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pancreatic exocrine insufficiency

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https://www.readbyqxmd.com/read/28315875/systematic-review-of-exocrine-pancreatic-insufficiency-after-gastrectomy-for-cancer
#1
Jennifer Straatman, Jim Wiegel, Nicole van der Wielen, E P Jansma, Miguel A Cuesta, Donald L van der Peet
BACKGROUND: Survival rates after a total gastrectomy with adequate lymphadenectomy are improving, leading to a shift in outcomes of interest from survival to postoperative outcomes and symptoms. In this systematic review, we investigate gastrointestinal symptoms that occur after a gastrectomy in relation to exocrine pancreatic insufficiency and the effect of pancreatic exocrine enzyme supplementation on these symptoms. METHODS: Online databases PubMed, Embase, and Cochrane Library were systematically searched in accordance with the PRISMA guidelines...
March 18, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28315028/potential-for-screening-for-pancreatic-exocrine-insufficiency-using-the-fecal-elastase-1-test
#2
REVIEW
J Enrique Domínguez-Muñoz, Philip D Hardt, Markus M Lerch, Matthias J Löhr
The early diagnosis of pancreatic exocrine insufficiency (PEI) is hindered because many of the functional diagnostic techniques used are expensive and require specialized facilities, which prevent their widespread availability. We have reviewed current evidence in order to compare the utility of these functional diagnostic techniques with the fecal elastase-1 (FE-1) test in the following three scenarios: screening for PEI in patients presenting with symptoms suggestive of pancreatic disease, such as abdominal pain or diarrhea; determining the presence of PEI in patients with an established diagnosis of pancreatic disease, such as chronic pancreatitis or cystic fibrosis; determining exocrine status in disorders not commonly tested for PEI, but which have a known association with this disorder...
March 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28291656/diagnosis-of-exocrine-pancreatic-insufficiency-in-chronic-pancreatitis-13-c-mixed-triglyceride-breath-test-versus-fecal-elastase
#3
Víctor González-Sánchez, Rahma Amrani, Victoria González, Celia Trigo, Antonio Picó, Enrique de-Madaria
BACKGROUND: Pancreatic enzyme replacement therapy (PERT) is indicated in case of clinically relevant exocrine pancreatic insufficiency (EPI). Clinical trials addressing PERT have used the coefficient of fat absorption (CFA) to define EPI but this test is cumbersome to perform. Our aim was to compare two easier-to-perform tests to detect clinically relevant EPI: Fecal Elastase-1 (FE-1) and (13)C-Mixed Triglyceride Breath Test (TGBT). METHODS: We prospectively included 54 patients with chronic pancreatitis (CP), 24...
March 6, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28281169/complications-of-chronic-pancreatitis
#4
REVIEW
Mitchell L Ramsey, Darwin L Conwell, Phil A Hart
Chronic pancreatitis is a disease that leads to irreversible changes in the pancreatic morphology and function. The loss of function can lead to diabetes mellitus and exocrine pancreatic insufficiency. The inflammation and fibrosis can also lead to other complications including a chronic abdominal pain syndrome, metabolic bone disease, and pancretic cancer. This article reviews our current understanding of the mechanisms and management of these complications of chronic pancreatitis.
March 9, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28272344/nutritional-and-metabolic-derangements-in-pancreatic-cancer-and-pancreatic-resection
#5
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/28253873/extended-clinical-features-associated-with-novel-glis3-mutation-a-case-report
#6
K A Alghamdi, A B Alsaedi, A Aljasser, A Altawil, Naglaa M Kamal
BACKGROUND: Mutations in the GLI-similar 3 (GLIS3) gene encoding the transcription factor GLIS3 are a rare cause of neonatal diabetes and congenital hypothyroidism with 12 reported patients to date. Additional features, previously described, include congenital glaucoma, hepatic fibrosis, polycystic kidneys, developmental delay, facial dysmorphism, osteopenia, sensorineural deafness, choanal atresia, craniosynostosis and pancreatic exocrine insufficiency. CASE PRESENTATION: We report a new case for consanguineous parents with homozygous novel mutation in GLIS3 gene who presented with neonatal diabetes mellitus, severe resistant congenital hypothyroidism, cholestatic liver disease, bilateral congenital glaucoma and facial dysmorphism...
March 2, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28248878/surgical-strategies-in-the-treatment-of-chronic-pancreatitis-an-updated-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#7
Xin Zhao, Naiqiang Cui, Ximo Wang, Yunfeng Cui
BACKGROUND: Chronic pancreatitis (CP) is a common and frequently occurring disease. Pancreaticoduodenectomy (PD), pylorus-preserving pancreaticoduodenectomy (PPPD), and duodenum-preserving pancreatic head resection (DPPHR) are important treatment options for patients with chronic pancreatitis. The Beger and Frey procedures are 2 main duodenum-preserving techniques in duodenum-preserving pancreatic head resection (DPPHR) strategies. We conducted this systematic review and meta-analysis to compare the clinical efficacy of DPPHR versus PD, the Beger procedure versus PD, the Frey procedure versus PD, and the Beger procedure versus the Frey procedure in the treatment of pancreatitis...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28245190/cystic-fibrosis-related-diabetes-cfrd-is-preceded-by-and-associated-with-growth-failure-and-deteriorating-lung-function
#8
Nicolas Terliesner, Mandy Vogel, Anna Steighardt, Ruth Gausche, Constance Henn, Julia Hentschel, Thomas Kapellen, Sabine Klamt, Julia Gebhardt, Wieland Kiess, Freerk Prenzel
BACKGROUND: Impaired glucose metabolism and cystic fibrosis (CF)-related diabetes (CFRD) are associated with insufficient weight gain and impaired lung function in children and adolescents with CF. We have asked whether imminent CFRD may be a cause of poor growth in children and adolescents. METHODS: A retrospective case control study including 32 patients with CF with or without diabetes was conducted. Sixteen pairs, matched according to age, gender and exocrine pancreatic insufficiency, were analysed...
February 28, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28244497/quality-of-life-in-chronic-pancreatitis-is-determined-by-constant-pain-disability-unemployment-current-smoking-and-associated-co-morbidities
#9
Jorge D Machicado, Stephen T Amann, Michelle A Anderson, Judah Abberbock, Stuart Sherman, Darwin L Conwell, Gregory A Cote, Vikesh K Singh, Michele D Lewis, Samer Alkaade, Bimaljit S Sandhu, Nalini M Guda, Thiruvengadam Muniraj, Gong Tang, John Baillie, Randall E Brand, Timothy B Gardner, Andres Gelrud, Christopher E Forsmark, Peter A Banks, Adam Slivka, C Mel Wilcox, David C Whitcomb, Dhiraj Yadav
OBJECTIVES: Chronic pancreatitis (CP) has a profound independent effect on quality of life (QOL). Our aim was to identify factors that impact the QOL in CP patients. METHODS: We used data on 1,024 CP patients enrolled in the three NAPS2 studies. Information on demographics, risk factors, co-morbidities, disease phenotype, and treatments was obtained from responses to structured questionnaires. Physical and mental component summary (PCS and MCS, respectively) scores generated using responses to the Short Form-12 (SF-12) survey were used to assess QOL at enrollment...
February 28, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28241470/pancreatic-exocrine-insufficiency-in-pancreatic-cancer
#10
REVIEW
Miroslav Vujasinovic, Roberto Valente, Marco Del Chiaro, Johan Permert, J-Matthias Löhr
Abstract: Cancer patients experience weight loss for a variety of reasons, commencing with the tumor's metabolism (Warburg effect) and proceeding via cachexia to loss of appetite. In pancreatic cancer, several other factors are involved, including a loss of appetite with a particular aversion to meat and the incapacity of the pancreatic gland to function normally when a tumor is present in the pancreatic head. Pancreatic exocrine insufficiency is characterized by a deficiency of the enzymes secreted from the pancreas due to the obstructive tumor, resulting in maldigestion...
February 23, 2017: Nutrients
https://www.readbyqxmd.com/read/28223257/the-fecal-microbiome-of-dogs-with-exocrine-pancreatic-insufficiency
#11
Anitha Isaiah, Joseph Cyrus Parambeth, Jörg M Steiner, Jonathan A Lidbury, Jan S Suchodolski
Exocrine pancreatic insufficiency (EPI) in dogs is a syndrome of inadequate synthesis and secretion of pancreatic enzymes. Small intestinal bacterial dysbiosis occurs in dogs with EPI, and is reversed with pancreatic enzyme therapy. However, there are no studies evaluating the fecal microbiome of dogs with EPI. The objective of this study was to evaluate the fecal microbiome of dogs with EPI. Three day pooled fecal samples were collected from healthy dogs (n = 18), untreated (n = 7) dogs with EPI, and dogs with EPI treated with enzyme replacement therapy (n = 19)...
February 18, 2017: Anaerobe
https://www.readbyqxmd.com/read/28212351/black-box%C3%A2-gastrointestinal%C3%A2-tract-needs%C3%A2-and%C3%A2-prospects%C3%A2-of%C3%A2-gaining%C3%A2-insights%C3%A2-of%C3%A2-fate%C3%A2-of%C3%A2-fat-%C3%A2-protein-%C3%A2-and%C3%A2-starch%C3%A2-in%C3%A2-case%C3%A2-of%C3%A2-exocrine%C3%A2-pancreatic%C3%A2-insufficiency%C3%A2-by%C3%A2-using%C3%A2-fistulated%C3%A2-pigs
#12
REVIEW
Anne Mößeler, Josef Kamphues
Exocrine pancreatic insufficiency (EPI) results in the maldigestion and malabsorption of nutrients. The digestive processes in humans and other monogastric species like rat and pig are characterized by a predominantly enzymatic digestion within the small intestine and microbial fermentation located in the hindgut. For protein, it is doctrine that only prececally absorbed amino acids can be transferred to the amino acid pool of the host, while postileal absorption of nitrogen-containing compounds occurs mainly in the form of ammonia, being a burden rather than a benefit for the organism...
February 16, 2017: Nutrients
https://www.readbyqxmd.com/read/28188746/context-dependent-epigenetic-regulation-of-nuclear-factor-of-activated-t-cells-1-in-pancreatic-plasticity
#13
Nai-Ming Chen, Albrecht Neesse, Moritz Lino Dyck, Benjamin Steuber, Alexander O Koenig, Clara Lubeseder-Martellato, Thore Winter, Teresa Forster, Hanibal Bohnenberger, Julia Kitz, Kirsten-Reuter Jessen, Heidi Griesmann, Jochen Gaedcke, Marian Grade, Jin-San Zhang, Wan-Chi Tsai, Jens Siveke, Hans-Ulrich Schildhaus, Philipp Ströbel, Steven A Johnsen, Volker Ellenrieder, Elisabeth Hessmann
BACKGROUND & AIMS: The ability of exocrine pancreatic cells to change the cellular phenotype is required for tissue regeneration upon injury but also contributes to their malignant transformation and tumor progression. We investigated context-dependent signaling and transcription mechanisms that determine pancreatic cell fate decisions toward regeneration and malignancy. In particular, we studied the function and regulation of the inflammatory transcription factor nuclear factor of activated T cells 1 (NFATC1) in pancreatic cell plasticity and tissue adaptation...
February 7, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28183317/practical-guide-to-exocrine-pancreatic-insufficiency-breaking-the-myths
#14
EDITORIAL
Maarten R Struyvenberg, Camilia R Martin, Steven D Freedman
BACKGROUND: Exocrine pancreatic insufficiency (EPI) is characterized by a deficiency of exocrine pancreatic enzymes, resulting in malabsorption. Numerous conditions account for the etiology of EPI, with the most common being diseases of the pancreatic parenchyma including chronic pancreatitis, cystic fibrosis, and a history of extensive necrotizing acute pancreatitis. Treatment for EPI includes dietary management, lifestyle changes (i.e., decrease in alcohol consumption and smoking cessation), and pancreatic enzyme replacement therapy...
February 10, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28180238/atrophic-exocrine-pancreatic-insufficiency-associated-with-anti-pd1-therapy
#15
A Hoadley, N Sandanayake, G V Long
No abstract text is available yet for this article.
November 17, 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28164596/genetic-expression-in-cystic-fibrosis-related-bone-disease-an-observational-transversal-cross-sectional-study
#16
Ioana M Ciuca, Liviu L Pop, Alexandru F Rogobete, Dan I Onet, Bogdan Guta-Almajan, Zoran Popa, Florin G Horhat
BACKGROUND: Cystic fibrosis (CF) is the most frequent monogenic genetic disease with autosomal recessive transmission and characterized by important clinical polymorphism and significant lethal prospective. CF related bone disease occurs frequently in adults with CF. Childhood is the period of bone formation, and therefore, children are more susceptible to low bone density. Several factors like pancreatic insufficiency, hormone imbalance, and physical inactivity contribute to CF bone disease development...
September 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28161789/treatment-of-pancreatic-insufficiency-using-pancreatic-extract-in-patients-with-advanced-pancreatic-cancer-a-pilot-study-picnic
#17
Nicholas Zdenkowski, George Radvan, Leanna Pugliese, Julie Charlton, Christopher Oldmeadow, Allison Fraser, Antonino Bonaventura
PURPOSE: Survival with advanced pancreatic cancer is less than 12 months. Pancreatic exocrine insufficiency may contribute to pancreatic cancer-related cachexia, via nutrient malabsorption. We aimed to determine the feasibility of prescribing pancreatic extract (Creon®) for patients with advanced pancreatic cancer. METHODS: Patients with advanced pancreatic cancer, without frank malabsorption, were randomised in this feasibility study to pancreatic extract 50,000 units with meals and 25,000 units with snacks, or placebo...
February 4, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28129231/specific-radiological-imaging-findings-in-patients-with-hereditary-pancreatitis-during-a-long-follow-up-of-disease
#18
Aura A J van Esch, Joost P H Drenth, John J Hermans
OBJECTIVES: Hereditary pancreatitis (HP) is characterized by recurrent episodes of inflammation of the pancreas. Radiological imaging is used to diagnose HP and to monitor complications. The aim of this study was to describe specific imaging findings in HP. METHODS: We retrospectively collected data of HP patients with serial imaging and reviewed all radiological imaging studies (transabdominal ultrasonography, computed tomography, and magnetic resonance imaging)...
March 2017: Pancreas
https://www.readbyqxmd.com/read/28099252/the-role-of-pancreatic-enzyme-replacement-therapy-in-unresectable-pancreatic-cancer-a-prospective-cohort-study
#19
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 little evidence 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)...
March 2017: Pancreas
https://www.readbyqxmd.com/read/28094661/diagnosis-of-pancreatic-disease-in-feline-platynosomosis
#20
Liza S Köster, Linda Shell, Jennifer Ketzis, Sreekumari Rajeev, Oscar Illanes
Objectives Platynosomum species are cat-specific parasitic trematodes that parasitize the biliary ducts and gall bladder. Due to the common connection to the major duodenal papilla of the pancreas and common bile ducts in addition to the periductal proximity of the pancreas, it is possible that platynosomosis could cause pancreatitis. The objective of this study was to determine whether platynosomosis, a commonly diagnosed parasitic disease in cats on St Kitts, has any association with pancreatic disease. Methods To investigate this possibility, the pancreas of free-roaming cats with naturally acquired platynosomosis were evaluated via ultrasound, serum concentrations of feline pancreatic lipase (fPL), cobalamin, folate and feline trypsin-like immunoreactivity (fTLI) and histopathology...
January 1, 2017: Journal of Feline Medicine and Surgery
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