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https://www.readbyqxmd.com/read/27924649/what-is-the-best-therapy-for-whipple-s-disease-our-point-of-view
#1
Federico Biagi, Gian Luigi Biagi, Gino Roberto Corazza
Although Whipple's disease (WD) has been treated with antibiotics since the early 50s, the best antibiotics and the duration of the therapy have not yet been established. We consider here the pro and cons of the two most commonly used therapies, ceftriaxone followed by trimethoprim-sulfamethoxazole (TMP-SMZ) and hydroxychloroquine in combination with doxycycline. The therapy based on ceftriaxone and TMP-SMZ is efficient in the vast majority of patients for the first few years. However, since reinfections or reactivations can occur, a life-long prophylaxis is necessary and doxycycline is nowadays the best option...
December 7, 2016: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/27923389/the-importance-of-albumin-infusion-rate-for-plasma-volume-expansion-following-major-abdominal-surgery-air-study-protocol-for-a-randomised-controlled-trial
#2
Svajunas Statkevicius, Johan Bonnevier, Björn P Bark, Erik Larsson, Carl M Öberg, Päivi Kannisto, Bobby Tingstedt, Peter Bentzer
BACKGROUND: Administration of fluids to restore normovolaemia is one of the most common therapeutic interventions performed peri-operatively and in the critically ill, but no study has evaluated the importance of infusion rate for the plasma volume-expanding effect of a resuscitation fluid. The present study is designed to test the hypothesis that a slow infusion of resuscitation fluid results in better plasma volume expansion than a rapid infusion. METHODS/DESIGN: The study is a single-centre, assessor-blinded, parallel-group, randomised prospective study...
December 7, 2016: Trials
https://www.readbyqxmd.com/read/27921207/pattern-of-venous-collateral-development-after-splenic-vein-occlusion-in-an-extended-whipple-procedure-whipple-at-the-splenic-artery-and-long-term-results
#3
Ismael Dominguez Rosado, Sanjeev Bhalla, Luis A Sanchez, Ryan C Fields, William G Hawkins, Steven M Strasberg
BACKGROUND: Extended Whipple procedures may require division of the splenic vein (SV). Controversy exists regarding the risk of sequelae of sinistral portal hypertension when the SV is ligated without reimplantation. The aim of this study was to identify postoperative venous collateral patterns and sequelae of SV ligation, as well as long-term results in an extended Whipple procedure. STUDY DESIGN: Patients who had an extended Whipple procedure (Whipple at the Splenic Artery or WATSA) were entered in an institutional database...
December 5, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27920655/deep-vein-thrombosis-as-initial-manifestation-of-whipple-disease
#4
Mônica Souza de Miranda Henriques, Alexandre Rolim da Paz, Ana Beatriz Person Gaertner, Cibelle Ingrid Stephen Melo, Priscyanne Lins Filgueiras, Rafaella Alencar Jerome
INTRODUCTION: Wipple disease (WD) is a rare chronic disease caused by the bacillus Tropheryma whipplei. Constitutive, rheumatologic, gastrointestinal, cardiac, cerebral, lymphatic, cutaneous, and ophthalmological signs are possible systemic symptoms. However, thrombotic manifestations are rarely described as "stroke-like syndrome" or arterial thrombosis. Diagnosis is based on clinical manifestations and pathological examination. Laboratory findings may include anemia, leukocytosis, and thrombocytosis...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27884091/whipple-s-disease
#5
Thomas Marth
In recent years, it has become apparent that Tropheryma whipplei not only causes a chronic multisystemic infection which is often preceded by arthropathies for many years, well known as 'classical' Whipple's disease, but also clinically becomes manifest with localized organ affections and acute (transient) infections in children. T. whipplei is found ubiquitously in the environment and colonizes in some healthy carriers. In this review, we highlight new aspects of this enigmatic infectious disorder.
December 2016: Acta Clinica Belgica
https://www.readbyqxmd.com/read/27882511/over-700-whipples-for-pancreaticobiliary-malignancies-postoperative-morbidity-is-an-additional-negative-prognostic-factor-for-distal-bile-duct-cancer
#6
Stefano Andrianello, Giovanni Marchegiani, Giuseppe Malleo, Borislav Chavdarov Rusev, Aldo Scarpa, Deborah Bonamini, Laura Maggino, Claudio Bassi, Roberto Salvia
BACKGROUND: Distal cholangiocarcinomas and pancreatic cancers both arise from pancreaticobiliary epithelium. Despite their common origin, there is a possible discrepancy in outcome. We analysed the surgical, pathological and survival outcome of resected distal cholangiocarcinoma compared with pancreatic cancer. METHODS: All cases of resected distal cholangiocarcinoma and pancreatic cancer from 1998 to 2014 were extracted from our database. Outcomes were compared...
November 23, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27864816/giant-insulinoma-report-of-a-case-and-review-of-published-reports
#7
Kazumitsu Ueda, Tetsuro Taira, Hiroyuki Hakoda, Shoko Nakata, Shinya Okata, Takeshi Nagai, Shigeo Aoki, Hideyuki Mishima, Akihiko Sako, Tsunehiko Maruyama, Minoru Okumura
BACKGROUND: Larger insulinomas are reportedly more likely to be malignant; however, their biological behavior has not been clearly elucidated. We here report the characteristics and treatment of a giant insulinoma with local invasion and lymph node metastasis. We also review published reports concerning the clinical features of giant insulinomas and comparing their grading with that of pancreatic neuroendocrine tumors. CASE PRESENTATION: A 71-year-old man was referred to our hospital for investigation of persistent hypoglycemia...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27864155/minimally-invasive-whipple-s-technique-for-laparoscopic-assisted-pylorus-preserving-pancreaticoduodenectomy
#8
Frederick Hong-Xiang Koh, Alfred Wc Kow
No abstract text is available yet for this article.
November 15, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27861351/small-amounts-of-tissue-preserve-pancreatic-function-long-term-follow-up-study-of-middle-segment-preserving-pancreatectomy
#9
Zipeng Lu, Jie Yin, Jishu Wei, Cuncai Dai, Junli Wu, Wentao Gao, Qing Xu, Hao Dai, Qiang Li, Feng Guo, Jianmin Chen, Chunhua Xi, Pengfei Wu, Kai Zhang, Kuirong Jiang, Yi Miao
Middle-segment preserving pancreatectomy (MPP) is a novel procedure for treating multifocal lesions of the pancreas while preserving pancreatic function. However, long-term pancreatic function after this procedure remains unclear.The aims of this current study are to investigate short- and long-term outcomes, especially long-term pancreatic endocrine function, after MPP.From September 2011 to December 2015, 7 patients underwent MPP in our institution, and 5 cases with long-term outcomes were further analyzed in a retrospective manner...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27860433/whipple-destructive-septic-arthritis
#10
Xavier Puéchal, Jonathan London
No abstract text is available yet for this article.
November 16, 2016: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/27855237/insulin-autoimmune-syndrome-a-rare-cause-of-postprandial-hypoglycemia
#11
Pooja Sahni, Nitin Trivedi, Abdulkadir Omer
: A 65-year-old obese Caucasian woman presented with symptomatic postprandial hypoglycemic episodes, resolution of symptoms with carbohydrate intake and significantly elevated anti-insulin antibody levels. She did not have any evidence for the use of oral antidiabetic medications, insulin, herbal substances, performing strenuous exercise or history of bariatric surgery. Fingerstick blood glucose readings revealed blood sugar of 35 mg/dL and 48 mg/dL, when she had these symptoms. Her medical history was significant for morbid obesity, hypothyroidism and gastro esophageal reflux disease...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27843072/toward-a-more-evidence-based-nosology-and-nomenclature-for-female-sexual-dysfunctions-part-ii
#12
Sharon J Parish, Andrew T Goldstein, Sue W Goldstein, Irwin Goldstein, James Pfaus, Anita H Clayton, Annamaria Giraldi, James A Simon, Stanley E Althof, Gloria Bachmann, Barry Komisaruk, Roy Levin, Susan Kellogg Spadt, Sheryl A Kingsberg, Michael A Perelman, Marcel D Waldinger, Beverly Whipple
INTRODUCTION: Current Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) definitions of sexual dysfunction do not identify all sexual problems experienced clinically by women and are not necessarily applicable for biologic or biopsychosocial management of female sexual dysfunction. A unified nomenclature system enables clinicians, researchers, and regulatory agencies to use the same language and criteria for determining clinical end points, assessing research results, and managing patients...
December 2016: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/27829601/whipple-s-disease-diagnosed-using-electron-microscopy-and-polymerase-chain-reaction
#13
Tomohiro Nagasue, Koichi Kurahara, Hiroki Yaita, Takahide Tanaka, Yumi Oshiro, Nobuaki Kuno, Akira Harada, Masashi Kameda, Kazuhide Iwasaki, Yutaka Tsutsumi
A 50-year-old man presented with bloody diarrhea and 25-kg weight loss over 3 months. Upper and lower endoscopy showed diffuse shaggy white villi in the duodenum and terminal ileum. In addition, capsule endoscopy and double-balloon enteroscopy revealed shaggy white villi in the entire small intestine. Histological examination of biopsy specimens found the lamina propria of the duodenal and intestinal mucosa to be densely infiltrated by rich foamy macrophages that were periodic acid-Schiff-positive. Electron microscopy showed numerous bacilli in the lamina propria...
2016: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/27829303/psychometric-validation-of-the-electronic-chronic-pain-questions-ecpq-in-a-primary-care-setting
#14
Karin S Coyne, Brooke M Currie, Sean Donevan, Marina Brodsky, Michael J Asmus, Daniel W Krichbaum, Joseph C Cappelleri, Rozelle Hegeman-Dingle, Alesia Sadosky, Samuel Z Whipple, Claire Burbridge, Elie Mulhem, J Bruce Hillenberg
OBJECTIVE: Collecting data that helps evaluate different types of pain may improve physicians' decision-making with regard to treatment selection and on-going monitoring of patients. To date, no chronic pain assessments have been widely implemented in primary care. The aim of this study was to psychometrically validate the electronic Chronic Pain Questions (eCPQ) in a primary care setting. RESEARCH DESIGN AND METHODS: All men and women ≥18 years arriving at two similar primary care clinics in southeastern Michigan were invited to participate...
November 10, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27826318/epigenetic-inheritance-across-the-landscape
#15
REVIEW
Amy V Whipple, Liza M Holeski
The study of epigenomic variation at the landscape-level in plants may add important insight to studies of adaptive variation. A major goal of landscape genomic studies is to identify genomic regions contributing to adaptive variation across the landscape. Heritable variation in epigenetic marks, resulting in transgenerational plasticity, can influence fitness-related traits. Epigenetic marks are influenced by the genome, the environment, and their interaction, and can be inherited independently of the genome...
2016: Frontiers in Genetics
https://www.readbyqxmd.com/read/27813101/gender-as-a-risk-factor-for-adverse-intraoperative-and-postoperative-outcomes-of-elective-pancreatectomy
#16
Aditya Mazmudar, Dominic Vitello, Mackenzie Chapman, James S Tomlinson, David J Bentrem
BACKGROUND AND OBJECTIVES: Patient selection remains paramount when developing and adopting quality-based assessment and reimbursement models, and enhanced recovery protocols. Gender is a patient characteristic known before surgery which can inform risk stratification. Our aim was to evaluate the effect of gender on intraoperative blood transfusions, operative time, length of hospital stay, estimated blood loss (EBL) as well as postoperative surgical site infections (SSIs), and mortality...
November 4, 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27809876/pancreatic-resection-for-intraductal-papillary-mucinous-neoplasm-a-thirteen-year-single-center-experience
#17
Katharina Marsoner, Johannes Haybaeck, Dora Csengeri, James Elvis Waha, Jakob Schagerl, Rainer Langeder, Hans Joerg Mischinger, Peter Kornprat
BACKGROUND: The purpose of this study is to review our results for pancreatic resection in patients with intraductal papillary mucinous neoplasm (IPMN) with and without associated carcinoma. METHODS: A total of 54 patients undergoing pancreatic resection for IPMN in a single university surgical center (Medical University of Graz) were reviewed retrospectively. Their survival rates were compared to those of patients with pancreatic ductal adenocarcinoma. RESULTS: Twenty-four patients exhibit non-invasive IPMN and thirty patients invasive IPMN with associated carcinoma...
November 4, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27769919/preoperative-levels-of-catecholamines-and-metanephrines-and-intraoperative-hemodynamics-of-patients-undergoing-pheochromocytoma-and-paraganglioma-resection
#18
Toby N Weingarten, Tasha L Welch, Tamara L Moore, Gulshat F Walters, Joni L Whipple, Alexandre Cavalcante, Irina Bancos, William F Young, Lucinda M Gruber, Muhammad Z Shah, Travis J McKenzie, Darrell R Schroeder, Juraj Sprung
OBJECTIVE: To determine whether, despite pharmacologic adrenergic receptor blockade, higher preoperative levels of catecholamines and metanephrines (adrenergic activity) are associated with increased intraoperative complications. METHODS: Records of patients undergoing paraganglioma and pheochromocytoma (PGL-PCC) resection from January 1, 2000, through June 31, 2015, were reviewed for preoperative levels of adrenergic activity, intraoperative variability in blood pressure and heart rate (range), and postoperative outcomes (hypotension requiring treatment)...
October 18, 2016: Urology
https://www.readbyqxmd.com/read/27729422/a-gene-for-genetic-background-in-zea-mays-fine-mapping-enhancer-of-teosinte-branched1-2-etb1-2-to-a-yabby-class-transcription-factor
#19
Chin Jian Yang, Lisa E Kursel, Anthony J Studer, Madelaine E Bartlett, Clinton J Whipple, John F Doebley
The effects of an allelic substitution at a gene often depend critically on genetic background, the genotype at other genes in the genome. During the domestication of maize from its wild ancestor (teosinte), an allelic substitution at teosinte branched (tb1) caused changes in both plant and ear architecture. The effects of tb1 on phenotype were shown to depend on multiple background loci including one called enhancer of tb1.2 (etb1.2) We mapped etb1.2 to a YABBY class transcription factor (ZmYAB2.1) and showed that the maize alleles of ZmYAB2...
October 11, 2016: Genetics
https://www.readbyqxmd.com/read/27701882/a-single-institution-s-21-year-experience-with-surgically-resected-pancreatic-neuroendocrine-tumors-an-analysis-of-survival-and-prognostic-factors
#20
Javier A Cienfuegos, Fernando Rotellar, Joseba Salguero, Miguel Ruiz-Canela, Jorge M Núñez Córdoba, Iosu Sola, Alberto Benito, Gabriel Zozaya, F Pardo, José Luis Hernández Lizoáin
BACKGROUND: Pancreatic neuroendocrine tumors (pNETs) comprise a heterogeneous group of tumors with a varied biological behavior. In the present study, we analyzed the experience of 79 pNETs resected between 1999 and 2014. The pathologic prognostic factors (European Neuroendocrine Tumor Society, ENETS; and AJCC) classification, vascular invasion (VI), proliferation index (ki-67) and the presence of necrosis were retrospectively reviewed. METHODS: The clinical data of 79 patients with pNETs who underwent surgery were retrospectively analyzed...
October 5, 2016: Revista Española de Enfermedades Digestivas
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