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https://www.readbyqxmd.com/read/29345595/hospital-management-of-severe-hypertriglyceridemia-in-children
#1
Ambika Ashraf, Badhma Valaiyapathi
Severe hypertriglyceridemia (HTG), i.e., triglyceride levels exceeding 1000 mg/dL, is one of the established causes of acute pancreatitis and severe abdominal pain. There are no established pediatric guidelines for treatment of children and adolescents with severe HTG. Management often includes hospital admission, fasting followed by fat free diet until the triglyceride (TG) levels are below 1000 mg/dL. Insulin infusion lowers TG levels in patients, especially in those with diabetes. Plasmapheresis is a limited option due to its restricted availability and scarcity of studies on its efficacy and safety in children...
January 16, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29344522/intraductal-papillary-mucinous-neoplasms-of-the-pancreas-strategic-considerations
#2
Vicente Morales-Oyarvide, Zhi Ven Fong, Carlos Fernández-Del Castillo, Andrew L Warshaw
Intraductal papillary mucinous neoplasms (IPMN) are cystic neoplasms with the potential for progression to pancreatic cancer. Recognized by the global medical community just over two decades ago, IPMN have gained great epidemiological and clinical relevance thanks to the widespread use of cross-sectional abdominal imaging, which has led to a surge in the number of incidental pancreatic cysts being diagnosed. As our understanding of this disease has improved, we now know that some IPMN have a very elevated risk of cancer and require surgical resection, while others are low-risk lesions and can be followed...
December 2017: Visceral Medicine
https://www.readbyqxmd.com/read/29333050/improvement-of-insulin-secretion-and-pancreatic-%C3%AE-cell-function-in-streptozotocin-induced-diabetic-rats-treated-with-aloe-vera-extract
#3
Ayesha Noor, S Gunasekaran, M A Vijayalakshmi
Background: Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia. Plant extracts and their products are being used as an alternative system of medicine for the treatment of diabetes. Aloe vera has been traditionally used to treat several diseases and it exhibits antioxidant, anti-inflammatory, and wound-healing effects. Streptozotocin (STZ)-induced Wistar diabetic rats were used in this study to understand the potential protective effect of A. vera extract on the pancreatic islets...
December 2017: Pharmacognosy Research
https://www.readbyqxmd.com/read/29325347/-opportunities-and-challenges-in-the-development-of-pancreatic-surgery
#4
T P Zhang, Y P Zhao
Pancreatic surgery is characteristic of various and complicated diseases and difficult surgeries. Pancreatic surgeons are required to grasp the new concept, apply new techniques and comprehend the study trends of pancreatic diseases. Otherwise, pancreatic surgeons should fully realize the opportunities and challenges resulted from application of new concept and techniques as well as learning new concept and techniques. Meanwhile, they should grasp the updating guidelines and research progress, intensively promote the development of prospective multicenter research involved in multidisciplinary team, and then promote the rapid development of pancreas surgery in China...
January 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29299757/benign-tumors-of-the-pancreas-radical-surgery-versus-parenchyma-sparing-local-resection-the-challenge-facing-surgeons
#5
EDITORIAL
Hans G Beger
Pancreaticoduodenectomy and left-sided pancreatectomy are the surgical treatment standards for tumors of the pancreas. Surgeons, who are requested to treat patients with benign tumors, using standard oncological resections, face the challenge of sacrificing pancreatic and extra-pancreatic tissue. Tumor enucleation, pancreatic middle segment resection and local, duodenum-preserving pancreatic head resections are surgical procedures increasingly used as alternative treatment modalities compared to classical pancreatic resections...
January 3, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29288277/new-guidelines-for-use-of-endoscopic-ultrasound-for-evaluation-and-risk-stratification-of-pancreatic-cystic-lesions-may-be-too-conservative
#6
Nadav Sahar, Anthony Razzak, Zaheer S Kanji, David L Coy, Richard Kozarek, Andrew S Ross, Michael Gluck, Michael Larsen, Shayan Irani, S Ian Gan
BACKGROUND: The role of EUS in managing asymptomatic pancreatic cystic lesions (PCLs) remains unresolved. We retrospectively evaluated EUS in risk stratification of PCLs when adhering to the most recent AGA guidelines. METHODS: Asymptomatic PCLs that were evaluated by EUS from January 2014 to December 2014 were retrospectively reviewed including associated cytology, fluid analysis, and relevant surgical pathology. Cross-sectional imaging reports were reviewed blindly by an expert radiologist using AGA risk stratification terminology...
December 29, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29282629/inflammatory-bowel-disease-is-not-a-contraindication-for-bariatric-surgery
#7
Stephanie Aelfers, Ignace M C Janssen, Edo O Aarts, Carolijn Smids, Marcel J Groenen, Frits J Berends
BACKGROUND: Inflammatory bowel diseases (IBD) are listed as a contraindication for bariatric surgery in various guidelines due to a theoretical higher complication risk. Therefore, little is known about safety and efficacy of bariatric surgery in IBD patients. AIM: We assessed the safety and efficacy of bariatric surgery and postoperative quality of life (QoL) in IBD patients. SETTING: The study was conducted in a large peripheral hospital in the Netherlands...
December 27, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29282264/comparing-the-diagnostic-accuracy-of-five-common-tumour-biomarkers-and-ca19-9-for-pancreatic-cancer-a-protocol-for-a-network-meta-analysis-of-diagnostic-test-accuracy
#8
Long Ge, Bei Pan, Fujian Song, Jichun Ma, Dena Zeraatkar, Jianguo Zhou, Jinhui Tian
INTRODUCTION: Surgical resection is the only curative treatment for patients with resectable pancreatic cancer. Unfortunately, 80%-85% of patients present with locally advanced or metastatic unresectable pancreatic cancer at the time of diagnosis. Detection of pancreatic cancer at early stages remains a great challenge due to lack of accurate detection tests. Recommendations in existing clinical practice guidelines on early diagnosis of pancreatic cancer are inconsistent and based on limited evidence...
December 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/29280782/management-of-acute-pancreatitis-in-the-pediatric-population-a-clinical-report-from-the-north-american-society-for-pediatric-gastroenterology-hepatology-and-nutrition-pancreas-committee
#9
Maisam Abu-El-Haija, Soma Kumar, Jose Antonio Quiros, Keshawadhana Balakrishnan, Bradley Barth, Samuel Bitton, John F Eisses, Elsie Jazmin Foglio, Victor Fox, Denease Francis, Alvin Jay Freeman, Tanja Gonska, Amit S Grover, Sohail Z Husain, Rakesh Kumar, Sameer Lapsia, Tom Lin, Quin Y Liu, Asim Maqbool, Zachary M Sellers, Flora Szabo, Aliye Uc, Steven L Werlin, Veronique D Morinville
BACKGROUND: Although the incidence of acute pancreatitis (AP) in children is increasing, management recommendations rely on adult published guidelines. Pediatric-specific recommendations are needed. METHODS: The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Pancreas committee performed a MEDLINE review using several preselected key terms relating to management considerations in adult and pediatric AP. The literature was summarized, quality of evidence reviewed, and statements of recommendations developed...
January 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29273876/surgeon-performed-endoscopic-retrograde-cholangiopancreatography-outcomes-of-2392-procedures-at-two-tertiary-care-centers
#10
Mazen R Al-Mansour, Eleanor C Fung, Edward L Jones, Nichole E Zayan, Timothy D Wetzel, Sara E Martin Del Campo, Anahita D Jalilvand, Andrew J Suzo, Rebecca R Dettorre, James K Fullerton, Michael P Meara, John D Mellinger, Vimal K Narula, Jeffrey W Hazey
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a common procedure that, in the United States, is traditionally performed by gastroenterologists. We hypothesized that when performed by well-trained surgeons, ERCP can be performed safely and effectively. The objectives of the study were to assess the rate of successful cannulation of the duct of interest and to assess the 30-day complication and mortality rates. METHODS: We retrospectively reviewed the charts of 1858 patients who underwent 2392 ERCP procedures performed by five surgeons between August 2003 and June 2016 in two centers...
December 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29261593/non-operative-management-of-abdominal-solid-organ-injuries-following-blunt-trauma-in-adults-results-from-an-international-consensus-conference
#11
Stefania Cimbanassi, Osvaldo Chiara, Ari Leppaniemi, Sharon Henry, Thomas M Scalea, Kathirkamanathan Shanmuganathan, Walter Biffl, Fausto Catena, Luca Ansaloni, Gregorio Tugnoli, Elvio De Blasio, Arturo Chieregato, Giovanni Gordini, Sergio Ribaldi, Maurizio Castriconi, Patrizio Festa, Federico Coccolini, Salomone di Saverio, Antonio Galfano, Massimo Massi, Marilena Celano, Massimiliano Mutignani, Stefano Rausei, Desiree Pantalone, Antonio Rampoldi, Luca Fattori, Stefano Miniello, Sebastian Sgardello, Francesca Bindi, Federica Renzi, Fabrizio Sammartano
BACKGROUND: Non-operative management (NOM) for blunt solid organ injuries has become the standard of care for patients who are hemodynamically stable, without other indications for explorative laparotomy. Our aims were to develop evidence-based guidelines to correctly identify the indications for NOM in adult blunt trauma patient, the best and most appropriate modality for follow-up, and the best techniques to manage complications. METHODS: The literature since 2000 to 2016 was systematically screened according to PRISMA [Preferred Reporting Items for Systematic Reviews and meta-analyses] protocol...
December 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29249649/systematic-review-on-the-impact-of-pancreatoduodenectomy-on-quality-of-life-in-patients-with-pancreatic-cancer
#12
REVIEW
Sven M van Dijk, Hanne D Heerkens, Dorine S J Tseng, Martijn Intven, I Quintus Molenaar, Hjalmar C van Santvoort
BACKGROUND: Patients undergoing pancreatoduodenectomy for pancreatic cancer have a high risk of major postoperative complications and a low survival rate. Insight in the impact of pancreatoduodenectomy on quality of life (QoL) is therefore of great importance. The aim of this systematic review was to assess QoL after pancreatoduodenectomy for pancreatic cancer. METHODS: A systematic review of the literature was performed according to the PRISMA guidelines. A systematic search of all the English literature available in PubMed and Medline was performed...
December 14, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29247546/jges-guidelines-for-endoscopic-sphincterotomy
#13
REVIEW
Shomei Ryozawa, Takao Itoi, Akio Katanuma, Yoshinobu Okabe, Hironari Kato, Jun Horaguchi, Naotaka Fujita, Kenjiro Yasuda, Toshio Tsuyuguchi, Kazuma Fujimoto
The Japan Gastroenterological Endoscopy Society (JGES) has recently compiled guidelines for endoscopic sphincterotomy (EST) using evidence-based methods. Content regarding actual clinical practice, including detailed endoscopic procedures, instruments, device types and usages, has already been published by the JGES postgraduate education committee in May 2015, and thus in these guidelines we avoided duplicating such content as much as possible. The guidelines do not address pancreatic sphincterotomy, endoscopic papillary balloon dilation (EPBD), and endoscopic papillary large balloon dilation (EPLBD)...
December 16, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29239038/gastroenteropancreatic-neuroendocrine-neoplasms-selected-pathology-review-and-molecular-updates
#14
REVIEW
Siaw M Chai, Ian S Brown, M Priyanthi Kumarasinghe
Gastroenteropancreatic (GEP) neuroendocrine neoplasms can be broadly separated into well- and poorly differentiated categories. Tumours within each category have similarities in morphology and immunophenotype, but vary in grade, behaviour, molecular signature and responses to therapy. The aetiology of these differences is multifactorial. Site of origin, mucosal milieu and hereditary influences are some of the currently known factors. Given these differences, staging and grading systems continue to evolve, and the most recent World Health Organization classification of pancreatic neuroendocrine neoplasms reflects this by introducing a grade 3 neuroendocrine tumour category for morphologically well-differentiated tumours with an elevated Ki-67 proliferation index and/or mitotic count...
January 2018: Histopathology
https://www.readbyqxmd.com/read/29215539/biliary-stenting-in-patients-with-pancreatic-cancer-results-from-a-population-based-cohort-study
#15
Madeleine Payne, Elizabeth A Burmeister, Mary Waterhouse, Susan J Jordan, Dianne L OʼConnell, Neil D Merrett, David Goldstein, David Wyld, Vanessa L Beesley, Helen Gooden, Monika Janda, Rachel E Neale
OBJECTIVE: We aimed to describe management of biliary obstruction (BO) in the context of pancreatic cancer within a population-based cohort. METHODS: We examined management of BO in 1863 patients diagnosed as having pancreatic cancer in 2010/2011. We used descriptive statistics and logistic regression to describe patterns of biliary stent usage, complications and duration of patency, associations between preoperative stenting and surgical outcomes, and between patient factors and management of jaundice...
January 2018: Pancreas
https://www.readbyqxmd.com/read/29198001/imaging-findings-of-recurrent-pancreatic-cancer-following-resection
#16
S Javadi, N Karbasian, P Bhosale, S de Castro Faria, O Le, M H Katz, E J Koay, E P Tamm
Pancreatic cancer is a challenging malignancy to treat, largely due to aggressive regional involvement, early systemic dissemination, high recurrence rate, and subsequent low patient survival. Generally, 15-20% of newly diagnosed pancreatic cancers are candidates for possible curative resection. Eighty percent of these patients, however, will experience locoregional or distant recurrence in first 2 years. Although there is no strong evidence-based guideline for optimal surveillance after pancreatic cancer resection, careful comparison of surveillance follow-up multi-detector CT (MDCT) studies with a postoperative baseline MDCT examination aids detection of early recurrent pancreatic cancer...
December 2, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29191271/incidental-intraductal-papillary-mucinous-neoplasm-cystic-or-premalignant-lesions-of-the-pancreas-the-case-for-aggressive-management
#17
REVIEW
Alexander T El Gammal, Jakob R Izbicki
Incidental cystic intrapancreatic lesions are daily findings in abdominal radiology. The discovery of incidental pancreatic lesions is increasingly common with technologic diagnostic advancements. This article provides a perspective and guideline on the clinical management of incidental intraductal papillary mucinous neoplasms and cystic or premalignant lesions of the pancreas.
February 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29183639/systematic-review-and-meta-analysis-of-prognostic-role-of-splenic-vessels-infiltration-in-resectable-pancreatic-cancer
#18
REVIEW
Stefano Crippa, Roberto Cirocchi, Patrick Maisonneuve, Stefano Partelli, Ilaria Pergolini, Domenico Tamburrino, Francesca Aleotti, Michele Reni, Massimo Falconi
BACKGROUND: Identification of factors associated with dismal survival after surgery in resectable pancreatic ductal adenocarcinoma is important to select patients for neoadjuvant treatment. The present meta-analysis aimed to compare the results of distal pancreatectomy for resectable adenocarcinoma of the pancreatic body-tail with and without splenic vessels infiltration. METHODS: A systematic search was performed of PubMed, Embase and the Cochrane Library in accordance with PRISMA guidelines...
November 20, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29177608/identification-of-educational-gaps-among-oncologists-who-manage-patients-with-pancreatic-cancer
#19
Justin A Barnes, Melissa L Ellis, Sharon Hwang, Joan Emarine, Patti Merwin, Gregory D Salinas, Benjamin L Musher
INTRODUCTION: Pancreatic ductal adenocarcinoma (PDA) is associated with poor outcomes and presents oncologists with a myriad of clinical challenges. This study was conducted to assess oncologists' practice patterns and to identify the greatest areas of need for future PDA continuing medical education (CME) programs. METHODS: Case vignettes have been validated as an effective tool to assess how physicians approach and treat a wide array of diseases. In order to assess practice patterns for resectable, locally advanced unresectable, and metastatic PDA, an online case vignette survey was distributed to practicing medical oncologists...
November 27, 2017: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/29177164/medical-therapy-of-gastrointestinal-neuroendocrine-tumors
#20
REVIEW
Kjell Öberg
Intestinal neuroendocrine tumors (NETs) constitute a heterogeneous group with duodenal, small intestinal, colonic and rectal NETs. They constitute more than half of all NETs, with the highest frequencies in the rectum, small intestine, and colon. The tumor biology varies with the location of the primary tumor as well as with the grade and staging of the tumor. Small intestinal NETs usually present low proliferation and are treated in the first line with somatostatin analogs according to current guidelines. If progression occurs, one can add interferon alpha or change the treatment to everolimus...
October 2017: Visceral Medicine
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