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New Diagnosis of Chronic Pancreatitis

Carlo Castellani, Baroukh M Assael
Cystic fibrosis (CF), a monogenic disease caused by mutations in the CFTR gene on chromosome 7, is complex and greatly variable in clinical expression. Airways, pancreas, male genital system, intestine, liver, bone, and kidney are involved. The lack of CFTR or its impaired function causes fat malabsorption and chronic pulmonary infections leading to bronchiectasis and progressive lung damage. Previously considered lethal in infancy and childhood, CF has now attained median survivals of 50 years of age, mainly thanks to the early diagnosis through neonatal screening, recognition of mild forms, and an aggressive therapeutic attitude...
October 5, 2016: Cellular and Molecular Life Sciences: CMLS
Chuntao Sun, Lihua Xue, Ziyang Zhu, Fan Zhang, Ruixue Yang, Xuewen Yuan, Zhanjun Jia, Qianqi Liu
Type 1 diabetes mellitus (T1DM) is an organ-specific autoimmune disease characterized by chronic and progressive apoptotic destruction of pancreatic beta cells. During the initial phases of T1DM, cytokines and other inflammatory mediators released by immune cells progressively infiltrate islet cells, induce alterations in gene expression, provoke functional impairment, and ultimately lead to apoptosis. Long noncoding RNAs (lncRNAs) are a new important class of pervasive genes that have a variety of biological functions and play key roles in many diseases...
2016: Mediators of Inflammation
Kara L Raphael, Field F Willingham
Hereditary pancreatitis (HP) is a rare cause of acute, recurrent acute, and chronic pancreatitis. It may present similarly to other causes of acute and chronic pancreatitis, and often there has been a protracted evaluation prior to the diagnosis of HP. Since it was first described in 1952, multiple genetic defects that affect the action of digestive enzymes in the pancreas have been implicated. The most common mutations involve the PRSS1, CFTR, SPINK1, and CTRC genes. New mutations in these genes and previously unrecognized mutations in other genes are being discovered due to the increasing use of next-generation genomic sequencing...
2016: Clinical and Experimental Gastroenterology
Julio Iglesias-García
Editorial on the role of ultrasound guided elastography for the diagnosis of chronic pancreatitis.
August 2016: Revista Española de Enfermedades Digestivas
Motohisa Yamamoto, Hiroki Takahashi
Immunoglobulin G4-related disease (IgG4-RD) is a new disease entity that was established in this century. It is a systemic and chronic inflammatory disorder. Autoimmune pancreatitis is a representative condition, but there is clearly involvement from other organs, including the kidneys, the retroperitoneal cavity, the lungs, and the thyroid, lacrimal, salivary, pituitary, and prostate glands. To aid in the resolution of the numerous issues related to IgG4-RD, the authors established a registry system of patients in multicenter institutes with IgG4-RD-the SMART registry...
August 2016: Seminars in Liver Disease
Daniel Hartmann, Benedikt Kaufmann, Helmut Friess
PURPOSE OF REVIEW: Surgery for pancreatic diseases is one of the most studied fields in general surgery and continues to evolve. This review focuses on recent advances in pancreatic surgery and summarizes the published research. RECENT FINDINGS: Surgery for pancreatic diseases is an evolving field with a wide range of innovations. Especially, contributions by high-volume pancreas centers have greatly improved outcomes in pancreatic surgery. In chronic pancreatitis, recent studies demonstrate that early surgical treatment should be favored over repeated endoscopic interventions, and local organ-preserving resection techniques should be preferred over classic Whipple resection...
July 15, 2016: Current Opinion in Gastroenterology
Alberto Pugliese
Type 1 diabetes (T1D) is a chronic autoimmune disease in which autoreactive T-cells and inflammation cause severe loss of pancreatic beta cells. Insulitis, the pathologic hallmark of T1D, is an inflammatory lesion consisting of immune cell infiltrates around and within the islets. New research initiatives and methodologies are advancing our understanding of pancreas pathology. Studies have revealed the predominant cellular types that infiltrate the islets, novel molecular aspects associated with insulitis, and the coexistence of additional pathological abnormalities...
July 2016: Pediatric Diabetes
Mingju Hao, Wenli Li, Lang Yi, Songlin Yu, Gaowei Fan, Tian Lu, Xin Yang, Guojing Wang, Dong Zhang, Jiansheng Ding, Kuo Zhang, Rui Zhang, Guigao Lin, Yanxi Han, Lunan Wang, Jinming Li
The only generally accepted serological marker currently used for the diagnosis of autoimmune pancreatitis (AIP) is IgG4. Our aim was mainly to determine whether hybrid κ\λ antibody can help to diagnose AIP and to differentiate it from pancreatic cancer. We established an enzyme-linked immunosorbent assay (ELISA) system to measure the levels of hybrid κ\λ antibodies in human sera. Sera were obtained from 338 patients, including 61 with AIP, 74 with pancreatic cancer, 50 with acute pancreatitis, 40 with ordinary chronic pancreatitis, 15 with miscellaneous pancreatic diseases, and 98 with normal pancreas...
2016: Scientific Reports
Ken Kamata, Masayuki Kitano, Shunsuke Omoto, Kumpei Kadosaka, Takeshi Miyata, Kosuke Minaga, Kentaro Yamao, Hajime Imai, Masatoshi Kudo
Endoscopic ultrasonography (EUS) is widely used to evaluate pancreaticobiliary diseases, especially pancreatic masses. EUS has a good ability to detect pancreatic masses, but it is not sufficient for the differential diagnosis of various types of lesions. In order to address the limitations of EUS, new techniques have been developed to improve the characterization of the lesions detected by EUS. EUS-guided fine needle aspiration (EUS-FNA) has been used for diagnosing pancreatic tumors. In order to improve the histological diagnostic yield, a EUS-FNA needle with a core trap has recently been developed...
July 2016: Ultrasonography
Ming-Tse Hsu, Cheng-Li Lin, Wei-Sheng Chung
Chronic inflammation may promote development of coronary heart disease. Studies on the relationship between chronic pancreatitis (CP) and cardiovascular diseases are scant.We conducted a nationwide retrospective cohort study to determine the risk of acute coronary syndrome (ACS) in patients with CP.We randomly selected a comparison cohort of individuals without CP from the Taiwan National Health Insurance Research Database (N = 23.74 million) and frequency-matched them with patients with CP from 2000 to 2010 in a 1:4 ratio according to age, sex, and index year...
May 2016: Medicine (Baltimore)
Marta Serrani, Andrea Lisotti, Giancarlo Caletti, Pietro Fusaroli
It is well established that endoscopic ultrasound (EUS) is fundamental in the characterization of many diseases concerning different organs, i.e. pancreaticobiliary diseases, gastrointestinal pathologic conditions, and lymph nodes of unknown origin. It is also well known that many factors can hamper the accuracy of EUS, i.e. biliary stents, chronic pancreatitis, poor operator's expertise. These factors can also lead to suboptimal accuracy when cytological confirmation through EUS-fine needle aspiration (EUS-FNA) is indicated...
August 2016: Minerva Medica
Tuck-Siu Wong, Kuan-Fu Liao, Chi-Ming Lin, Cheng-Li Lin, Wen-Chi Chen, Shih-Wei Lai
The aim of this study is to explore whether there is a relationship between chronic pancreatitis and cerebrovascular disease in Taiwan. Using the claims data of the Taiwan National Health Insurance Program, we identified 16,672 subjects aged 20 to 84 years with a new diagnosis of chronic pancreatitis from 2000 to 2010 as the chronic pancreatitis group. We randomly selected 65,877 subjects aged 20 to 84 years without chronic pancreatitis as the nonchronic pancreatitis group. Both groups were matched by sex, age, comorbidities, and the index year of diagnosing chronic pancreatitis...
April 2016: Medicine (Baltimore)
David C Whitcomb, Luca Frulloni, Pramod Garg, Julia B Greer, Alexander Schneider, Dhiraj Yadav, Tooru Shimosegawa
BACKGROUND: A definition of chronic pancreatitis (CP) is needed for diagnosis and distinguishing CP from other disorders. Previous definitions focused on morphology. Advances in epidemiology, genetics, molecular biology, modeling and other disciplines provide new insights into pathogenesis of CP, and allow CP to be better defined. METHODS: Expert physician-scientists from the United States, India, Europe and Japan reviewed medical and scientific literature and clinical experiences...
March 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Fiona Reid, Janet Peacock, Bola Coker, Viktoria McMillan, Cornelius Lewis, Stephen Keevil, Roy Sherwood, Gill Vivian, Robert Logan, Jennifer Summers
BACKGROUND: Bile acid malabsorption (BAM) is one possible explanation for chronic diarrhea. BAM may be idiopathic, or result from ileal resection or inflammation including Crohn's disease, or may be secondary to other conditions, including cholecystectomy, peptic ulcer surgery, and chronic pancreatitis. No "gold standard" exists for clinical diagnosis of BAM, but response to treatment with a bile acid sequestrant (BAS) is often accepted as confirmation. The SeHCAT (tauroselcholic [selenium-75] acid) test uses a radiolabeled synthetic bile acid and provides a diagnostic test for BAM, but its performance against "trial of treatment" is unknown...
2016: JMIR Research Protocols
Venkata S Katabathina, Erin M Flaherty, Anil K Dasyam, Christine O Menias, Nicole D Riddle, Narayan Lath, Kazuto Kozaka, Osamu Matsui, Yasuni Nakanuma, Srinivasa R Prasad
On the basis of the similarities in the histopathologic findings and the clinical-biologic behaviors of select biliary and pancreatic conditions, a new disease concept, "biliary diseases with pancreatic counterparts," has been proposed. Both nonneoplastic and neoplastic pathologic conditions of the biliary tract have their counterparts in the pancreas. Immunoglobulin G4 (IgG4)-related sclerosing cholangitis is the biliary manifestation of IgG4-related sclerosing disease, and type 1 autoimmune pancreatitis is its pancreatic counterpart...
March 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Tetsuhide Ito, Hiroshi Ishiguro, Hirotaka Ohara, Terumi Kamisawa, Junichi Sakagami, Naohiro Sata, Yoshifumi Takeyama, Morihisa Hirota, Hiroyuki Miyakawa, Hisato Igarashi, Lingaku Lee, Takashi Fujiyama, Masayuki Hijioka, Keijiro Ueda, Yuichi Tachibana, Yoshio Sogame, Hiroaki Yasuda, Ryusuke Kato, Keisho Kataoka, Keiko Shiratori, Masanori Sugiyama, Kazuichi Okazaki, Shigeyuki Kawa, Yusuke Tando, Yoshikazu Kinoshita, Mamoru Watanabe, Tooru Shimosegawa
Chronic pancreatitis is considered to be an irreversible progressive chronic inflammatory disease. The etiology and pathology of chronic pancreatitis are complex; therefore, it is important to correctly understand the stage and pathology and provide appropriate treatment accordingly. The newly revised Clinical Practice Guidelines of Chronic Pancreatitis 2015 consist of four chapters, i.e., diagnosis, staging, treatment, and prognosis, and includes a total of 65 clinical questions. These guidelines have aimed at providing certain directions and clinically practical contents for the management of chronic pancreatitis, preferentially adopting clinically useful articles...
February 2016: Journal of Gastroenterology
Xin-Wu Cui, Jian-Min Chang, Quan-Cheng Kan, Liliana Chiorean, Andre Ignee, Christoph F Dietrich
Elastography is a new ultrasound modality that provides images and measurements related to tissue stiffness. Endoscopic ultrasound (EUS) has played an important role in the diagnosis and management of numerous abdominal and mediastinal diseases. Elastography by means of EUS examination can assess the elasticity of tumors in the proximity of the digestive tract that are hard to reach with conventional transcutaneous ultrasound probes, such as pancreatic masses and mediastinal or abdominal lymph nodes, thus improving the diagnostic yield of the procedure...
December 21, 2015: World Journal of Gastroenterology: WJG
Huajian Gu, Xiaoyan Xin, Yaozhen Pan, Hong Zhang, She Tian, Chengyi Sun
BACKGROUND: Studies evaluating the role of telomerase activity in pancreatic adenocarcinoma are inconsistent and a systemic review of the available literature may shed new light on this issue. OBJECTIVE: To systematically review the usefulness of telomerase activity in distinguishing pancreatic cancer from other pancreatic diseases. METHODS: A comprehensive search of the PubMed and Embase databases was conducted to identify eligible studies...
2016: International Journal of Biological Markers
Satish Munigala, Ajaypal Singh, Andres Gelrud, Banke Agarwal
OBJECTIVES: New-onset diabetes mellitus (NODM) in adults is often an early manifestation of pancreatic cancer (PaCa), but the incidence of PaCa in this cohort is rather low. We evaluated whether combining other patient factors such as age, smoking history, the absence of obesity, the presence of chronic pancreatitis (CP), and gallstone disease can result in a more enriched cohort. METHODS: After a washout period of 2 years to exclude pre-existing PaCa or DM, 507,378 non-diabetic patients in the veterans' administration healthcare system were identified...
2015: Clinical and Translational Gastroenterology
Kimberly A Kelly, Michael A Hollingsworth, Randall E Brand, Christina H Liu, Vikesh K Singh, Sudhir Srivastava, Ajay D Wasan, Dhiraj Yadav, Dana K Andersen
A workshop sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases and the National Institute of Biomedical Imaging and Bioengineering focused on research gaps and opportunities in the development of new biomarkers of pancreatic disease. The session was held on July 22, 2015, and structured into 6 sessions: 1) Introduction and Overview; 2) Keynote Address; 3) New Approaches to the Diagnosis of Chronic Pancreatitis; 4) Biomarkers of Pain and Inflammation; 5) New Approaches to the Detection of Pancreatic Cancer; and 6) Shed Exosomes, Shed Cells, and Shed Proteins...
November 2015: Pancreas
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