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exocrine pancreatic insufficiency

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https://www.readbyqxmd.com/read/28727476/options-for-addressing-exocrine-pancreatic-insufficiency-in-patients-receiving-enteral-nutrition-supplementation
#1
Steven D Freedman
Patients with exocrine pancreatic insufficiency (EPI) have suboptimal secretion of pancreatic digestive enzymes and experience a range of clinical symptoms related to the malabsorption of fat. In patients with EPI unable to meet their nutritional requirements, enteral nutrition (EN) support is used to augment nutritional status. In addition to protein and carbohydrate, EN formulas contain fats as a calorie source, as well as vitamins and minerals to help prevent nutritional deficiencies related to malabsorption...
July 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28727474/a-primer-on-exocrine-pancreatic-insufficiency-fat-malabsorption-and-fatty-acid-abnormalities
#2
Samer Alkaade, Ashley A Vareedayah
Exocrine pancreatic insufficiency (EPI) is characterized by a deficiency of exocrine pancreatic enzymes, resulting in deficits in digestion of all macronutrients, with deficiencies in digestion of fats being the most clinically relevant. The leading cause of EPI is chronic pancreatitis. However, many other causes and conditions may be implicated, including cystic fibrosis, pancreatic duct obstruction, gastric and pancreatic surgery, diabetes mellitus and other conditions. Physical and biochemical causes of EPI include decreased production and secretion of lipase, increased lipase destruction, pancreatic duct obstruction, decreased lipase stimulation and degradation, as well as gastrointestinal motility disorders...
July 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28711377/pancreas-exocrine-replacement-therapy-is-associated-with-increased-survival-following-pancreatoduodenectomy-for-periampullary-malignancy
#3
Keith J Roberts, Harald Schrem, James Hodson, Roberta Angelico, Bobby V M Dasari, Chris A Coldham, Ravi Marudanayagam, Robert P Sutcliffe, Paolo Muiesan, John Isaac, Darius F Mirza
BACKGROUND: Although many patients undergoing pancreatoduodenectomy (PD) for cancer have pancreatic exocrine insufficiency, pancreatic enzyme replacement therapy (PERT) is not routinely used, and effects upon post-operative survival are unclear. METHODS: This review of patients undergoing PD for periampullary malignancy sought to test for an association between PERT and overall survival, with post-hoc subgroup analysis performed after stratifying patients by the year of surgery, pancreatic duct width and tumour type...
July 12, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28703808/rip3-attenuates-the-pancreatic-damage-induced-by-deletion-of-atg7
#4
Xiaodong Zhou, Li Xie, Leizhou Xia, Frank Bergmann, Markus W Büchler, Guido Kroemer, Thilo Hackert, Franco Fortunato
Invalidation of pancreatic autophagy entails pancreatic atrophy, endocrine and exocrine insufficiency and pancreatitis. The aim of this study was to investigate whether depletion of Rip3, which is involved in necroptotic signaling, may attenuate the pancreatic atrophy and pancreatitis resulting from autophagy inhibition. Autophagy and necroptosis signaling were evaluated in mice lacking expression of Rip3 in all organs and Atg7 in the pancreas. Acinar cell death, inflammation and fibrosis were evaluated by using of a compendium of immunofluorescence methods and immunoblots...
July 13, 2017: Cell Death & Disease
https://www.readbyqxmd.com/read/28636207/specificity-of-and-influence-of-hemolysis-lipemia-and-icterus-on-serum-lipase-activity-as-measured-by-the-v-lip-p-slide
#5
Joerg M Steiner, Robynne Gomez, Jan S Suchodolski, Jonathan A Lidbury
BACKGROUND: Measurement of pancreatic lipase in serum is being used for the diagnosis of pancreatitis. OBJECTIVES: The aims of this study were to measure serum lipase activity by the v-LIP-P slide and serum canine pancreatic lipase immunoreactivity (cPLI) concentration by Spec cPL in dogs with exocrine pancreatic insufficiency (EPI) and in serum samples that were hemolyzed, lipemic, or icteric. METHODS: Serum samples from 50 dogs with EPI, 8 samples spiked with canine hemoglobin, Intralipid, or ditaurobilirubin, and 8 samples from dogs with severe hypertriglyceridemia were evaluated using v-LIP-P and Spec cPL assays...
June 21, 2017: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/28628651/the-density-of-parasympathetic-axons-is-reduced-in-the-exocrine-pancreas-of-individuals-recently-diagnosed-with-type-1-diabetes
#6
Marcus Lundberg, Andreas Lindqvist, Nils Wierup, Lars Krogvold, Knut Dahl-Jørgensen, Oskar Skog
To elucidate the etiology of type 1 diabetes, the affected pancreas needs to be thoroughly characterized. Pancreatic innervation has been suggested to be involved in the pathology of the disease and a reduction of sympathetic innervation of the islets was recently reported. In the present study, we hypothesized that parasympathetic innervation would be altered in the type 1 diabetes pancreas. Human pancreatic specimens were obtained from a unique cohort of individuals with recent onset or long standing type 1 diabetes...
2017: PloS One
https://www.readbyqxmd.com/read/28612201/supportive-care-in-pancreatic-ductal-adenocarcinoma
#7
REVIEW
B Laquente, A Calsina-Berna, A Carmona-Bayonas, P Jiménez-Fonseca, I Peiró, A Carrato
Pancreatic ductal adenocarcinoma (PDAC) is one of the cancers with poorest prognosis and represents the third leading cause of cancer-related deaths in Western countries. Despite advances in diagnostic procedures and treatment, diagnosis is made in most cases when the disease is locally advanced or metastatic. Supportive care aims to improve symptoms, reduce hospital admission rates, and preserve quality of life. Proper symptomatic management is critical to allow administration of chemotherapy and radiotherapy...
June 13, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28604838/effect-of-acute-pancreatitis-on-the-risk-of-developing-osteoporosis-a-nationwide-cohort-study
#8
Shih-Yi Lin, Wu-Huei Hsu, Cheng-Chieh Lin, Cheng-Li Lin, Chung-Hao Tsai, Chia-Hung Kao
PURPOSE: Chronic exocrine pancreatic insufficiency can lead to osteoporosis. However, the incidence and risk of osteoporosis after acute inflammation of pancreas remained known. Thus, we conducted a population-based cohort study to clarify the association between acute pancreatitis (AP) and osteoporosis. METHODS: Patients newly diagnosed with AP with index date between 2000 and 2011 were identified from the National Health Insurance Research Database. Osteoporosis were defined according to the International Classification of Diseases, Ninth Revision, Clinical Modification codes...
2017: PloS One
https://www.readbyqxmd.com/read/28597350/short-and-long-term-outcomes-of-the-frey-procedure-for-chronic-pancreatitis-a-single-center-experience-and-summary-of-outcomes-in-japan
#9
Kazuhiro Suzumura, Etsuro Hatano, Toshihiro Okada, Yasukane Asano, Naoki Uyama, Ikuo Nakamura, Seikan Hai, Jiro Fujimoto
PURPOSE: To evaluate the short- and long-term outcomes of the Frey procedure for chronic pancreatitis (CP). METHODS: The subjects of this study were 12 patients who underwent the Frey procedure for CP between January, 2000 and December, 2016. We assessed pain relief, weight gain, and exocrine/endocrine insufficiency during follow-up. RESULTS: The study population comprised 11 men and 1 woman (91.7% vs. 8.3%; mean age, 50.3 ± 6.8 years; range 39-61 years)...
June 8, 2017: Surgery Today
https://www.readbyqxmd.com/read/28580288/restoration-of-lepr-in-%C3%AE-cells-of-lepr-null-mice-does-not-prevent-hyperinsulinemia-and-hyperglycemia
#10
Anna M D'souza, Timothy J Kieffer
OBJECTIVE: The adipose-derived hormone leptin plays an important role in regulating body weight and glucose homeostasis. Leptin receptors are expressed in the central nervous system as well as peripheral tissues involved in regulating glucose homeostasis, including insulin-producing β cells of the pancreas. Previous studies assessing the role of leptin receptors in β cells used Cre-loxP to disrupt the leptin receptor gene (Lepr) in β cells, but variable results were obtained. Furthermore, recombination of Lepr was observed in the hypothalamus or exocrine pancreas, in addition to the β cells, and Lepr in non-β cells may have compensated for the loss of Lepr in β cells, thus making it difficult to assess the direct effects of Lepr in β cells...
June 2017: Molecular Metabolism
https://www.readbyqxmd.com/read/28580220/pancreatic-lipomatosis-in-cystic-fibrosis-rare-manifestation-of-an-uncommon-disease
#11
Harshal S Mandavdhare, Amit Kumar, Vishal Sharma, Surinder S Rana
Cystic fibrosis is deemed to be uncommon in India. The presentation is usually in the childhood although more cases are now being recognized in adolescence and adulthood. We report a case of an adolescent male who had been treated for recurrent pulmonary infections and received anti-tubercular therapy for a possible diagnosis of sputum negative pulmonary tuberculosis and was evaluated for steatorrhea. The presence of pancreatic exocrine insufficiency along with pancreatic lipomatosis suggested the diagnosis of cystic fibrosis...
May 2017: Intractable & Rare Diseases Research
https://www.readbyqxmd.com/read/28566224/response-to-diagnosis-of-exocrine-pancreatic-insufficiency-in-chronic-pancreatitis-13-c-mixed-triglyceride-breath-test-versus-fecal-elastase-methodological-issues
#12
EDITORIAL
Enrique de-Madaria, Víctor González-Sánchez, Antonio Picó, Pedro Zapater
No abstract text is available yet for this article.
May 22, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28554722/common-clinical-features-of-cf-respiratory-disease-and-exocrine-pancreatic-insufficiency
#13
Ranjani Somayaji, Kathleen J Ramos, Siddhartha G Kapnadak, Moira L Aitken, Christopher H Goss
First described as a disease of the pancreas, cystic fibrosis is a genetically inherited progressive disease affecting multiple organ systems. Pulmonary and pancreatic involvement is common in individuals with cystic fibrosis, and the former is attributable to most of the mortality that occurs with the condition. This chapter provides an overview of a clinical approach to the pulmonary and pancreatic manifestations of cystic fibrosis.
May 26, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28502446/pancreatic-disorders
#14
REVIEW
Aliye Uc, Douglas S Fishman
Once considered uncommon, pancreatic diseases are increasingly recognized in the pediatric age group. Acute pancreatitis, acute recurrent pancreatitis, and chronic pancreatitis occur in children with an incidence approaching that of adults. Risk factors are broad, prompting the need for a completely different diagnostic and therapeutic approach in children. Although cystic fibrosis remains the most common cause of exocrine pancreatic insufficiency, other causes such as chronic pancreatitis may be as common as Shwachman Diamond syndrome...
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28478840/alzheimer-s-disease-and-other-neurodegenerative-diseases-may-be-due-to-nutritional-deficiencies-secondary-to-unrecognized-exocrine-pancreatic-insufficiency
#15
Steven R Brenner
Alzheimer's disease (AD) may be related to nutritional deficiencies from exocrine pancreatic insufficiency (EPI) with mal-absorption of essential nutrients, vitamins and minerals. EPI occurs in about twenty percent of the elderly population, sometimes without obvious symptoms, a number similar to the incidence of AD. Other Neurological degenerative diseases with potential nutritional components such as Parkinson's disease, frailty of age and Multiple Sclerosis, a disease with increased activity from vitamin D deficiency, may also be related to untreated exocrine pancreatic insufficiency causing impaired absorption of essential dietary elements...
May 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28471312/the-scandinavian-baltic-pancreatic-club-sbpc-database-design-rationale-and-characterisation-of-the-study-cohort
#16
Søren S Olesen, Jakob L Poulsen, Asbjørn M Drewes, Jens B Frøkjær, Johanna Laukkarinen, Mikael Parhiala, Iben Rix, Srdan Novovic, Björn Lindkvist, Louise Bexander, Georg Dimcevski, Trond Engjom, Friedemann Erchinger, Ingfrid S Haldorsen, Aldis Pukitis, Imanta Ozola-Zālīte, Stephan Haas, Miroslav Vujasinovic, J Matthias Löhr, Antanas Gulbinas, Nanna M Jensen, Maiken T Jørgensen, Camilla Nøjgaard
OBJECTIVES: Chronic pancreatitis (CP) is a multifaceted disease associated with several risk factors and a complex clinical presentation. We established the Scandinavian Baltic Pancreatic Club (SBPC) Database to characterise and study the natural history of CP in a Northern European cohort. Here, we describe the design of the database and characteristics of the study cohort. METHODS: Nine centres from six different countries in the Scandinavian-Baltic region joined the database...
May 4, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28469230/improving-outcomes-of-chronic-pancreatitis-is-isolated-pancreatic-exocrine-insufficiency-an-early-marker-to-identify-modifiable-risks
#17
Andrew D Hopper, Jennifer A Campbell, David S Sanders
No abstract text is available yet for this article.
May 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28436541/pdx1-mody-and-dorsal-pancreatic-agenesis-new-phenotype-of-a-rare-disease
#18
L A Caetano, L S Santana, A D Costa-Riquetto, A M Lerario, M Nery, G F Nogueira, C D Ortega, M S Rocha, Aal Jorge, M G Teles
Maturity-Onset Diabetes of the Young (MODY) type 4 or PDX1-MODY is a rare form of monogenic diabetes caused by heterozygous variants in PDX1. Pancreatic developmental anomalies related to PDX1 are reported only in neonatal diabetes cases. Here, we describe dorsal pancreatic agenesis in two patients with PDX1-MODY. The proband presented with diabetes since 14 years of age and maintained regular glycemic control with low doses of basal insulin and detectable C-peptide levels after 30 years with diabetes. A diagnosis of MODY was suspected...
April 24, 2017: Clinical Genetics
https://www.readbyqxmd.com/read/28406793/population-level-incidence-and-predictors-of-surgically-induced-diabetes-and-exocrine-insufficiency-after-partial-pancreatic-resection
#19
Irmina A Elliott, Irene Epelboym, Megan Winner, John D Allendorf, Philip I Haigh
CONTEXT: Endocrine and exocrine insufficiency after partial pancreatectomy affect quality of life, cardiovascular health, and nutritional status. However, their incidence and predictors are unknown. OBJECTIVE: To identify the incidence and predictors of new-onset diabetes and exocrine insufficiency after partial pancreatectomy. DESIGN: We retrospectively reviewed 1165 cases of partial pancreatectomy, performed from 1998 to 2010, from a large population-based database...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28405150/comparing-acid-steatocrit-and-faecal-elastase-estimations-for-use-in-m-annheim-staging-for-pancreatitis
#20
M Ganesh Kamath, C Ganesh Pai, Asha Kamath, Annamma Kurien
AIM: To compare two tests for exocrine pancreatic function (EPF) for use in M-ANNHEIM staging for pancreatitis. METHODS: One hundred and ninety four consecutive patients with acute pancreatitis (AP; n = 13), recurrent acute pancreatitis (RAP; n = 65) and chronic pancreatitis (CP; n = 116) were enrolled. EPF was assessed by faecal elastase-1 (FE-1) estimation and stool fat excretion by the acid steatocrit method. Patients were classified as per M-ANNHEIM stages separately based on the results of the two tests for comparison...
March 28, 2017: World Journal of Gastroenterology: WJG
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