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Pancreatitis and thrombosis

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https://www.readbyqxmd.com/read/28076318/beta-cell-function-and-clinical-course-in-three-siblings-with-thiamine-responsive-megaloblastic-anemia-trma-treated-with-thiamine-supplementation
#1
Kathryn Potter, John Wu, Julie Lauzon, Josephine Ho
Three siblings with thiamine-responsive megaloblastic anemia (TRMA) with a homozygous c.454delGGCATinsAT mutation in SLC19A2 are described. The index case presented at 14 months' old with severe non-ketotic hyperglycemia, dehydration, seizures and sinovenous thrombosis. She was started on insulin and developed sensorineural hearing loss around 2 years old. Two siblings were found to have the same mutation and were started on thiamine. One sibling developed transient hyperglycemia after several years of thiamine supplementation of 12 mg/kg that resolved with an increased thiamine dose (23 mg/kg)...
January 11, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28059968/multicenter-phase-ii-study-of-intravenous-and-intraperitoneal-paclitaxel-with-s-1-for-pancreatic-ductal-adenocarcinoma-patients-with-peritoneal-metastasis
#2
Sohei Satoi, Tsutomu Fujii, Hiroaki Yanagimoto, Fuyuhiko Motoi, Masanao Kurata, Naminatsu Takahara, Suguru Yamada, Tomohisa Yamamoto, Masamichi Mizuma, Goro Honda, Hiroyuki Isayama, Michiaki Unno, Yasuhiro Kodera, Hironori Ishigami, Masanori Kon
OBJECTIVE: To evaluate the clinical efficacy and tolerability of intravenous (i.v.) and intraperitoneal (i.p.) paclitaxel combined with S-1, "an oral fluoropyrimidine derivative containing tegafur, gimestat, and otastat potassium" in chemotherapy-naive pancreatic ductal adenocarcinoma (PDAC) patients with peritoneal metastasis. BACKGROUND: PDAC patients with peritoneal metastasis (peritoneal deposits and/or positive peritoneal cytology) have an extremely poor prognosis...
February 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28029328/when-what-and-why-of-perioperative-treatment-of-potentially-curable-pancreatic-adenocarcinoma
#3
Kimberly Perez, Thomas E Clancy, Joseph D Mancias, Michael H Rosenthal, Brian M Wolpin
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
December 28, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28008405/renal-vein-and-inferior-vena-cava-thrombosis-a-rare-extrasplanchnic-complication-of-acute-pancreatitis
#4
Ruchir Patel, Dhaval Choksi, Alisha Chaubal, Nirav Pipaliya, Meghraj Ingle, Prabha Sawant
Acute pancreatitis is an inflammatory disorder often associated with various complications. Approximately one fourth of patients with acute pancreatitis develop vascular complications, of which venous thrombosis forms a major group. Extrasplanchnic venous thrombosis is less common, and simultaneous renal vein and inferior vena cava thrombosis is reported only twice. We report a case of alcohol-related acute pancreatitis complicated by simultaneous renal vein and inferior vena cava thrombosis.
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27960048/artificial-neural-networks-predict-the-incidence-of-portosplenomesenteric-venous-thrombosis-in-patients-with-acute-pancreatitis
#5
Yang Fei, Jian Hu, Wei-Qin Li, Wei Wang, Guang-Quan Zong
OBJECTIVE: To construct and validate artificial neural networks (ANNs) for predicting the occurrence of portosplenomesenteric venous thrombosis (PSMVT) and compare the predictive ability of the ANNs with that of logistic regression. METHODS: The ANNs and logistic regression modeling were constructed using simple clinical and laboratory data of 72 acute pancreatitis (AP) patients. The ANNs and logistic modeling were first trained on 48 randomly chosen patients and validated on the remaining 24 patients...
December 13, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27958223/a-single-institution-experience-with-open-irreversible-electroporation-for-locally-advanced-pancreatic-carcinoma
#6
Li Yan, Yong-Liang Chen, Ming Su, Tian Liu, Kai Xu, Feng Liang, Wan-Qing Gu, Shi-Chun Lu
BACKGROUND: Locally advanced pancreatic carcinoma (LAPC) is characterized by poor prognosis despite recommended concurrent chemoradiotherapy. Irreversible electroporation (IRE) has emerged as a potential option for the management of unresectable pancreatic cancer. This study was conducted to evaluate the safety and short-term efficacy of open IRE for the treatment of LAPC. METHODS: Retrospective data of 25 consecutive patients receiving IRE for T3 lesions from July 2015 to June 2016 at a single center were analyzed...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27938471/human-recombinant-antithrombin-atrynsup-sup-administration-improves-survival-and-prevents-intravascular-coagulation-after-intraportal-islet-transplantation-in-a-piglet-model
#7
Valery Gmyr, Caroline Bonner, Ericka Moerman, Antoine Tournoys, Nathalie Delalleau, Audrey Quenon, Julien Thevenet, Mikael Chetboun, Julie KerrConte, Franois Pattou, Thomas Hubert, Merce Jourdain
Human islet transplantation is a viable treatment option for type 1 diabetes mellitus (T1D). However, pancreatic isletinflammation after transplantation induced by innate immune responses is likely to hinder graft function. This is mediated by incompatibility between islets and the blood interface, known as instant blood-mediated inflammatory reaction (IBMIR). Herein, we hypothesized that portal venous administration of islet cells with human recombinant antithrombin (ATryn(®)), a serine protease inhibitor (serpin), which plays a central role in the physiological regulation of coagulation and exerts indirect anti-inflammatory activities may offset coagulation abnormalities such as Disseminated Intravascular Coagulation (DIC) and IBMIR...
27, 2016: Cell Transplantation
https://www.readbyqxmd.com/read/27933671/causal-inference-in-obesity-research
#8
REVIEW
P W Franks, N Atabaki-Pasdar
Obesity is a risk factor for a plethora of severe morbidities and premature death. Most supporting evidence comes from observational studies that are prone to chance, bias and confounding. Even data on the protective effects of weight loss from randomized controlled trials will be susceptible to confounding and bias if treatment assignment cannot be masked, which is usually the case with lifestyle and surgical interventions. Thus, whilst obesity is widely considered the major modifiable risk factor for many chronic diseases, its causes and consequences are often difficult to determine...
December 8, 2016: Journal of Internal Medicine
https://www.readbyqxmd.com/read/27932185/inferior-vena-cava-duodenal-drainage-in-pancreas-alone-transplantation-for-chronic-pancreatitis-a-case-report
#9
B H Choi, Y M Park, K H Yang, C W Chu, J H Ryu
Enteric drainage has been the main trend in solitary pancreas transplantation. Compared with bladder drainage, it does not cause metabolic or urologic complications, but there is no way to perform immunologic monitoring, except by graft pancreas biopsy. Additionally, although portal drainage of the graft vein is considered physiological drainage, it has more of a risk for surgical complications. To overcome these disadvantages, we successfully performed inferior vena cava (IVC)-duodenal drainage in pancreas alone transplantation...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27891150/splenic-artery-embolization-for-the-treatment-of-gastric-variceal-bleeding-secondary-to-splenic-vein-thrombosis-complicated-by-necrotizing-pancreatitis-report-of-a-case
#10
Hee Joon Kim, Eun Kyu Park, Young Hoe Hur, Yang Seok Koh, Chol Kyoon Cho
Splenic vein thrombosis is a relatively common finding in pancreatitis. Gastric variceal bleeding is a life-threatening complication of splenic vein thrombosis, resulting from increased blood flow to short gastric vein. Traditionally, splenectomy is considered the treatment of choice. However, surgery in necrotizing pancreatitis is dangerous, because of severe inflammation, adhesion, and bleeding tendency. In the Warshaw operation, gastric variceal bleeding is rare, even though splenic vein is resected. Because the splenic artery is also resected, blood flow to short gastric vein is not increased problematically...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/27887016/inferior-vena-caval-filter-strut-perforation-causing-intramural-duodenal-haematoma
#11
Zoheb Berry Williams, Nicole M Organ, Stephen Deane
We present a case of intramural duodenal haematoma caused by inferior vena caval (IVC) filter strut perforation requiring innovative open and endovascular retrieval. A 32-year-old woman presents in shock with dull epigastric pain and non-bilious vomiting. She had previously had an IVC filter for deep venous thrombosis and pulmonary embolism. Computed tomography demonstrated strut perforation into the second part of the duodenum, causing intramural haematoma and duodenal obstruction. Laparotomy facilitated evacuation of the duodenal haematoma, while the IVC filter was retrieved by endovascular means...
November 24, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27872862/oxygenation-of-the-intraportally-transplanted-pancreatic-islet
#12
Thomas M Suszynski, Efstathios S Avgoustiniatos, Klearchos K Papas
Intraportal islet transplantation (IT) is not widely utilized as a treatment for type 1 diabetes. Oxygenation of the intraportally transplanted islet has not been studied extensively. We present a diffusion-reaction model that predicts the presence of an anoxic core and a larger partly functional core within intraportally transplanted islets. Four variables were studied: islet diameter, islet fractional viability, external oxygen partial pressure (P) (in surrounding portal blood), and presence or absence of a thrombus on the islet surface...
2016: Journal of Diabetes Research
https://www.readbyqxmd.com/read/27855353/challenging-the-limits-in-pancreatic-surgery-a-case-report
#13
Johannes Lemke, Stefan A Schmidt, Marko Kornmann, Karl-Heinz Orend, Doris Henne-Bruns
INTRODUCTION: Today, pancreatic surgery can be performed with low mortality and tolerable morbidity in specialized centers. Nevertheless, due to its anatomical localization and proximity to important vascular structures, surgical resection of the pancreas remains challenging in many cases. PRESENTATION OF CASE: Here, we present the case of a young woman who presented in our department with abdominal pain and a tumor mass located at the pancreatic head. She had undergone explorative laparotomy elsewhere before, in which the pancreatic tumor mass was reported to be unresectable due to infiltration of the mesenteric root...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27853493/implantability-complications-and-follow-up-after-transjugular-intrahepatic-portosystemic-stent-shunt-creation-with-the-6f-self-expanding-sinus-superflex-visual-stent
#14
Daniel Spira, Jakub Wiskirchen, Ulrich Lauer, Dominik Ketelsen, Konstantin Nikolaou, Benjamin Wiesinger
BACKGROUND: The transjugular intrahepatic portosystemic stent-shunt (TIPSS) builds a shortcut between the portal vein and a liver vein, and represents a sophisticated alternative to open surgery in the management of portal hypertension or its complications. OBJECTIVES: To describe clinical experiences with a low-profile nitinol stent system in TIPSS creation, and to assess primary and long-term success. PATIENTS AND METHODS: Twenty-six patients (5 females, 21 males; mean age 54...
July 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
https://www.readbyqxmd.com/read/27843428/a-rare-case-of-gastric-variceal-hemorrhage-secondary-to-infiltrative-b-cell-lymphoma
#15
Adrienne Lenhart, Juan Fernandez-Castillo, Keith Mullins, Reena Salgia
Portal hypertension commonly arises in the setting of advanced liver cirrhosis and is the consequence of increased resistance within the portal vasculature. Less commonly, left-sided noncirrhotic portal hypertension can develop in a patient secondary to isolated obstruction of the splenic vein. We present a rare case of left-sided portal hypertension and isolated gastric varices in a patient with large B-cell lymphoma, who was treated with splenic artery embolization. The patient is a 73-year-old male with no previous history of liver disease, who presented with coffee ground emesis and melena...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27836513/anticoagulant-therapy-for-symptomatic-calf-deep-vein-thrombosis-cactus-a-randomised-double-blind-placebo-controlled-trial
#16
Marc Righini, Jean-Philippe Galanaud, Hervé Guenneguez, Dominique Brisot, Antoine Diard, Pascale Faisse, Marie-Thérèse Barrellier, Claudine Hamel-Desnos, Christine Jurus, Olivier Pichot, Myriam Martin, Lucia Mazzolai, Clarisse Choquenet, Sandrine Accassat, Helia Robert-Ebadi, Marc Carrier, Grégoire Le Gal, Bernadette Mermilllod, Jean-Pierre Laroche, Henri Bounameaux, Arnaud Perrier, Susan R Kahn, Isabelle Quere
BACKGROUND: The efficacy and safety of anticoagulant treatment is not established for patients with acute symptomatic deep vein thrombosis (DVT) of the calf. We aimed to assess whether therapeutic anticoagulation is superior to placebo in patients with symptomatic calf DVT. METHODS: In this randomised, double-blind, placebo-controlled trial, we enrolled low-risk outpatients (without active cancer or previous venous thromboembolic disease) with a first acute symptomatic DVT in the calf from 23 university medical centres or community medical clinics in Canada, France, and Switzerland...
December 2016: Lancet Haematology
https://www.readbyqxmd.com/read/27835633/tumor-specific-d-dimer-concentration-ranges-and-influencing-factors-a-cross-sectional-study
#17
Jing Yu, Dongqing Li, Dansheng Lei, Feng Yuan, Feng Pei, Huifeng Zhang, Anming Yu, Kun Wang, Hu Chen, Liang Chen, Xianglei Wu, Xianli Tong, Yefu Wang
D-dimer level in cancer patients is associated with risk of venous thromboembolism and deep venous thrombosis. Most cancer patients have "abnormal" D-dimer levels based on the current normal reference range. To investigate tumor-specific D-dimer reference range, we compared D-dimer levels for nine different tumour types with healthy controls by using simultaneous quantile regression and constructing a median, 5th percentile, and 95th percentile model of normal tumour D-dimer concentration. Associations with tumour primary site, stage, pathological type, and treatment were also explored...
2016: PloS One
https://www.readbyqxmd.com/read/27832695/isolated-common-hepatic-artery-branch-thrombosis-results-and-risk-factors
#18
Abdoulhossein Davoodabadi, Hamid Reza Talari, Maseeh Jahanbakhsh
Isolated common hepatic artery branch thrombosis with severe gastric ischemia and duodenojejunal infarction is a rare condition; it usually presents with acute abdomen and may be associated with underlying thrombotic risk factors. We present a 35-year-old man admitted to our hospital with five days history of sudden abdominal pain and deteriorating epigastric pain. He was a driver and had no any past medical history. Explorative laparotomy showed: distal 2/3 gastric, duodenojejunal and papilla vater was sloughed...
September 2016: Acta Medica Iranica
https://www.readbyqxmd.com/read/27798925/deep-vein-thrombosis-an-independent-poor-prognosis-factor-of-advanced-pancreatic-adenocarcinoma
#19
Marc Lambert, Anne Ploquin, Lydie Declerck, Alain Duhamel, Samira Makhloufi, Anthony Turpin, Stéphanie Truant, Mohamed Hebbar
BACKGROUND/AIM: Pancreatic adenocarcinoma (PA) is frequently associated with venous thromboembolic events (VTEs). Although the prognostic value of VTEs remains controversial, these events can darken the prognosis. In contrast, because they necessitate anticoagulant therapy, some authors found that VTEs improved the prognosis. Indeed, anticoagulants could have an anti-tumor action. Therefore, we evaluated the prognostic value of VTEs in patients with locally advanced or metastatic PA. PATIENTS AND METHODS: This retrospective study included all patients followed in a medical oncology Department...
2016: Anticancer Research
https://www.readbyqxmd.com/read/27789550/obscure-upper-gastrointestinal-haemorrhage-haemosuccus-pancreaticus
#20
Prateush Singh, Asim Khan, Manuel Jasper, Javaid Subhani
A Caucasian man aged 28 years with a history of pancreatitis presented with fatigue, intermittent melaena and severe anaemia. Symptomatic treatment for anaemia was coupled with thorough investigation to localise the source of gastrointestinal haemorrhage. Two oesophagogastroduodenoscopies and colonoscopies failed to identify a cause. CT abdomen revealed splenomegaly secondary to splenic vein thrombosis with evidence of portal hypertension and small collateral vessels. A CT mesenteric angiogram revealed a splenic artery pseudoaneurysm as the likely source of bleeding...
October 27, 2016: BMJ Case Reports
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