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https://www.readbyqxmd.com/read/28643979/-acute-pancreatitis-new-aspects-for-the-management
#1
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/28634486/%C3%AE-cell-replacement-strategies-the-increasing-need-for-a-%C3%AE-cell-dogma
#2
REVIEW
Andhira Vieira, Noémie Druelle, Fabio Avolio, Tiziana Napolitano, Sergi Navarro-Sanz, Serena Silvano, Patrick Collombat
Type 1 diabetes is an auto-immune disease resulting in the loss of pancreatic β-cells and, consequently, in chronic hyperglycemia. Insulin supplementation allows diabetic patients to control their glycaemia quite efficiently, but treated patients still display an overall shortened life expectancy and an altered quality of life as compared to their healthy counterparts. In this context and due to the ever increasing number of diabetics, establishing alternative therapies has become a crucial research goal. Most current efforts therefore aim at generating fully functional insulin-secreting β-like cells using multiple approaches...
2017: Frontiers in Genetics
https://www.readbyqxmd.com/read/28624178/liver-transplantation-in-patients-with-liver-metastases-from-neuroendocrine-tumors-a%C3%A2-systematic-review
#3
Dimitrios Moris, Diamantis I Tsilimigras, Ioannis Ntanasis-Stathopoulos, Eliza W Beal, Evangelos Felekouras, Spiridon Vernadakis, John J Fung, Timothy M Pawlik
BACKGROUND: Liver transplantation to treat neuroendocrine tumors, especially in the setting of diffuse liver involvement not amenable to operative resection remains controversial. We sought to perform a systematic review of the current literature to summarize data on patients undergoing liver transplantation with neuroendocrine tumors liver metastases as the indication. METHODS: A systematic review was conducted in accordance to the Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines...
June 14, 2017: Surgery
https://www.readbyqxmd.com/read/28617885/the-role-of-wireless-capsule-endoscopy-wce-in-the-detection-of-occult-primary-neuroendocrine-tumors
#4
Manuele Furnari, Andrea Buda, Gabriele Delconte, Davide Citterio, Theodor Voiosu, Giovanni Ballardini, Flaminia Cavallaro, Edoardo Savarino, Vincenzo Mazzaferro, Emanuele Meroni
BACKGROUND AND AIMS: Neuroendocrine tumors (NETs) are a heterogeneous group of neoplasms with unclear etiology that may show functioning or non-functioning features. Primary tumor localization often requires integrated imaging. The European Neuroendocrine Tumors Society (ENETS) guidelines proposed wireless-capsule endoscopy (WCE) as a possible diagnostic tool for NETs, if intestinal origin is suspected. However, its impact on therapeutic management is debated. We aimed to evaluate the yield of WCE in detecting intestinal primary tumors in patients showing liver NET metastases when first-line investigations are inconclusive...
June 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28616721/biomarkers-in-pancreatic-ductal-adenocarcinoma
#5
REVIEW
J Gallego, C López, R Pazo-Cid, F López-Ríos, A Carrato
Pancreatic ductal adenocarcinoma (PDAC) is currently the third most frequent form of malignancy. The role of biomarkers in the diagnostic and therapeutic strategy of cancer is constantly expanding. Translational research is already changing paradigms in tumours encompassing from early diagnosis to precision medicine in advanced disease. Nomenclature for molecular subtypes of tumours is gradually gaining acceptance and there are growing expectations it will further go from the bench to the bedside. However, the clinical relevance of biomarkers in PDAC is still far behind the relevance of biomarkers in other solid tumours...
June 14, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28609361/pancreatic-cysts-part-2-should-we-be-less-cyst-centric
#6
Anne Marie Lennon, Marcia Irene Canto
The management of pancreatic cysts is a common problem faced by physicians and surgeons. Pancreatic cysts are important because some of them are mucin-producing cysts (MPCs), which may harbor or develop pancreatic ductal adenocarcinoma. Thus, accurate classification of pancreatic cysts and diagnosis of MPCs offer a potential for the prevention or early detection of pancreatic cancer. However, the diagnosis and management of asymptomatic pancreatic cysts are complicated by 2 factors. First, incidentally detected pancreatic cysts are often misdiagnosed as branch duct intraductal papillary mucinous neoplasms...
July 2017: Pancreas
https://www.readbyqxmd.com/read/28609360/pancreatic-cysts-part-1-using-the-american-gastroenterological-association-guidelines-for-the-management-of-pancreatic-cysts-a-practical-approach
#7
James M Scheiman
The recent publication of evidence-based guidelines by the American Gastroenterological Association for the management of the incidental pancreatic cyst has stimulated considerable discussion among clinicians and researchers. The guidelines examined the evidence in an accompanying technical review defining current diagnostic approaches, as well as cyst natural history. Recognizing that the risk of malignant degeneration of these cystic neoplasms has been overestimated, the guidelines boldly increased thresholds for endoscopic ultrasound imaging and cyst fluid sampling, as well as proposing a reduced frequency of surveillance compared with previous expert consensus recommendations...
July 2017: Pancreas
https://www.readbyqxmd.com/read/28609359/pancreatic-cysts-controversies-advances-diagnoses-and-therapies
#8
Jodie A Barkin, Jamie S Barkin
Pancreatic cysts are commonly found on cross-sectional imaging. The question arises in determining which lesions are premalignant or malignant and may require further testing, intervention, or follow-up. In pancreatic cysts without obvious malignancy on imaging, we approach them using the Four "S" Criteria. These are (1) symptoms that may be originating from the pancreatic cyst; (2) size of the cyst 2 cm or larger and/or main pancreatic duct greater than 5 mm; (3) survival of the patient, based on comorbidity index to determine surgical fitness; and then endoscopic ultrasound with fine needle aspiration (FNA) recommended to determine (4) solid component presence in the cyst, namely, nodule or thick walls, as well as to perform FNA to obtain cyst content...
July 2017: Pancreas
https://www.readbyqxmd.com/read/28603054/comparable-long-term-outcomes-of-1-minute-vs-5-minute-endoscopic-papillary-balloon-dilation-for-bile-duct-stones
#9
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/28597909/diagnostic-and-therapeutic-guidelines-for-gastro-entero-pancreatic-neuroendocrine-neoplasms-recommended-by-the-polish-network-of-neuroendocrine-tumours
#10
Beata Kos-Kudła, Jolanta Blicharz-Dorniak, Janusz Strzelczyk, Agata Bałdys-Waligórska, Tomasz Bednarczuk, Marek Bolanowski, Agnieszka Boratyn-Nowicka, Małgorzata Borowska, Andrzej Cichocki, Jarosław B Ćwikła, Massimo Falconi, Wanda Foltyn, Daria Handkiewicz-Junak, Alicja Hubalewska-Dydejczyk, Barbara Jarząb, Roman Junik, Dariusz Kajdaniuk, Grzegorz Kamiński, Agnieszka Kolasińska-Ćwikła, Aldona Kowalska, Robert Król, Leszek Królicki, Maciej Krzakowski, Jolanta Kunikowska, Katarzyna Kuśnierz, Paweł Lampe, Dariusz Lange, Anna Lewczuk-Myślicka, Andrzej Lewiński, Michał Lipiński, Magdalena Londzin-Olesik, Bogdan Marek, Anna Nasierowska-Guttmejer, Sergiusz Nawrocki, Ewa Nowakowska-Duława, Joanna Pilch-Kowalczyk, Violetta Rosiek, Marek Ruchała, Lucyna Siemińska, Anna Sowa-Staszczak, Teresa Starzyńska, Katarzyna Steinhof-Radwańska, Krzysztof Sworczak, Anhelli Syrenicz, Andrzej Szawłowski, Marek Szczepkowski, Ewa Wachuła, Wojciech Zajęcki, Anna Zemczak, Wojciech Zgliczyński, Krzysztof Zieniewicz
Progress in the diagnostics and therapy of gastro-entero-pancreatic (GEP) neuroendocrine neoplasms (NEN), the published results of new randomised clinical trials, and the new guidelines issued by the European Neuroendocrine Tumour Society (ENETS) have led the Polish Network of Neuroendocrine Tumours to update the 2013 guidelines regarding management of these neoplasms. We present the general recommendations for the management of NENs, developed by experts during the Third Round Table Conference - Diagnostics and therapy of gastro-entero-pancreatic neuroendocrine neoplasms: Polish recommendations in view of current European recommenda-tions, which took place in December 2016 in Żelechów near Warsaw...
2017: Endokrynologia Polska
https://www.readbyqxmd.com/read/28593459/impact-of-surgery-and-surveillance-in-the-management-of-branch-duct-intraductal-papillary-mucinous-neoplasms-of-the-pancreas-according-to-fukuoka-guidelines-the-bologna-experience
#11
Riccardo Casadei, Claudio Ricci, Giovanni Taffurelli, Carlo Alberto Pacilio, Marina Migliori, Francesco Minni
The objective of the study was to evaluate the Fukuoka guidelines in indicating the proper management for recognising the risk factors of malignancy. Data of patients with branch duct intraductal papillary mucinous neoplasms who underwent pancreatic resection or surveillance according to the Fukuoka risk parameters were collected in a prospective database. The clinical outcome (development of pancreatic cancer, overall and disease-specific survival) and pathological results were evaluated in all patients and in resected cases, respectively...
June 7, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28591030/pancreatic-carcinosarcoma-mimics-malignant-intraductal-papillary-mucinous-neoplasm-a-rare-case-report-and-literature-review
#12
Bing-Qi Li, Qiao-Fei Liu, Xiao-Yan Chang, Ya Hu, Jie Chen, Jun-Chao Guo
RATIONALE: Carcinosarcoma, an extremely rare pancreatic primary tumor, is characterized by coexistence of both carcinomatous and sarcomatous components. Due to its rarity, the clinical manifestation and imaging features have not been recognized. An accurate diagnostic method has not been available and a widely accepted guidelines instructing treatment has not been established. PATIENT CONCERNS: We present an uncommon case of pancreatic carcinosarcoma (PCS) which has been preoperatively diagnosed as pancreatic malignant intraductal papillary mucinous neoplasm...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28590353/proposed-clinical-pathway-for-non-operative-management-of-high-grade-pediatric-pancreatic-injuries-based-on-a-multicenter-analysis-a-pediatric-trauma-society-collaborative
#13
Bindi J Naik-Mathuria, Eric H Rosenfeld, Adam Vogel, 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, Stephanie Polites, Adam Pattyn, Christine Leeper, Laura V Veras, Ilan Maizlin, Shefali Thaker, Alexis Smith, Megan Waddell, Joseph Drews, James Gilmore, Lindsey Armstrong, Alexis Alex Ler, Suzanne Moody, Brandon Behrens, Laurence Carmant
BACKGROUND: Guidelines for non-operative 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 in order to develop a consensus-based standard clinical pathway. METHODS: A multicenter, retrospective review was conducted of children with high-grade (AAST grade III-V) pancreatic injuries treated with NOM between 2010-15...
June 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28588798/combination-therapy-with-gemcitabine-and-nab-paclitaxel-for-locally-advanced-unresectable-pancreatic-cancer
#14
Takeshi Saito, Keinosuke Ishido, Daisuke Kudo, Norihisa Kimura, Taiichi Wakiya, Yoshihito Nakayama, Kenichi Hakamada
The aim of the present study was to investigate the early treatment outcomes of combined gemcitabine and nab-paclitaxel treatment for locally advanced unresectable pancreatic cancer (LURPC). The subjects comprised 7 patients with LURPC receiving the abovementioned combination therapy at the Hirosaki University Hospital (Hirosaki, Japan) between January and September, 2015. The clinicopathological factors, adverse events and response to treatment were investigated. To determine whether the cases were unresectable, the National Comprehensive Cancer Network guidelines, version 2...
June 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28583792/role-of-palliative-resection-of-the-primary-tumour-in-advanced-pancreatic-and-small-intestinal-neuroendocrine-tumours-a-systematic-review-and-meta-analysis
#15
REVIEW
L M Almond, J Hodson, S J Ford, D Gourevitch, K J Roberts, T Shah, J Isaac, A Desai
PURPOSE: This study aimed to evaluate the impact on overall survival following palliative surgery to remove the primary lesion in unresectable metastatic small intestinal (SI-NET) and pancreatic neuroendocrine tumours (P-NET). METHODS: A systematic review of the literature and meta-analysis was performed. MEDLINE and Embase databases were searched to identify articles comparing patients undergoing palliative primary tumour resection without metastatectomy vs. no resection...
May 25, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28583749/predictors-for-early-readmission-in-acute-pancreatitis-ap-in-the-united-states-us-a-nationwide-population-based-study
#16
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/28565894/contemporary-strategies-to-improve-the-outcome-in-locally-advanced-pancreatic-cancer
#17
Rick Schneider, Christoph Späth, Ulrich Nitsche, Mert Erkan, Jörg Kleeff
Pancreatic ductal adenocarcinoma (PDAC) is a devastating disease with an overall 5-year survival rate of less than 7%. After many years of basic and clinical research efforts, pancreatic cancer patients presenting with locally advanced, unresectable tumors remain a therapeutic challenge. Despite the lack of high quality randomized controlled trials, perioperative/ neoadjuvant treatment strategies seem to be beneficial in these patients. At present the FOLFIRINOX regimen, which was established in the palliative setting, is increasingly recognized as the backbone of neoadjuvant therapy for locally advanced PDAC...
May 30, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28561672/pancreatic-adenocarcinoma-improving-prevention-and-survivorship
#18
Davendra P S Sohal, Field F Willingham, Massimo Falconi, Kara L Raphael, Stefano Crippa
Pancreatic cancer is a growing problem in oncology, given slowly rising incidence and continued suboptimal outcomes. A concerted effort to reverse this tide will require prevention, early diagnosis, and improved systemic therapy for curable disease. We focus on these aspects in detail in this study. Hereditary pancreatic cancer is an underappreciated area. With the growing use of genomics (both somatic and germline) in cancer care, there is increasing recognition of hereditary pancreatic cancer cases: around 10% of all pancreatic cancer may be related to familial syndromes, such as familial atypical multiple mole and melanoma (FAMMM) syndrome, hereditary breast and ovarian cancer, Lynch syndrome, and Peutz-Jeghers syndrome...
2017: American Society of Clinical Oncology Educational Book
https://www.readbyqxmd.com/read/28560225/minimum-volume-standards-in-surgery-are-we-there-yet
#19
REVIEW
Hartwig Bauer, Kim C Honselmann
The quality of surgery is directly dependent on the quantity, more specifically, on the number of operations performed at a given hospital as well as on the designated surgeon. This fact is supported by numerous studies and meta-analyses that will be presented in the following text. Most of the convincing data for complex procedures can be obtained from visceral (upper and lower gastrointestinal) surgery studies. Mortality of large oncological procedures, such as esophageal or pancreatic surgery, can be reduced by 50% if a certain number of interventions are guaranteed per year...
May 2017: Visceral Medicine
https://www.readbyqxmd.com/read/28540973/pancreatic-neuroendocrine-neoplasms-management-guidelines-recommended-by-the-polish-network-of-neuroendocrine-tumours
#20
Beata Kos-Kudła, Violetta Rosiek, Małgorzata Borowska, Agata Bałdys-Waligórska, Tomasz Bednarczuk, Jolanta Blicharz-Dorniak, Marek Bolanowski, Agnieszka Boratyn-Nowicka, Andrzej Cichocki, Jarosław B Ćwikła, Massimo Falconi, Wanda Foltyn, Foltyn Handkiewicz-Junak, Alicja Hubalewska-Dydejczyk, Barbara Jarząb, Michał Jarząb, Roman Junik, Dariusz Kajdaniuk, Grzegorz Kamiński, Agnieszka Kolasińska-Ćwikła, Aldona Kowalska, Robert Król, Leszek Królicki, Jolanta Kunikowska, Katarzyna Kuśnierz, Paweł Lampe, Dariusz Lange, Anna Lewczuk-Myślicka, Andrzej Lewiński, Michał Lipiński, Magdalena Londzin-Olesik, Bogdan Marek, Anna Nasierowska-Guttmejer, Ewa Nowakowska-Duława, Joanna Pilch-Kowalczyk, Marek Ruchała, Lucyna Siemińska, Anna Sowa-Staszczak, Teresa Starzyńska, Katarzyna Steinhof-Radwańska, Janusz Strzelczyk, Krzysztof Sworczak, Anhelli Syrenicz, Andrzej Szawłowski, Marek Szczepkowski, Ewa Wachuła, Wojciech Zajęcki, Anna Zemczak, Wojciech Zgliczyński
This article presents updated diagnostic and therapeutic guidelines for the management of pancreatic neuroendocrine tumours (PNEN), proposed by the Polish Network of Neuroendocrine Tumours. The guidelines contain new data received in the years 2013-2016, which confirm previous recommendations, and have led to modification of previous guidelines or have resulted in the formulation of new guidelines. Biochemical and imaging (anatomical and functional) tests are of great importance in diagnostics, as well as histopathological diagnosis to determine the management of PNEN patients, but they must be confirmed by an immunohistochemical examination...
2017: Endokrynologia Polska
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