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acute pancreatitis guidelines

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https://www.readbyqxmd.com/read/28720341/lipase-or-amylase-for-the-diagnosis-of-acute-pancreatitis
#1
REVIEW
Ola Z Ismail, Vipin Bhayana
Acute pancreatitis is a rapid onset of inflammation of the pancreas causing mild to severe life threatening conditions [1, 2]. In Canada, acute pancreatitis is the 5th most expensive digestive disease in Canada with a considerable economic burden on the health care system [3]. The diagnosis of acute pancreatitis is usually based on the presence of abdominal pain and elevated levels of serum amylase and/or lipase. Many health care centers use either serum amylase, lipase or both to diagnose acute pancreatitis without considering which one could provide a better diagnostic accuracy...
July 16, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28697124/effect-of-intravenous-fluids-and-analgesia-on-dysmotility-in-patients-with-acute-pancreatitis-a-prospective-cohort-study
#2
Landy M Wu, Sayali A Pendharkar, Varsha M Asrani, John A Windsor, Maxim S Petrov
OBJECTIVES: Analgesia and intravenous fluid resuscitation are cornerstones of initial patient management in acute pancreatitis (AP). The aim was to investigate the effect of intravenous fluids and analgesia on gastrointestinal motility in the early course of AP. METHODS: Gastrointestinal dysmotility was assessed using the Gastroparesis Cardinal Symptom Index (GCSI). One-way analysis of variance and analysis of covariance were conducted, adjusting for age, sex, body mass index, severity of AP, preexisting diabetes mellitus, and time from first symptom onset to hospital admission...
August 2017: Pancreas
https://www.readbyqxmd.com/read/28655321/stratified-analysis-and-clinical-significance-of-elevated-serum-triglyceride-levels-in-early-acute-pancreatitis-a-retrospective-study
#3
Jianhua Wan, Wenhua He, Yin Zhu, Yong Zhu, Hao Zeng, Pi Liu, Liang Xia, Nonghua Lu
BACKGROUND: Hypertriglyceridemia is one of the three most common causes of AP, which is associated with the AP prognosis that has not been clearly defined. METHODS: In this retrospective study, 1539 AP patients, who had serum triglyceride (TG) levels measured within the first 72 h, were assessed. The study groups consisted of patients with normal, mild, moderate, and severe/very severe HTG levels based on the Endocrine Society Clinical Practice Guidelines. We collected baseline demographic information, laboratory values, complications, and clinical outcome data in different HTG severity groups to analyze the clinical significance of elevated TG levels in AP...
June 27, 2017: Lipids in Health and Disease
https://www.readbyqxmd.com/read/28643979/-acute-pancreatitis-new-aspects-for-the-management
#4
Olivier Windisch, Toni Raffoul, Catrina Hansen, Jean-Louis Frossard, Philippe Morel, Léo Bühler
Acute pancreatitis is a frequent disease, with a simple course in 80 % of the cases but a high morbidity and mortality in its severe form. Biliary origin and alcohol represent 80 % of the etiologies. Except endoscopic removal of gallstone for biliary origin, treatment remains symptomatic and focuses on fluid resuscitation, effective antalgia and adapted management of nutrition. This article focuses on the novelties introduced by the revision of the Classification of Atlanta in 2012 and details current guidelines for the management of the disease...
June 14, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28603054/comparable-long-term-outcomes-of-1-minute-vs-5-minute-endoscopic-papillary-balloon-dilation-for-bile-duct-stones
#5
Yu-Ting Kuo, Hsiu-Po Wang, Chi-Yang Chang, Joseph W Leung, Jiann-Hwa Chen, Ming-Chang Tsai, Wei-Chih Liao
BACKGROUND & AIMS: Endoscopic papillary balloon dilation (EPBD) is an alternative to endoscopic sphincterotomy (EST) for choledocholithiasis. Unlike EST, EPBD preserves biliary sphincter function, reducing long-term risk of recurrent choledocholithiasis by 50%. Guidelines recommend that duration of EPBD exceeds 2 minutes, to adequately loosen the sphincter and reduce risks of failed stone extraction and post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. However, it is unclear whether this long duration of EPBD impairs sphincter function and negates the long-term benefit of EPBD...
June 8, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28583749/predictors-for-early-readmission-in-acute-pancreatitis-ap-in-the-united-states-us-a-nationwide-population-based-study
#6
Satish Munigala, Divya Subramaniam, Dipti P Subramaniam, Paula Buchanan, Hong Xian, Thomas Burroughs, Guru Trikudanathan
BACKGROUND & AIMS: Population based data on the burden and patterns of acute pancreatitis (AP) early readmissions (≤30-days) are limited. METHODS: 2013 Nationwide Readmission Database (NRD) was queried. AP etiology was determined using associated diagnoses codes. Proportion, reasons for readmission, and associated costs were evaluated. Multivariate logistic regression analysis was performed to identify independent predictors for 30-day readmission. RESULTS: After exclusions, we identified 178,541 patients with primary diagnosis of AP (mean age 53 ± 17 years, 51% male)...
May 29, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28522901/transition-of-early-phase-treatment-for-acute-pancreatitis-an-analysis-of-nationwide-epidemiological-survey
#7
EDITORIAL
Shin Hamada, Atsushi Masamune, Tooru Shimosegawa
Treatment of acute pancreatitis (AP) is one of the critical challenges to the field of gastroenterology because of its high mortality rate and high medical costs associated with the treatment of severe cases. Early-phase treatments for AP have been optimized in Japan, and clinical guidelines have been provided. However, changes in early-phase treatments and the relationship between treatment strategy and clinical outcome remain unclear. Retrospective analysis of nationwide epidemiological data shows that time for AP diagnosis has shortened, and the amount of initial fluid resuscitation has increased over time, indicating the compliance with guidelines...
April 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28506430/george-e-palade-memorial-lecture-my-life-in-pancreatic-research-unexpected-results-may-open-the-door
#8
REVIEW
Makoto Otsuki
The Palade Prize is the most distinguished award of the IAP for achievement in pancreatic research. It is named after George E. Palade, who in 1974 was awarded the Nobel Prize for his work on protein trafficking in pancreatic acinar cells. It is a great honor to be awarded the 2016 Palade Prize. While I was in graduate school, I was conducting research on hypothalamo-pituitary-thyroid axis; after finishing graduate school, I began research on amylase isoenzymes. This was the first step of my pancreatic research...
May 6, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28487729/severity-treatment-and-outcome-of-acute-pancreatitis-in-thailand-the-first-comprehensive-review-using-revised-atlanta-classification
#9
Supot Pongprasobchai, Peeradon Vibhatavata, Piyaporn Apisarnthanarak
Background. Severity and outcome of acute pancreatitis (AP) in Thailand are unknown. Methods. A retrospective study of 250 patients with AP during 2011-2014 was performed. Severity, treatment, and outcome were evaluated. Severity was classified by revised Atlanta classification. Results. The mean age was 58 years and 56% were men. Etiologies were gallstones (45%), alcohol (16%), postendoscopic retrograde cholangiopancreatography (14%), and idiopathic (15%). Overall, 72%, 16%, and 12% of patients had mild, moderately severe, and severe AP, respectively...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28487653/chinese-herbal-medicines-attenuate-acute-pancreatitis-pharmacological-activities-and-mechanisms
#10
REVIEW
Hong Xiang, Qingkai Zhang, Bing Qi, Xufeng Tao, Shilin Xia, Huiyi Song, Jialin Qu, Dong Shang
Acute pancreatitis (AP) is a commonly occurring gastrointestinal disorder. An increase in the annual incidence of AP has been observed, and it causes acute hospitalization and high mortality. The diagnosis and treatment guidelines for AP recommend conservative medical treatments focused on reducing pancreatic secretion and secondary injury, as a primary therapeutic approach. Unfortunately, the existing treatment options have limited impact on the incidence and severity of AP due to the complex and multifaceted pathological process of this disease...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28479718/potential-lipid-lowering-effects-of-eleusine-indica-l-gaertn-extract-on-high-fat-diet-induced-hyperlipidemic-rats
#11
Siew Ling Ong, Koteswara Rao Nalamolu, How Yee Lai
BACKGROUND: To date, anti-obesity agents based on natural products are tested for their potential using lipase inhibition assay through the interference of hydrolysis of fat by lipase resulting in reduced fat absorption without altering the central mechanisms. Previous screening study had indicated strong anti-obesity potential in Eleusine indica (E. indica), but to date, no pharmacologic studies have been reported so far. OBJECTIVE: This study was performed to investigate the lipid-lowering effects of E...
January 2017: Pharmacognosy Magazine
https://www.readbyqxmd.com/read/28465716/acute-care-surgery-a-means-for-providing-cost-effective-quality-care-for-gallstone-pancreatitis
#12
Patrick B Murphy, Dave Paskar, Richard Hilsden, Jennifer Koichopolos, Tina S Mele
BACKGROUND: Modern practice guidelines recommend index cholecystectomy (IC) for patients admitted with gallstone pancreatitis (GSP). However, this benchmark has been difficult to widely achieve. Previous work has demonstrated that dedicated acute care surgery (ACS) services can facilitate IC. However, the associated financial costs and economic effectiveness of this intervention are unknown and represent potential barriers to ACS adoption. We investigated the impact of an ACS service at two hospitals before and after implementation on cost effectiveness, patient quality-adjusted life years (QALY) and impact on rates of IC...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28452889/surgical-management-of-pancreatic-necrosis-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#13
Nathan T Mowery, Brandon R Bruns, Heather G MacNew, Suresh Agarwal, Toby M Enniss, Mansoor Khan, Weidun Alan Guo, Jeremy W Cannon, Matthew E Lissauer, Therese M Duane, Amy N Hildreth, Peter A Pappas, Lynn M Gries, Meghann Kaiser, Bryce R H Robinson
BACKGROUND: Pancreatic or peripancreatic tissue necrosis confers substantial morbidity and mortality. New modalities have created a wide variation in approaches and timing of interventions for necrotizing pancreatitis. As acute care surgery evolves, its practitioners are increasingly being called upon to manage these complex patients. METHODS: A systematic review of the MEDLINE database using PubMed was performed. English language articles regarding pancreatic necrosis from 1980 to 2014 were included...
August 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28440015/hypertriglyceridemia-during-asparaginase-treatment-in-children-with-acute-lymphoblastic-leukemia-correlates-with-antithrombin-activity-in-adolescents
#14
Lisa Persson, Arja Harila-Saari, Ida Hed Myrberg, Mats Heyman, Anna Nilsson, Susanna Ranta
BACKGROUND: Asparaginase (ASP) is a cornerstone in the treatment of acute lymphoblastic leukemia (ALL). It is also known for its ability to cause side effects, such as allergy and pancreatitis, as well as lipid and coagulation disturbances. The most important laboratory abnormalities are hypertriglyceridemia (HTG) and low antithrombin (AT). HTG is usually considered to be transient and benign in children with ALL, whereas low AT activity predisposes to thrombosis. Studies on the incidence and significance of HTG in children with ALL are scarce, and their findings have not always been congruent...
April 25, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28381378/severe-acute-pancreatitis-pathogenesis-diagnosis-and-surgical-management
#15
Mark Portelli, Christopher David Jones
BACKGROUND: Severe acute pancreatitis is a subtype of acute pancreatitis, associated with multiple organ failure and systemic inflammatory response syndrome. In this qualitative review we looked at the principles of pathogenesis, classification and surgical management of severe acute pancreatitis. We also looked at the current shift in paradigm in the management of severe acute pancreatitis since the guideline developed by the British Society of Gastroenterology. DATA SOURCES: Studies published between 1st January 1991 and 31st December 2015 were identified with PubMed, MEDLINE, EMBASE and Google Scholar online search engines using the following Medical Subject Headings: "acute pancreatitis, necrosis, mortality, pathogenesis, incidence" and the terms "open necrosectomy and minimally invasive necrosectomy"...
April 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28375803/routine-use-of-prophylactic-antibiotics-during-laparoscopic-cholecystectomy-does-not-reduce-the-risk-of-surgical-site-infections
#16
Pinar Sarkut, Sadik Kilicturgay, Hikmet Aktas, Yilmaz Ozen, Ekrem Kaya
BACKGROUND: Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of symptomatic gallbladder stones. As infections are rare in uncomplicated LC, it is widely accepted that prophylactic antibiotics need not be administered, and guidelines do not support routine antibiotic prophylaxis during elective LC. However, routine antibiotic prophylaxis for elective LC is still popular in many clinical settings. We investigated this situation in our department. METHOD: This randomized double-blind controlled study included 570 patients who underwent LC between March 2007 and February 2010...
July 2017: Surgical Infections
https://www.readbyqxmd.com/read/28348985/current-concepts-in-the-management-of-acute-pancreatitis
#17
REVIEW
Gautham Srinivasan, L Venkatakrishnan, Swaminathan Sambandam, Gursharan Singh, Maninder Kaur, Krishnaveni Janarthan, B Joseph John
Guidelines for the management of acute pancreatitis (AP) are based on the Western experience, which may be difficult to extrapolate in India due to socioeconomic constraints. Hence, modifications based on the available resources and referral patterns should be introduced so as to ensure appropriate care. We reviewed the current literature on the management of AP available in English on Medline and proposed guidelines locally applicable. Patients of AP presenting with systemic inflammatory response syndrome are at risk of moderate-severe pancreatitis and hence, should be referred to a tertiary center early...
October 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28318891/lessons-from-a-national-audit-of-acute-pancreatitis-a-summary-of-the-ncepod-report-treat-the-cause
#18
REVIEW
D A O'Reilly, S J McPherson, M T Sinclair, N Smith
The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) is an independent organisation whose remit is to review the quality of medical and surgical care provided in the United Kingdom. We undertook a review into the care provided to patients treated for acute pancreatitis during a 6 month study period between 1st January and 30th June 2014. This included assessment of care at an organisational level, clinical level within hospitals and external peer review. From a random sample, 712 patients underwent hospital clinician review and 418 patients had external peer review...
February 17, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28262458/early-management-of-acute-pancreatitis-a-review-of-the-best-evidence
#19
REVIEW
Serena Stigliano, Hanna Sternby, Enrique de Madaria, Gabriele Capurso, Maxim S Petrov
In the 20th century early management of acute pancreatitis often included surgical intervention, despite overwhelming mortality. The emergence of high-quality evidence (randomized controlled trials and meta-analyses) over the past two decades has notably shifted the treatment paradigm towards predominantly non-surgical management early in the course of acute pancreatitis. The present evidence-based review focuses on contemporary aspects of early management (which include analgesia, fluid resuscitation, antibiotics, nutrition, and endoscopic retrograde cholangiopancreatography) with a view to providing clear and succinct guidelines on early management of patients with acute pancreatitis in 2017 and beyond...
June 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28236520/frequency-and-prognosis-of-acute-pancreatitis-associated-with-fulminant-or-non-fulminant-acute-hepatitis-a-a-systematic-review
#20
Samir Haffar, Fateh Bazerbachi, Larry Prokop, Kymberly D Watt, M Hassan Murad, Suresh T Chari
BACKGROUND: Acute pancreatitis (AP) in patients with fulminant viral hepatitis is well recognized and its mortality depends on the severity of hepatitis rather than pancreatitis. Acute pancreatitis associated with non-fulminant acute hepatitis A (AHA) has been rarely described, and is considered to have a benign course with good response to conservative management. OBJECTIVE: To perform a systematic review of the frequency and prognosis of AP associated with fulminant or non-fulminant AHA...
March 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
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