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Pancreatic enzyme replacement

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https://www.readbyqxmd.com/read/28935122/prevalence-of-exocrine-pancreatic-insufficiency-in-patients-with-chronic-pancreatitis-without-follow-up-pancr-evol-study
#1
Carlos Marra-Lopez Valenciano, Federico Bolado Concejo, Eva Marín Serrano, Judith Millastre Bocos, Emma Martínez-Moneo, Esperanza Pérez Rodríguez, María Francisco González, Andrés Del Pozo-García, Anaiansi Hernández Martín, Elena Labrador Barba, María Luisa Orera Peña, Enrique de-Madaria
BACKGROUND/OBJECTIVES: Exocrine pancreatic insufficiency (EPI) is an important complication of chronic pancreatitis (CP). Guidelines recommend to rule out EPI in CP, to detect those patients who would benefit from pancreatic enzyme replacement therapy. The aim of this study was to evaluate the prevalence of EPI in patients with CP without follow-up in the last 2 years and to describe their nutritional status and quality of life (QoL). METHODS: This was a cross-sectional, multicenter Spanish study...
September 18, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28914856/-the-russian-consensus-on-the-diagnosis-and-treatment-of-chronic-pancreatitis-enzyme-replacement-therapy
#2
I E Khatkov, I V Maev, D S Bordin, Yu A Kucheryavyi, S R Abdulkhakov, S A Alekseenko, E I Alieva, R B Alikhanov, I G Bakulin, A Yu Baranovsky, E V Beloborodova, E A Belousova, I M Buriev, E V Bystrovskaya, S V Vertyankin, L V Vinokurova, E I Galperin, A V Gorelov, V B Grinevich, M V Danilov, V V Darvin, E A Dubtsova, T G Dyuzheva, V I Egorov, M G Efanov, N V Zakharova, V E Zagainov, V T Ivashkin, R E Izrailov, N V Korochanskaya, E A Kornienko, V L Korobka, N Yu Kokhanenko, M A Livzan, I D Loranskaya, K A Nikolskaya, M F Osipenko, A V Okhlobystin, V D Pasechnikov, E Yu Plotnikova, S I Polyakova, O A Sablin, V I Simanenkov, N I Ursova, V V Tsvirkun, V V Tsukanov, A V Shabunin
Pancreatology Club Professional Medical Community, 1A.S. Loginov Moscow Clinical Research and Practical Center, Moscow Healthcare Department, Moscow; 2A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Moscow; 3Kazan State Medical University, Ministry of Health of Russia, Kazan; 4Kazan (Volga) Federal University, Kazan; 5Far Eastern State Medical University, Ministry of Health of Russia, Khabarovsk; 6Morozov City Children's Clinical Hospital, Moscow Healthcare Department, Moscow; 7I...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28912050/pancreatic-enzyme-replacement-therapy-in-children-with-severe-acute-malnutrition-a-randomized-controlled-trial
#3
Rosalie H Bartels, Céline Bourdon, Isabel Potani, Brian Mhango, Deborah A van den Brink, John S Mponda, Anneke C Muller Kobold, Robert H Bandsma, Michael Boele van Hensbroek, Wieger P Voskuijl
OBJECTIVE: To assess the benefits of pancreatic enzyme replacement therapy (PERT) in children with complicated severe acute malnutrition. STUDY DESIGN: We conducted a randomized, controlled trial in 90 children aged 6-60 months with complicated severe acute malnutrition at the Queen Elizabeth Central Hospital in Malawi. All children received standard care; the intervention group also received PERT for 28 days. RESULTS: Children treated with PERT for 28 days did not gain more weight than controls (13...
September 11, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28902790/impact-of-treatments-on-diabetic-control-and-gastrointestinal-symptoms-after-total-pancreatectomy
#4
Maarten R Struyvenberg, Zhi Ven Fong, Camilia R Martin, Jennifer F Tseng, Thomas E Clancy, Carlos Fernández-Del Castillo, Hanna J Tillman, Melena D Bellin, Steven D Freedman
OBJECTIVES: The aims of this study were to compare the safety, efficacy, and patients' quality of life with continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDIs) in type 3c diabetes mellitus (T3cDM) following total pancreatectomy (TP) and pancreatic enzyme usage. METHODS: Thirty-nine patients with T3cDM (18 CSII patients vs 21 MDI patients) who underwent TP between 2000 and 2016 at 3 Harvard-affiliated hospitals and the University of Minnesota returned prospectively obtained questionnaires examining quality of life and both endocrine and exocrine pancreatic functions...
October 2017: Pancreas
https://www.readbyqxmd.com/read/28902785/predictors-of-pancreatic-cancer-associated-weight-loss-and-nutritional-interventions
#5
Laura Nemer, Somashekar G Krishna, Zarine K Shah, Darwin L Conwell, Zobeida Cruz-Monserrate, Mary Dillhoff, Denis C Guttridge, Alice Hinton, Andrei Manilchuk, Timothy M Pawlik, Carl R Schmidt, Erin E Talbert, Tanios Bekaii-Saab, Phil A Hart
OBJECTIVES: Pancreatic ductal adenocarcinoma (PDAC) is often accompanied by weight loss. We sought to characterize factors associated with weight loss and observed nutritional interventions, as well as define the effect of weight loss on survival. METHODS: Consecutive subjects diagnosed with PDAC (N = 123) were retrospectively evaluated. Univariate analysis was used to compare subjects with and without substantial (>5%) weight loss. Multivariate logistic regression was performed to identify factors associated with weight loss, and survival analyses were performed using Kaplan-Meier curves and Cox survival models...
October 2017: Pancreas
https://www.readbyqxmd.com/read/28870723/managing-malnourishment-in-pregnancy-after-bariatric-surgery
#6
Rachel K Harrison, Charles Berkelhammer, Victor Suarez, Helen H Kay
BACKGROUND: Little information exists to guide monitoring and treatment of malnourishment during pregnancy after bariatric surgery. Here we present a case with severe deficiencies and recommendations for testing and treatment. CASE: Our patient underwent a duodenal switch procedure resulting in significant weight loss and numerous deficiencies. She then experienced a neonatal demise with multiple congenital abnormalities, including diaphragmatic hernia, possibly related to severe vitamin A deficiency...
September 1, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28838283/exocrine-pancreatic-insufficiency-is-common-in-people-living-with-hiv-on-effective-antiretroviral-therapy
#7
Aylin Yilmaz, Lars Hagberg
OBJECTIVES: The primary aim of this prospective study was to determine the prevalence of exocrine pancreatic insufficiency (EPI) in people living with HIV (PLHIV) on suppressive antiretroviral therapy (ART). METHODS: PLHIV ≥18 years of age and on ART for >6 months and with HIV RNA <50 copies/mL plasma were included. Faecal elastase-1 measurement was performed on a single stool sample, serum markers of malnutrition were collected, and participants answered a short questionnaire about gastrointestinal symptoms...
August 25, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28814218/diagnosis-and-management-of-pancreatic-exocrine-insufficiency
#8
Mehrdad Nikfarjam, Jeremy S Wilson, Ross C Smith
In 2015, the Australasian Pancreatic Club (APC) published the Australasian guidelines for the management of pancreatic exocrine insufficiency (http://pancreas.org.au/2016/01/pancreatic-exocrine-insufficiency-guidelines). Pancreatic exocrine insufficiency (PEI) occurs when normal digestion cannot be sustained due to insufficient pancreatic digestive enzyme activity. This may be related to a breakdown, at any point, in the pancreatic digestive chain: pancreatic stimulation; synthesis, release or transportation of pancreatic enzymes; or synchronisation of secretions to mix with ingested food...
August 21, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28804801/pancreatic-enzyme-supplementation-after-gastrectomy-for-gastric-cancer-a-randomized-controlled-trial
#9
Marco Catarci, Manuele Berlanda, Giovanni Battista Grassi, Francesco Masedu, Stefano Guadagni
BACKGROUND: Gastrectomy for gastric cancer is a significant cause of secondary exocrine pancreatic insufficiency. Pancreatic enzyme replacement therapy may influence nutritional status and quality of life after gastrectomy, but the pertinent clinical research to date remains controversial. A randomized controlled trial to test this hypothesis was carried out. METHODS: After gastrectomy, 43 patients with gastric cancer were randomly assigned to a normal diet (Normal-d; n = 21) or to a pancreatic enzyme supplementation diet (PES-d; n = 22) and were followed up during a 12-month period, assessing nutritional status and quality of life through body mass index (BMI), instant nutritional assessment (INA) class status, serum pre-albumin (SPA) values, and GastroiIntestinal Quality of Life Index (GIQLI)...
August 14, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28747058/pancreatic-enzyme-replacement-therapy-in-cystic-fibrosis-dose-variability-and-coefficient-of-fat-absorption
#10
Joaquim Calvo-Lerma, Sandra Martínez-Barona, Etna Masip, Victoria Fornés, Carmen Ribes-Koninckx
OBJECTIVES: Pancreatic enzyme replacement therapy (PERT) remains a backbone in the nutritional treatment of cystic fibrosis. Currently, there is a lack of an evidence-based tool that allows dose adjustment. To date, no studies have found an association between PERT dose and fat absorption. Therefore, the aim of the study was to assess the influence of both the PERT dose and the variability in this dose on the coefficient of fat absorption (CFA). METHODS: This is a retrospective longitudinal study of 16 pediatric patients (192 food records) with three consecutive visits to the hospital over a twelve-month period...
July 27, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28735575/negotiating-the-complexities-of-exocrine-and-endocrine-dysfunction-in-chronic-pancreatitis
#11
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/28727476/options-for-addressing-exocrine-pancreatic-insufficiency-in-patients-receiving-enteral-nutrition-supplementation
#12
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/28711377/pancreas-exocrine-replacement-therapy-is-associated-with-increased-survival-following-pancreatoduodenectomy-for-periampullary-malignancy
#13
Keith J Roberts, Harald Schrem, James Hodson, Roberta Angelico, Bobby V M Dasari, Chris A Coldham, Ravi Marudanayagam, Robert P Sutcliffe, Paolo Muiesan, John Isaac, Darius F Mirza
BACKGROUND: Although many patients undergoing pancreatoduodenectomy (PD) for cancer have pancreatic exocrine insufficiency, pancreatic enzyme replacement therapy (PERT) is not routinely used, and effects upon post-operative survival are unclear. METHODS: This review of patients undergoing PD for periampullary malignancy sought to test for an association between PERT and overall survival, with post-hoc subgroup analysis performed after stratifying patients by the year of surgery, pancreatic duct width and tumour type...
July 12, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28657944/health-related-quality-of-life-and-functional-outcomes-in-5-year-survivors-after-pancreaticoduodenectomy
#14
Zhi Ven Fong, Donna M Alvino, Carlos Fernández-Del Castillo, Ryan D Nipp, Lara N Traeger, Margaret Ruddy, Carrie C Lubitz, Colin D Johnson, David C Chang, Andrew L Warshaw, Keith D Lillemoe, Cristina R Ferrone
OBJECTIVE: Our aim was to assess quality of life (QOL) and functionality in a large cohort of patients ≥5-years after pancreaticoduodenectomy (PD). BACKGROUND: Long-term QOL outcomes after PD for benign or malignant disease are largely undocumented. METHODS: We administered the EORTC QLQ-C30 questionnaire to patients who underwent PD for neoplasms from 1998 to 2011 and compared their scores with an age- and sex-matched normal population...
October 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28545504/a-case-report-of-zinc-phosphide-poisoning-complicated-by-acute-renal-failure-and-tubulo-interstitial-nephritis
#15
Nilukshana Yogendranathan, H M M T B Herath, Thenuka Sivasundaram, R Constantine, Aruna Kulatunga
BACKGROUND: Run Rat® is a rodenticide widely used against small mammals. It comprises of a minimum of 32% zinc phosphide which is highly toxic in acute exposures to humans. It may be consumed accidentally or intentionally. It enters the body via skin, respiratory and gastrointestinal tracts. Zinc phosphide is hydrolyzed by the gastric acid and is transformed into phosphine gas. Phosphine is a respiratory toxin that inhibits cytochrome C oxidase system resulting in renal failure and liver failure...
May 25, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28482390/-clinical-analysis-of-11-children-with-pancreatic-cystic-fibrosis
#16
G L Wang, C N Zhao, J Zhou, F H Yu, H Q Shen, J Zhang, S Y Zhao, X W Xu
Objective: To increase the recognition of pancreatic cystic fibrosis (PCF) in children and facilitate diagnosing and treatment of this rare entity. Method: This is a retrospective analysis of children who presented to Beijing Children's Hospital affiliated to Capital Medical University from January 2010 to December 2015. We describe their clinical features, laboratory testing and management. Result: Eleven children were diagnosed with PCF by genetic testing or sweat chloride test during these 5 years, including 4 boys and 7 girls...
May 4, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28478840/alzheimer-s-disease-and-other-neurodegenerative-diseases-may-be-due-to-nutritional-deficiencies-secondary-to-unrecognized-exocrine-pancreatic-insufficiency
#17
Steven R Brenner
Alzheimer's disease (AD) may be related to nutritional deficiencies from exocrine pancreatic insufficiency (EPI) with mal-absorption of essential nutrients, vitamins and minerals. EPI occurs in about twenty percent of the elderly population, sometimes without obvious symptoms, a number similar to the incidence of AD. Other Neurological degenerative diseases with potential nutritional components such as Parkinson's disease, frailty of age and Multiple Sclerosis, a disease with increased activity from vitamin D deficiency, may also be related to untreated exocrine pancreatic insufficiency causing impaired absorption of essential dietary elements...
May 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28394477/preparation-of-selenoinsulin-as-a-long-lasting-insulin-analogue
#18
Kenta Arai, Toshiki Takei, Masaki Okumura, Satoshi Watanabe, Yuta Amagai, Yuya Asahina, Luis Moroder, Hironobu Hojo, Kenji Inaba, Michio Iwaoka
Synthetic insulin analogues with a long lifetime are current drug targets for the therapy of diabetic patients. The replacement of the interchain disulfide with a diselenide bridge, which is more resistant to reduction and internal bond rotation, can enhance the lifetime of insulin in the presence of the insulin-degrading enzyme (IDE) without impairing the hormonal function. The [C7U(A) ,C7U(B) ] variant of bovine pancreatic insulin (BPIns) was successfully prepared by using two selenocysteine peptides (i.e...
May 8, 2017: Angewandte Chemie
https://www.readbyqxmd.com/read/28386318/pax4-promotes-pdx1-induced-differentiation-of-mesenchymal-stem-cells-into-insulin-secreting-cells
#19
Lifa Xu, Congjing Xu, Shuping Zhou, Xueke Liu, Jian Wang, Xinkuang Liu, Suping Qian, Yingru Xin, Yi Gao, Yongqiang Zhu, Xiaolong Tang
A shortage of postmortem pancreatic tissue for islet isolation impedes the application of cell replacement therapy in patients with diabetes. As an alternative for islet cell transplantation, transcription factors, including PDX1, PAX4, and neurogenin-3, that aid in the formation of insulin-producing β cells during development have been investigated. The present study evaluated the effects of PAX4 and PDX1 on the differentiation of mesenchymal stem cells (MSCs) into insulin-producing β-like cells in vitro using recombinant adenoviruses carrying PDX1 or PDX1 plus PAX4...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28335094/growth-and-physiological-responses-of-broiler-chickens-to-diets-containing-raw-full-fat-soybean-and-supplemented-with-a-high-impact-microbial-protease
#20
Mammo M Erdaw, Shubiao Wu, Paul A Iji
OBJECTIVE: This study evaluated the change and function of the pancreas, and small intestine in relation to growth performance of broilers on diets supplemented with raw soybean meal (RSBM) and protease. Samples of test ingredients and diets, after mixing and prior to being used were also assessed on contents of anti-nutritional factors. METHODS: A 3×3 factorial study was used, with three levels of RSBM (commercial soybean meal [SBM] was replaced by RSBM at 0, 10%, or 20%) and protease (0...
September 2017: Asian-Australasian Journal of Animal Sciences
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