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exocrine pancreatic insufficiency

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https://www.readbyqxmd.com/read/29791723/functional-and-morphological-recovery-is-incomplete-after-acute-and-acute-recurrent-pancreatitis-in-children
#1
Srikanth Puttaiah Kadyada, Babu Ram Thapa, Karanvir Kaushal, Rama Walia, S V Rana, Narendra Dhaka, Sadhna B Lal, Rajendra Prasad, Subhamoy Das, Rajini Thakur, Kishore Kamal
OBJECTIVE: There is lack of data on functional and morphological recovery after an attack of acute pancreatitis (AP) or acute recurrent pancreatitis (ARP) in children. This study aims to evaluate the functional impairment and morphological changes in the pancreas after recovery. METHODS: All consecutive patients presenting with AP (n=61) or ARP (n=35), as per standard diagnostic criteria were enrolled. After 2 months of pancreatitis, fecal elastase-1(μg/g) and 2-hour oral glucose tolerance test to calculate oral disposition index (DIo )mmol/L-1 (beta cell function) were done...
May 23, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29779830/exocrine-pancreatic-insufficiency-in-type-1-and-type-2-diabetes-mellitus-do-we-need-to-treat-it-a-systematic-review
#2
REVIEW
Gábor Zsóri, Dóra Illés, Viktória Terzin, Emese Ivány, László Czakó
The exocrine and endocrine pancreata are very closely linked both anatomically and physiologically. Abdominal symptoms such as nausea, bloating, diarrhea, steatorrhea, and weight loss can often occur in diabetic patients. Impairments of the exocrine pancreatic function seem to be a frequent complication of diabetes mellitus; however, they are largely overlooked. The aim of this paper is to provide an overview of the current concepts of exocrine pancreatic insufficiency (PEI) in diabetes mellitus. The prevalence and symptoms of PEI in diabetes mellitus, the pathomechanism, and difficulties of diagnosis and therapy of PEI are summarized in this systematic review...
May 17, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29764411/contrast-enhanced-ultrasonography-of-the-pancreas-shows-impaired-perfusion-in-pancreas-insufficient-cystic-fibrosis-patients
#3
Trond Engjom, Kim Nylund, Friedemann Erchinger, Marcus Stangeland, Birger Norderud Lærum, Martin Mézl, Radovan Jiřík, Odd Helge Gilja, Georg Dimcevski
BACKGROUND: Perfusion assessment of the pancreas is challenging and poorly evaluated. Pancreatic affection is a prevalent feature of cystic fibrosis (CF). Little is known about pancreatic perfusion in CF. We aimed to assess pancreatic perfusion by contrast-enhanced ultrasound (CEUS) analysed in the bolus-and-burst model and software. METHODS: We performed contrast enhanced ultrasound of the pancreas in 25 CF patients and 20 healthy controls. Perfusion data was analysed using a dedicated perfusion model providing the mean capillary transit-time (MTT), blood flow (BF) and blood-volume (BV)...
May 15, 2018: BMC Medical Imaging
https://www.readbyqxmd.com/read/29746344/nutritional-considerations-in-pediatric-pancreatitis-a-position-paper-from-the-naspghan-pancreas-committee-espghan-pancreas-working-group
#4
Maisam Abu-El-Haija, Aliye Uc, Steven L Werlin, A Jay Freeman, Miglena Georgieva, Danijela Jojkić - Pavkov, Daina Kalnins, Brigitte Kochavi, Bart G P Koot, Stephanie Van Biervliet, Jaroslaw Walkowiak, Michael Wilschanski, Veronique D Morinville
OBJECTIVES: Wide variations exist in how physicians manage the nutritional aspects of children affected by acute pancreatitis (AP), acute recurrent pancreatitis (ARP) and chronic (CP) pancreatitis. Better consensus for optimal management is needed. METHODS: This consensus statement on nutrition in pediatric pancreatic diseases was developed through a joint ESPGHAN-NASPGHAN working group that performed an evidence-based search of the literature on nutrition in AP, ARP, and CP with a focus on pediatrics...
May 8, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29742705/earlier-surgery-improves-outcomes-from-painful-chronic-pancreatitis
#5
Nengwen Ke, Dan Jia, Wei Huang, Quentin M Nunes, John A Windsor, Xubao Liu, Robert Sutton
The timing of surgery for painful chronic pancreatitis (CP) may affect outcomes.Clinical course, Izbicki pain scores, and pancreatic function were retrospectively compared and analyzed between patients undergoing either early or late surgery (< 3 or ≥ 3 years from diagnosis) for painful CP in a single center from 2007 to 2012.The early surgery group (n = 98) more frequently than the late group (n = 199) had abdominal pain with jaundice (22.4% vs 9.5%, P = .002) and pancreatic mass +/- ductal dilatation (47% vs 27%, P < ...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29737796/pancreatic-enzyme-replacement-therapy-pert-in-children-with-persistent-diarrhea-avoidance-of-elemental-diet-need-accessibility-and-costs
#6
Ariani Dewi Widodo, Rianto Setiabudy, Ina S Timan, Saptawati Bardosono, Widdy Winarta, Agus Firmansyah
BACKGROUND AND OBJECTIVES: Persistent diarrhea has been proven to cause pancreatic exocrine insufficiency, due to decreased stimulation to the pancreas caused by prolonged mucosal injury. Pancreatic enzyme replacement therapy (PERT) given in conjunction to regular treatment is thought to be beneficial in replacing this pancreatic enzyme deficiency, avoiding the need of elemental diet. This study aims to evaluate the benefit of PERT in chil-dren with persistent diarrhea. METHODS AND STUDY DESIGN: This is a randomized, two double-blind parallel group, placebo-controlled clinical trial to evaluate the effects of pancreatic enzyme supplementation in persistent diar-rhea...
2018: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29736106/a-novel-mitochondrial-dna-deletion-in-patient-with-pearson-syndrome
#7
Rame Khasawneh, Hala Alsokhni, Bayan Alzghoul, Asim Momani, Nazih Abualsheikh, Nazmi Kamal, Mousa Qatawneh
Introduction: Arteriovenous Pearson syndrome is a very rare multisystemic mitochondrial disease characterized by sideroblastic anemia and exocrine pancreatic insufficiency. It is usually fatal in infancy. Case report: We reported a four-month-old infant presented with fever and pancytopenia. Bone marrow examination showed hypoplastic changes and sideroblastic features. Molecular Study showed a novel hetroplasmic mitochondrial deletions (m. 10760 -m. 15889+) in multiple genes (ND4,ND5,ND6, CYTB)...
April 2018: Medical Archives
https://www.readbyqxmd.com/read/29728096/impact-of-the-treatment-of-pancreatic-exocrine-insufficiency-on-survival-of-patients-with-unresectable-pancreatic-cancer-a-retrospective-analysis
#8
Juan Enrique Domínguez-Muñoz, Laura Nieto-Garcia, Javier López-Díaz, Jose Lariño-Noia, Ihab Abdulkader, Julio Iglesias-Garcia
BACKGROUND: Malnutrition and weight loss are commonly observed in patients with pancreatic cancer and contribute to poor survival. Pancreatic exocrine insufficiency (PEI), which can be caused by ductal obstruction by a tumor, causes maldigestion and malabsorption of nutrients, thus contributing to malnutrition in these patients. In this study, we evaluated the effects of pancreatic enzyme replacement therapy (PERT) on survival in patients with unresectable pancreatic cancer. METHODS: A retrospective analysis was conducted on a database of patients with unresectable, pathologically confirmed pancreatic cancer...
May 5, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29658186/use-of-an-in-line-digestive-cartridge-with-enteral-nutrition-improves-the-weight-trajectory-of-2-children-with-cystic-fibrosis-complicated-by-another-medical-diagnosis
#9
Catherine Giguere-Rich, Amy Mathew, Elizabeth Reid, Kimberly Autore, Margaret F Guill
This clinical observation describes the enteral nutrition (EN) management of 2 toddlers at high nutrition risk due to cystic fibrosis (CF), exocrine pancreatic insufficiency, and comorbid medical conditions. The first case report describes a boy with severe malabsorption after intestinal resection. The second case report reviews a boy with CF and neuroblastoma. When pancreatic enzyme replacement therapy with EN was not effective or appropriate, use of an in-line digestive cartridge was initiated. While using the digestive cartridge, both children showed improvements in their anthropometric measures...
April 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29599363/effects-of-%C3%AF-3-fatty-acid-supplementation-in-patients-with-bile-duct-or-pancreatic-cancer-undergoing-chemotherapy
#10
Kyohei Abe, Tadashi Uwagawa, Koichiro Haruki, Yuki Takano, Shinji Onda, Taro Sakamoto, Takeshi Gocho, Katsuhiko Yanaga
BACKGROUND/AIM: Omega-3 fatty acids may improve cancer cachexia, but only in patients with pancreatic and bile duct cancer. Patients with pancreatic cancer commonly suffer from exocrine pancreatic insufficiency, and the ingestion of digestive enzyme supplements may improve absorption. PATIENTS AND METHODS: Racol®, an enteral nutrient formulated with omega-3 fatty acids, was administered to patients with unresectable pancreatic and bile duct cancer. The skeletal muscle mass and blood test data were taken pre-administration and at 4 and 8 weeks after...
April 2018: Anticancer Research
https://www.readbyqxmd.com/read/29599360/transient-exocrine-pancreatic-insufficiency-first-report-of-an-unrecognized-complication-of-cytoreductive-surgery-and-hipec
#11
Samer A Naffouje, George I Salti
BACKGROUND: As cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are being increasingly adopted as the standard treatment for peritoneal surface malignancies, familiarity with this procedure's adverse events is also growing. Herein, we describe an unreported adverse event of exocrine pancreatic insufficiency (EPI) following CRS and HIPEC. PATIENTS AND METHODS: Patients who underwent CRS and HIPEC between 9/2016 and 9/2017 were prospectively recruited...
April 2018: Anticancer Research
https://www.readbyqxmd.com/read/29593816/pancreatic-like-enzymes-of-microbial-origin-restore-growth-and-normalize-lipid-absorption-in-a-pig-model-with-exocrine-pancreatic-insufficiency
#12
Kateryna Pierzynowska, Jose Valverde-Piedra, Sylwia Szymanczyk, Olena Prykhod'ko, Marek Pieszka, Marek Kardas, Elżbieta Grochowska-Niedworok, Tomasz Grabowski, Mateusz Winiarczyk, Stefan Pierzynowski
Introduction: The standard therapy for exocrine pancreatic insufficiency (EPI) is porcine-derived pancreatic enzyme replacement therapy (PERT). In the present study we tested a new approach with a mixture of pancreatic-like enzymes of microbial origin (PLEM) in a 1-week efficacy study in EPI pigs. In addition to the conventionally used coefficient of fat and nitrogen absorption (CFA and CNA), parameters that more accurately reflect the nutritional and health status, such as changes in the lipemic index (LI), plasma triglyceride (TG) and non-esterified fatty acid (NEFA) levels, and somatic growth, were determined...
March 2018: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29589071/distribution-of-il-1%C3%AE-immunoreactive-cells-in-pancreatic-biopsies-from-living-volunteers-with-new-onset-type-1-diabetes-comparison-with-donors-without-diabetes-and-with-longer-duration-of-disease
#13
Shiva Reddy, Lars Krogvold, Charlton Martin, Rebecca Holland, Jaimin Choi, Hannah Woo, Fiona Wu, Knut Dahl-Jørgensen
AIMS/HYPOTHESIS: Although IL-1β is considered a key mediator of beta cell destruction, its cellular expression in islets during early type 1 diabetes remains unclear. We compared its expression in rare pancreatic biopsies from new-onset living volunteers with its expression in cadaveric pancreas sections from non-diabetic autoantibody-positive and -negative individuals and those with long-standing disease. METHODS: Pancreatic biopsy sections from six new-onset living volunteers (group 1) and cadaveric sections from 13 non-diabetic autoantibody-negative donors (group 2), four non-diabetic autoantibody-positive donors (group 3) and nine donors with diabetes of longer duration (0...
March 27, 2018: Diabetologia
https://www.readbyqxmd.com/read/29572825/new-onset-non-alcoholic-fatty-liver-disease-after-resection-of-pancreatic-neuroendocrine-tumors
#14
Tara Michella Mackay, Cansu Güney Genç, Robert Bart Takkenberg, Marc Gerard Besselink, Inne Somers, Elisabeth Jacqueline Maria Nieveen van Dijkum
BACKGROUND AND OBJECTIVES: Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatis (NASH) may occur after pancreatic resection due to exocrine pancreatic insufficiency (EPI). Patients with long-term survival, such as after pancreatic neuroendocrine tumor (pNET) resection, are at risk of NAFLD/NASH. We aimed to determine the incidence and risk factors for new onset NAFLD/NASH and EPI after pNET resection. METHODS: Retrospective monocenter cohort study...
March 24, 2018: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29552341/irreversible-electroporation-of-locally-advanced-solid-pseudopapillary-carcinoma-of-the-pancreas-a-case-report
#15
Luciano Tarantino, Aurelio Nasto, Giuseppina Busto, Vincenzo Iovino, Raffaele Fristachi, Sara Bortone
Introduction: Solid pseudopapillary Carcinoma (SPC) is a rare pancreatic Tumor with variable, usually low, malignancy potential. Howewer, several SPC are associated with aggressive behavior, local vascular infiltration, organ invasion, distant metastasis, and can be unresectable. Irreversible Electroporation (IRE) is an emerging non-thermal ablation technique for the treatment of locally advanced pancreatic carcinoma. We report the results of four year disease-free follow-up in a case of locally advanced unresectable SPC treated with IRE...
April 2018: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29543697/nutritional-status-the-first-two-years-of-life-in-cystic-fibrosis-diagnosed-by-newborn-screening
#16
Anne Munck, Rym Boulkedid, Laurence Weiss, Pierre Foucaud, Nathalie Wizla-Derambure, Philippe Reix, François Bremont, Jocelyne Derelle, Julien Schroedt, Corinne Alberti
OBJECTIVE: To evaluate nutritional status and associated factors in a cystic fibrosis (CF) cohort diagnosed by newborn screening and followed up to month 24. METHODS: A prospective longitudinal multicenter study assessing nutritional status according to pancreatic status, feeding modalities, prescriptions, pulmonary outcome and biological nutritional parameters. RESULTS: One-hundred-and-five infants were recruited and 99 completed the study...
March 14, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29535950/exocrine-dysfunction-correlates-with-endocrinal-impairment-of-pancreas-in-type-2-diabetes-mellitus
#17
H R Prasanna Kumar, H Basavana Gowdappa, Tejashwi Hosmani, Tejashri Urs
Background: Diabetes mellitus (DM) is a chronic abnormal metabolic condition, which manifests elevated blood sugar level over a prolonged period. The pancreatic endocrine system generally gets affected during diabetes, but often abnormal exocrine functions are also manifested due to its proximity to the endocrine system. Fecal elastase-1 (FE-1) is found to be an ideal biomarker to reflect the exocrine insufficiency of the pancreas. Aim: The aim of this study was conducted to assess exocrine dysfunction of the pancreas in patients with type-2 DM (T2DM) by measuring FE levels and to associate the level of hyperglycemia with exocrine pancreatic dysfunction...
January 2018: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29526248/predictive-factors-of-endocrine-and-exocrine-insufficiency-after-resection-of-a-benign-tumour-of-the-pancreas
#18
Hélène Neophytou, Marc Wangermez, Elise Gand, Michel Carretier, Jérôme Danion, Jean-Pierre Richer
BACKGROUND: The aim of the present study is to evaluate the risk factors of endocrine and exocrine insufficiency occurring few years after pancreatic resections in a consecutive series of patients who underwent pancreatoduodenectomy (PD), left pancreatectomy (LP) or enucleation for benign neoplasms at a referral centre. METHODS: Pancreatic exocrine insufficiency (PEI) was defined by the onset of steatorrhea associated with weight loss, and endocrine insufficiency was determinate by fasting plasma glucose...
April 2018: Annales D'endocrinologie
https://www.readbyqxmd.com/read/29525465/enucleation-of-pancreatic-solid-pseudopapillary-neoplasm-short-term-and-long-term-outcomes-from-a-7-year-large-single-center-experience
#19
Xing Wang, Yong-Hua Chen, Chun-Lu Tan, Hao Zhang, Jun-Jie Xiong, Hong-Yu Chen, Neng-Wen Ke, Xu-Bao Liu
BACKGROUND: Enucleation is increasingly used for pancreatic solid pseudopapillary neoplasm (SPN) to preserve function of the pancreas. The data was limited due to rarity of this low-grade neoplasm. We sought to describe the indications, operative technique, short and long-term outcomes after enucleation with largest series of enucleated SPNs. METHODS: Data collected retrospectively from 110 patients with SPN who underwent pancreatectomy between 2009 and 2016 in our institution were reviewed...
May 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29522553/association-between-chronic-pancreatitis-and-urolithiasis-a-population-based-cohort-study
#20
Chien-Hua Chen, Cheng-Li Lin, Long-Bin Jeng
PURPOSE: Chronic pancreatitis (CP) can cause fat or bile acid malabsorption due to exocrine insufficiency. Fat or bile acid malabsorption has been reported to increase the risk of urolithiasis through increased intestinal oxalate absorption. However, no studies have reported an association between CP and urolithiasis. METHODS: We identified 15,848 patients (age: ≥20 years) diagnosed as having CP between 2000 and 2010 from the National Health Insurance Research Database as the study cohort...
2018: PloS One
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