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Intensive therapy of acute pancreatitis

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https://www.readbyqxmd.com/read/29719210/cell-encapsulation-overcoming-barriers-in-cell-transplantation-in-diabetes-and-beyond
#1
Marco Farina, Jenolyn F Alexander, Usha Thekkedath, Mauro Ferrari, Alessandro Grattoni
Cell-based therapy is emerging as a promising strategy for treating a wide range of human diseases, such as diabetes, blood disorders, acute liver failure, spinal cord injury, and several types of cancer. Pancreatic islets, blood cells, hepatocytes, and stem cells are among the many cell types currently used for this strategy. The encapsulation of these "therapeutic" cells is under intense investigation to not only prevent immune rejection but also provide a controlled and supportive environment so they can function effectively...
April 29, 2018: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/29697688/-preventive-therapy-with-mexidol-in-toxic-damage-to-the-heart
#2
E I Polozova
The purpose of this study was to efficacy of mexidol in the prevention of toxic damage to the heart in acute pancreatitis. MATERIAL AND METHODS: The paper presents the results of experimental studies conducted on 30 adult mongrel adult dogs, which simulated acute focal pancreatic necrosis. We studied the influence of mexidol in the complex therapy for changes in the qualitative and quantitative composition of the lipid tissue structures of the heart, the intensity of processes of lipid peroxidation, antioxidant capacity, phospholipase A2 activity and morphofunctional state of the heart muscle in experimental acute focal pancreatic necrosis...
2018: Khirurgiia
https://www.readbyqxmd.com/read/29683955/successful-management-of-a-child-with-drug-induced-necrotizing-pancreatitis-during-acute-lymphoblastic-leukemia-therapy-a-case-report
#3
Anna Płotka, Agnieszka Wziątek, Jacek Wachowiak, Katarzyna Derwich
Acute pancreatitis in children acute lymphoblastic leukemia is commonly caused by drugs, for example, L-Asparaginase, pegapargase, steroids. The incidence of this complication is estimated at 6.7% to 18%. Although the majority of drug-induced acute pancreatitis cases are mild, severe cases can rarely occur. This work presents a case of successful management of a child with drug-induced necrotizing pancreatitis during acute lymphoblastic leukemia therapy. This case illustrates that comprehensive care and immediate intensive treatment can rescue patient despite poor prognosis...
April 20, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29657730/lemierre-s-syndrome-presented-with-acute-pancreatitis
#4
Laura Garcia, Kaori Ito
Case: Lemierre's syndrome is a rare clinical condition that is characterized by infected internal jugular vein thrombosis with metastatic septicemia. The most common causative agent is Fusobacterium necrophorum . A previously healthy 37-year-old woman presented to our emergency department with nausea, vomiting, and diarrhea. She was admitted to the general practice unit with a diagnosis of acute pancreatitis then was subsequently transferred to the intensive care unit due to shock. Physical examination revealed tenderness on right side of the neck...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29409663/penta-therapy-for-severe-acute-hyperlipidemic-pancreatitis-a-retrospective-chart-review-over-a-10-year-period
#5
Jian Lu, Yun Xie, Jiang Du, Mei Kang, Wei Jin, Yan Li, Hui Xie, Ruijie Cheng, Rui Tian, Ruilan Wang
INTRODUCTION: The purpose of our study is to evaluate the efficacy of penta-therapy for HL-SAP in a retrospective study. METHODS: Retrospective study between January 2007 and December 2016 in a hospital intensive care unit. HL-SAP patients were assigned to conventional treatment alone (the control group) or conventional treatment with the experimental protocol (the penta-therapy group) consists of blood purification, antihyperlipidemic agents, low-molecular weight heparin, insulin, covering the whole abdomen with Pixiao (a traditional Chinese medicine)...
February 3, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29395619/development-and-validation-of-a-multivariate-prediction-model-for-patients-with-acute-pancreatitis-in-intensive-care-medicine
#6
Felix Zubia-Olaskoaga, Enrique Maraví-Poma, Iratxe Urreta-Barallobre, María-Rosario Ramírez-Puerta, Mónica Mourelo-Fariña, María-Pilar Marcos-Neira, Miguel Ángel García-García
BACKGROUND/OBJECTIVES: Development and validation of a multivariate prediction model for patients with acute pancreatitis (AP) admitted in Intensive Care Units (ICU). METHODS: A prospective multicenter observational study, in 1 year period, in 46 international ICUs (EPAMI study). PATIENTS: adults admitted to an ICU with AP and at least one organ failure. INTERVENTIONS: Development of a multivariate prediction model, using the worst data of the stay in ICU, based in multivariate analysis, simple imputation in a development cohort...
March 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29358874/emphysematous-pancreatitis-associated-with-penetrating-duodenal-ulcer
#7
Claudio Tana, Mauro Silingardi, Maria Adele Giamberardino, Francesco Cipollone, Tiziana Meschi, Cosima Schiavone
In the "proton pump inhibitors era", a penetrating peptic ulcer (PPU) represents an exceptional cause of abdominal pain, and was more frequently observed in the past where there was not an effective antacid treatment. Ulcer-induced pancreatitis is very rare, too, and manifests with persistent, intense pain radiating to the back. A mild to severe pancreatitis with peripancreatic fluid collection can be observed at imaging. However, only a few cases of association between PPU and emphysematous pancreatitis (EP) have been published in the literature...
December 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29215543/fungal-infections-in-patients-with-infected-pancreatic-necrosis-and-pseudocysts-risk-factors-and-outcome
#8
Philipp A Reuken, Hanna Albig, Jürgen Rödel, Michael Hocke, Uwe Will, Andreas Stallmach, Tony Bruns
OBJECTIVES: Fungal infections in patients with acute pancreatitis are common and potentially life threatening. Data on fungal pancreatic infections are inconsistent. Therefore, the aim of this study was to identify risk factors for fungal infection and to determine their impact on survival. METHODS: This was a retrospective analysis of pathogen spectrum and outcome of infected pancreatic necrosis or pseudocysts from 3 German hospitals from 2002 to 2016. RESULTS: A total of 187 fine-needle aspirations were performed in 113 patients...
January 2018: Pancreas
https://www.readbyqxmd.com/read/29212080/clinical-evaluation-of-continuous-renal-replacement-therapy-in-combination-with-ultrasound-guided-percutaneous-transhepatic-gallbladder-drainage-for-acute-severe-biliary-pancreatitis-a-retrospective-study
#9
Qingyun Zhu, Xinting Pan, Yongxian Cao, Hongqiao Wang, Ning Yu, Fuguo Liu, Shigang Yang, Yunlong Wang, Yunbo Sun, Zhengbin Wang
BACKGROUND/AIMS: This study aimed to report the clinical efficacy of continuous renal replacement therapy (CRRT) in combination with ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGD) (CRRT+PTGD) in the treatment of acute severe biliary pancreatitis (ASBP). METHODS: Between January 2010 and January 2016, 40 cases of patients with ASBP who received routine CRRT (CRRT group) and 40 of those who received CRRT+PTGD (CRRT+PTGD group) at the Affiliated Hospital of Qingdao University (Qingdao, China) were retrospectively reviewed...
2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29114609/dose-escalation-with-an-imrt-technique-in-15-to-28-fractions-is-better-tolerated-than-standard-doses-of-3dcrt-for-lapc
#10
Lauren E Colbert, Shalini Moningi, Awalpreet Chadha, Ahmed Amer, Yeonju Lee, Robert A Wolff, Gauri Varadhachary, Jason Fleming, Matthew Katz, Prajnan Das, Sunil Krishnan, Eugene J Koay, Peter Park, Christopher H Crane, Cullen M Taniguchi
Purpose: To review acute and late toxicities after chemoradiation for locally advanced pancreatic ductal adenocarcinoma in patients who were treated with escalated dose radiation (EDR). Methods and materials: Maximum Common Terminology Criteria for Adverse Events Version 4.0 acute toxicities (AT) during radiation and within 60 days after radiation were recorded for both acute gastrointestinal toxicity and overall toxicity (OT). Late toxicities were also recorded...
July 2017: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/29076486/-complications-of-the-open-surgeries-for-severe-acute-pancreatitis
#11
V P Glabay, O V Cridnev, A V Arkharov, A N Bykov, I A Kaprin, B G Muslimov
INTRODUCTION: With the unsuccessfulness of an intensive therapy and minimally invasive interventions in severe acute pancreatitis they resort to the 'open' surgical interventions. It is important to know about the classification of complications of such surgeries, the frequency of occurrences, the recognition peculiarities and the determination of a treatment plan for the practical surgery. AIM: The optimization of the usage of 'open' surgeries for patients with severe acute pancreatitis...
2017: Khirurgiia
https://www.readbyqxmd.com/read/29023527/dose-escalated-radiotherapy-for-unresectable-or-locally-recurrent-pancreatic-cancer-dose-volume-analysis-toxicity-and-outcome-of-28-consecutive-patients
#12
Sebastian Zschaeck, Bibiana Blümke, Peter Wust, David Kaul, Marcus Bahra, Hanno Riess, Fritz Klein, Marianne Sinn, Uwe Pelzer, Volker Budach, Pirus Ghadjar
PURPOSE: The role of radiotherapy for unresectable pancreatic cancer is controversial. A benefit of additional radiotherapy is supported by some observations. A dose-effect relationship was recently found by dose escalation employing image guided and intensity modulated radiotherapy. METHODS: We retrospectively evaluated 28 consecutive patients, all with history of extensive prior therapies for unresectable locally advanced/ recurrent pancreatic cancer (LAPC/LRPC)...
2017: PloS One
https://www.readbyqxmd.com/read/28966194/open-abdomen-in-trauma-and-critical-care
#13
Eleanor R Fitzpatrick
The open abdomen technique and temporary abdominal closure after damage control surgery is fast becoming the standard of care for managing intra-abdominal bleeding and infectious or ischemic processes in critically ill patients. Expansion of this technique has evolved from damage control surgery in severely injured trauma patients to use in patients with abdominal compartment syndrome due to acute pancreatitis and other disorders. Subsequent therapies after use of the open abdomen technique and temporary abdominal closure are resuscitation in the intensive care unit and planned reoperation to manage the underlying cause of bleeding, infection, or ischemia...
October 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28661823/stereotactic-body-radiation-vs-intensity-modulated-radiation-for-unresectable-pancreatic-cancer
#14
COMPARATIVE STUDY
Joseph J Park, Carla Hajj, Marsha Reyngold, Weiji Shi, Zhigang Zhang, John J Cuaron, Christopher H Crane, Eileen M O'Reilly, Maeve A Lowery, Kenneth H Yu, Karyn A Goodman, Abraham J Wu
BACKGROUND: Stereotactic body radiation therapy (SBRT) is an emerging treatment option for unresectable pancreatic cancer, and is postulated to be more effective and less toxic than conventionally fractionated intensity modulated radiation therapy (IMRT). MATERIAL AND METHODS: We retrospectively reviewed unresectable stage I-III pancreatic adenocarcinoma treated from 2008 to 2016 at our institution with SBRT (five fractions, 30-33 Gy) or IMRT (25-28 fractions, 45-56 Gy with concurrent chemotherapy)...
December 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28630246/ominous-triad-triggered-by-high-dose-glucocorticosteroid-therapy
#15
Sarah Bär, Fritz Daudel, Thomas Zueger
Glucocorticosteroids (CS) play a key role in the treatment of numerous diseases. Nonetheless, they can be accompanied by several adverse effects. We present the case of a 51-year-old woman who was treated with high-dose CS for a relapse of her multiple sclerosis. After 5 days of treatment, the patient developed severe diabetic ketoacidosis, hypertriglyceridemia and acute pancreatitis-a potentially life-threatening triad which has previously been described, in our case, however, for the first time as a complication of CS therapy...
June 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28596690/continuing-episodes-of-pain-in-recurrent-acute-pancreatitis-prospective-follow-up-on-a-standardised-protocol-with-drugs-and-pancreatic-endotherapy
#16
C Ganesh Pai, M Ganesh Kamath, Mamatha V Shetty, Annamma Kurien
AIM: To assess the outcomes of drug therapy (DT) followed by pancreatic endotherapy for continuing painful episodes in recurrent acute pancreatitis. METHODS: DT comprised of pancreatic enzymes and anti-oxidants failing which, endotherapy (ET; pancreatic sphincterotomy and stent placement) was done. The frequency of pain, its visual analogue score (VAS), quality of life (QoL), serum C peptide and faecal elastase were compared between baseline and after 1 year of follow up in all patients and in the two subgroups on DT and ET...
May 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28482383/-efficacy-of-continuous-blood-purification-in-treatment-of-severe-acute-pancreatitis-in-children
#17
Y Zhu, Y Cui, Y C Zhang, H J Miao, F Wang, R X Chen, Q F Rong
Objective: To explore the therapeutic role of bedside continuous blood purification(CBP) in children with severe acute pancreatitis(SAP). Method: The clinical and laboratory data of 11 children with SAP who were admitted to Pediatric Intensive Care Unit (PICU) of Shanghai Children's Hospital from June 2013 to May 2016 were analyzed, including using pediatric critical illness score (PCIS) and pediatric risk of score mortality (PRISM)-Ⅲ score to assessing the severity of the disease.For those patients with severe organ dysfunction, CBP treatment was used when conventional therapy was not efficient...
May 4, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28435316/subanesthetic-ketamine-for-pain-management-in-hospitalized-children-adolescents-and-young-adults-a-single-center-cohort-study
#18
Kathy A Sheehy, Caroline Lippold, Amy L Rice, Raissa Nobrega, Julia C Finkel, Zenaide Mn Quezado
BACKGROUND: Subanesthetic doses of ketamine, an N -methyl-d-aspartate receptor antagonist used as an adjuvant to opioid for the treatment of pain in adults with acute and chronic pain, have been shown, in some instances, to improve pain intensity and to decrease opioid intake. However, less is known about the role of ketamine in pain management in children, adolescents, and young adults. PURPOSE: We examined the effects of subanesthetic ketamine on pain intensity and opioid intake in children, adolescents, and young adults with acute and chronic pain syndromes treated in an inpatient setting...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28414683/recurrent-hypertriglyceridemic-pancreatitis-htgp-and-the-use-of-insulin-drip-as-treatment
#19
T Tran, N Lee
INTRODUCTION: Chronic pancreatitis by definition is a recurrent episode of acute pancreatitis and is commonly associated with alcoholism in the US. Another cause of chronic pancreatitis is hypertriglyceridemia (HTGP);, occurring in 1-5 percent of cases. The incidence of HTGP is higher in patients with diabetes and HIV, usually requiring triglyceride levels > 1000 mg/dL. CASE: A 33 year old man with uncontrolled type 1 diabetes and recurrent pancreatitis, first diagnosed 5 years prior, presented as a transfer from an outside hospital for a recurrent episode of HTGP...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28246469/restoration-of-energy-level-in-the-early-phase-of-acute-pediatric-pancreatitis
#20
REVIEW
Dóra Mosztbacher, Nelli Farkas, Margit Solymár, Gabriella Pár, Judit Bajor, Ákos Szűcs, József Czimmer, Katalin Márta, Alexandra Mikó, Zoltán Rumbus, Péter Varjú, Péter Hegyi, Andrea Párniczky
Acute pancreatitis (AP) is a serious inflammatory disease with rising incidence both in the adult and pediatric populations. It has been shown that mitochondrial injury and energy depletion are the earliest intracellular events in the early phase of AP. Moreover, it has been revealed that restoration of intracellular ATP level restores cellular functions and defends the cells from death. We have recently shown in a systematic review and meta-analysis that early enteral feeding is beneficial in adults; however, no reviews are available concerning the effect of early enteral feeding in pediatric AP...
February 14, 2017: World Journal of Gastroenterology: WJG
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