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https://www.readbyqxmd.com/read/28935122/prevalence-of-exocrine-pancreatic-insufficiency-in-patients-with-chronic-pancreatitis-without-follow-up-pancr-evol-study
#1
Carlos Marra-Lopez Valenciano, Federico Bolado Concejo, Eva Marín Serrano, Judith Millastre Bocos, Emma Martínez-Moneo, Esperanza Pérez Rodríguez, María Francisco González, Andrés Del Pozo-García, Anaiansi Hernández Martín, Elena Labrador Barba, María Luisa Orera Peña, Enrique de-Madaria
BACKGROUND/OBJECTIVES: Exocrine pancreatic insufficiency (EPI) is an important complication of chronic pancreatitis (CP). Guidelines recommend to rule out EPI in CP, to detect those patients who would benefit from pancreatic enzyme replacement therapy. The aim of this study was to evaluate the prevalence of EPI in patients with CP without follow-up in the last 2 years and to describe their nutritional status and quality of life (QoL). METHODS: This was a cross-sectional, multicenter Spanish study...
September 18, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28930953/proposed-clinical-pathway-for-nonoperative-management-of-high-grade-pediatric-pancreatic-injuries-based-on-a-multicenter-analysis-a-pediatric-trauma-society-collaborative
#2
Bindi J Naik-Mathuria, Eric H Rosenfeld, Ankush Gosain, Randall Burd, Richard A Falcone, Rajan Thakkar, Barbara Gaines, David Mooney, Mauricio Escobar, Mubeen Jafri, Anthony Stallion, Denise B Klinkner, Robert Russell, Brendan Campbell, Rita V Burke, Jeffrey Upperman, David Juang, Shawn St Peter, Stephon J Fenton, Marianne Beaudin, Hale Wills, Adam Vogel, Stephanie Polites, Adam Pattyn, Christine Leeper, Laura V Veras, Ilan Maizlin, Shefali Thaker, Alexis Smith, Megan Waddell, Joseph Drews, James Gilmore, Lindsey Armstrong, Alexis Sandler, Suzanne Moody, Brandon Behrens, Laurence Carmant
BACKGROUND: Guidelines for nonoperative management (NOM) of high-grade pancreatic injuries in children have not been established, and wide practice variability exists. The purpose of this study was to evaluate common clinical strategies across multiple pediatric trauma centers to develop a consensus-based standard clinical pathway. METHODS: A multicenter, retrospective review was conducted of children with high-grade (American Association of Surgeons for Trauma grade III-V) pancreatic injuries treated with NOM between 2010 and 2015...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28906293/frequency-and-variables-associated-with-fasting-orders-in-inpatients-with-ulcerative-colitis-the-audit-of-diet-orders-ulcerative-colitis-adore-uc-study
#3
Zane R Gallinger, Amir Rumman, Kevin Pivovarov, Kyle J Fortinsky, A Hillary Steinhart, Adam V Weizman
INTRODUCTION: Current clinical practice guidelines suggest that patients with ulcerative colitis (UC) hospitalized because of a disease flare should be offered a normal diet, unless such a diet is not tolerated. Studies of hospitalized patients have demonstrated iatrogenic malnutrition from unjustified or inappropriate nil per os (NPO) or clear liquid diet (CLD) orders. In this study, we aim to characterize the burden of this problem in hospitalized patients with UC. METHODS: We conducted a retrospective cohort study of all patients with UC admitted to the gastroenterology service or the general internal medicine service at a tertiary, academic hospital between January 2009 and December 2014, with a length of stay between 2 and 30 days...
October 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28902776/pancreatic-cancer-arising-from-the-remnant-pancreas-is-it-a-local-recurrence-or-new-primary-lesion
#4
Daisuke Hashimoto, Akira Chikamoto, Toshiro Masuda, Shigeki Nakagawa, Katsunori Imai, Yo-Ichi Yamashita, Howard A Reber, Hideo Baba
Local recurrence of pancreatic cancer (PC) can occur in the pancreatic remnant. In addition, new primary PC can develop in the remnant. There are limited data available regarding this so-called remnant PC. The aim of this review was to describe the characteristics and therapeutic strategy regarding remnant PC. A literature search was performed using Medline published in English according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The incidence of remnant PC has been reported to be 3% to 5%...
October 2017: Pancreas
https://www.readbyqxmd.com/read/28898917/technical-aspects-of-endoscopic-ultrasound-eus-guided-sampling-in-gastroenterology-european-society-of-gastrointestinal-endoscopy-esge-technical-guideline-march-2017
#5
Marcin Polkowski, Christian Jenssen, Philip Kaye, Silvia Carrara, Pierre Deprez, Angels Gines, Gloria Fernández-Esparrach, Pierre Eisendrath, Guruprasad P Aithal, Paolo Arcidiacono, Marc Barthet, Pedro Bastos, Adele Fornelli, Bertrand Napoleon, Julio Iglesias-Garcia, Andrada Seicean, Alberto Larghi, Cesare Hassan, Jeanin E van Hooft, Jean-Marc Dumonceau
For routine EUS-guided sampling of solid masses and lymph nodes (LNs) ESGE recommends 25G or 22G needles (high quality evidence, strong recommendation); fine needle aspiration (FNA) and fine needle biopsy (FNB) needles are equally recommended (high quality evidence, strong recommendation).When the primary aim of sampling is to obtain a core tissue specimen, ESGE suggests using 19G FNA or FNB needles or 22G FNB needles (low quality evidence, weak recommendation).ESGE recommends using 10-mL syringe suction for EUS-guided sampling of solid masses and LNs with 25G or 22G FNA needles (high quality evidence, strong recommendation) and other types of needles (low quality evidence, weak recommendation)...
September 12, 2017: Endoscopy
https://www.readbyqxmd.com/read/28898386/pancreaticojejunostomy-versus-pancreaticogastrostomy-reconstruction-for-the-prevention-of-postoperative-pancreatic-fistula-following-pancreaticoduodenectomy
#6
REVIEW
Yao Cheng, Marta Briarava, Mingliang Lai, Xiaomei Wang, Bing Tu, Nansheng Cheng, Jianping Gong, Yuhong Yuan, Pierluigi Pilati, Simone Mocellin
BACKGROUND: Pancreatoduodenectomy is a surgical procedure used to treat diseases of the pancreatic head and, less often, the duodenum. The most common disease treated is cancer, but pancreatoduodenectomy is also used for people with traumatic lesions and chronic pancreatitis. Following pancreatoduodenectomy, the pancreatic stump must be connected with the small bowel where pancreatic juice can play its role in food digestion. Pancreatojejunostomy (PJ) and pancreatogastrostomy (PG) are surgical procedures commonly used to reconstruct the pancreatic stump after pancreatoduodenectomy...
September 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28898198/appropriate-interval-for-imaging-follow-up-of-small-simple-pancreatic-cysts
#7
Jordan Menda, Maile E Yoon, Hyo-Chun Yoon
CONTEXT: The frequency at which patients should undergo follow-up imaging of small pancreatic cysts is problematic because different medical societies have different follow-up guidelines. OBJECTIVE: To determine whether short-term follow-up of small pancreatic cysts is necessary to detect pancreatic cancer or cystic neoplasia. DESIGN: We retrospectively reviewed all abdominal magnetic resonance imaging (MRI) studies obtained in a geographically isolated health maintenance organization between January 1, 2012, and December 31, 2014, looking for pancreatic cysts...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28890819/the-role-of-induction-chemotherapy-chemoradiotherapy-in-localised-pancreatic-cancer-initial-experience-in-scotland
#8
Derek Grose, David McIntosh, Nigel Jamieson, Ross Carter, Euan Dickson, David Chang, Husam Marashi, Christina Wilson, Mohammed Alfayez, Ashleigh Kerr, Roisin O'Donoghue, Lea Haskins, Fraser Duthie, Colin J McKay, Janet Graham
BACKGROUND: Despite being relatively rare pancreatic cancer is one of the highest causes of death. Even within the potentially resectable group outcomes are poor. We present our initial experiences utilising a neoadjuvant approach to localised pancreatic cancer, evaluating survival, response rates and tolerability. METHODS: This was a retrospective analysis of a prospectively maintained database. Patients from 2012 to 2015 referred to a busy regional Hepato-Pancreatic Biliary (HPB) MDT were included...
August 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28874893/systemic-therapy-in-incurable-gastroenteropancreatic-neuroendocrine-tumours-a-clinical-practice-guideline
#9
S Singh, D Sivajohanathan, T Asmis, C Cho, N Hammad, C Law, R Wong, K Zbuk
PURPOSE: The purpose of the present review was to determine which antineoplastic systemic therapy is most effective in improving clinical outcomes for patients with incurable gastroenteropancreatic neuroendocrine tumours (nets). METHODS: A systematic search (2008-2016) of the literature in the medline and embase databases and the Cochrane Database of Systematic Reviews was conducted; abstracts from the American Society of Clinical Oncology, the American Society of Clinical Oncology Gastrointestinal Cancers Symposium, the European Society for Medical Oncology, the European Cancer Congress, the European Neuroendocrine Tumor Society, and the North American Neuroendocrine Tumor Society were reviewed...
August 2017: Current Oncology
https://www.readbyqxmd.com/read/28873162/mutation-detection-in-patients-with-advanced-cancer-by-universal-sequencing-of-cancer-related-genes-in-tumor-and-normal-dna-vs-guideline-based-germline-testing
#10
Diana Mandelker, Liying Zhang, Yelena Kemel, Zsofia K Stadler, Vijai Joseph, Ahmet Zehir, Nisha Pradhan, Angela Arnold, Michael F Walsh, Yirong Li, Anoop R Balakrishnan, Aijazuddin Syed, Meera Prasad, Khedoudja Nafa, Maria I Carlo, Karen A Cadoo, Meg Sheehan, Megan H Fleischut, Erin Salo-Mullen, Magan Trottier, Steven M Lipkin, Anne Lincoln, Semanti Mukherjee, Vignesh Ravichandran, Roy Cambria, Jesse Galle, Wassim Abida, Marcia E Arcila, Ryma Benayed, Ronak Shah, Kenneth Yu, Dean F Bajorin, Jonathan A Coleman, Steven D Leach, Maeve A Lowery, Julio Garcia-Aguilar, Philip W Kantoff, Charles L Sawyers, Maura N Dickler, Leonard Saltz, Robert J Motzer, Eileen M O'Reilly, Howard I Scher, Jose Baselga, David S Klimstra, David B Solit, David M Hyman, Michael F Berger, Marc Ladanyi, Mark E Robson, Kenneth Offit
Importance: Guidelines for cancer genetic testing based on family history may miss clinically actionable genetic changes with established implications for cancer screening or prevention. Objective: To determine the proportion and potential clinical implications of inherited variants detected using simultaneous sequencing of the tumor and normal tissue ("tumor-normal sequencing") compared with genetic test results based on current guidelines. Design, Setting, and Participants: From January 2014 until May 2016 at Memorial Sloan Kettering Cancer Center, 10 336 patients consented to tumor DNA sequencing...
September 5, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28871458/percutaneous-irreversible-electroporation-combined-with-allogeneic-natural-killer-cell-immunotherapy-for-patients-with-unresectable-stage-iii-iv-pancreatic-cancer-a-promising-treatment
#11
Mao Lin, Shuzhen Liang, Xiaohua Wang, Yinqing Liang, Mingjie Zhang, Jibing Chen, Lizhi Niu, Kecheng Xu
PURPOSE: This study was attempted to investigate the safety and clinical efficacy of percutaneous irreversible electroporation combined with allogeneic natural killer cell therapy for treating stage III/IV pancreatic cancer, evaluate median progression-free survival (PFS), and overall survival (OS). METHODS: Between March 2016 and February 2017, we enrolled 67 patients who met the enrollment criteria. According to the latest NCCN Guidelines, the patients were divided into stage III (35 patients, 16 patients received only irreversible electroporation (IRE) and 19 patients received IRE-NK: 8 patients underwent one course NK and 11 patients underwent ≥3 courses) and stage IV (32 patients, 14 patients received only IRE and 18 patients received IRE-NK: 8 patients underwent one course NK and 10 patients underwent ≥3 courses)...
September 4, 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/28869389/the-use-of-imaging-in-acute-pancreatitis-in-united-kingdom-hospitals-findings-from-a-national-quality-of-care-study
#12
Simon John McPherson, Derek A O'Reilly, Martin T Sinclair, Neil Smith
OBJECTIVE: To assess use of imaging in patients admitted to UK hospitals with acute pancreatitis (AP). METHODS: 4,479 patients had a diagnosis AP in the first 6 months of 2014. The National Confidential Enquiry into Patient Outcome and Death Patients (NCEPOD) selected patients with more severe AP for case review. Clinicians completed 712 questionnaires and case reviewers assessed 418 cases. The use of imaging in patients with AP is reported. RESULTS: The common causes of AP were gallstones (46...
September 4, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28867641/a-comparison-of-the-management-of-blunt-splenic-injury-in-children-and-young-people-a-new-south-wales-population-based-retrospective-study
#13
Susan E Adams, Andrew Holland, Julie Brown
The importance and safety of non-operative management (NOM) of Blunt Splenic Injury (BSI) has been established in children and adults over recent decades. However, studies have shown higher operation rates in adults. There is international evidence that when children are managed in adult centres, operation rates are higher while adolescents in paediatric centres, are operated on in line with paediatric guidelines. This difference between children and young adults, and the factors responsible, have not been examined in New South Wales (NSW)...
August 14, 2017: Injury
https://www.readbyqxmd.com/read/28866457/randomized-trial-of-cholangioscopy-guided-laser-lithotripsy-versus-conventional-therapy-for-large-bile-duct-stones-with-videos
#14
James Buxbaum, Ara Sahakian, Christopher Ko, Preeth Jayaram, Christianne Lane, Chung Yao Yu, Ravi Kankotia, Loren Laine
BACKGROUND: Bile duct stones >1 cm have a decreased incidence of successful endoscopic extraction and often require lithotripsy. Although prior guidelines suggested mechanical lithotripsy for large CBD stones, current guidelines suggest cholangioscopy-guided lithotripsy as an adjunct with or without balloon dilation or mechanical lithotripsy. However, no randomized trials have assessed the utility of this practice. METHODS: Patients with bile duct stones >1 cm in diameter were randomized in a 2:1 ratio to cholangioscopy-guided laser lithotripsy versus conventional therapy only...
August 30, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28864733/approach-to-hypertriglyceridemia-in-the-pediatric-population
#15
Badhma Valaiyapathi, Bhuvana Sunil, Ambika P Ashraf
Hypertriglyceridemia is increasingly identified in children and adolescents, owing to improved screening and higher prevalence of childhood obesity. Hypertriglyceridemia can result from either increased triglyceride (TG) production or reduced TG clearance. The etiologic origin can be primary (genetic) or secondary, but it is often multifactorial. Management is challenging because of the interplay of genetic and secondary causes and lack of evidence-based guidelines. Lifestyle changes and dietary interventions are most important, especially in hypertriglyceridemia associated with obesity...
September 2017: Pediatrics in Review
https://www.readbyqxmd.com/read/28858107/comparison-of-the-diagnostic-accuracy-of-three-current-guidelines-for-the-evaluation-of-asymptomatic-pancreatic-cystic-neoplasms
#16
Ming-Ming Xu, Shi Yin, Ali A Siddiqui, Ronald R Salem, Beth Schrope, Amrita Sethi, John M Poneros, Frank G Gress, Jeanine M Genkinger, Catherine Do, Christian A Brooks, John A Chabot, Michael D Kluger, Thomas Kowalski, David E Loren, Harry Aslanian, James J Farrell, Tamas A Gonda
Asymptomatic pancreatic cysts are a common clinical problem but only a minority of these cases progress to cancer. Our aim was to compare the accuracy to detect malignancy of the 2015 American Gastroenterological Association (AGA), the 2012 International Consensus/Fukuoka (Fukuoka guidelines [FG]), and the 2010 American College of Radiology (ACR) guidelines.We conducted a retrospective study at 3 referral centers for all patients who underwent resection for an asymptomatic pancreatic cyst between January 2008 and December 2013...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28842734/-resection-of-main-duct-and-mixed-type-ipmn-%C3%A2-5%C3%A2-mm
#17
REVIEW
G O Ceyhan, F Scheufele, H Friess
The incidence of cystic pancreatic lesions is steadily increasing due to the technical advances in imaging. Within the group of cystic pancreatic lesions intraductal papillary mucinous neoplasms (IPMNs) depict an important entity. Due to a possible progression to malignancy the clinical strategy has to be well chosen. For primary diagnostic work-up imaging by magnetic resonance imaging (MRI) with MR cholangiopancreatography (MRCP) and computed tomography (CT) scanning is recommended. Additional information can be gained by endosonography and a biopsy of the cystic lesion, allowing analysis of biomarkers, such as GNAS and KRAS mutation as wells as NLR...
August 25, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28840381/early-abdominal-imaging-remains-over-utilized-in-acute-pancreatitis
#18
David X Jin, Julia Y McNabb-Baltar, Shadeah L Suleiman, Bechien U Wu, Ramin Khorasani, Thomas L Bollen, Peter A Banks, Vikesh K Singh
BACKGROUND: Early abdominal computed tomography (CT) or magnetic resonance (MR) imaging is common in acute pancreatitis (AP). Guidelines (2007-2013) indicate routine use is unwarranted. AIMS: To compare the frequency and evaluate the predictors of early CT/MR utilization for AP between September 2006-2007 (period A) and September 2014-2015 (period B). METHODS: AP patients presenting directly to a large academic emergency department were prospectively enrolled during each period...
August 24, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28840303/pancreatic-cancer-screening
#19
Chris M Lindquist, Frank H Miller, Nancy A Hammond, Paul Nikolaidis
PURPOSE: This article reviews the current evidence surrounding pancreatic cancer screening. The current targets of screening include identification of early pancreatic cancer, as well as the two most important precursor lesions; intraductal papillary mucinous neoplasm and high grade pancreatic intraepithelial neoplasia. Given the relatively low incidence of pancreatic adenocarcinoma in the general population, patients with elevated risk based on family history or an underlying genetic syndrome are felt to be the most appropriate patients to undergo screening...
August 24, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28839881/a-regional-eus-service-using-a-collaborative-network
#20
H M Gordon, D A J Lloyd, A Higginson, R McCrudden, C Bent, F W Shek, R Beable, A Al-Badri, B Green, E Jaynes, B Foria, B S F Stacey
Endoscopic ultrasound (EUS) is increasingly used in the management of hepatobiliary lesions, allowing staging and tissue acquisition. It is operator-dependent, and fine needle aspiration (FNA) of solid lesions provides an auditable standard; high-volume centres have shown excellent results for solid pancreatic lesion FNA with sensitivities of 92%-97%. The British Society of Gastroenterology guidelines stress that clinical quality should determine service provision, with geographical accessibility a secondary consideration...
January 2017: Frontline Gastroenterology
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