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Intensive therapy of acute pancreatitis

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https://www.readbyqxmd.com/read/27881128/effect-of-intensive-insulin-treatment-on-plasma-levels-of-lipoprotein-associated-phospholipase-a2-and-secretory-phospholipase-a2-in-patients-with-newly-diagnosed-type-2-diabetes
#1
Xiu-Hong Lin, Ming-Tong Xu, Jv-Ying Tang, Li-Fang Mai, Xiao-Yi Wang, Meng Ren, Li Yan
BACKGROUND: China has the highest absolute disease burden of diabetes worldwide. For diabetic patients, diabetes-related vascular complications are major causes of morbidity and mortality. The roles of lipoprotein-associated phospholipase A2 (Lp-PLA2) and secretory phospholipase A2 (sPLA2) as inflammatory markers have been recently evaluated in the pathogenesis of both diabetes and atherosclerosis. We aimed to determine the mechanism through which patients with newly diagnosed type 2 diabetes gain long-term vascular benefit from intensive insulin therapy by evaluating the change in Lp-PLA2 and sPLA2 levels after early intensive insulin treatment and its relevance with insulin resistance and pancreatic β-cell function...
November 23, 2016: Lipids in Health and Disease
https://www.readbyqxmd.com/read/27796165/chemotherapy-and-intensity-modulated-radiation-therapy-for-locally-advanced-pancreatic-cancer-achieves-a-high-rate-of-r0-resection
#2
Florence Huguet, Carla Hajj, Corrine B Winston, Weiji Shi, Zhigang Zhang, Abraham J Wu, Eileen M O'Reilly, Diane L Reidy, Peter Allen, Karyn A Goodman
BACKGROUND: To assess local control, survival and conversion to resectability among locally advanced pancreatic cancer (LAPC) patients treated with induction chemotherapy (ICT) followed by chemoradiotherapy treatment using intensity-modulated radiation therapy (IMRT). MATERIAL AND METHODS: Between 2007 and 2012, 134 LAPC patients were treated with ICT followed by IMRT. After chemoradiotherapy, 40 patients received maintenance chemotherapy. RESULTS: With a median follow-up of 20 months, median overall survival (OS) was 23 months...
October 31, 2016: Acta Oncologica
https://www.readbyqxmd.com/read/27675789/interim-acute-toxicity-analysis-and-surgical-outcomes-of-neoadjuvant-gemcitabine-nab-paclitaxel-and-hypofractionated-image-guided-intensity-modulated-radiation-therapy-in-resectable-and-borderline-resectable-pancreatic-cancer-anchor-study
#3
M Palta, B Czito, J Abbruzzese, H Uronis, E A Duffy, D T Blazer, C G Willett
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27619808/natural-history-after-acute-necrotizing-pancreatitis-a-large-us-tertiary-care-experience
#4
Chandraprakash Umapathy, Amit Raina, Shreyas Saligram, Gong Tang, Georgios I Papachristou, Mordechai Rabinovitz, Jennifer Chennat, Herbert Zeh, Amer H Zureikat, Melissa E Hogg, Kenneth K Lee, Melissa I Saul, David C Whitcomb, Adam Slivka, Dhiraj Yadav
BACKGROUND: Most studies of acute necrotizing pancreatitis (ANP) focus on short-term outcomes. We evaluated long-term survival and outcomes following ANP. METHODS: Patients treated for ANP at the University of Pittsburgh Medical Center from 2001 to 2008 were studied. Data on presentation and course during initial hospitalization and follow-up (median 34 months) was extracted. RESULTS: Mean age of patients (n = 167) was 53 ± 16 years; 70 % were male, 94 % white, 71 % transfers, 52 % biliary etiology, and 78 % had first-attack of acute pancreatitis...
September 12, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27549125/the-clinical-value-of-adipokines-in-predicting-the-severity-and-outcome-of-acute-pancreatitis
#5
Andrius Karpavicius, Zilvinas Dambrauskas, Audrius Gradauskas, Arturas Samuilis, Kristina Zviniene, Juozas Kupcinskas, Gintautas Brimas, Artur Meckovski, Audrius Sileikis, Kestutis Strupas
BACKGROUND: Recent data shows that patients with severe acute pancreatic might benefit from early intensive therapy, enteral nutrition and timely transfer to specialized centers. The early prophylactic use of antibiotics in AP remains controversial. The role and need for new markers in stratification of acute pancreatitis is also uncertain. This study aims to evaluate the prognostic usefulness of adipokines in prediction of the severity and outcome of acute pancreatitis (AP). METHODS: Prospective study was conducted in four clinical centers...
August 22, 2016: BMC Gastroenterology
https://www.readbyqxmd.com/read/27412455/long-term-retrospective-analysis-of-gene-therapy-with-alipogene-tiparvovec-and-its-effect-on-lipoprotein-lipase-deficiency-induced-pancreatitis
#6
Daniel Gaudet, Erik S Stroes, Julie Méthot, Diane Brisson, Karine Tremblay, Sophie J Bernelot Moens, Giorgio Iotti, Irene Rastelletti, Diego Ardigo, Deyanira Corzo, Christian Meyer, Marc Andersen, Philippe Ruszniewski, Mark Deakin, Marco J Bruno
Alipogene tiparvovec (Glybera) is a gene therapy product approved in Europe under the "exceptional circumstances" pathway as a treatment for lipoprotein lipase deficiency (LPLD), a rare genetic disease resulting in chylomicronemia and a concomitantly increased risk of acute and recurrent pancreatitis, with potentially lethal outcome. This retrospective study analyzed the frequency and severity of pancreatitis in 19 patients with LPLD up to 6 years after a single treatment with alipogene tiparvovec. An independent adjudication board of three pancreas experts, blinded to patient identification and to pre- or post-gene therapy period, performed a retrospective review of data extracted from the patients' medical records and categorized LPLD-related acute abdominal pain events requiring hospital visits and/or hospitalizations based on the adapted 2012 Atlanta diagnostic criteria for pancreatitis...
November 2016: Human Gene Therapy
https://www.readbyqxmd.com/read/27359113/a-platform-for-rapid-quantitative-assessment-of-multiple-drug-combinations-simultaneously-in-solid-tumors-in-vivo
#7
Joyoti Dey, William S Kerwin, Marc O Grenley, Joseph R Casalini, Ilona Tretyak, Sally H Ditzler, Derek J Thirstrup, Jason P Frazier, Daniel W Pierce, Michael Carleton, Richard A Klinghoffer
While advances in high-throughput screening have resulted in increased ability to identify synergistic anti-cancer drug combinations, validation of drug synergy in the in vivo setting and prioritization of combinations for clinical development remain low-throughput and resource intensive. Furthermore, there is currently no viable method for prospectively assessing drug synergy directly in human patients in order to potentially tailor therapies. To address these issues we have employed the previously described CIVO platform and developed a quantitative approach for investigating multiple combination hypotheses simultaneously in single living tumors...
2016: PloS One
https://www.readbyqxmd.com/read/27159517/pathology-image-of-the-month-cough-and-shortness-of-breath-in-a-noncompliant-patient-with-hiv-aids
#8
Reggie Thomasson, Tracy Dewenter, Robin R McGoey
A 37- year-old man with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) was admitted to the intensive care unit following a four month history of progressive shortness of breath, productive cough, and flu-like symptoms. His HIV/AIDS was diagnosed at the age of 19 (CD4 count =15; viral load = 294,436 copies/ mL) and was complicated by hemodialysis-dependent, HIV-associated nephropathy, prior Pneumocystis pneumonia and known noncompliance with prescribed antiretroviral therapy. Chest film at admission was interpreted as diffuse bilateral interstitial and airspace opacities with a right sided layering density representative of laminar pleural effusion...
July 2015: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27138544/pathology-image-of-the-month-cough-and-shortness-of-breath-in-a-noncompliant-patient-with-hiv-aids
#9
Reggie Thomasson Md, Tracy Dewenter Md, Robin R McGoey Md
A 37- year-old man with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) was admitted to the intensive care unit following a four month history of progressive shortness of breath, productive cough, and flu-like symptoms. His HIV/AIDS was diagnosed at the age of 19 (CD4 count =15; viral load = 294,436 copies/ mL) and was complicated by hemodialysis-dependent, HIV-associated nephropathy, prior Pneumocystis pneumonia and known noncompliance with prescribed antiretroviral therapy. Chest film at admission was interpreted as diffuse bilateral interstitial and airspace opacities with a right sided layering density representative of laminar pleural effusion...
July 2015: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27106240/-surgical-treatment-of-acute-mediastinitis
#10
M Krüger, S Decker, J P Schneider, A Haverich, O Schega
Despite modern intensive care management, acute mediastinitis is still associated with a high morbidity and mortality (up to approximately 40 %). Effective antibiotic therapy, intensive care management, elimination of the causative sources of infection and drainage of the affected mediastinal compartments are the cornerstones of therapy in a multidisciplinary treatment concept. Early diagnosis, prompt and uncompromising initial therapy and planned computed tomography (CT) control after the first stages of therapy in order to decide on the necessity for surgical re-interventions are essential for achieving optimal results...
June 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/27083933/interventions-for-necrotising-pancreatitis
#11
REVIEW
Kurinchi Selvan Gurusamy, Ajay P Belgaumkar, Adam Haswell, Stephen P Pereira, Brian R Davidson
BACKGROUND: Acute necrotising pancreatitis carries significant mortality, morbidity, and resource use. There is considerable uncertainty as to how people with necrotising pancreatitis should be treated. OBJECTIVES: To assess the benefits and harms of different interventions in people with acute necrotising pancreatitis. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2015, Issue 4), MEDLINE, EMBASE, Science Citation Index Expanded, and trials registers to April 2015 to identify randomised controlled trials (RCT)...
April 16, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27017851/-incretin-based-antidiabetic-treatment-and-diseases-of-the-pancreas-pancreatitis-pancreas-carcinoma
#12
REVIEW
György Jermendy
In the last couple of years incretin-based antidiabetic drugs became increasingly popular and widely used for treating patients with type 2 diabetes. Immediately after launching, case reports and small case series were published on the potential side effects of the new drugs, with special attention to pancreatic disorders such as acute pancreatitis or pancreatic cancer. As clinical observations accumulated, these side-effects were noted with nearly all drugs of this class. Although these side-effects proved to be rare, an intensive debate evolved in the literature...
April 3, 2016: Orvosi Hetilap
https://www.readbyqxmd.com/read/27006853/management-of-a-septic-open-abdomen-patient-with-spontaneous-jejunal-perforation-after-emergent-c-s-with-confounding-factor-of-mild-acute-pancreatitis
#13
Fahri Yetisir, Akgün Ebru Sarer, Hasan Zafer Acar, Gokhan Osmanoglu, Mehmet Özer, Faik Yaylak
Introduction. We report the management of a septic Open Abdomen (OA) patient by the help of negative pressure therapy (NPT) and abdominal reapproximation anchor (ABRA) system in pregnant woman with spontaneous jejunal perforation after emergent cesarean section (C/S) with confounding factor of mild acute pancreatitis (AP). Presentation of Case. A 29-year-old and 34-week pregnant woman with AP underwent C/S. She was arrested after anesthesia induction and responded to cardiopulmonary resuscitation (CPR). There were only ash-colored serosanguinous fluid within abdomen during C/S...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/26872431/acute-pancreatitis-as-a-complication-of-childhood-cancer-treatment
#14
REVIEW
Milica Stefanović, Janez Jazbec, Fredrik Lindgren, Milutin Bulajić, Matthias Löhr
Acute pancreatitis (AP) is now well recognized as a possible complication of childhood cancer treatment, interrupting the chemotherapy regimen, and requiring prolonged hospitalization, possibly with intensive care and surgical intervention, thereby compromising the effect of chemotherapy and the remission of the underlying malignant disease. This review summarizes the current literature and presents the various etiological factors for AP during chemotherapy as well as modern trends in the diagnosis and therapy of AP in children...
May 2016: Cancer Medicine
https://www.readbyqxmd.com/read/26646268/origin-presentation-and-clinical-course-of-nonpancreatic-hyperlipasemia
#15
Ben L Da, Ira A Shulman, Christianne Joy Lane, James Buxbaum
OBJECTIVE: The diagnosis of acute pancreatitis (AP) is defined as a constellation of abnormal pancreatic enzymes, imaging, and characteristic pain. The origin and clinical significance of isolated hyperlipasemia is unclear. METHODS: We prospectively evaluated patients with serum lipase level greater than 3 times the upper limit of normal (ULN) admitted to Los Angeles County Hospital from October 2014 to April 2015. Patients were identified by a daily laboratory query used to support an ongoing randomized trial of goal-directed therapy for AP (NCT 01761539)...
July 2016: Pancreas
https://www.readbyqxmd.com/read/26541280/improved-effect-of-continuous-renal-replacement-therapy-in-metabolic-status-and-body-composition-of-early-phase-of-acute-pancreatitis
#16
Chao Wu, Xinying Wang, Tingting Jiang, Weiqin Li, Ning Li, Jieshou Li
OBJECTIVE: To observe the metabolic changes in the early phase of acute pancreatitis (AP) patients induced by continuous renal replacement therapy (CRRT), and to investigate the correlation between the metabolic changes and outcomes of the AP patients. METHODS: We performed a retrospective analysis in the surgical intensive care unit (ICU) of a tertiary teaching hospital. A total of 169 patients diagnosed as AP were divided into 2 groups: CRRT group (n = 71) and non-CRRT group (n = 98), based on whether they received CRRT for more than 24 hours within 7 days from onset of AP...
October 2015: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/26332486/contrast-enhanced-ultrasonography-of-the-pancreas-in-healthy-dogs-and-in-dogs-with-acute-pancreatitis
#17
Nathalie Rademacher, David Schur, Frédéric Gaschen, Michael Kearney, Lorrie Gaschen
Pancreatitis is the most frequent disease affecting the exocrine pancreas in dogs and reliable diagnostic techniques for predicting fatal complications are lacking. Contrast-enhanced ultrasound (CEUS) improves detection of tissue perfusion as well as organ lesion vascular pattern. Objectives of this prospective case control study were to compare perfusion characteristics and enhancement patterns of the pancreas in healthy dogs and dogs with pancreatitis using CEUS. Ten healthy dogs and eight dogs with pancreatitis were selected based on physical examination, abdominal ultrasound, and blood analysis findings...
January 2016: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/26296750/long-chain-omega-3-fatty-acids-fibrates-and-niacin-as-therapeutic-options-in-the-treatment-of-hypertriglyceridemia-a-review-of-the-literature
#18
REVIEW
Matthew K Ito
Hypertriglyceridemia affects approximately 33% of the US population. Elevated triglyceride levels are independently associated with cardiovascular disease (CVD) risk, and severe hypertriglyceridemia is a risk factor for acute pancreatitis. Guidelines for the management of severe hypertriglyceridemia (≥5.6 mmol/L [≥500 mg/dL]) recommend immediate use of triglyceride-lowering agents; however, statins remain the first line of therapy for the management of mild to moderate hypertriglyceridemia (1.7-5.6 mmol/L [150-499 mg/dL])...
October 2015: Atherosclerosis
https://www.readbyqxmd.com/read/26290642/impact-of-a-clinical-pathway-on-treatment-outcome-in-patients-with-acute-pancreatitis
#19
Miroslav Vujasinovic, Jana Makuc, Bojan Tepes, Apolon Marolt, Zdenko Kikec, Nace Robac
AIM: To determine the impact of a clinical pathway (CP) on acute pancreatitis (AP) treatment outcome. METHODS: A retrospective analysis of medical records was performed. We compared the results of AP treatment outcome over two time periods in our centre, before (2006-2007) and after (2010-2012) the implementation of a CP. The CP comprised the following indicators of quality: performance of all laboratory tests on admission (including lipids and carbohydrate deficient transferrin), determination of AP aetiology, abdomen ultrasound (US) within the first 24 h after admission, contrast-enhanced computed tomography of the abdomen in all cases of suspected pancreatic necrosis, appropriately selected and sufficiently used antibiotic therapy (if necessary), pain control, adequate hydration, control of haemodynamic parameters and transfer to the Intensive Care Unit (ICU) (if necessary), endoscopic retrograde cholangiopancreatography (ERCP) in biliary AP, surgical treatment (if necessary), and advice on outpatient follow-up after discharge...
August 14, 2015: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/26138414/-an-analysis-of-prognostic-factors-in-patients-suffering-from-acute-lung-injury-acute-respiratory-distress-syndrome-complicated-with-yangming-fushi-syndrome-a-report-of-206-cases-from-multiple-centers
#20
MULTICENTER STUDY
Lina Yan, Qiang Fu, Chao Du, Yangzi Yu, Jing Li, Qingquan Liu, Chengrui Xue, Qinghui Qi, Jianping Li
OBJECTIVE: To investigate the risk factors of patients with acute lung injury/acute respiratory distress syndrome (ALI/ARDS) complicated with Yangming Fushi syndrome. METHODS: A prospective study was conducted. From August 2009 to July 2013, 206 patients with Yangming Fushi syndrome combined with ALI/ARDS were enrolled in the intensive care units (ICUs) of the following five hospitals: Tianjin Nankai Hospital, Dongzhimen Hospital Affiliated to Beijing Traditional Chinese Medicine University, General Hospital of Tianjin Medical University, the First Affiliated Hospital of Dalian Medical University, and Wuxi Third People's Hospital in Jiangsu Province...
July 2015: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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