetes in Nigeria. This study investigated the anti-diabetic potential of OG leaf fractions (OGLF) in a rat model of Type-2 diabetes (T2D). Method: Methanol crude extract of OG leaf was fractionated with solvents of increasing order of polarity (n-hexane, chloroform, ethyl-acetate, n-butanol and water). The anti-diabetic potential of the fractions was evaluated in vivo. T2D was induced in Albino Wistar rats and treated with OGLF...
October 11, 2017: Medicines (Basel, Switzerland)
https://www.readbyqxmd.com/read/29019583/management-of-infected-pancreatic-necrosis-state-of-the-art
#7
Roberto Rasslan, Fernando da Costa Ferreira Novo, Alberto Bitran, Edivaldo Massazo Utiyama, Samir Rasslan
Pancreatic necrosis occurs in 15% of acute pancreatitis. The presence of infection is the most important factor in the evolution of pancreatitis. The diagnosis of infection is still challenging. Mortality in infected necrosis is 20%; in the presence of organic dysfunction, mortality reaches 60%. In the last three decades, there has been a real revolution in the treatment of infected pancreatic necrosis. However, the challenges persist and there are many unsolved questions: antibiotic treatment alone, tomography-guided percutaneous drainage, endoscopic drainage, video-assisted extraperitoneal debridement, extraperitoneal access, open necrosectomy? A step up approach has been proposed, beginning with less invasive procedures and reserving the operative intervention for patients in which the previous procedure did not solve the problem definitively...
September 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/29019567/management-of-pancreaticopleural-fistulas-secondary-to-chronic-pancreatitis
#8
Everton Cazzo, Márcio Apodaca-Rueda, Martinho Antonio Gestic, Fábio Henrique Mendonça Chaim, Helena Paes de Almeida de Saito, Murillo Pimentel Utrini, Francisco Callejas-Neto, Elinton Adami Chaim
INTRODUCTION: Pancreaticopleural fistula is a rare complication of chronic pancreatitis. OBJECTIVE: To describe pancreaticopleural fistula due to chronic pancreatitis and perform an extensive review of literature on this topic. METHODS: Comprehensive narrative review through online research on the databases Medline and Lilacs for articles published over the last 20 years. There were 22 case reports and four case series selected. RESULTS: The main indication for surgical treatment is the failure of clinical and/or endoscopic treatments...
July 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/29018453/inulin-type-fructans-modulates-pancreatic-gut-innate-immune-responses-and-gut-barrier-integrity-during-experimental-acute-pancreatitis-in-a-chain-length-dependent-manner
#9
Yue He, Chengfei Wu, Jiahong Li, Hongli Li, Zhenghua Sun, Hao Zhang, Paul de Vos, Li-Long Pan, Jia Sun
Acute pancreatitis (AP) is a common abdominal inflammatory disorder and one of the leading causes of hospital admission for gastrointestinal disorders. No specific pharmacological or nutritional therapy is available but highly needed. Inulin-type fructans (ITFs) are capable of modifying gut immune and barrier homeostasis in a chemistry-dependent manner and hence potentially applicable for managing AP, but their efficacy in AP has not been demonstrated yet. The current study aimed to examine and compare modulatory effects of ITFs with different degrees of fermentability on pancreatic-gut immunity and barrier function during experimentally induced AP in mice...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29017830/suvmax-after-18-fluoro-deoxyglucose-positron-emission-tomography-computed-tomography-a-tool-to-define-treatment-strategies-in-pancreatic-cancer
#10
Ilaria Pergolini, Stefano Crippa, Matteo Salgarello, Giulio Belfiori, Stefano Partelli, Giacomo Ruffo, Alessandro Pucci, Giuseppe Zamboni, Massimo Falconi
BACKGROUND: (18)fluoro-deoxyglucose positron emission tomography/computed tomography (18FDG-PET/CT) might be a useful tool in the management of pancreatic ductal adenocarcinoma (PDAC). AIMS: The aim of this study was to analyze maximum standard uptake value (SUVmax) after 18FDG-PET/CT as predictor of survival outcomes and method to determine treatment strategies. METHODS: A consecutive series of patients who underwent preoperative 18FDG-PET/CT and subsequent resection for PDAC were retrospectively reviewed...
September 22, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29017354/persistent-sirs-and-acute-fluid-collections-are-associated-with-increased-ct-scanning-in-acute-interstitial-pancreatitis
#11
Ayesha Kamal, Mahya Faghih, Robert A Moran, Elham Afghani, Amitasha Sinha, Nasim Parsa, Martin A Makary, Atif Zaheer, Elliot K Fishman, Mouen A Khashab, Anthony N Kalloo, Vikesh K Singh
BACKGROUND: The use of computed tomography (CT) in acute pancreatitis (AP) continues to increase in parallel with the increasing use of diagnostic imaging in clinical medicine. AIM: To determine the factors associated with obtaining >1 CT scan in acute interstitial pancreatitis (AIP). METHODS: Demographic and clinical data of all adult patients admitted between 1/2010 and 1/2015 with AP (AP) were evaluated. Only patients with a CT severity index (CTSI) ≤ 3 on a CT obtained within 48 h of presentation were included...
October 11, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28992887/risk-factors-and-managements-of-hemorrhage-associated-with-pancreatic-fistula-after-pancreaticoduodenectomy
#12
Xing Liang, Li-Gang Shi, Jun Hao, An-An Liu, Dan-Lei Chen, Xian-Gui Hu, Cheng-Hao Shao
BACKGROUND: Post-pancreaticoduodenectomy pancreatic fistula associated hemorrhage (PPFH) is one of the leading lethal complications. Our study was to analyze the risk factors and managements of hemorrhage associated with pancreatic fistula after pancreaticoduodenectomy, and to evaluate treatment options. METHOD: We analyzed 445 patients who underwent pancreaticoduodenectomy or pylorus-preserving pancreaticoduodenectomy and evaluated the relevance between clinical data and PPFH...
October 15, 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28992409/hypoxia-targeting-tumor-microenvironment-responsive-nanocluster-bomb-for-radical-enhanced-radiotherapy
#13
Da Huo, Sen Liu, Chao Zhang, Jian He, Zhengyang Zhou, Hao Zhang, Yong Hu
Although ultrasmall metal nanoparticles (NPs) have been used as radiosensitizers to enhance the local damage to tumor tissues while reducing injury to the surrounding organs, their rapid clearance from the circulatory system and the presence of hypoxia within the tumor continue to hamper their further application in radiotherapy (RT). In this study, we report a size tunable nanocluster bomb with a initial size of approximately 33 nm featuring a long half-life during blood circulation and destructed to release small hypoxia microenvironment-targeting NPs (∼5 nm) to achieve deep tumor penetration...
October 11, 2017: ACS Nano
https://www.readbyqxmd.com/read/28990794/value-of-the-revised-atlanta-classification-rac-and-determinant-based-classification-dbc-classification-systems-in-the-evaluation-of-acute-pancreatitis
#14
Xiaolei Wang, Li Qin, Jingli Cao
Objective Since increasing AP severity is significantly associated with mortality, accurate and rapid determination of severity is crucial for effective clinical management of AP. This study investigated the value of the revised Atlanta classification (RAC) and the determinant-based classification (DBC) systems in stratifying severity of acute pancreatitis (AP). Methods This retrospective observational cohort study included 480 AP patients. Patient demographics and clinical characteristics were recorded. The primary outcome was mortality, and secondary outcomes were admission to intensive care unit (ICU), duration of ICU stay, and duration of hospital stay...
October 9, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28990311/comprehensive-data-of-3-820-patients-newly-diagnosed-with-colorectal-liver-metastasis-between-2005-and-2007-report-of-a-nationwide-survey-in-japan
#15
Katsunori Sakamoto, Goro Honda, Toru Beppu, Kenjiro Kotake, Masakazu Yamamoto, Keiichi Takahashi, Itaru Endo, Kiyoshi Hasegawa, Michio Itabashi, Yojiro Hashiguchi, Yoshihito Kotera, Shin Kobayashi, Tatsuro Yamaguchi, Satoshi Morita, Masaru Miyazaki, Kenichi Sugihara
To collect big data for further research to improve treatment outcomes in patients with colorectal liver metastasis (CRLM), the Joint Committee for Nationwide Survey on Colorectal Liver Metastasis was established by the Japanese Society for Cancer of the Colon and Rectum and the Japanese Society of Hepato-Biliary-Pancreatic Surgery. The joint committee initiated data collection since 2014. The data of 4,237 patients newly diagnosed with CRLM between 2005 and 2007 were registered from 134 departments of 127 institutions (64%) among 209 departments (from 201 institutions) that agreed to participate in this study...
October 9, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28990119/dual-src-and-egfr-inhibition-in-combination-with-gemcitabine-in-advanced-pancreatic-cancer-phase-i-results-a-phase-i-clinical-trial
#16
Dana B Cardin, Laura W Goff, Emily Chan, Jennifer G Whisenant, G Dan Ayers, Naoko Takebe, Lori R Arlinghaus, Thomas E Yankeelov, Jordan Berlin, Nipun Merchant
Pancreatic adenocarcinoma remains a major therapeutic challenge, as the poor (<8%) 5-year survival rate has not improved over the last three decades. Our previous preclinical data showed cooperative attenuation of pancreatic tumor growth when dasatinib (Src inhibitor) was added to erlotinib (EGFR inhibitor) and gemcitabine. Thus, this study was designed to determine the maximum-tolerated dose of the triplet combination. Standard 3 + 3 dose escalation was used, starting with daily oral doses of 70 mg dasatinib and 100 mg erlotinib with gemcitabine on days 1, 8, and 15 (800 mg/m(2)) of a 28-day cycle (L0)...
October 9, 2017: Investigational New Drugs
https://www.readbyqxmd.com/read/28988702/prognosis-of-sporadic-resected-small-%C3%A2-2%C3%A2-cm-nonfunctional-pancreatic-neuroendocrine-tumors-a-multi-institutional-study
#17
Ville J Sallinen, Tessa T Y Le Large, Elke Tieftrunk, Shamil Galeev, Zahar Kovalenko, Sven-Petter Haugvik, Anne Antila, Oskar Franklin, Emma Martinez-Moneo, Stuart M Robinson, Francesco Panzuto, Nicolas Regenet, Francesca Muffatti, Stefano Partelli, Dominik Wiese, Philippe Ruszniewski, Bertrand Dousset, Bjørn Edwin, Detlef K Bartsch, Alain Sauvanet, Falconi Massimo, Güralp O Ceyhan, Sebastien Gaujoux
BACKGROUND: Malignant potential of small (≤20 mm) nonfunctional pancreatic neuroendocrine tumors (sNF-PNET) is difficult to predict and management remain controversial. The aim of this study was to assess the prognosis of sporadic nonmetastatic sNF-PNETs. METHODS: Patients were identified from databases of 16 centers. Outcomes and risk factors for recurrence were identified by uni- and multivariate analyses. RESULTS: sNF-PNET was resected in 210 patients, and 66% (n = 138) were asymptomatic...
October 5, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28986019/pancreatic-insufficiency-in-cystic-fibrosis
#18
Vikesh K Singh, Sarah Jane Schwarzenberg
Pancreatic insufficiency (PI) affects about 85% of the cystic fibrosis population. Although most are PI soon after birth, some will have pancreatic sufficiency (PS) for some or all of their life. Understanding the clinical presentation, diagnosis, and management of PI is crucial to the care of people with cystic fibrosis.
September 20, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28985843/total-parenteral-nutrition-in-patients-following-pancreaticoduodenectomy-lessons-from-1184-patients
#19
Cullen E Worsh, Talar Tatarian, Awinder Singh, Michael J Pucci, Jordan M Winter, Charles J Yeo, Harish Lavu
BACKGROUND: Total parenteral nutrition (TPN) has historically been used conservatively in the management of patients after pancreaticoduodenectomy (PD). Herein, we evaluate the indications for and outcomes associated with TPN use in a high-volume pancreatic surgery center. MATERIALS AND METHODS: We retrospectively queried our institution's pancreatic surgery database for patients who received TPN after PD from 2006 through 2015. RESULTS: Of 1184 patients who underwent PD, 232 (19...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28985688/diagnosis-and-management-of-pancreatic-exocrine-insufficiency-pei-in-primary-care-consensus-guidance-of-a-canadian-expert-panel
#20
P Durie, J-D Baillargeon, S Bouchard, F Donnellan, S Zepeda-Gomez, C Teshima
Pancreatic exocrine insufficiency (PEI) results in maldigestion due to inadequate activity of pancreatic enzymes in the small bowel. PEI can arise from a variety of medical conditions that reduce enzyme synthesis within the pancreatic parenchyma or from secondary factors that may occur despite optimal parenchymal function, such as pancreatic duct obstruction or reduced or poorly synchronized enzyme release. The most characteristic symptom of PEI is steatorrhea - voluminous, lipid-rich stools; other common signs and symptoms include unexplained weight loss and deficiencies of fat-soluble vitamins and other micronutrients...
October 6, 2017: Current Medical Research and Opinion
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