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https://www.readbyqxmd.com/read/28099382/failure-of-nonoperative-management-of-pediatric-blunt-liver-and-spleen-injuries-a-prospective-atomac-study
#1
Maria E Linnaus, Crystal S Langlais, Nilda M Garcia, Adam C Alder, James W Eubanks, R Todd Maxson, Robert W Letton, Todd A Ponsky, Shawn D St Peter, Charles Leys, Amina Bhatia, Daniel J Ostlie, David W Tuggle, Karla A Lawson, Alexander R Raines, David M Notrica
BACKGROUND: Nonoperative management (NOM) is standard of care for most pediatric blunt liver and spleen injuries (BLSI); only 5% of patients fail NOM in retrospective reports. No prospective studies examine failure of NOM of BLSI in children. The aim of this study was to determine the frequency and clinical characteristics of failure of NOM in pediatric BLSI patients. METHODS: A prospective observational study was conducted on patients ≤18 years presenting to any of ten level 1 pediatric trauma centers April 2013 and January 2016 with BLSI on computed tomography...
January 17, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28099352/acute-pancreatitis-in-patients-with-pancreatic-cancer-timing-of-surgery-and-survival-duration
#2
Shaojun Li, Bole Tian
Acute pancreatitis (AP) is a rare manifestation of pancreatic cancer (PC). The relationship between AP and PC remains less distinct.From January 2009 to November 2015, 47consecutive patients with PC who presented with AP were reviewed for this study. Clinical features, clinicopathologic variables, postoperative complications, and follow-up evaluations of patients were documented in detail from our database. In order to identify cutoff threshold time for surgery, receiver operating curve (ROC) was built according to patients with or without postoperative complications...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28095040/consensus-statement-by-the-american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-on-the-comprehensive-type-2-diabetes-management-algorithm-2017-executive-summary
#3
Alan J Garber, Martin J Abrahamson, Joshua I Barzilay, Lawrence Blonde, Zachary T Bloomgarden, Michael A Bush, Samuel Dagogo-Jack, Ralph A DeFronzo, Daniel Einhorn, Vivian A Fonseca, Jeffrey R Garber, W Timothy Garvey, George Grunberger, Yehuda Handelsman, Irl B Hirsch, Paul S Jellinger, Janet B McGill, Jeffrey I Mechanick, Paul D Rosenblit, Guillermo E Umpierrez
EXECUTIVE SUMMARY This algorithm for the comprehensive management of persons with type 2 diabetes (T2D) was developed to provide clinicians with a practical guide that considers the whole patient, their spectrum of risks and complications, and evidence-based approaches to treatment. It is now clear that the progressive pancreatic beta-cell defect that drives the deterioration of metabolic control over time begins early and may be present before the diagnosis of diabetes (1). In addition to advocating glycemic control to reduce microvascular complications, this document highlights obesity and prediabetes as underlying risk factors for the development of T2D and associated macrovascular complications...
January 17, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28089481/recommendations-for-mri-based-contouring-of-gross-tumor-volume-and-organs-at-risk-for-radiation-therapy-of-pancreatic-cancer
#4
H D Heerkens, W A Hall, X A Li, P Knechtges, E Dalah, E S Paulson, C A T van den Berg, G J Meijer, E J Koay, C H Crane, K Aitken, M van Vulpen, B A Erickson
PURPOSE: Local recurrence is a common and morbid event in patients with unresectable pancreatic adenocarcinoma. A more conformal and targeted radiation dose to the macroscopic tumor in nonmetastatic pancreatic cancer is likely to reduce acute toxicity and improve local control. Optimal soft tissue contrast is required to facilitate delineation of a target and creation of a planning target volume with margin reduction and motion management. Magnetic resonance imaging (MRI) offers considerable advantages in optimizing soft tissue delineation and is an ideal modality for imaging and delineating a gross tumor volume (GTV) within the pancreas, particularly as it relates to conformal radiation planning...
October 17, 2016: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28089436/the-significance-of-histologic-examination-of-gastrectomy-specimens-a-clinicopathologic-study-of-511-cases
#5
Pavel Kopach, Elizabeth M Genega, Sajani N Shah, Julie J Kim, Yvelisse Suarez
BACKGROUND: Sleeve gastrectomy (SG) is quickly becoming the preferred procedure for bariatric surgery. According to the American Society for Metabolic and Bariatric Surgery guidelines, routine preoperative upper gastrointestinal endoscopies are not recommended universally for bariatric surgery. Some studies have shown that the histologic examination of SG specimens is insignificant and not a cost-effective practice. However, some speculate SG examination may unveil pertinent findings and prevent further progression of precursor lesions...
November 15, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28079345/towards-reducing-the-risk-of-new-onset-diabetes-after-pancreatitis
#6
Chirag J Jivanji, Danielle H Soo, Maxim S Petrov
Metabolic abnormalities due to acute and chronic pancreatitis are common. In particular, post-pancreatitis diabetes mellitus (PPDM) is increasingly recognised as a distinct clinical entity. However, most of research in this field is focused on unravelling the pathogenesis of PPDM whereas research frontiers are rarely extended to reducing the risk of new onset diabetes after pancreatitis (NODAP). The recent development and validation of the PERSEUS score paved the way to identifying individuals after acute pancreatitis who are at high risk of developing NODAP...
January 12, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28074277/patient-reported-outcomes-for-acute-gallstone-pathology
#7
Ed Parkin, Martyn Stott, Joy Brockbank, Simon Galloway, Ian Welch, Andrew Macdonald
BACKGROUND: A number of prominent surgical trials and clinical guidelines regard length of hospital stay and rates of daycase surgery as being of upmost importance following cholecystectomy. However, it is unclear whether these outcomes also matter to patients. This study aimed to identify the factors patients regard as most important when admitted with acute gallstone pathology. METHODS: A 41-item survey was produced by combining outcomes assessed in recent clinical trials with results from a preliminary patient questionnaire...
January 10, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28071655/effectiveness-of-guideline-recommended-cholecystectomy-to-prevent-recurrent-pancreatitis
#8
Ayesha Kamal, Eboselume Akhuemonkhan, Venkata S Akshintala, Vikesh K Singh, Anthony N Kalloo, Susan M Hutfless
OBJECTIVES: Cholecystectomy during or within 4 weeks of hospitalization for acute biliary pancreatitis is recommended by guidelines. We examined adherence to the guidelines for incident mild-to-moderate acute biliary pancreatitis and the effectiveness of cholecystectomy to prevent recurrent episodes of pancreatitis. METHODS: Individuals in the 2010-2013 MarketScan Commercial Claims & Encounters database with a hospitalization associated with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes of 577...
January 10, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28065547/comparison-of-the-diabetes-guidelines-from-the-ada-easd-and-the-aace-ace
#9
Susan Cornell
OBJECTIVE: To compare recent diabetes guideline updates from the American Diabetes Association-European Association for the Study of Diabetes (ADA/EASD) and the American Association of Clinical Endocrinologists-American College of Endocrinology (AACE/ACE). SUMMARY: The ADA/EASD guideline continues to advocate a stepwise approach to glycemic control that initiates with metformin and intensifies treatment incrementally to dual and triple therapy at 3-month intervals until the patient is at their individualized goal...
January 5, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28062947/low-dose-maintenance-steroid-treatment-could-reduce-the-relapse-rate-in-patients-with-type-1-autoimmune-pancreatitis-a-long-term-japanese-multicenter-analysis-of-510-patients
#10
Kensuke Kubota, Terumi Kamisawa, Kazuichi Okazaki, Shigeyuki Kawa, Kenji Hirano, Yoshiki Hirooka, Kazushige Uchida, Hideyuki Shiomi, Hirotaka Ohara, Kyoko Shimizu, Norikazu Arakura, Atsushi Kanno, Junichi Sakagami, Takao Itoi, Tetsuhide Ito, Toshiharu Ueki, Takayoshi Nishino, Kazuo Inui, Nobumasa Mizuno, Hitoshi Yoshida, Masanori Sugiyama, Eisuke Iwasaki, Atshishi Irisawa, Toru Shimosegawa, Yoshifumi Takeyama, Tsutomu Chiba
BACKGROUND: The effect of maintenance steroid treatment (MST) in reducing the risk of relapse in patients with autoimmune pancreatitis (AIP) remains under debate. The aim of this study was to validate the effect of MST on AIP administered in accordance with the 2010 Japanese consensus guidelines. METHODS: The clinical data of patients with (n = 510) from 22 high-volume centers in Japan were studied. The primary endpoints were the relapse rates (RRs) in patients administered MST versus those not administered MST...
January 6, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28057354/neuroendrocrine-tumors-of-the-uterine-cervix-a-therapeutic-challenge-for-gynecologic-oncologists
#11
REVIEW
Gadducci Angiolo, Carinelli Silvestro, Aletti Giovanni
Neuroendocrine tumors (NETs) are aggressive diseases developing from neuroendocrine cells that most frequently involve the gastro-entero-pancreatic tract and the lung, but more rarely are found in almost all body tissues. Limited biological and clinical data are currently available for NETs in uncommon sites, such as female genital tract. NETs represent 0.9% to 1.5% of the tumors of the uterine cervix. They are more likely to have lymph-vascular space invasion and lymph node involvement, and to develop local and distant relapses when compared with the mostly common cervical squamous cell carcinomas or adenocarcinomas...
January 2, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28046466/su-f-t-395-evaluation-of-best-dosimetry-achievable-with-vmat-and-imrt-treatment-techniques-targeting-borderline-resectable-pancreatic-cancer
#12
K Harpool, E Schnell, T Herman, S Ahmad, T De La Fuente Herman
PURPOSE: To determine from retrospective study the most appropriate technique for targeting small borderline operable pancreatic cancer surrounding blood vessels by evaluating the dosimetry and normal tissue sparing achievable using Volumetric Modulated Arc Therapy (VMAT) and Intensity Modulated Radiation Therapy (IMRT). METHODS: Treatment plans from ten patients who have undergone treatment with a prescribed dose of 4950 cGy, at 275 cGy per fraction, were analyzed...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28043760/endoscopic-ultrasonography-complements-computed-tomography-in-predicting-portal-or-superior-mesenteric-vein-resection-in-patients-with-borderline-resectable-pancreatic-carcinoma
#13
Evan S Glazer, Omar M Rashid, Jason B Klapman, Cynthia L Harris, Pamela J Hodul, Jose M Pimiento, Mokenge P Malafa
BACKGROUND: Current guidelines recommend computed tomographic (CT) scans for vascular staging of patients with pancreatic carcinoma; however, endoscopic ultrasonography (EUS) in these patients is not required and its utility in combination with CT scan is less well-defined. The purpose of this study is to explore the utility of EUS in addition to CT in identifying patients with borderline resectable pancreatic carcinoma (BRPC). METHODS: We reviewed our database of patients with BRPC who went to surgery with curative intent...
December 5, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28043693/preoperative-biliary-stenting-versus-operation-first-in-jaundiced-patients-due-to-malignant-lesions-in-the-pancreatic-head-a-meta-analysis-of-current-literature
#14
REVIEW
Florian Scheufele, Stephan Schorn, Ihsan Ekin Demir, Mine Sargut, Elke Tieftrunk, Lenika Calavrezos, Carsten Jäger, Helmut Friess, Güralp Onur Ceyhan
BACKGROUND: Obstructive jaundice is a common presenting symptom among patients with pancreatic cancer. While benefits of preoperative biliary drainage have been suggested by previous studies, recent evidence has shown no significant improvements of preoperative biliary drainage on the postoperative outcome but rather an increase of complications. There is no clear consensus on whether to treat malignant obstructive jaundice with preoperative biliary drainage prior to operative intervention or to proceed directly to resection...
December 30, 2016: Surgery
https://www.readbyqxmd.com/read/28042957/papanicolaou-society-of-cytopathology-new-guidelines-have-a-greater-ability-of-risk-stratification-for-pancreatic-endoscopic-ultrasound-guided-fine-needle-aspiration-specimens
#15
Bo Chen, Yu Zhao, Jiangang Gu, Huanwen Wu, Zhiyong Liang, Zhilan Meng
The Papanicolaou Society of Cytopathology has recently proposed a standardized terminology and nomenclature guidelines for pancreatic cytology. However the risk of malignancy associated with the new guidelines has been scarcely studied. In this study, a series of pancreatic cytology cases obtained by endoscopic ultrasound-guided fine-needle aspiration from 294 Chinese patients were retrospectively re-categorized into six categories according the new guidelines. The risks of malignancy were 18.1% for "negative," 20...
December 22, 2016: Oncotarget
https://www.readbyqxmd.com/read/28028930/an-update-on-cancer-risk-and-surveillance-in-primary-sclerosing-cholangitis
#16
Jennifer L Horsley-Silva, Eduardo A Rodriguez, Diana L Franco, Keith D Lindor
Malignancy represents substantial morbidity and mortality in patients with primary sclerosing cholangitis (PSC). This subset of patients has been proven to be at increased risk for developing cholangiocarcinoma, gallbladder carcinoma, and colorectal cancer in those with overlapping inflammatory bowel disease. Herein we review the prevalence of these malignancies and recommend screening tools and current knowledge to reduce the disease burden in this population. Cholangiocarcinoma is the most dominant malignancy affecting PSC patients, with a lifetime risk ranging from 5-20%...
December 27, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28025817/cost-effectiveness-of-metal-stents-in-relieving-obstructive-jaundice-in-patients-with-pancreatic-cancer
#17
J M Martinez, A Anene, T G K Bentley, M J Cangelosi, L M Meckley, J D Ortendahl, A J Montero
BACKGROUND: ASGE and ESGE guidelines recommend endoscopic metal stent placement for pancreatic carcinoma patients with biliary obstruction, and whose estimated life expectancy is greater than 6 months. Because median overall survival (OS) of metastatic pancreatic adenocarcinoma until recently has been less than 6 months, plastic biliary stents were preferentially placed rather than metal due to the greater upfront cost of the latter. Recent advances in the treatment of metastatic pancreatic cancer have extended median OS beyond the 6-month range...
December 27, 2016: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/28005639/pancreatic-uptake-by-18f-fdopa-pet-ct-in-patients-with-hypoglycemia-after-gastric-bypass-surgery-compared-with-controls-with-or-without-carbidopa-pretreatment
#18
André P van Beek, Loek J M de Heide, Bram van Ginkel, Riemer H J A Slart, Anouk N A van der Horst-Schrivers, Ronald Boellaard, Elisabeth G E de Vries, Walter Noordzij, Andor W J M Glaudemans
PURPOSE: The use of Fluorine-labeled dihydroxy-phenyl-alanine (F-FDOPA) PET/CT in patients with hypoglycemia suspected to be caused by pancreatic disease can be helpful to localize the source of excess insulin production. In this setting, carbidopa pretreatment is not recommended. However, quantitative comparisons of pancreatic tracer uptake in patients with or without carbidopa pretreatment and in diffuse pancreatic disease are lacking. Therefore, we aimed to describe and quantify pancreatic F-FDOPA uptake in patients without pancreatic disease with or without carbidopa pretreatment and in patients with hypoglycemia after gastric bypass surgery...
December 21, 2016: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28005258/pancreatic-cancer-management-and-treatment-landscape-awareness-of-gastroenterologists-results-from-us-physician-surveys-conducted-in-2013-and-2015
#19
Gregory D Salinas, Lee Whitworth, Patti Merwin, Joan Emarine
INTRODUCTION: In the US, gastroenterologists (GIs) often inform patients of the initial diagnosis of pancreatic cancer. Thus, GIs are frequently the first physicians to provide vital information regarding treatment strategies and options to patients which can have significant impact on subsequent clinical decision-making. Since treatments for pancreatic cancer are rapidly evolving, it may be challenging for GIs to maintain an adequate knowledge base required to provide accurate cursory information or avoid providing inaccurate data to patients at a very sensitive point in time in their care...
December 22, 2016: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/28003762/biomarkers-in-pancreatic-adenocarcinoma-current-perspectives
#20
REVIEW
Douglas S Swords, Matthew A Firpo, Courtney L Scaife, Sean J Mulvihill
Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis, with a 5-year survival rate of 7.7%. Most patients are diagnosed at an advanced stage not amenable to potentially curative resection. A substantial portion of this review is dedicated to reviewing the current literature on carbohydrate antigen (CA 19-9), which is currently the only guideline-recommended biomarker for PDAC. It provides valuable prognostic information, can predict resectability, and is useful in decision making about neoadjuvant therapy...
2016: OncoTargets and Therapy
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