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https://www.readbyqxmd.com/read/28742542/clinical-practice-guidelines-for-cryosurgery-of-pancreatic-cancer-a-consensus-statement-from-the-china-cooperative-group-of-cryosurgery-on-pancreatic-cancer-international-society-of-cryosurgery-and-asian-society-of-cryosurgery
#1
Lihua He, Lizhi Niu, Nikolai N Korpan, Sajio Sumida, Yueyong Xiao, Jiaping Li, Barlian Sutedja, Youyong Lu, Jiansheng Zuo, Jianguo Liu, Kecheng Xu
Pancreatic cancer (PC), one of the most lethal malignancies, accounts for 8% to 10% of digestive system cancers, and the incidence is increasing. Surgery, chemotherapy, and radiotherapy have been the main treatment methods but are not very effective. Cryosurgery was first used in 1984 for treatment of locally advanced PC and has since become a considerable treatment for most cases of unresectable PC. During the past decade, cryosurgery has been applied in some hospitals in China, and the newly developed technique of computed tomography- and/or ultrasound-guided percutaneous cryosurgery has shown better results than chemotherapy in cases of unresectable locally advanced PC, with the 1-year survival rate reported to be more than 50%...
July 24, 2017: Pancreas
https://www.readbyqxmd.com/read/28739291/pancreatic-cancer-screening-still-a-delusion
#2
REVIEW
Pedro Moutinho-Ribeiro, Rosa Coelho, Marc Giovannini, Guilherme Macedo
Pancreatic adenocarcinoma represents the fourth most common cause of cancer mortality and death due to pancreatic cancer (PC) have increased since 2003. Its incidence has also raised about 30% in the past decade and it is expected to become the second cause of cancer mortality by 2020 in the USA. Most PC present with metastatic disease and improvements in treatment outcomes for this group have been disappointing. These observations support the idea that screening to identify patients at an earlier stage might be an important strategy in improving overall PC outcomes...
July 13, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28738031/perioperative-care-implementation-evidence-based-practice-for-patients-with-pancreaticoduodenectomy-using-the-enhanced-recovery-after-surgery-guidelines-%C3%A2
#3
Cesar Aviles, Marilyn Hockenberry, Dionisios Vrochides, David Iannitti, Allyson Cochran, Kendra Tezber, Misty Eller, Janet Desamero
BACKGROUND: Pancreatic adenocarcinoma is an aggressive cancer that carries a poor prognosis. Pancreaticoduodenectomy (PD) offers the only potential cure, but the associated morbidity is high. The Enhanced Recovery After Surgery (ERAS) evidence-based guidelines for perioperative care for PD can be used to reduce variations in practice.
. OBJECTIVES: The primary aim was to evaluate the feasibility of the ERAS guidelines for patients undergoing PD. Secondary aims were to assess length of stay (LOS), readmission within 30 days, 30-day mortality, and total surgical complication rates...
August 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28735806/revisions-of-international-consensus-fukuoka-guidelines-for-the-management-of-ipmn-of-the-pancreas
#4
REVIEW
Masao Tanaka, Carlos Fernández-Del Castillo, Terumi Kamisawa, Jin Young Jang, Philippe Levy, Takao Ohtsuka, Roberto Salvia, Yasuhiro Shimizu, Minoru Tada, Christopher L Wolfgang
The management of intraductal papillary mucinous neoplasm (IPMN) continues to evolve. In particular, the indications for resection of branch duct IPMN have changed from early resection to more deliberate observation as proposed by the international consensus guidelines of 2006 and 2012. Another guideline proposed by the American Gastroenterological Association in 2015 restricted indications for surgery more stringently and recommended physicians to stop surveillance if no significant change had occurred in a pancreatic cyst after five years of surveillance, or if a patient underwent resection and a non-malignant IPMN was found...
July 13, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28735575/negotiating-the-complexities-of-exocrine-and-endocrine-dysfunction-in-chronic-pancreatitis
#5
Sinead N Duggan
Chronic pancreatitis is a chronic inflammatory disease of the pancreas characterised by irreversible morphological change and typically causing pain and/or permanent loss of function. This progressive, irreversible disease results in destruction of healthy pancreatic tissue and the development of fibrous scar tissue. Gradual loss of exocrine and endocrine function follows, along with clinical manifestations such as steatorrhoea, abdominal pain and diabetes. Nutrition in chronic pancreatitis has been described as a problem area and, until recently, there was little research on the topic...
July 24, 2017: Proceedings of the Nutrition Society
https://www.readbyqxmd.com/read/28735375/perioperative-practices-concerning-one-anastomosis-mini-gastric-bypass-a-survey-of-210-surgeons
#6
Kamal K Mahawar, Kuldeepak Singh Kular, Chetan Parmar, Michael Van den Bossche, Yitka Graham, William R J Carr, Brijesh Madhok, Conor Magee, Sanjay Purkayastha, Peter K Small
BACKGROUND: There is currently little evidence available on the perioperative practices concerning one anastomosis/mini gastric bypass (OAGB/MGB) and no published consensus amongst experts. Even the published papers are not clear on these aspects. The purpose of this study was to understand various perioperative practices concerning OAGB/MGB. METHODS: Bariatric surgeons from around the world were invited to participate in a questionnaire-based survey. Only surgeons performing this procedure were included...
July 22, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28734722/guidelines-for-the-understanding-and-management-of-pain-in-chronic-pancreatitis
#7
REVIEW
Asbjørn M Drewes, Stefan A W Bouwense, Claudia M Campbell, Güralp O Ceyhan, Myriam Delhaye, Ihsan Ekin Demir, Pramod K Garg, Harry van Goor, Christopher Halloran, Shuiji Isaji, John P Neoptolemos, Søren S Olesen, Tonya Palermo, Pankaj Jay Pasricha, Andrea Sheel, Tooru Shimosegawa, Eva Szigethy, David C Whitcomb, Dhiraj Yadav
Abdominal pain is the foremost complication of chronic pancreatitis (CP). Pain can be related to recurrent or chronic inflammation, local complications or neurogenic mechanisms with corresponding changes in the nervous systems. Both pain intensity and the frequency of pain attacks have been shown to reduce quality of life in patients with CP. Assessment of pain follows the guidelines for other types of chronic pain, where the multidimensional nature of symptom presentation is taken into consideration. Quantitative sensory testing may be used to characterize pain, but is currently used in a research setting in advanced laboratories...
July 13, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28728311/clinical-approach-to-incidental-pancreatic-cystic-neoplasm-in-outpatient-clinics
#8
REVIEW
Young Sik Woo, Kyu Taek Lee
Cystic lesions of the pancreas are increasingly observed due to increased use of abdominal images. The malignant rate of pancreas cystic lesion varies widely between various types. Identification of malignant or high-risk lesions is important when determining the appropriate course of management. Using these image findings, including cyst size, presence of solid components, and pancreatic duct involvement, the 2012 International Association of Pancreatology (IAP) and the 2015 American Gastroenterological Association (AGA) guidelines provide a rationale in identifying higher risk patients requiring further workups using an endoscopic ultrasound (EUS)...
July 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28727476/options-for-addressing-exocrine-pancreatic-insufficiency-in-patients-receiving-enteral-nutrition-supplementation
#9
Steven D Freedman
Patients with exocrine pancreatic insufficiency (EPI) have suboptimal secretion of pancreatic digestive enzymes and experience a range of clinical symptoms related to the malabsorption of fat. In patients with EPI unable to meet their nutritional requirements, enteral nutrition (EN) support is used to augment nutritional status. In addition to protein and carbohydrate, EN formulas contain fats as a calorie source, as well as vitamins and minerals to help prevent nutritional deficiencies related to malabsorption...
July 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28727475/guidance-for-supplemental-enteral-nutrition-across-patient-populations
#10
Douglas L Nguyen
Enteral nutrition is preferred over parenteral nutrition as a result of the greater safety of enteral nutrition therapy and comparative convenience. A wide variety of enteral nutrition products have been developed, including disease-specific products to help manage the nutritional needs of patients with kidney failure, liver failure, lung disease, diabetes, and other conditions. An assessment of each patient's nutritional needs and digestive function should be conducted prior to initiation of enteral nutrition therapy...
July 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28721972/ultrasound-imaging-features-of-isolated-pancreatic-tuberculosis
#11
Yi Dong, Christian Jürgensen, Rajesh Puri, Mirko D'Onofrio, Michael Hocke, Wen-Ping Wang, Nathan Atkinson, Malay Sharma, Christoph F Dietrich
BACKGROUND AND OBJECTIVES: Isolated pancreatic tuberculosis (PTB) is extremely rare worldwide. The purpose of this multicenter retrospective study is to analyze imaging features of histologically confirmed isolated PTB in order to determine the diagnostic features of the new methods contrast enhanced ultrasound (CEUS), ultrasound elastography and contrast enhanced endoscopic ultrasound (CE-EUS). PATIENTS AND METHODS: We report on a retrospective data collection of 12 cases of PTB confirmed by histology or cytology...
July 19, 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28720341/lipase-or-amylase-for-the-diagnosis-of-acute-pancreatitis
#12
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/28701182/do-we-really-need-to-differentiate-mesenchymal-stem-cells-into-insulin-producing-cells-for-attenuation-of-the-autoimmune-responses-in-type-1-diabetes-immunoprophylactic-effects-of-precursors-to-insulin-producing-cells
#13
Anshu Sharma, Rajni Rani
BACKGROUND: Type 1 diabetes (T1D) is a multifactorial autoimmune disorder where pancreatic beta cells are lost before the clinical manifestations of the disease. Administration of mesenchymal stem cells (MSCs) or MSCs differentiated into insulin-producing cells (IPCs) have yielded limited success when used therapeutically. We have evaluated the immunoprophylactic potentials of precursors to insulin-producing cells (pIPCs) and IPCs in nonobese diabetic (NOD) mice to ask a basic question: do we need to differentiate MSCs into IPCs or will pIPCs suffice to attenuate autoimmune responses in T1D? METHODS: Bone marrow-derived MSCs from Balb/c mice were characterized following the International Society for Cellular Therapy (ISCT) guidelines...
July 12, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28697124/effect-of-intravenous-fluids-and-analgesia-on-dysmotility-in-patients-with-acute-pancreatitis-a-prospective-cohort-study
#14
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/28682431/uptodate-in-the-assessment-and-management-of-intraductal-papillary-mucinous-neoplasms-of-the-pancreas
#15
D Pagliari, A Saviano, M L Serricchio, A A Dal Lago, M G Brizi, F Lanza, R Manfredi, A Gasbarrini, F Attili
Intraductal Papillary Mucinous Neoplasms (IPMNs) are the most common cystic tumors of the pancreas and are considered premalignant lesions. IPMNs are characterized by the papillary growth of the ductal epithelium with rich mucin production, which is responsible for cystic segmental or diffuse dilatation of the main pancreatic duct (MPD) and/or its branches. According to the different involvement of pancreatic duct system, IPMNs are divided into main duct type (MD-IPMN), branch duct type (BD-IPMN), and mixed type (MT-IPMN)...
June 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28681158/sporadic-small-%C3%A2-20%C3%A2-mm-nonfunctioning-pancreatic-neuroendocrine-neoplasm-is-the-risk-of-malignancy-negligible-when-adopting-a-more-conservative-strategy-a-systematic-review-and-meta-analysis
#16
Claudio Ricci, Riccardo Casadei, Giovanni Taffurelli, Carlo Alberto Pacilio, Davide Campana, Valentina Ambrosini, Santini Donatella, Francesco Minni
BACKGROUND: The management of small (≤20 mm), nonfunctioning pancreatic neuroendocrine neoplasms (pNENs) remains under debate. The European Neuroendocrine Tumor Society guidelines advocate the possibility of a conservative approach. METHODS: A systematic literature search was conducted to identify all studies comparing the risk of malignancy in small pNENs with respect to large ones (>20 mm). Malignancy was defined based on the presence of nodal metastases...
July 5, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28669686/pharmacologic-approaches-for-the-management-of-patients-with-moderately-elevated-triglycerides-150-499-mg-dl
#17
REVIEW
Michael S Kelly, Craig Beavers, John D Bucheit, Evan M Sisson, Dave L Dixon
Hypertriglyceridemia, defined as serum triglyceride (TG) levels >150 mg/dL, now affects over one-quarter of the US adult population and is associated with an increased risk of atherosclerotic cardiovascular disease. Available guidelines for managing hypertriglyceridemia vary with respect to TG thresholds and severity of disease. Lifestyle modifications and management of secondary causes (eg, diabetes) remain the first step in managing hypertriglyceridemia, with pharmacotherapy reserved to reduce the risk of pancreatitis and/or further reduce TG levels...
June 6, 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28667432/evaluation-of-the-international-consensus-guidelines-for-the-surgical-resection-of-intraductal-papillary-mucinous-neoplasms
#18
Mariko Tsukagoshi, Kenichiro Araki, Fumiyoshi Saito, Norio Kubo, Akira Watanabe, Takamichi Igarashi, Norihiro Ishii, Takahiro Yamanaka, Ken Shirabe, Hiroyuki Kuwano
BACKGROUND: International consensus guidelines for intraductal papillary mucinous neoplasms (IPMNs) were revised in 2012. AIMS: We aimed to evaluate the clinical utility of each predictor in the 2006 and 2012 guidelines and validate the diagnostic value and surgical indications. METHODS: Forty-two patients with surgically resected IPMNs were included. Each predictor was applied to evaluate its diagnostic value. RESULTS: The 2012 guidelines had greater accuracy for invasive carcinoma than the 2006 guidelines (64...
June 30, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28667316/the-specific-vulnerabilities-of-cancer-cells-to-the-cold-atmospheric-plasma-stimulated-solutions
#19
Dayun Yan, Haitao Cui, Wei Zhu, Niki Nourmohammadi, Julian Milberg, Lijie G Zhang, Jonathan H Sherman, Michael Keidar
Cold atmospheric plasma (CAP), a novel promising anti-cancer modality, has shown its selective anti-cancer capacity on dozens of cancer cell lines in vitro and on subcutaneous xenograft tumors in mice. Over the past five years, the CAP-stimulated solutions (PSS) have also shown their selective anti-cancer effect over different cancers in vitro and in vivo. The solutions used to make PSS include several bio-adaptable solutions, mainly cell culture medium and simple buffered solutions. Both the CAP-stimulated medium (PSM) and the CAP-stimulated buffered solution (PSB) are able to significantly kill cancer cells in vitro...
June 30, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28659676/outcomes-of-101-consecutive-surgical-resections-of-gastroenteropancreatic-neuroendocrine-tumours-gepnets-at-tata-memorial-hospital-a-referral-bias-for-nonfunctional-duodenopancreatic-tumours-and-the-need-for-greater-awareness-of-gepnets-as-a-distinct-entity
#20
Vinay Gaikwad, Shraddha Patkar, Savio George Barreto, Bhawna Sirohi, Mahesh Goel, Shailesh V Shrikhande
Data from India regarding the disease spectrum and surgical results of neuroendocrine tumours (GEPNETs) are sparse. Tempered surgical radicality in a high-volume oncology centre, conforming to existing guidelines, may further our understanding of tumour characteristics and behavioural patterns of nonfunctional GEPNETs. Surgical outcomes of patients with histopathologically confirmed GEPNETs from January 2003 to December 2013 were analyzed from a prospectively maintained database. Tumour grade, organ of primary tumour, perioperative factors, quality/radicality of resection and presence of metastatic disease were correlated with perioperative outcomes, overall survival and disease-free survival...
June 2017: Indian Journal of Surgery
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