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pediatric pancreatitis

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https://www.readbyqxmd.com/read/28188033/success-and-safety-of-endoscopic-retrograde-cholangiopancreatography-in-children
#1
Jordan D Rosen, Rebecca S Lane, Jose M Martinez, Eduardo A Perez, Jun Tashiro, Amy E Wagenaar, Robert M Van Haren, Ashwini Kumar, Juan E Sola
PURPOSE: Despite its diagnostic and therapeutic utility, endoscopic retrograde cholangiopancreatography (ERCP) is underutilized in children. METHODS: Patients younger than 18years undergoing ERCP from 2000 to 2014 at a children's hospital were identified. Patient characteristics and outcomes were evaluated. RESULTS: Overall, 215 ERCPs (78% therapeutic) were performed in 184 patients. Our cohort was 67% female, with a median age (IQR) of 14 (8) years...
February 1, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28160250/thiopurines-and-methotrexate-use-in-ibd-patients-in-a-biologic-era
#2
REVIEW
Gerassimos J Mantzaris
Although we have been living in the era of biologic therapy for several decades, the use of immunomodulators (primarily thiopurines [azathioprine and mercaptopurine] and less so methotrexate) still remains an important component of the inflammatory bowel disease (IBD) pharmaceutical arsenal. Thiopurines as monotherapy exert corticosteroid-sparing effects and can maintain long-term remission in a considerable proportion of patients who have frequent relapses and are or have become mesalazine and/or corticosteroid intolerant or refractory...
February 3, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28139109/-distal-pancreatectomy-with-splenic-preservation-in-pediatric-patient-with-blunt-abdominal-trauma
#3
J T Palacios-Zertuche, J G Martínez-Flores, Q Gilte-Limas, M A Pinzón-Uresti, F J Reyna-Sepúlveda, G E Muñoz-Maldonado
INTRODUCTION: Traumatic injuries of the pancreas occur in 3 to 12% of cases of blunt abdominal trauma in children and these are associated with a mortality of 30%. CASE REPORT: A four-year-old girl was brought to the emergency room after an automobile accident. On physical examination, she was stable with abdominal pain and signs of peritoneal irritation. An abdominal CT scan showed a grade II liver lesion, a grade II splenic lesion, and a grade III pancreatic lesion...
April 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28130170/identifying-children-at-very-low-risk-for-blunt-intra-abdominal-injury-in-whom-ct-of-the-abdomen-can-be-avoided-safely
#4
Christian J Streck, Adam M Vogel, Jingwen Zhang, Eunice Y Huang, Matthew T Santore, Kuojen Tsao, Richard A Falcone, Melvin S Dassinger, Robert T Russell, Martin L Blakely
BACKGROUND: Computed tomography is commonly used to rule out intra-abdominal injury (IAI) in children, despite associated cost and radiation exposure. Our purpose was to derive a prediction rule to identify children at very low risk for IAI after blunt abdominal trauma (BAT) for whom a CT scan of the abdomen would be unnecessary. STUDY DESIGN: We prospectively enrolled children younger than 16 years of age who presented after BAT at 14 Level I pediatric trauma centers during 1 year...
January 24, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28101933/associations-of-common-variants-in-the-slc16a11-tcf7l2-and-abca1-genes-with-pediatric-onset-type-2-diabetes-and-related-glycemic-traits-in-families-a-case-control-and-case-parent-trio-study
#5
América L Miranda-Lora, Miguel Cruz, Mario Molina-Díaz, Jorge Gutiérrez, Samuel Flores-Huerta, Miguel Klünder-Klünder
BACKGROUND: There is evidence of associations of single-nucleotide polymorphisms (SNPs) with type 2 diabetes (T2D) and related glycemic traits in adults, but there is a little information about such associations in youths. OBJECTIVE: The aim of this study was to evaluate the associations of SNPs in the TCF7L2, SLC16A11, and ABCA1 genes with T2D and related glycemic traits in Mexican children and adolescents. SUBJECTS: A total of 99 families with children with T2D (n = 327) and 83 families with children without the disease (n = 212)...
January 19, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28101805/ketogenic-diet-in-pyruvate-dehydrogenase-complex-deficiency-short-and-long-term-outcomes
#6
Kalliopi Sofou, Maria Dahlin, Tove Hallböök, Marie Lindefeldt, Gerd Viggedal, Niklas Darin
OBJECTIVES: Our aime was to study the short- and long-term effects of ketogenic diet on the disease course and disease-related outcomes in patients with pyruvate dehydrogenase complex deficiency, the metabolic factors implicated in treatment outcomes, and potential safety and compliance issues. METHODS: Pediatric patients diagnosed with pyruvate dehydrogenase complex deficiency in Sweden and treated with ketogenic diet were evaluated. Study assessments at specific time points included developmental and neurocognitive testing, patient log books, and investigator and parental questionnaires...
March 2017: Journal of Inherited Metabolic Disease
https://www.readbyqxmd.com/read/28099382/failure-of-nonoperative-management-of-pediatric-blunt-liver-and-spleen-injuries-a-prospective-atomac-study
#7
Maria E Linnaus, Crystal S Langlais, Nilda M Garcia, Adam C Alder, James W Eubanks, R Todd Maxson, Robert W Letton, Todd A Ponsky, Shawn D St Peter, Charles Leys, Amina Bhatia, Daniel J Ostlie, David W Tuggle, Karla A Lawson, Alexander R Raines, David M Notrica
BACKGROUND: Nonoperative management (NOM) is standard of care for most pediatric blunt liver and spleen injuries (BLSI); only 5% of patients fail NOM in retrospective reports. No prospective studies examine failure of NOM of BLSI in children. The aim of this study was to determine the frequency and clinical characteristics of failure of NOM in pediatric BLSI patients. METHODS: A prospective observational study was conducted on patients ≤18 years presenting to any of ten level 1 pediatric trauma centers April 2013 and January 2016 with BLSI on computed tomography...
January 17, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28068001/in-vivo-and-in-vitro-ivacaftor-response-in-cystic-fibrosis-patients-with-residual-cftr-function-n-of-1-studies
#8
Meghan E McGarry, Beate Illek, Ngoc P Ly, Lorna Zlock, Sabrina Olshansky, Courtney Moreno, Walter E Finkbeiner, Dennis W Nielson
RATIONALE: Ivacaftor, a cystic fibrosis transmembrane conductance regulator (CFTR) potentiator, decreases sweat chloride concentration, and improves pulmonary function in 6% of cystic fibrosis (CF) patients with specific CFTR mutations. Ivacaftor increases chloride transport in many other CFTR mutations in non-human cells, if CFTR is in the epithelium. Some CF patients have CFTR in the epithelium with residual CFTR function. The effect of ivacaftor in these patients is unknown. METHODS: This was a series of randomized, crossover N-of-1 trials of ivacaftor and placebo in CF patients ≥8 years old with potential residual CFTR function (intermediate sweat chloride concentration, pancreatic sufficient, or mild bronchiectasis on chest CT)...
January 9, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27992493/clinical-and-metabolic-characteristics-among-mexican-children-with-different-types-of-diabetes-mellitus
#9
María Lola Evia-Viscarra, Rodolfo Guardado-Mendoza, Edel Rafael Rodea-Montero
BACKGROUND: Current classification of diabetes mellitus (DM) is based on etiology and includes type 1 (T1DM), type 2 (T2DM), gestational, and other. Clinical and pathophysiological characteristics of T1DM and T2DM in the same patient have been designated as type 1.5 DM (T1.5DM). OBJECTIVES: The aim of this study was to classify pediatric patients with DM based on pancreatic autoimmunity and the presence or absence of overweight/obesity, and to compare the clinical, anthropometric, and biochemical characteristics between children in the different classes of DM...
2016: PloS One
https://www.readbyqxmd.com/read/27941426/pancreatic-fat-is-associated-with-metabolic-syndrome-and-visceral-fat-but-not-beta-cell-function-or-body-mass-index-in-pediatric-obesity
#10
Johan Staaf, Viktor Labmayr, Katharina Paulmichl, Hannes Manell, Jing Cen, Iris Ciba, Marie Dahlbom, Kirsten Roomp, Christian-Heinz Anderwald, Matthias Meissnitzer, Reinhard Schneider, Anders Forslund, Kurt Widhalm, Jonas Bergquist, Håkan Ahlström, Peter Bergsten, Daniel Weghuber, Joel Kullberg
OBJECTIVE: Adolescents with obesity have increased risk of type 2 diabetes and metabolic syndrome (MetS). Pancreatic fat has been related to these conditions; however, little is known about associations in pediatric obesity. The present study was designed to explore these associations further. METHODS: We examined 116 subjects, 90 with obesity. Anthropometry, MetS, blood samples, and oral glucose tolerance tests were assessed using standard techniques. Pancreatic fat fraction (PFF) and other fat depots were quantified using magnetic resonance imaging...
March 2017: Pancreas
https://www.readbyqxmd.com/read/27941194/-genetic-mutations-as-a-cause-of-acute-recurrent-pancreatitis-in-children-case-report-and-literature-review
#11
Tatiana Jamer, Barbara Iwańczak
Acute recurrent pancreatitis is not common in children. The epidemiology, etiology and clinical presentation of pediatric acute recurrent pancreatitis are not well understood. The etiology is diverse and multifactorial, with many cases being idiopathic. The most common etiology of acute recurrent pancreatitis in children are genetic factors, biliary duct disorders, anatomic anomalies of the pancreatobiliary system and metabolic diseases. Mutations are most commonly found in the cationic trypsynogen gene (PRSS1), the pancreatic secretory trypsin inhibitor gene (SPINK1) and the cystic fibrosis transmembrane conductance regulator gene (CFTR)...
2016: Developmental Period Medicine
https://www.readbyqxmd.com/read/27920643/elevated-lipase-during-initial-presentation-of-ulcerative-colitis-in-a-pediatric-patient-do-we-check-for-it
#12
Piyali Ray, Melissa R Van Arsdall
There are very few reports of elevated lipase in pediatric inflammatory bowel disease (IBD). Symptoms of pancreatitis may be masked by abdominal pain in pediatric IBD. During the initial presentation of IBD in our patient, lipase was elevated to more than 3 times the upper limit of normal. Normalization of values coincided with remission of IBD. This may be due to extraintestinal involvement of the pancreas as part of the inflammatory process or due to leakage of pancreatic enzymes from an inflamed gut or mediated by inflammatory cytokines...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27894759/pancreaticoduodenectomy-for-pediatric-and-adolescent-pancreatic-malignancy-a-single-center-retrospective-analysis
#13
Erika B Lindholm, Abdulaziz K Alkattan, Sara J Abramson, Anita P Price, Todd E Heaton, Vinod P Balachandran, Michael P La Quaglia
PURPOSE: While pancreaticoduodenectomy (PD) has been extensively studied in adults, there are few data pertaining specifically to pediatric patients. We retrospectively analyzed PD-associated morbidity and mortality in pediatric patients. METHODS: Our analytic cohort included all consecutive patients ≤18years of age treated at our institution from 1993 to 2015 who underwent PD. Patient data (demographics, disease characteristics, surgical and adjuvant treatment, length of hospital stay, and postoperative course) were extracted from the medical records...
February 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27878593/re-evaluation-of-liver-transaminase-cutoff-for-ct-after-pediatric-blunt-abdominal-trauma
#14
Jessica A Zagory, Avafia Dossa, Jamie Golden, Aaron R Jensen, Catherine J Goodhue, Jeffrey S Upperman, Christopher P Gayer
PURPOSE: Current guidelines for computed tomography (CT) after blunt trauma were developed to capture all intra-abdominal injuries (IAI). We hypothesize that current AST/ALT guidelines are too low leading to unnecessary CT scans for children after blunt abdominal trauma (BAT). METHODS: Patients who received CT of the abdomen after blunt trauma at our Level I Pediatric Trauma Center were stratified into a high risk (HR) (liver/spleen/kidney grade ≥III, hollow viscous, or pancreatic injuries) and low risk (LR) (liver/kidney/spleen injuries grade ≤II, or no IAI) groups...
November 23, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27849238/diabetes-mellitus-in-childhood-an-emerging-condition-in-the-21st-century
#15
Thais Della Manna, Nuvarte Setian, Roberta Diaz Savoldelli, Dulce Rondina Guedes, Hilton Kuperman, Hamilton Cabral Menezes, Leandra Steinmetz, Louise Cominato, Vaê Dichtchekenian, Durval Damiani
The International Diabetes Federation (IDF-2015) estimates the existence of 30,900 children under 15 years old with type 1 diabetes mellitus (DM1) in Brazil, and an increase of 3.0% per year is expected. This review focused on meta-analysis and pediatric diabetes update articles in order to draw attention to the need of planning coping strategies to support this serious public health problem in coming years. DM1 is considered an immuno-mediated disease with a complex transmission influenced by genetic and environmental factors responsible for a gradual destruction of the insulin producing pancreatic beta cells...
September 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27846143/a-report-of-320-cases-of-childhood-pancreatitis-increasing-incidence-etiologic-categorization-dynamics-severity-assessment-and-outcome
#16
Ujjal Poddar, Surender Kumar Yachha, Vibhor Borkar, Anshu Srivastava, Sheo Kumar
OBJECTIVES: Because there is paucity of data on natural history of pediatric pancreatitis, we studied prevalence, etiology, severity, and outcome of pancreatitis. METHODS: Over 12 years consecutive children with pancreatitis were included. Pancreatitis was classified as acute (AP), acute recurrent (ARP), and chronic pancreatitis (CP) as per standard definitions. RESULTS: The study group comprised of 320 children (age, 11.4 ± 3.5 years, 201 males); AP, 160 (50%); ARP, 67 (21%); and CP, 93 (29%)...
January 2017: Pancreas
https://www.readbyqxmd.com/read/27846137/utility-of-direct-pancreatic-function-testing-in-children
#17
Ligia Alfaro Cruz, Andrea Parniczky, Allison Mayhew, Lindsey N Hornung, Tom K Lin, Joseph J Palermo, Kimberly Jackson, Maisam Abu-El-Haija
OBJECTIVES: Exocrine pancreatic insufficiency (EPI) can have a significant impact on a child's growth and nutrition. Our aim was to evaluate the utility of direct endoscopic pancreatic function testing (ePFT) in pediatrics. METHODS: A single-center retrospective chart review was performed of children who underwent ePFT from December 2007 through February 2015. Endoscopic pancreatic function testings were performed by 1 of 2 methods: (1) intravenous cholecystokinin, followed by the collection of a single duodenal aspirate at 10 minutes, or (2) intravenous cholecystokinin or secretin, followed by the collection of 3 duodenal aspirates at a 5, 10, and 15 minutes...
February 2017: Pancreas
https://www.readbyqxmd.com/read/27842589/the-course-of-diabetes-in-children-adolescents-and-young-adults-does-the-autoimmunity-status-matter
#18
Rasa Verkauskiene, Evalda Danyte, Rimante Dobrovolskiene, Ingrida Stankute, Diana Simoniene, Dovile Razanskaite-Virbickiene, Audrone Seibokaite, Brone Urbonaite, Nijole Jurgeviciene, Astra Vitkauskiene, Valerie Schwitzgebel, Dalia Marciulionyte
BACKGROUND: Initial classification of diabetes of young may require revision to improve diagnostic accuracy of different forms of diabetes. The aim of our study was to examine markers of beta-cell autoimmunity in a cohort of young (0-25 years) patients with type 1 diabetes and compare the presentation and course of the disease according to the presence of pancreatic antibodies. METHODS: Cross-sectional population-based study was performed covering 100% of pediatric (n = 860) and 70% of 18-25 years old adult patients (n = 349) with type 1 diabetes in Lithuania...
November 15, 2016: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/27815641/the-impact-of-surgical-strategies-on-outcomes-for-pediatric-chronic-pancreatitis
#19
Maria G Sacco Casamassima, Seth D Goldstein, Jingyan Yang, Colin D Gause, Fizan Abdullah, Avner Meoded, Martin A Makary, Paul M Colombani
PURPOSE: To review our institutional experience in the surgical treatment of pediatric chronic pancreatitis (CP) and evaluate predictors of long-term pain relief. METHODS: Outcomes of patients ≤21 years surgically treated for CP in a single institution from 1995 to 2014 were evaluated. RESULTS: Twenty patients underwent surgery for CP at a median of 16.6 years (IQR 10.7-20.6 years). The most common etiology was pancreas divisum (n = 7; 35%)...
November 4, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27782962/causal-evaluation-of-acute-recurrent-and-chronic-pancreatitis-in-children-consensus-from-the-insppire-group
#20
Cheryl E Gariepy, Melvin B Heyman, Mark E Lowe, John F Pohl, Steven L Werlin, Michael Wilschanski, Bradley Barth, Douglas S Fishman, Steven D Freedman, Matthew J Giefer, Tanja Gonska, Ryan Himes, Sohail Z Husain, Veronique D Morinville, Chee Y Ooi, Sarah J Schwarzenberg, David M Troendle, Elizabeth Yen, Aliye Uc
OBJECTIVES: Acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) have been diagnosed in children at increasing rates during the past decade. As pediatric ARP and CP are still relatively rare conditions, little quality evidence is available on which to base the diagnosis and determination of etiology. The aim of the study was to review the current state of the literature regarding the etiology of these disorders and to developed a consensus among a panel of clinically active specialists caring for children with these disorders to help guide the diagnostic evaluation and identify areas most in need of future research...
January 2017: Journal of Pediatric Gastroenterology and Nutrition
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