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Pancreatic enzyme replacement

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https://www.readbyqxmd.com/read/28099252/the-role-of-pancreatic-enzyme-replacement-therapy-in-unresectable-pancreatic-cancer-a-prospective-cohort-study
#1
Tomotaka Saito, Kenji Hirano, Hiroyuki Isayama, Yousuke Nakai, Kei Saito, Gyotane Umefune, Dai Akiyama, Takeo Watanabe, Kaoru Takagi, Tsuyoshi Hamada, Naminatsu Takahara, Rie Uchino, Suguru Mizuno, Hirofumi Kogure, Saburo Matsubara, Natsuyo Yamamoto, Minoru Tada, Kazuhiko Koike
OBJECTIVES: Although patients with pancreatic cancer (PC) are prone to exocrine pancreatic insufficiency, there are few evidences about pancreatic enzyme replacement therapy (PERT) in patients with PC, especially those receiving chemotherapy. METHODS: This is a prospective consecutive observational study of PERT in patients with unresectable PC. We prospectively enrolled patients receiving chemotherapy for unresectable PC from April 2012 to February 2014 and prescribed oral pancrelipase of 48,000 lipase units per meal (pancrelipase group)...
January 18, 2017: Pancreas
https://www.readbyqxmd.com/read/28004474/gastrointestinal-dysmotility-and-pancreatic-insufficiency-in-2-siblings-with-donohue-syndrome
#2
Eirini Kostopoulou, Pratik Shah, Noman Ahmad, Robert Semple, Khalid Hussain
Donohue syndrome is a rare congenital syndrome of insulin-resistance and abnormal glucose homeostasis, caused by mutations in the insulin receptor (INSR) gene. It is characterized by specific phenotypic and clinical features and the diagnosis is based on clinical, biochemical and genetic criteria. We report 2 siblings with Donohue syndrome (cases 1, 2) with multiple clinical and biochemical characteristics. Both patients shared the same mutation and presented with intra-uterine growth restriction, failure to thrive, fasting hyperinsulinaemic hypoglycaemia and episodic post-prandial hyperglycaemia...
December 22, 2016: Pediatric Diabetes
https://www.readbyqxmd.com/read/27992105/cyclobutanone-analogues-of-%C3%AE-lactam-antibiotics-%C3%AE-lactamase-inhibitors-with-untapped-potential
#3
Prarthana Devi, Peter J Rutledge
β-Lactam antibiotics have been used for many years to treat bacterial infections. However the effective treatment of an increasing range of microbial infections is threatened by bacterial resistance to β-lactams: the prolonged, widespread and at times reckless use of these drugs has spawned widespread resistance, which renders them ineffective against many bacterial strains. The cyclobutanone ring system is isosteric with β-lactam: in cyclobutanone analogues, the eponymous cyclic amide is replaced with an all-carbon ring, the amide N substituted by a tertiary C-H α to a ketone...
December 19, 2016: Chembiochem: a European Journal of Chemical Biology
https://www.readbyqxmd.com/read/27988026/-assessment-of-amylase-and-lipase-levels-following-puncture-biopsy-and-fine-needle-aspiration-guided-by-endoscopic-ultrasound-in-pancreatic-lesions
#4
Alejandro Membrillo-Romero, Rubén Gonzalez-Lanzagorta, Dulce María Rascón-Martínez
BACKGROUND: Puncture biopsy and fine needle aspiration guided by endoscopic ultrasound has been used as an effective technique and is quickly becoming the procedure of choice for diagnosis and staging in patients suspected of having pancreatic cancer. This procedure has replaced retrograde cholangiopancreatography and brush cytology due to its higher sensitivity for diagnosis, and lower risk of complications. OBJECTIVE: To assess the levels of pancreatic enzymes amylase and lipase, after the puncture biopsy and fine needle aspiration guided by endoscopic ultrasound in pancreatic lesions and the frequency of post-puncture acute pancreatitis...
December 14, 2016: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/27941156/efficacy-of-pancreatic-enzyme-replacement-therapy-in-chronic-pancreatitis-systematic-review-and-meta-analysis
#5
Daniel de la Iglesia-García, Wei Huang, Peter Szatmary, Iria Baston-Rey, Jaime Gonzalez-Lopez, Guillermo Prada-Ramallal, Rajarshi Mukherjee, Quentin M Nunes, J Enrique Domínguez-Muñoz, Robert Sutton
OBJECTIVE: The benefits of pancreatic enzyme replacement therapy (PERT) in chronic pancreatitis (CP) are inadequately defined. We have undertaken a systematic review and meta-analysis of randomised controlled trials of PERT to determine the efficacy of PERT in exocrine pancreatic insufficiency (EPI) from CP. DESIGN: Major databases were searched from 1966 to 2015 inclusive. The primary outcome was coefficient of fat absorption (CFA). Effects of PERT versus baseline and versus placebo, and of different doses, formulations and schedules were determined...
December 9, 2016: Gut
https://www.readbyqxmd.com/read/27878805/pancreatic-enzyme-replacement-therapy-for-people-with-cystic-fibrosis
#6
REVIEW
Usha Rani Somaraju, Arturo Solis-Moya
BACKGROUND: Most people with cystic fibrosis (80% to 90%) need pancreatic enzyme replacement therapy to prevent malnutrition. Enzyme preparations need to be taken whenever food is taken, and the dose needs to be adjusted according to the food consumed. A systematic review on the efficacy and safety of pancreatic enzyme replacement therapy is needed to guide clinical practice, as there is variability between centres with respect to assessment of pancreatic function, time of commencing treatment, dose and choice of supplements...
23, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27825371/effective-and-safe-proton-pump-inhibitor-therapy-in-acid-related-diseases-a-position-paper-addressing-benefits-and-potential-harms-of-acid-suppression
#7
EDITORIAL
Carmelo Scarpignato, Luigi Gatta, Angelo Zullo, Corrado Blandizzi
BACKGROUND: The introduction of proton pump inhibitors (PPIs) into clinical practice has revolutionized the management of acid-related diseases. Studies in primary care and emergency settings suggest that PPIs are frequently prescribed for inappropriate indications or for indications where their use offers little benefit. Inappropriate PPI use is a matter of great concern, especially in the elderly, who are often affected by multiple comorbidities and are taking multiple medications, and are thus at an increased risk of long-term PPI-related adverse outcomes as well as drug-to-drug interactions...
November 9, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27798670/prospective-multicentre-nationwide-clinical-data-from-600-cases-of-acute-pancreatitis
#8
Andrea Párniczky, Balázs Kui, Andrea Szentesi, Anita Balázs, Ákos Szűcs, Dóra Mosztbacher, József Czimmer, Patrícia Sarlós, Judit Bajor, Szilárd Gódi, Áron Vincze, Anita Illés, Imre Szabó, Gabriella Pár, Tamás Takács, László Czakó, Zoltán Szepes, Zoltán Rakonczay, Ferenc Izbéki, Judit Gervain, Adrienn Halász, János Novák, Stefan Crai, István Hritz, Csaba Góg, János Sümegi, Petra Golovics, Márta Varga, Barnabás Bod, József Hamvas, Mónika Varga-Müller, Zsuzsanna Papp, Miklós Sahin-Tóth, Péter Hegyi
OBJECTIVE: The aim of this study was to analyse the clinical characteristics of acute pancreatitis (AP) in a prospectively collected, large, multicentre cohort and to validate the major recommendations in the IAP/APA evidence-based guidelines for the management of AP. DESIGN: Eighty-six different clinical parameters were collected using an electronic clinical research form designed by the Hungarian Pancreatic Study Group. PATIENTS: 600 adult patients diagnosed with AP were prospectively enrolled from 17 Hungarian centres over a two-year period from 1 January 2013...
2016: PloS One
https://www.readbyqxmd.com/read/27726974/pancreatic-exocrine-insufficiency-after-pancreaticoduodenectomy-is-more-prevalent-with-pancreaticogastrostomy-than-with-pancreaticojejunostomy-a-retrospective-multicentre-observational-cohort-study
#9
Geert Roeyen, Miet Jansen, Laure Ruyssinck, Thiery Chapelle, Aude Vanlander, Bart Bracke, Vera Hartman, Dirk Ysebaert, Frederik Berrevoet
OBJECTIVE: Recently, pancreaticogastrostomy (PG) has attracted renewed interest as a reconstruction technique after pancreaticoduodenectomy (PD), as it may imply a lower risk of clinical pancreatic fistula than reconstruction by pancreaticojejunostomy (PJ). We hypothesise that pancreatic exocrine insufficiency (PEI) is more common during clinical follow-up after PG than it is after PJ. RESEARCH DESIGN AND METHODS: This study compares the prevalence of PEI in patients undergoing PD for malignancy with reconstruction by PG versus reconstruction by PJ...
December 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27709245/cystic-fibrosis-a-clinical-view
#10
REVIEW
Carlo Castellani, Baroukh M Assael
Cystic fibrosis (CF), a monogenic disease caused by mutations in the CFTR gene on chromosome 7, is complex and greatly variable in clinical expression. Airways, pancreas, male genital system, intestine, liver, bone, and kidney are involved. The lack of CFTR or its impaired function causes fat malabsorption and chronic pulmonary infections leading to bronchiectasis and progressive lung damage. Previously considered lethal in infancy and childhood, CF has now attained median survivals of 50 years of age, mainly thanks to the early diagnosis through neonatal screening, recognition of mild forms, and an aggressive therapeutic attitude...
January 2017: Cellular and Molecular Life Sciences: CMLS
https://www.readbyqxmd.com/read/27689193/should-we-investigate-gastroenterology-patients-for-pancreatic-exocrine-insufficiency-a-dual-centre-uk-study
#11
Jennifer A Campbell, David S Sanders, Katherine A Francis, Matthew Kurien, Sai Lee, Hatim Taha, Arvind Ramadas, Diamond Joy, Andrew D Hopper
BACKGROUND AND AIMS: Pancreatic exocrine insufficiency may be under recognised in gastroenterological practice. We aimed to identify the prevalence of pancreatic insufficiency in secondary care gastroenterology clinics and determine if co-morbidity or presenting symptoms could predict diagnosis. A secondary aim was to assess response to treatment. METHODS: A dual centre retrospective analysis was conducted in secondary care gastroenterology clinics. Patients tested for pancreatic exocrine insufficiency with faecal elastase-1 (FEL-1) between 2009 and 2013 were identified in two centres...
September 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/27623555/the-pancreatic-duct-ligated-mini-pig-as-a-model-for-pancreatic-exocrine-insufficiency-in-man
#12
Peter Colin Gregory, Katrin Hoffmann, Josef Kamphues, Anne Möeler
Modern therapy of pancreatic exocrine insufficiency (PEI) using pancreatic enzyme replacement therapy (PERT) has largely been very effective and has greatly helped in improving the nutritional status of patients with PEI and in increasing the life expectancy in cystic fibrosis. It is believed that the use of predictable large animal models could play an important role in assessing and developing new therapies. This article reviews the pancreatic duct ligated (adult) minipig as a chronic model of total PEI, with a detailed look at the influence of PEI and response to PERT on prececal compared to fecal digestibility, to directly investigate effects on protein and starch digestion and absorption...
October 2016: Pancreas
https://www.readbyqxmd.com/read/27619808/natural-history-after-acute-necrotizing-pancreatitis-a-large-us-tertiary-care-experience
#13
Chandraprakash Umapathy, Amit Raina, Shreyas Saligram, Gong Tang, Georgios I Papachristou, Mordechai Rabinovitz, Jennifer Chennat, Herbert Zeh, Amer H Zureikat, Melissa E Hogg, Kenneth K Lee, Melissa I Saul, David C Whitcomb, Adam Slivka, Dhiraj Yadav
BACKGROUND: Most studies of acute necrotizing pancreatitis (ANP) focus on short-term outcomes. We evaluated long-term survival and outcomes following ANP. METHODS: Patients treated for ANP at the University of Pittsburgh Medical Center from 2001 to 2008 were studied. Data on presentation and course during initial hospitalization and follow-up (median 34 months) was extracted. RESULTS: Mean age of patients (n = 167) was 53 ± 16 years; 70 % were male, 94 % white, 71 % transfers, 52 % biliary etiology, and 78 % had first-attack of acute pancreatitis...
November 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27602238/management-of-pain-in-chronic-pancreatitis-with-emphasis-on-exogenous-pancreatic-enzymes
#14
REVIEW
Paul M Hobbs, William G Johnson, David Y Graham
One of the most challenging issues arising in patients with chronic pancreatitis is the management of abdominal pain. Many competing theories exist to explain pancreatic pain including ductal hypertension from strictures and stones, increased interstitial pressure from glandular fibrosis, pancreatic neuritis, and ischemia. This clinical problem is superimposed on a background of reduced enzyme secretion and altered feedback mechanisms. Throughout history, investigators have used these theories to devise methods to combat chronic pancreatic pain including: Lifestyle measures, antioxidants, analgesics, administration of exogenous pancreatic enzymes, endoscopic drainage procedures, and surgical drainage and resection procedures...
August 6, 2016: World Journal of Gastrointestinal Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27546383/drug-therapies-for-reducing-gastric-acidity-in-people-with-cystic-fibrosis
#15
REVIEW
Sze May Ng, Helen S Moore
BACKGROUND: Malabsorption of fat and protein contributes to poor nutritional status in people with cystic fibrosis. Impaired pancreatic function may also result in increased gastric acidity, leading in turn to heartburn, peptic ulcers and the impairment of oral pancreatic enzyme replacement therapy. The administration of gastric acid-reducing agents has been used as an adjunct to pancreatic enzyme therapy to improve absorption of fat and gastro-intestinal symptoms in people with cystic fibrosis...
August 22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27522847/digestive-enzyme-replacement-therapy-pancreatic-enzymes-and-lactase
#16
Rhea Faye D Felicilda-Reynaldo, Maria Kenneally
Maldigestion occurs when digestive enzymes are lacking to help break complex food components into absorbable nutrients within the gastrointestinal tract. Education is needed to help patients manage the intricacies of digestive enzyme replacement therapies and ensure their effectiveness in reducing symptoms of maldigestion.
May 2016: Medsurg Nursing: Official Journal of the Academy of Medical-Surgical Nurses
https://www.readbyqxmd.com/read/27518039/novel-ciliate-lipases-for-enzyme-replacement-during-exocrine-pancreatic-insufficiency
#17
Alexander Brock, Ingo Aldag, Stella Edskes, Marcus Hartmann, Torsten Herzog, Waldemar Uhl, Juergen Schnekenburger
AIM AND OBJECTIVES: Exocrine pancreatic insufficiency caused by inflammation or pancreatic tumors results in nutrient malfunction by a lack of digestive enzymes and neutralization compounds. Despite satisfactory clinical results with current enzyme therapies, a normalization of fat absorption in patients is rare. An individualized therapy is required that includes high dosage of enzymatic units, usage of enteric coating, and addition of gastric proton pump inhibitors. The key goal to improve this therapy is to identify digestive enzymes with high activity and stability in the gastrointestinal tract...
November 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27459204/specificity-of-a-polyclonal-fecal-elastase-elisa-for-cela3
#18
Frank Ulrich Weiss, Christoph Budde, Markus M Lerch
INTRODUCTION: Elastase is a proteolytic pancreatic enzyme that passes through the gastrointestinal tract undergoing only limited degradation. ELISA tests to determine stool elastase concentrations have therefore been developed for the diagnosis of exocrine pancreatic insufficiency. Five different isoforms of pancreatic elastase (CELA1, CELA2A, CELA2B, CELA3A, CELA3B) are encoded in the human genome. We have investigated three different polyclonal antisera that are used in a commercial fecal elastase ELISA to determine their specificity for different pancreatic elastase isoforms...
2016: PloS One
https://www.readbyqxmd.com/read/27446865/prevalence-of-small-intestinal-bacterial-overgrowth-among-chronic-pancreatitis-patients-a-case-control-study
#19
Amelie Therrien, Simon Bouchard, Sacha Sidani, Mickael Bouin
Background. Patients with chronic pancreatitis (CP) exhibit numerous risk factors for the development of small intestinal bacterial overgrowth (SIBO). Objective. To determine the prevalence of SIBO in patients with CP. Methods. Prospective, single-centre case-control study conducted between January and September 2013. Inclusion criteria were age 18 to 75 years and clinical and radiological diagnosis of CP. Exclusion criteria included history of gastric, pancreatic, or intestinal surgery or significant clinical gastroparesis...
2016: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27425634/pancreatic-involvement-in-cystic-fibrosis
#20
Yesim Ozen Alahdab, Deniz G Duman
Cystic fibrosis (CF) is an important genetic disorder that usually manifests in early childhood. Better understanding and improved care of CF patients in our current practice with pancreatic enzyme replacement therapy and nutritional support has enabled physicians to see them more frequently from any age groups. After the lungs, pancreas is the most important organ involved with CF. Its most frequently affected component is the exocrine pancreas while endocrine functions may also be deranged. Parenchymal damage as acute or chronic pancreatitis may also develop...
December 2016: Minerva Medica
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