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pancreatic exocrine insufficiency

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https://www.readbyqxmd.com/read/29138633/influence-of-spk-with-enteric-drainage-on-the-pancreatic-exocrine-function-in-diabetic-patients-with-uremia
#1
Guanghui Pei, Wu Lv, Xiaohang Li, Guoqing Zhang, Jialin Zhang
Objective: This study aimed to determine the use of fecal elastase in evaluating the effect of simultaneous pancreas-kidney transplantation with enteric drainage on the pancreatic exocrine function of diabetic patients with uremia. Methods: A total of 19 patients with simultaneous pancreas-kidney transplantation (SPK) with enteric drainage, 31 diabetic patients with uremia (chronic renal failure (CRF)), 22 diabetic patients with uremia who underwent renal transplantation (RT), and 20 normal individuals (CON) were included in the study...
2017: International Journal of Endocrinology
https://www.readbyqxmd.com/read/29137169/pancreatic-exocrine-insufficiency-after-bariatric-surgery
#2
REVIEW
Miroslav Vujasinovic, Roberto Valente, Anders Thorell, Wiktor Rutkowski, Stephan L Haas, Urban Arnelo, Lena Martin, J-Matthias Löhr
Morbid obesity is a lifelong disease, and all patients require complementary follow-up including nutritional surveillance by a multidisciplinary team after bariatric procedures. Pancreatic exocrine insufficiency (PEI) refers to an insufficient secretion of pancreatic enzymes and/or sodium bicarbonate. PEI is a known multifactorial complication after upper gastrointestinal surgery, and might constitute an important clinical problem due to the large number of bariatric surgical procedures in the world. Symptoms of PEI often overlap with sequelae of gastric bypass, making the diagnosis difficult...
November 13, 2017: Nutrients
https://www.readbyqxmd.com/read/29137016/binding-pancreaticogastrostomy-anastomosis-in-central-pancreatectomy-a-single-center-experience
#3
Pengcheng Kang, Zhidong Wang, Kaiming Leng, Xiangyu Zhong, Hao Wang, Ming Wan, Sheng Tai, Yunfu Cui
A growing number of central pancreatectomies are performed. However, reconstruction of pancreaticoenteral digestive continuity after central pancreatectomy remains debated. This study evaluates the short-term outcomes of binding pancreaticogastrostomy anastomosis in central pancreatectomy.We have reviewed our experience with 52 patients who underwent binding pancreaticogastrostomy following central pancreatectomy from February 2009 to March 2015. Indication includes 6 noninvasive intraductal papillary mucinous neoplasms, 11 neuroendocrine tumors, 12 solid pseudopapillary tumor, 9 serous cystadenoma, 6 mucinous cystadenoma, and 8 focal pancreatic traumas...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29134356/secretin-stimulated-ultrasound-estimation-of-pancreatic-secretion-in-cystic-fibrosis-validated-by-magnetic-resonance-imaging
#4
Trond Engjom, Erling Tjora, Gaute Wathle, Friedemann Erchinger, Birger N Lærum, Odd H Gilja, Ingfrid Salvesen Haldorsen, Georg Dimcevski
OBJECTIVES: Secretin-stimulated magnetic resonance imaging (s-MRI) is the best validated radiological modality assessing pancreatic secretion. The purpose of this study was to compare volume output measures from secretin-stimulated transabdominal ultrasonography (s-US) to s-MRI for the diagnosis of exocrine pancreatic failure in cystic fibrosis (CF). METHODS: We performed transabdominal ultrasonography and MRI before and at timed intervals during 15 minutes after secretin stimulation in 21 CF patients and 13 healthy controls...
November 13, 2017: European Radiology
https://www.readbyqxmd.com/read/29106956/supplementation-of-pancreatic-digestive-enzymes-alters-the-composition-of-intestinal-microbiota-in-mice
#5
Hiroki Nishiyama, Tomoyuki Nagai, Masatoshi Kudo, Yoshihisa Okazaki, Yoshinao Azuma, Tomohiro Watanabe, Susumu Goto, Hiroyuki Ogata, Toshiharu Sakurai
Although pancreatic enzyme replacement therapy (PERT) is effective in the alleviation of pancreatic exocrine insufficiency (PEI)-related symptoms in patients with chronic pancreatitis, its mechanism of action is poorly understood. Recent studies suggest that the intestinal microbiota is associated with the pathogenesis of chronic pancreatitis. Therefore, we hypothesized that PERT exerts its effect by modifying the intestinal microbiota in addition to its presumed role in promoting fat and protein absorption...
October 26, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/29097865/staging-chronic-pancreatitis-with-exocrine-function-tests-are-we-better
#6
EDITORIAL
Cosimo Sperti, Lucia Moletta
Chronic pancreatitis (CP) is an inflammatory disease of the pancreas evolving in progressive fibrotic disruption of the gland with exocrine and endocrine pancreatic insufficiency. Although imaging features of CP are well known, their correlation with exocrine pancreatic function tests are not obvious, particularly in the early stage of the disease. There are many clinical classification of CP, all suggested for better distinguish and manage different forms based on etiological and clinical factors, and severity of the disease...
October 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29093615/less-common-etiologies-of-exocrine-pancreatic-insufficiency
#7
REVIEW
Vikesh K Singh, Mark E Haupt, David E Geller, Jerry A Hall, Pedro M Quintana Diez
Exocrine pancreatic insufficiency (EPI), an important cause of maldigestion and malabsorption, results from primary pancreatic diseases or secondarily impaired exocrine pancreatic function. Besides cystic fibrosis and chronic pancreatitis, the most common etiologies of EPI, other causes of EPI include unresectable pancreatic cancer, metabolic diseases (diabetes); impaired hormonal stimulation of exocrine pancreatic secretion by cholecystokinin (CCK); celiac or inflammatory bowel disease (IBD) due to loss of intestinal brush border proteins; and gastrointestinal surgery (asynchrony between motor and secretory functions, impaired enteropancreatic feedback, and inadequate mixing of pancreatic secretions with food)...
October 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29079714/tocilizumab-for-the-treatment-of-slc29a3-mutation-positive-phid-syndrome
#8
Nadia K Rafiq, Khalid Hussain, Paul A Brogan
Pigmentary hypertrichosis and non-autoimmune insulin-dependent diabetes mellitus (PHID) is associated with recessive mutations in SLC29A3, encoding the equilibrative nucleoside transporter hENT3 expressed in mitochondria, causing PHID and H syndromes, familial Rosai-Dorfman disease, and histiocytosis-lymphadenopathy-plus syndrome. Autoinflammation is increasingly recognized in these syndromes. We previously reported a 16-year-old girl with PHID syndrome associated with severe autoinflammation that was recalcitrant to interleukin-1 and tumor necrosis factor-α blockade...
November 2017: Pediatrics
https://www.readbyqxmd.com/read/29078749/endocrine-and-exocrine-pancreatic-insufficiency-after-acute-pancreatitis-long-term-follow-up-study
#9
Jianfeng Tu, Jingzhu Zhang, Lu Ke, Yue Yang, Qi Yang, Guotao Lu, Baiqiang Li, Zhihui Tong, Weiqin Li, Jieshou Li
BACKGROUND: Patients could develop endocrine and exocrine pancreatic insufficiency after acute pancreatitis (AP), but the morbidity, risk factors and outcome remain unclear. The aim of the present study was to evaluate the incidence of endocrine and exocrine pancreatic insufficiency after AP and the risk factors of endocrine pancreatic insufficiency through a long-term follow-up investigation. METHODS: Follow-up assessment of the endocrine and exocrine function was conducted for the discharged patients with AP episodes...
October 27, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29078656/robotic-central-pancreatectomy
#10
REVIEW
Ahmad Hamad, Stephanie Novak, Melissa E Hogg
Central pancreatectomy (CP) is a parenchyma-sparing procedure that can be utilized in the resection of tumors of the neck or the proximal body of the pancreas. Among 872 open CP reported since 1993, the mean rate of morbidity was 43.2% and mean rate of mortality was 0.24%. The mean pancreatic fistula rate was 28%. The rate of clinically significant pancreatic fistulas with ISGPF Grades B and C was 19%. The rate of development of post-operative diabetes mellitus was at 2% and the average incidence of exocrine insufficiency experienced by patients undergoing open CP was 4...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29075621/pancreatic-involvement-in-pediatric-inflammatory-bowel-disease
#11
REVIEW
Javier Martín-de-Carpi, Melinda Moriczi, Gemma Pujol-Muncunill, Victor M Navas-López
Inflammatory bowel disease (IBD) is a chronic condition that includes two clinical entities: Crohn's disease and ulcerative colitis. Although both entities mainly affect the gastrointestinal tract are considered multisystemic diseases and may present extraintestinal manifestations involving other organs and systems. Pancreatic involvement in Pediatric IBD includes a heterogeneous group of clinical entities like acute pancreatitis, chronic pancreatitis, autoimmune pancreatitis, asymptomatic exocrine pancreatic insufficiency, increased pancreatic enzyme levels, structural abnormalities, and granulomatous inflammation...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29074486/metabolic-markers-of-protein-maldigestion-after-a-15-n-test-meal-in-minipigs-with-pancreatic-exocrine-insufficiency
#12
Florence Mary, Anne Moesseler, Nadezda Khodorova, Angélique Foucault-Simonin, Robert Benamouzig, Daniel Tomé, Peter Colin Gregory, Claire Gaudichon
The effect of pancreatic exocrine insufficiency (PEI) on protein malabsorption is little documented, partly due to methodological barriers. We aimed to validate biomarkers of protein malabsorption using a (15)N test meal in a minipig model of PEI. Six pancreatic duct-ligated minipigs were used as a model of PEI and four non-operated animals as a control. All animals were equipped with an ileo-caecal re-entrant cannula. Minipigs were given a test meal containing (15)N casein. The PEI animals repeated the test 3 times, in the absence of any pancreatic enzymes, or after pancreatic substitution at 2 levels (A or B: 7500 or 75,000 (lipase) and 388 or 3881 (protease) FIP U)...
October 26, 2017: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/28991838/the-relation-between-malnutrition-and-the-exocrine-pancreas-a-systematic-review
#13
Rosalie H Bartels, Deborah A van den Brink, Robert H Bandsma, Michael Boele van Hensbroek, Merit M Tabbers, Wieger P Voskuijl
OBJECTIVE: The relation between malnutrition and exocrine pancreatic insufficiency (EPI) has been described previously, but it is unclear if malnutrition leads to EPI or vice versa. We systematically synthesized current evidence evaluating the association between malnutrition and EPI in children. METHODS: Pubmed, Embase, and Cochrane databases were searched from inception until February 2017. We included cohort or case- controlled studies in children reporting on prevalence or incidence of EPI and malnutrition...
October 6, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28985688/diagnosis-and-management-of-pancreatic-exocrine-insufficiency-pei-in-primary-care-consensus-guidance-of-a-canadian-expert-panel
#14
P Durie, J-D Baillargeon, S Bouchard, F Donnellan, S Zepeda-Gomez, C Teshima
Pancreatic exocrine insufficiency (PEI) results in maldigestion due to inadequate activity of pancreatic enzymes in the small bowel. PEI can arise from a variety of medical conditions that reduce enzyme synthesis within the pancreatic parenchyma or from secondary factors that may occur despite optimal parenchymal function, such as pancreatic duct obstruction or reduced or poorly synchronized enzyme release. The most characteristic symptom of PEI is steatorrhea - voluminous, lipid-rich stools; other common signs and symptoms include unexplained weight loss and deficiencies of fat-soluble vitamins and other micronutrients...
October 6, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28972538/mutations-in-signal-recognition-particle-srp54-cause-syndromic-neutropenia-with-shwachman-diamond-like-features
#15
Raphael Carapito, Martina Konantz, Catherine Paillard, Zhichao Miao, Angélique Pichot, Magalie S Leduc, Yaping Yang, Katie L Bergstrom, Donald H Mahoney, Deborah L Shardy, Ghada Alsaleh, Lydie Naegely, Aline Kolmer, Nicodème Paul, Antoine Hanauer, Véronique Rolli, Joëlle S Müller, Elisa Alghisi, Loïc Sauteur, Cécile Macquin, Aurore Morlon, Consuelo Sebastia Sancho, Patrizia Amati-Bonneau, Vincent Procaccio, Anne-Laure Mosca-Boidron, Nathalie Marle, Naël Osmani, Olivier Lefebvre, Jacky G Goetz, Sule Unal, Nurten A Akarsu, Mirjana Radosavljevic, Marie-Pierre Chenard, Fanny Rialland, Audrey Grain, Marie-Christine Béné, Marion Eveillard, Marie Vincent, Julien Guy, Laurence Faivre, Christel Thauvin-Robinet, Julien Thevenon, Kasiani Myers, Mark D Fleming, Akiko Shimamura, Elodie Bottollier-Lemallaz, Eric Westhof, Claudia Lengerke, Bertrand Isidor, Seiamak Bahram
Shwachman-Diamond syndrome (SDS) (OMIM #260400) is a rare inherited bone marrow failure syndrome (IBMFS) that is primarily characterized by neutropenia and exocrine pancreatic insufficiency. Seventy-five to ninety percent of patients have compound heterozygous loss-of-function mutations in the Shwachman-Bodian-Diamond syndrome (sbds) gene. Using trio whole-exome sequencing (WES) in an sbds-negative SDS family and candidate gene sequencing in additional SBDS-negative SDS cases or molecularly undiagnosed IBMFS cases, we identified 3 independent patients, each of whom carried a de novo missense variant in srp54 (encoding signal recognition particle 54 kDa)...
October 3, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28971839/simultaneous-k-ras-activation-and-keap1-deletion-cause-atrophy-of-pancreatic-parenchyma
#16
Shin Hamada, Tooru Shimosegawa, Keiko Taguchi, Tatsuhide Nabeshima, Masayuki Yamamoto, Atsushi Masamune
The Keap1-Nrf2 system has a wide variety of effects in addition to the oxidative stress response, such as growth promotion and chemoresistance of cancer cells. Nrf2 is constitutively activated in most cancer cells. However, the activation of Nrf2 together with oncogenic mutations does not always result in cancer promotion. K-ras(LSL-G12D/+)::p53(LSL-R172H/+)::Pdx-1-Cre (KPC) mice are an established model of pancreatic cancer, which specifically express mutants of both K-ras and p53 in the pancreas by using Pdx-1-Cre...
September 28, 2017: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/28958898/the-impact-of-pancreaticoduodenectomy-on-endocrine-and-exocrine-pancreatic-function-a-prospective-cohort-study-based-on-pre-and-postoperative-function-tests
#17
Geert Roeyen, Miet Jansen, Vera Hartman, Thiery Chapelle, Bart Bracke, Dirk Ysebaert, Christophe De Block
BACKGROUND/OBJECTIVES: Studies reporting on function after pancreatic surgery are frequently based on diabetes history, fasting glycemia or random glycemia. The aim of this study was to investigate prospectively the evolution of pancreatic function in patients undergoing pancreaticoduodenectomy based on proper pre- and postoperative function tests. It was hypothesised that pancreatic function deteriorates after pancreaticoduodenectomy. METHODS: Between 2013 and 2016, 78 patients undergoing pancreaticoduodenectomy for oncologic indications had a prospective evaluation of their endocrine and exocrine pancreatic function...
September 9, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28948530/pancreatic-neuroendocrine-tumor-with-complete-replacement-of-the-pancreas-by-serous-cystic-neoplasms-in-a-patient-with-von-hippel-lindau-disease-a-case-report
#18
Shimpei Maeda, Fuyuhiko Motoi, Shuhei Oana, Kyohei Ariake, Masamichi Mizuma, Takanori Morikawa, Hiroki Hayashi, Kei Nakagawa, Takashi Kamei, Takeshi Naitoh, Michiaki Unno
BACKGROUND: von Hippel-Lindau disease is a dominantly inherited multi-system syndrome with neoplastic hallmarks. Pancreatic lesions associated with von Hippel-Lindau include serous cystic neoplasms, simple cysts, and neuroendocrine tumors. The combination of pancreatic neuroendocrine tumors and serous cystic neoplasms is relatively rare, and the surgical treatment of these lesions must consider both preservation of pancreatic function and oncological clearance. We report a patient with von Hippel-Lindau disease successfully treated with pancreas-sparing resection of a pancreatic neuroendocrine tumor where the pancreas had been completely replaced by serous cystic neoplasms, in which pancreatic function was preserved...
September 25, 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28945459/importance-of-pancreatic-enzyme-replacement-therapy-after-surgery-of-cancer-of-the-esophagus-or-the-esophagogastric-junction
#19
Thomas Kiefer, Dorothea Krahl, Kathrin Osthoff, Peter Thuss-Patience, Jörg Bunse, Ulrich Adam, Marc H Jansen, Rudolf Ott, Robert Pfitzmann, Matthias Pross, Thomas Kohlmann, Georg Daeschlein, Hermann Buhlert, Heinz Völler, Carsten Hirt
After surgical treatment of cancer of the esophagus or the esophagogastric junction we observed steatorrhea, which is so far seldom reported. We analyzed all patients treated in our rehabilitation clinic between 2011 and 2014 and focused on the impact of surgery on digestion of fat. Reported steatorrhea was anamnestic, no pancreatic function test was made. Here we show the results from 51 patients. Twenty-three (45%) of the patients reported steatorrhea. Assuming decreased pancreatic function pancreatic enzyme replacement therapy (PERT) was started or modified during the rehabilitation stay (in the following called STEA(+))...
September 25, 2017: Nutrition and Cancer
https://www.readbyqxmd.com/read/28945313/severe-infantile-isolated-exocrine-pancreatic-insufficiency-caused-by-the-complete-functional-loss-of-the-spink1-gene
#20
Théa Venet, Emmanuelle Masson, Cécile Talbotec, Kareen Billiemaz, Renaud Touraine, Claire Gay, Sylvie Destombe, David N Cooper, Hugues Patural, Jian-Min Chen, Claude Férec
Exocrine pancreatic insufficiency (EPI) is rare in children, with most if not all cases occurring as part of syndromic conditions such as cystic fibrosis and Shwachman-Diamond syndrome. Here we report two cases, both presenting with severe EPI around 5 months of age. Characterized by diffuse pancreatic lipomatosis, they otherwise exhibited no remarkable deficiencies in other organs. Novel non-identical homozygous variants (a deletion removing the entire SPINK1 gene and an insertion of a full-length inverted Alu element into the 3'-untranslated region of the SPINK1 gene) resulting in the complete functional loss of the SPINK1 gene (encoding pancreatic secretory trypsin inhibitor) were identified in each patient...
September 25, 2017: Human Mutation
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