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https://www.readbyqxmd.com/read/28079861/endoscopic-vs-surgical-interventions-for-painful-chronic-pancreatitis-what-is-needed-for-future-clinical-trials
#1
REVIEW
John A Windsor, Nageshwar D Reddy
The treatment of painful chronic pancreatitis remains controversial. The available evidence from two randomized controlled trials favor surgical intervention, whereas an endotherapy-first approach is widely practiced. Chronic pancreatitis is complex disease with different genetic and environmental factors, different pain mechanisms and different treatment modalities including medical, endoscopic, and surgical. The widely practiced step-up approach remains unproven. In designing future clinical trials there are some important pre-requisites including a more comprehensive pain assessment tool, the optimization of conservative medical treatment and interventional techniques...
January 12, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28079345/towards-reducing-the-risk-of-new-onset-diabetes-after-pancreatitis
#2
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/28078430/blood-urea-nitrogen-to-serum-creatinine-ratio-is-an-accurate-predictor-of-outcome-in-diarrhea-associated-hemolytic-uremic-syndrome-a-preliminary-study
#3
Werner Keenswijk, Jill Vanmassenhove, Ann Raes, Evelyn Dhont, Johan Vande Walle
: Diarrhea-associated hemolytic uremic syndrome (D+HUS) is a common thrombotic microangiopathy during childhood and early identification of parameters predicting poor outcome could enable timely intervention. This study aims to establish the accuracy of BUN-to-serum creatinine ratio at admission, in addition to other parameters in predicting the clinical course and outcome. Records were searched for children between 1 January 2008 and 1 January 2015 admitted with D+HUS. A complicated course was defined as developing one or more of the following: neurological dysfunction, pancreatitis, cardiac or pulmonary involvement, hemodynamic instability, and hematologic complications while poor outcome was defined by death or development of chronic kidney disease...
January 11, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28078128/endoscopic-ultrasound-in-pancreatic-cancer-innovative-applications-beyond-the-basics
#4
REVIEW
Joseph Yoo, C Andrew Kistler, Linda Yan, Andrew Dargan, Ali A Siddiqui
Endoscopic ultrasound (EUS) has become a mainstay in assisting in the diagnosis and staging of pancreatic cancer. In addition, EUS provides a modality to treat chronic pain through celiac plexus neurolysis. Currently, there is growing data and utilization of EUS in more diverse and innovative applications aimed at providing more sophisticated diagnostic, prognostic and therapeutic options for patients with pancreatic cancer. EUS delivery of chemotherapy, viral and biological vectors and fiducial markers may eventually revolutionize the way clinicians approach the care of a patient with pancreatic cancer...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28075452/a-novel-pathway-in-nsclc-cells-mir%C3%A2-191-targeting-nfia-is-induced-by-chronic-hypoxia-and-promotes-cell-proliferation-and-migration
#5
Jia Zhao, Cheng-Rui Qiao, Zheng Ding, Yin-Liang Sheng, Xiang-Nan Li, Yang Yang, Deng-Yan Zhu, Chun-Yang Zhang, Dong-Lei Liu, Kai Wu, Song Zhao
MicroRNAs (miRs) have emerged as being important in cancer biology. miR‑191 is a conserved miRNA, which has been investigated in detail and is reported to be induced by hypoxia-inducible factor (HIF)‑1α and has an contributory action in the progression of breast, hepatic and pancreatic cancer. However, the effects of miR‑191 in the progression of lung cancer are a subject of debate. In the present study, it was found that the expression of miR-191 was significantly upregulated in non‑small cell lung cancer (NSCLC) cells in patients in vivo...
January 4, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28075092/diabetes-mellitus-management-of-gastrointestinal-complications
#6
Beth Careyva, Brian Stello
Gastrointestinal disorders are common complications of diabetes mellitus and include gastroparesis, nonalcoholic fatty liver disease, gastroesophageal reflux disease, and chronic diarrhea. Symptoms of gastroparesis include early satiety, postprandial fullness, nausea, vomiting of undigested food, bloating, and abdominal pain. Gastroparesis is diagnosed based on clinical symptoms and a delay in gastric emptying in the absence of mechanical obstruction. Gastric emptying scintigraphy is the preferred diagnostic test...
December 15, 2016: American Family Physician
https://www.readbyqxmd.com/read/28074846/novel-blood-based-microrna-biomarker-panel-for-early-diagnosis-of-chronic-pancreatitis
#7
Lei Xin, Jun Gao, Dan Wang, Jin-Huan Lin, Zhuan Liao, Jun-Tao Ji, Ting-Ting Du, Fei Jiang, Liang-Hao Hu, Zhao-Shen Li
Chronic pancreatitis (CP) is an inflammatory disease characterized by progressive fibrosis of pancreas. Early diagnosis will improve the prognosis of patients. This study aimed to obtain serum miRNA biomarkers for early diagnosis of CP. In the current study, we analyzed the differentially expressed miRNAs (DEmiRs) of CP patients from Gene Expression Omnibus (GEO), and the DEmiRs in plasma of early CP patients (n = 10) from clinic by miRNA microarrays. Expression levels of DEmiRs were further tested in clinical samples including early CP patients (n = 20), late CP patients (n = 20) and healthy controls (n = 18)...
January 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28073869/pancreatic-lymphoma-complicating-early-stage-chronic-hepatitis-c
#8
Vicky H Bhagat, Thomas Sepe
Hepatitis C virus (HCV) infection has also been associated with many extrahepatic manifestations including the development of B-cell non-Hodgkin's lymphoma (NHL). Primary pancreatic lymphoma is very rare and comprises 2.2% of NHL and 4.9% of all pancreatic malignancies. Our patient was a woman with a history of infection with HCV found to have a mass in the head of the pancreas. Biopsy of the mass revealed a high-grade B-cell lymphoma consistent with Burkitt's lymphoma. Our case reflects a need to initiate antiviral therapy for all patients infected with HCV even in early stages of fibrosis to prevent cirrhosis and other extrahepatic manifestations of infection with HCV...
January 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28071655/effectiveness-of-guideline-recommended-cholecystectomy-to-prevent-recurrent-pancreatitis
#9
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/28069865/interleukin-22-restored-mitochondrial-damage-and-impaired-glucose-stimulated-insulin-secretion-through-down-regulation-of-uncoupling-protein-2-in-ins-1-cells
#10
Minling Hu, Hanxiao Lin, Li Yang, Yanzhen Cheng, Hua Zhang
Defective glucose-stimulated insulin secretion (GSIS) induced by chronic exposure to fatty acids is a hallmark of type 2 diabetes (T2D). Interleukin-22 (IL-22) has been shown to exert beneficial effects on insulin secretion and to protect pancreatic β-cells from stress. Moreover, uncoupling protein-2 (UCP-2) plays a central role in the regulation of GSIS and β-cell dysfunction, whereas the role of UCP-2 in IL-22-enhanced glycemic control under conditions of lipotoxicity remains unclear. In this present study, we investigated the effects of IL-22 on rat insulin-secreting cells (INS-1 cells) and the mechanisms that underlie IL-22 and lipotoxicity-impaired GSIS in vitro...
January 7, 2017: Journal of Biochemistry
https://www.readbyqxmd.com/read/28069287/feline-cholangitis
#11
REVIEW
Lara Boland, Julia Beatty
Cholangitis is common in felines, including neutrophilic, lymphocytic, and chronic cholangitis (liver fluke). History, physical examination, laboratory testing, and abdominal ultrasound support a diagnosis. Diagnosis using hepatic histopathology and/or bile analysis is ideal but not always practical. Neutrophilic cholangitis is associated with bacterial cholecystitis, pancreatitis, and inflammatory bowel disease. The typical presentation is a short illness with lethargy, inappetence, pyrexia, and jaundice. Lymphocytic cholangitis, suspected to be immune-mediated, can have a prolonged clinical course with weight loss and ascites as the predominant features...
January 6, 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/28067794/the-tgf-%C3%AE-smad4-signaling-pathway-in-pancreatic-carcinogenesis-and-its-clinical-significance
#12
REVIEW
Sunjida Ahmed, Azore-Dee Bradshaw, Shweta Gera, M Zahidunnabi Dewan, Ruliang Xu
Pancreatic ductal adenocarcinoma (PDAC) is one of the most fatal human cancers due to its complicated genomic instability. PDAC frequently presents at an advanced stage with extensive metastasis, which portends a poor prognosis. The known risk factors associated with PDAC include advanced age, smoking, long-standing chronic pancreatitis, obesity, and diabetes. Its association with genomic and somatic mutations is the most important factor for its aggressiveness. The most common gene mutations associated with PDAC include KRas2, p16, TP53, and Smad4...
January 5, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28065464/lipid-metabolism-in-patients-with-chronic-hyperglycemia-after-an-episode-of-acute-pancreatitis
#13
Nicola A Gillies, Sayali A Pendharkar, Ruma G Singh, Varsha M Asrani, Maxim S Petrov
BACKGROUND: The importance of dyslipidemia is well recognized in the context of both risk factor for acute pancreatitis and prognostic factor for its in-hospital outcomes. With a growing appreciation of post-pancreatitis diabetes mellitus, there is a need to catalogue changes in lipid metabolism after hospitalization due to an acute pancreatitis attack and their associations with glucose metabolism. OBJECTIVE: To investigate lipid metabolism in patients with impaired glucose homeostasis following acute pancreatitis...
December 23, 2016: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28065243/autoimmune-pancreatitis-typing-diagnosis-and-treatment
#14
Yi-Xiao Zhao, Hong Lü
Autoimmune pancreatitis (AIP),a special type of chronic pancreatitis,is autoimmune-mediated and can be accompanied by swelling of the pancreas and irregular stenosis of the pancreatic duct. The main pathological features are fibrosis of pancreatic duct with IgG4-positive lymphoplasmacytic infiltration. Different typing methods of AIP can have differerent disease conditions. This paper reviews the history,clinical presentation,diagnostic criteria,and treatment of different AIP types to provide a new basis for the diagnosis and treatment...
December 20, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28065242/advances-in-glycemic-characteristics-complications-and-treatment-for-patients-undergoing-total-pancreatectomy
#15
Ying Zhou, Wei-Gang Zhao
Total pancreatectomy has been mainly used to treat malignant diseases of the pancreas, di-ffuse ductal involvement, and severe chronic pancreatitis. Patients may develop pancreatic diabetes after the surgery, in whom the glucose levels fluctuate widely and are hard to control, which increases the incidence of recurrent hypoglycemia. Postoperative complications are closely associated with the glucose levels. Thus, tighter glycemic management is essential for increasing the survival of these patients. Few cases have been discribed in China...
December 20, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28062871/-chronic-diarrhea-in-the-diabetic-a-review-of-the-literature
#16
Juan Sebastián Frías Ordoñez, William Otero Regino
The association of diarrhea with diabetes mellitus has been known for more than 70 years. In diabetic patients its prevalence is around 20%.Its clinical manifestations are diverse, and represents a diagnostic and therapeutic challenge.There are certain diagnoses of higher prevalence in diabetic patients than in the general population.The different related etiologies can be adequately diagnosed through the clinical history and complementary diagnostic tests.The medications used by the diabetic patient to manage their disease often cause chronic diarrhea, so the pharmacological background should be studied at the time of the study of diarrhea...
October 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28062312/incidence-and-risk-factors-for-post-ercp-pancreatitis-in-chronic-pancreatitis
#17
Zhen-Hua Zhao, Liang-Hao Hu, Hong-Bo Ren, An-Jing Zhao, Yang-Yang Qian, Xiao-Tian Sun, Song Su, Shu-Guang Zhu, Jin Yu, Wen-Bin Zou, Xiao-Rong Guo, Lei Wang, Zhao-Shen Li, Zhuan Liao
BACKGROUND AND AIMS: Almost all studies on post-ERCP pancreatitis (PEP) have mainly involved patients with biliary diseases, rather than chronic pancreatitis; and the concept that chronic pancreatitis (CP) seems to be a protective factor associated with PEP has not been studied in detail. The aim of this study was to determine the incidence of PEP in patients with CP at different clinical stages and to identify the predictive and protective factors of PEP in a large cohort. METHODS: This is an observational cohort study...
January 3, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28061324/oral-corticosterone-administration-reduces-insulitis-but-promotes-insulin-resistance-and-hyperglycemia-in-male-nonobese-diabetic-mice
#18
Susan J Burke, Heidi M Batdorf, Adrianna E Eder, Michael D Karlstad, David H Burk, Robert C Noland, Z Elizabeth Floyd, J Jason Collier
Steroid-induced diabetes is the most common form of drug-induced hyperglycemia. Therefore, metabolic and immunological alterations associated with chronic oral corticosterone were investigated using male nonobese diabetic mice. Three weeks after corticosterone delivery, there was reduced sensitivity to insulin action measured by insulin tolerance test. Body composition measurements revealed increased fat mass and decreased lean mass. Overt hyperglycemia (>250 mg/dL) manifested 6 weeks after the start of glucocorticoid administration, whereas 100% of the mice receiving the vehicle control remained normoglycemic...
January 3, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28060789/the-long-term-prospective-follow-up-of-pancreatic-function-after-the-first-episode-of-acute-alcoholic-pancreatitis-recurrence-predisposes-one-to-pancreatic-dysfunction-and-pancreatogenic-diabetes
#19
Jussi Nikkola, Johanna Laukkarinen, Jorma Lahtela, Hanna Seppänen, Satu Järvinen, Isto Nordback, Juhani Sand
BACKGROUND: Data on the prevalence of pancreatic dysfunction after an episode of acute pancreatitis are conflicting. Our aim was to evaluate the natural course of endocrine and exocrine pancreatic function in the long-term follow-up after the first episode of acute alcoholic pancreatitis (AAP). METHODS: A total of 77 patients who survived their first episode of AAP between January 2001 and February 2005 were prospectively followed up for a maximum of 13 years. During the follow-up, patients were repeatedly interviewed and monitored for recurrences, new diabetes, and chronic pancreatitis...
February 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28060763/comparison-of-the-tumor-cell-secretome-and-patient-sera-for-an-accurate-serum-based-diagnosis-of-pancreatic-ductal-adenocarcinoma
#20
Shakhawan Mustafa, Longqiang Pan, Aseel Marzoq, Malak Fawaz, Laureen Sander, Felix Rückert, Andrea Schrenk, Christina Hartl, Rico Uhler, Adem Yildirim, Oliver Strobel, Thilo Hackert, Nathalia Giese, Markus W Büchler, Jörg D Hoheisel, Mohamed Saiel Saeed Alhamdani
Pancreatic cancer is the currently most lethal malignancy. Toward an accurate diagnosis of the disease in body liquids, we studied the protein composition of the secretomes of 16 primary and established cell lines of pancreatic ductal adenocarcinoma (PDAC). Compared to the secretome of non-tumorous cells, 112 proteins exhibited significantly different abundances. Functionally, the proteins were associated with PDAC features, such as decreased apoptosis, better cell survival and immune cell regulation. The result was compared to profiles obtained from 164 serum samples from two independent cohorts - a training and a test set - of patients with PDAC or chronic pancreatitis and healthy donors...
January 2, 2017: Oncotarget
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