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https://www.readbyqxmd.com/read/28318891/lessons-from-a-national-audit-of-acute-pancreatitis-a-summary-of-the-ncepod-report-treat-the-cause
#1
REVIEW
D A O'Reilly, S J McPherson, M T Sinclair, N Smith
The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) is an independent organisation whose remit is to review the quality of medical and surgical care provided in the United Kingdom. We undertook a review into the care provided to patients treated for acute pancreatitis during a 6 month study period between 1st January and 30th June 2014. This included assessment of care at an organisational level, clinical level within hospitals and external peer review. From a random sample, 712 patients underwent hospital clinician review and 418 patients had external peer review...
February 17, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28272344/nutritional-and-metabolic-derangements-in-pancreatic-cancer-and-pancreatic-resection
#2
REVIEW
Taylor M Gilliland, Nicole Villafane-Ferriol, Kevin P Shah, Rohan M Shah, Hop S Tran Cao, Nader N Massarweh, Eric J Silberfein, Eugene A Choi, Cary Hsu, Amy L McElhany, Omar Barakat, William Fisher, George Van Buren
Pancreatic cancer is an aggressive malignancy with a poor prognosis. The disease and its treatment can cause significant nutritional impairments that often adversely impact patient quality of life (QOL). The pancreas has both exocrine and endocrine functions and, in the setting of cancer, both systems may be affected. Pancreatic exocrine insufficiency (PEI) manifests as weight loss and steatorrhea, while endocrine insufficiency may result in diabetes mellitus. Surgical resection, a central component of pancreatic cancer treatment, may induce or exacerbate these dysfunctions...
March 7, 2017: Nutrients
https://www.readbyqxmd.com/read/28262458/early-management-of-acute-pancreatitis-a-review-of-the-best-evidence
#3
REVIEW
Serena Stigliano, Hanna Sternby, Enrique de Madaria, Gabriele Capurso, Maxim S Petrov
In the 20th century early management of acute pancreatitis often included surgical intervention, despite overwhelming mortality. The emergence of high-quality evidence (randomized controlled trials and meta-analyses) over the past two decades has notably shifted the treatment paradigm towards predominantly non-surgical management early in the course of acute pancreatitis. The present evidence-based review focuses on contemporary aspects of early management (which include analgesia, fluid resuscitation, antibiotics, nutrition, and endoscopic retrograde cholangiopancreatography) with a view to providing clear and succinct guidelines on early management of patients with acute pancreatitis in 2017 and beyond...
February 7, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28246469/restoration-of-energy-level-in-the-early-phase-of-acute-pediatric-pancreatitis
#4
REVIEW
Dóra Mosztbacher, Nelli Farkas, Margit Solymár, Gabriella Pár, Judit Bajor, Ákos Szűcs, József Czimmer, Katalin Márta, Alexandra Mikó, Zoltán Rumbus, Péter Varjú, Péter Hegyi, Andrea Párniczky
Acute pancreatitis (AP) is a serious inflammatory disease with rising incidence both in the adult and pediatric populations. It has been shown that mitochondrial injury and energy depletion are the earliest intracellular events in the early phase of AP. Moreover, it has been revealed that restoration of intracellular ATP level restores cellular functions and defends the cells from death. We have recently shown in a systematic review and meta-analysis that early enteral feeding is beneficial in adults; however, no reviews are available concerning the effect of early enteral feeding in pediatric AP...
February 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28193160/analysis-of-risk-factors-related-to-gastrointestinal-fistula-in-patients-with-severe-acute-pancreatitis-a-retrospective-study-of-344-cases-in-a-single-chinese-center
#5
Zhipeng Hua, Yongjie Su, Xuefeng Huang, Kang Zhang, Zhengyu Yin, Xiaoming Wang, Pingguo Liu
BACKGROUND: Gastrointestinal fistula (GIF) in severe acute pancreatitis (SAP) is considered as a sparse episode and studied sporadically in the literature. There is paucity of data on the prediction of the effect on risk of GIF in patient with SAP. This study was aimed to investigate risk factors related to GIF in the development of SAP. METHODS: The clinical data of 344 patients with SAP from 2011 to 2016 were reviewed retrospectively. All patients were divided into the GIF group and the non-GIF group, and their data analyzed with respect to 15 parameters were applied to explore potential risk factors for GIF in patients with SAP...
February 14, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28185886/macronutrient-intake-in-preschoolers-with-cystic-fibrosis-and-the-relationship-between-macronutrients-and-growth
#6
Stephanie S Filigno, Shannon M Robson, Rhonda D Szczesniak, Leigh A Chamberlin, Meredith A Baker, Stephanie M Sullivan, John Kroner, Scott W Powers
BACKGROUND: Adequate nutrition is essential for growth in children with cystic fibrosis (CF). The new CF Foundation Clinical Practice Guidelines bring attention to monitoring macronutrient intake as well as total energy. METHODS: Dietary intake of 75 preschool children with CF and pancreatic insufficiency was examined and compared to the Clinical Practice Guidelines. Regression analyses examined relationships between macronutrient intake and growth. RESULTS: Approximately 45% of children met the 110% minimum recommended dietary allowance (RDA) recommendation...
February 6, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28168570/early-enteral-nutrition-in-critically-ill-patients-esicm-clinical-practice-guidelines
#7
REVIEW
Annika Reintam Blaser, Joel Starkopf, Waleed Alhazzani, Mette M Berger, Michael P Casaer, Adam M Deane, Sonja Fruhwald, Michael Hiesmayr, Carole Ichai, Stephan M Jakob, Cecilia I Loudet, Manu L N G Malbrain, Juan C Montejo González, Catherine Paugam-Burtz, Martijn Poeze, Jean-Charles Preiser, Pierre Singer, Arthur R H van Zanten, Jan De Waele, Julia Wendon, Jan Wernerman, Tony Whitehouse, Alexander Wilmer, Heleen M Oudemans-van Straaten
PURPOSE: To provide evidence-based guidelines for early enteral nutrition (EEN) during critical illness. METHODS: We aimed to compare EEN vs. early parenteral nutrition (PN) and vs. delayed EN. We defined "early" EN as EN started within 48 h independent of type or amount. We listed, a priori, conditions in which EN is often delayed, and performed systematic reviews in 24 such subtopics. If sufficient evidence was available, we performed meta-analyses; if not, we qualitatively summarized the evidence and based our recommendations on expert opinion...
March 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28165542/nutritional-support-in-acute-pancreatitis-from-physiopathology-to-practice-an-evidence-based-approach
#8
E Rinninella, M G Annetta, M L Serricchio, A A Dal Lago, G A D Miggiano, M C Mele
Acute Pancreatitis (AP) is a potentially fatal syndrome, associated with a hyper-catabolic state as well as early and late complications that may lead to multi-organ failure and death. Clinical researches produced in recent years suggest that acute pancreatitis may benefit from early oral or enteral nutrition. Nevertheless, many clinicians still believe erroneously that fasting - particularly in the early phase - may reduce AP complications and mortality. The goal of our review is to demonstrate that such false belief may harm the patients and that the whole management paradigm must change, adopting a more rational, evidence-based approach...
January 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28154369/sham-feeding-with-chewing-gum-in-early-stage-of-acute-pancreatitis-a-randomized-clinical-trial
#9
Zongxing Jiang, Hongyin Liang, Zhu Huang, Jiajia Tang, Lijun Tang
BACKGROUND The correlation between sham feeding and acute pancreatitis (AP) has only been examined in limited studies. We aimed to investigate the efficacy and safety of sham feeding in the early stage of AP. MATERIAL AND METHODS A randomized controlled clinical trial was performed. Equal groups of AP patients were recruited. Patients in the sham feeding group received chewing gum 4 times a day after admission. All patients in the trial received standard treatment consistent with the guidelines for AP. The primary outcomes were mortality, length of stay (LOS), and medical expenses...
February 3, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28141617/nutritional-management-of-acute-pancreatitis
#10
Kumar Krishnan
PURPOSE OF REVIEW: Acute pancreatitis is one of the most common causes for hospitalization related to a gastrointestinal disorder. It carries significant morbidity, and when severe, significant mortality. Multiple interventions have been studied to treat pancreatitis. Of all these interventions, none is more important or impactful than nutrition. RECENT FINDINGS: High-quality evidence along with society guidelines have recommended the use of enteral nutrition over parenteral nutrition in patients with pancreatitis...
March 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28127200/impact-of-postoperative-glycemic-control-and-nutritional-status-on-clinical-outcomes-after-total-pancreatectomy
#11
Hao-Jun Shi, Chen Jin, De-Liang Fu
AIM: To evaluate the impact of glycemic control and nutritional status after total pancreatectomy (TP) on complications, tumor recurrence and overall survival. METHODS: Retrospective records of 52 patients with pancreatic tumors who underwent TP were collected from 2007 to 2015. A series of clinical parameters collected before and after surgery, and during the follow-up were evaluated. The associations of glycemic control and nutritional status with complications, tumor recurrence and long-term survival were determined...
January 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27994337/management-of-graft-duodenal-leak-in-simultaneous-pancreas-kidney-transplant-a-case-report-from-india-and-review-of-literature
#12
REVIEW
Sunil Kumar, Sarbpreet Singh, Deepesh Benjamin Kenwar, Manish Rathi, Sanjay Bhadada, Ashish Sharma, Vikas Gupta, Anil Bhansali, Anupam Lal, Mukut Minz
Pancreatic transplantation is currently the only effective cure for Type 1 diabetes mellitus. It allows long-term glycemic control without exogenous insulin and amelioration of secondary diabetic complications. In India, pancreas transplant has not yet established with only a single successful transplant reported so far in the literature. We report a 24-year-old Type 1 diabetic patient with renal failure who underwent a simultaneous pancreas kidney transplant. On postoperative day 15, he had leak from the graft duodenal stump for which a tube duodenostomy and proximal diversion enterostomy was done...
October 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/27921058/celiac-crisis-associated-with-herpes-simplex-virus-esophagitis
#13
Alan Chen, Christopher M Linz, Julie L Tsay, Ming Jin, Samer S El-Dika
Celiac crisis is a rare presentation of celiac disease that is characterized by life-threatening electrolyte abnormalities, vitamin and mineral deficiencies, and diarrhea. Triggers for celiac crisis include major surgeries, pancreatitis, and infections of cytomegalovirus, and salmonella. A 24-year-old woman presented with celiac crisis associated with severe herpes simplex virus (HSV) esophagitis. This case demonstrates that nutritional deficiencies seen in celiac disease can result in a relative immunodeficiency, which may lead to other infectious complications...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27875754/the-impact-of-diet-and-arginine-supplementation-on-pancreatic-mass-digestive-enzyme-activity-and-insulin-containing-cell-cluster-morphology-during-the-estrous-cycle-in-sheep
#14
F E Keomanivong, A T Grazul-Bilska, D A Redmer, C S Bass, S L Kaminski, P P Borowicz, J D Kirsch, K C Swanson
To determine the effect of feed intake and arginine treatment during different stages of the estrous cycle on pancreatic mass, digestive enzyme activity, and histological measurements, ewes (n = 120) were randomly allocated to 1 of 3 dietary groups; control (CON; 2.14-Mcal metabolizable energy/kg), underfed (UF; 0.6 × CON), or overfed (OF; 2 × CON) over 2 yr. Estrus was synchronized using a controlled internal drug release device for 14 d. At controlled internal drug release withdrawal, ewes from each dietary group were assigned to 1 of 2 treatments; Arg (L-Arg HCl, 155-μmol/kg BW) or Sal (approximately 10-mL saline)...
October 21, 2016: Domestic Animal Endocrinology
https://www.readbyqxmd.com/read/27812517/a-study-on-the-dietary-intake-and-the-nutritional-status-among-the-pancreatic-cancer-surgical-patients
#15
Jimin Kang, Joon Seong Park, Dong Sup Yoon, Woo Jeong Kim, Hae-Yun Chung, Song Mi Lee, Namsoo Chang
The adequate dietary intake is important to maintain the nutritional status of the patients after pancreatic cancer surgery. This prospective study was designed to investigate the dietary intake and the nutritional status of the patients who had pancreatic cancer surgery. Thirty-one patients (15 men, 16 women) were enrolled and measured body weight, body mass index (BMI), nutritional risk index (NRI), and Malnutrition Universal Screening Tool (MUST). Actual oral intake with nutritional impact symptoms recorded on the clinical research foam at every meal and medical information were collected from electronic medical charts...
October 2016: Clinical Nutrition Research
https://www.readbyqxmd.com/read/27778325/a-possible-link-between-famine-exposure-in-early-life-and-future-risk-of-gastrointestinal-cancers-implications-from-age-period-cohort-analysis
#16
Shao-Hua Xie, Jesper Lagergren
The Chinese famine in 1958-1962 was one of the worst in human history, but its potential influence on cancer risks is uncertain. Using cancer incidence data in Shanghai, China, during 1983-2007, we calculated age-specific incidence rates of gastrointestinal cancers in birth cohorts exposed to the Chinese famine in different periods of life and a non-exposed reference cohort. Age-period-cohort regressions estimated the overall relative risks of gastrointestinal cancers in each birth cohort. A total of 212,098 new cases of gastrointestinal cancer were identified during the study period (129,233 males and 82,865 females), among whom 18,146 had esophageal cancer, 71,011 gastric cancer, 55,864 colorectal cancer, 42,751 liver cancer, 9,382 gallbladder cancer and 14,944 had pancreatic cancer...
February 1, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/27775609/meta-analysis-of-early-nutrition-the-benefits-of-enteral-feeding-compared-to-a-nil-per-os-diet-not-only-in-severe-but-also-in-mild-and-moderate-acute-pancreatitis
#17
Katalin Márta, Nelli Farkas, Imre Szabó, Anita Illés, Áron Vincze, Gabriella Pár, Patrícia Sarlós, Judit Bajor, Ákos Szűcs, József Czimmer, Dóra Mosztbacher, Andrea Párniczky, Kata Szemes, Dániel Pécsi, Péter Hegyi
The recently published guidelines for acute pancreatitis (AP) suggest that enteral nutrition (EN) should be the primary therapy in patients suffering from severe acute pancreatitis (SAP); however, none of the guidelines have recommendations on mild and moderate AP (MAP). A meta-analysis was performed using the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P). The following PICO (problem, intervention, comparison, outcome) was applied: P: nutrition in AP; I: enteral nutrition (EN); C: nil per os diet (NPO); and O: outcome...
October 20, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27673710/the-etiology-and-clinical-course-of-chronic-pancreatitis-in-children-with-early-onset-of-the-disease
#18
Karolina Wejnarska, Elwira Kolodziejczyk, Katarzyna Wertheim-Tysarowska, Maciej Dadalski, Agnieszka Sobczynska-Tomaszewska, Jarosław Kierkus, Jerzy Bal, Agnieszka Magdalena Rygiel, Grzegorz Oracz
OBJECTIVES: The etiological factors of chronic pancreatitis (CP) in children differ from those in adults. To date, no study has assessed the clinical course of CP in young children. The aim of our study was to evaluate the etiology and the clinical presentation of the disease in children with disease onset before 5 years of age in comparison to later-onset of CP. METHODS: A total of 276 children with CP, hospitalized from 1988 to 2015, were enrolled in the study...
December 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27549125/the-clinical-value-of-adipokines-in-predicting-the-severity-and-outcome-of-acute-pancreatitis
#19
MULTICENTER STUDY
Andrius Karpavicius, Zilvinas Dambrauskas, Audrius Gradauskas, Arturas Samuilis, Kristina Zviniene, Juozas Kupcinskas, Gintautas Brimas, Artur Meckovski, Audrius Sileikis, Kestutis Strupas
BACKGROUND: Recent data shows that patients with severe acute pancreatic might benefit from early intensive therapy, enteral nutrition and timely transfer to specialized centers. The early prophylactic use of antibiotics in AP remains controversial. The role and need for new markers in stratification of acute pancreatitis is also uncertain. This study aims to evaluate the prognostic usefulness of adipokines in prediction of the severity and outcome of acute pancreatitis (AP). METHODS: Prospective study was conducted in four clinical centers...
August 22, 2016: BMC Gastroenterology
https://www.readbyqxmd.com/read/27529811/brief-neonatal-nutritional-supplementation-has-sex-specific-effects-on-glucose-tolerance-and-insulin-regulating-genes-in-juvenile-lambs
#20
Anne L Jaquiery, Sharon S Park, Hui Hui Phua, Mary J Berry, Daphne Meijler, Jane E Harding, Mark H Oliver, Frank H Bloomfield
BACKGROUND: The nutritional plane and composition during fetal life can impact upon growth and epigenetic regulation of genes affecting pancreatic β-cell development and function. However, it is not clear whether β-cell development can be altered by nutritional factors or growth rate after birth. We therefore investigated the effect of neonatal nutritional supplements on growth, glucose tolerance, and pancreatic development in lambs. METHODS: Newborn lambs were randomized to daily nutritional supplements, calculated to increase macronutrient intake to a similar degree as human breast milk fortifier, or an equivalent volume of water, for 2 wk while continuing to suckle ewe milk...
December 2016: Pediatric Research
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