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apache and pancreatitis

Sara Bertilsson, Per Swärd, Anders Håkansson, Rafid Tofik, Bengt Rippe, Evangelos Kalaitzakis
BACKGROUND AND AIMS: The disease course of acute pancreatitis (AP) ranges from mild and self-limiting to severe inflammation, associated with significant morbidity and mortality. At present, there are no universally accepted and reliable predictors for severity. Microproteinuria has been associated with the presence of systemic inflammatory response syndrome as well as trauma, although its association with AP is not well understood. The aim of this study was to investigate the value of microproteinuria to predict development of organ failure in AP...
October 12, 2016: Digestive Diseases and Sciences
Jing Zhou, Lu Ke, Dongliang Yang, Yizhe Chen, Gang Li, Zhihui Tong, Weiqin Li, Jieshou Li
BACKGROUND: Splanchnic venous thrombosis (SVT) is a relatively rare but important complication of necrotizing acute pancreatitis (NAP). Clinical manifestations and severity of this complication in different patients vary greatly, ranging from mild abdominal discomfort even asymptomatic to lethal gastrorrhagia or hepatic failure. The aim of the present study was to develop a model to predict the clinical manifestations of SVT in NAP patients. METHODS: This retrospective cohort study was conducted in the surgical intensive care unit (SICU) of Jinling Hospital...
October 3, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Yejiang Zhou, Lulu Wang, Xinwu Huang, Hua Li, Yuxia Xiong
ETHNOPHARMACOLOGICAL RELEVANCE: Rhubarb is one of the common herbs used in traditional Chinese complex prescriptions for the treatment of various inflammatory diseases. We sought to determine the add-on effect of crude rhubarb to somatostatin in patients with acute pancreatitis by conducting a meta-analysis. MATERIALS AND METHODS: We searched the Pubmed, EMBASE, Cochrane Library, CNKI, Wanfang, VIP databases up to November 2015. Randomized controlled trials (RCTs) comparing crude rhubarb plus somatostatin to somatostatin alone for acute pancreatitis were included...
September 29, 2016: Journal of Ethnopharmacology
Christos Skouras, Xiaozhong Zheng, Margaret Binnie, Natalie Z M Homer, Toby B J Murray, Darren Robertson, Lesley Briody, Finny Paterson, Heather Spence, Lisa Derr, Alastair J Hayes, Andreas Tsoumanis, Dawn Lyster, Rowan W Parks, O James Garden, John P Iredale, Iain J Uings, John Liddle, Wayne L Wright, George Dukes, Scott P Webster, Damian J Mole
Inhibition of kynurenine 3-monooxygenase (KMO) protects against multiple organ dysfunction (MODS) in experimental acute pancreatitis (AP). We aimed to precisely define the kynurenine pathway activation in relation to AP and AP-MODS in humans, by carrying out a prospective observational study of all persons presenting with a potential diagnosis of AP for 90 days. We sampled peripheral venous blood at 0, 3, 6, 12, 24, 48, 72 and 168 hours post-recruitment. We measured tryptophan metabolite concentrations and analysed these in the context of clinical data and disease severity indices, cytokine profiles and C-reactive protein (CRP) concentrations...
September 27, 2016: Scientific Reports
Liang Luo, Ciara M Shaver, Zhiguo Zhao, Tatsuki Koyama, Carolyn S Calfee, Julie A Bastarache, Lorraine B Ware
BACKGROUND: Direct (pulmonary) and indirect (extrapulmonary) ARDS are distinct syndromes with important pathophysiologic differences. The goal of this study was to determine whether clinical characteristics and predictors of mortality differ between direct or indirect ARDS. METHODS: A retrospective observational cohort study of 417 ARDS patients. Each patient was classified as having direct (pneumonia or aspiration, n=250) or indirect ARDS (non-pulmonary sepsis or pancreatitis, n=167)...
September 20, 2016: Chest
Amit Velagapudi, Matthew McKay, Tasmin Barry, Simon Bann, Susrutha K Wickremesekera
BACKGROUND: Infected pancreatic necrosis develops in approximately one third of patients with necrotizing pancreatitis and can lead to significant morbidity and mortality rates. Historically, open necrosectomy has been the mainstay of management for these patients but is in itself a morbid procedure. In recent times, minimally invasive techniques have evolved to allow a less invasive approach to these patients. Percutaneous catheter drainage of infected pancreatic necrosis is a technique that has been demonstrated to be potentially useful in the treatment of this group of patients...
September 19, 2016: Surgical Infections
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...
September 12, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
L X Yang, L C Du, X Liu, J Chen, J Y Hao
OBJECTIVE: To explore the four criteria, including bedside index for severity in acute pancreatitis(BISAP), Ranson score, modified CT severity index(MCTSI) and acute physiology and chronic health evaluation scoring systemⅡ(APACHE Ⅱ) in assessment of severity and prognosis of hyperlipidemic acute pancreatitis. METHODS: A total of 326 patients with hyperlipidemic acute pancreatitis were studied retrospectively from August 2006 to July 2015. The discrepancy of the four criteria in assessment of severity and prognosis of hyperlipidemic acute pancreatitis was compared with chi-square test and receiver operating characteristic curve...
September 1, 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Mousalreza Hosseini, Payman Shalchiantabrizi, Khadijeh Yektaroudy, Maliheh Dadgarmoghaddam, Masoumeh Salari
BACKGROUND: Acute Post ERCP Pancreatitis (PEP) is the most common major complication of Endoscopic retrograde cholangiopancreatography (ERCP). The aim of the current study was to assess the utility of single dose rectal indomethacin with and without  intravenous perfusion of normal saline to prevent acute pancreatitis. METHODS: In this randomized clinical trial, 406 patients with choledocolithiasis underwent ERCP. Based on computer-generated  numbers, the patients were allocated into 4 groups, each group receiving a different intervention prior to the ERCP procedure...
August 2016: Archives of Iranian Medicine
Meng-Yang Di, Hao Liu, Zu-Yao Yang, Peter A L Bonis, Jin-Ling Tang, Joseph Lau
Background: Acute pancreatitis (AP) varies in severity, prompting development of systems aimed at predicting prognosis to help guide therapy. Although several prediction approaches are available, their test characteristics and clinical utility are not completely understood. Purpose: To evaluate the test characteristics (prognostic accuracy, incremental predictive value) and clinical utility (effect on patient outcomes) of severity scores for predicting mortality in AP...
October 4, 2016: Annals of Internal Medicine
Xiao-Xiao Chi, Tian-Wu Chen, Xiao-Hua Huang, Lin Yang, Wei Tang, Yì-Xiáng J Wáng, Bo Xiao, Xiao-Ming Zhang
BACKGROUND: To study the magnetic resonance imaging (MRI) features of acute pancreatitis (AP) involving the retroperitoneal interfascial planes and to analyze the correlations of interfascial plane involvement with the magnetic resonance severity index (MRSI) and the Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system. METHODS: A total of 316 consecutive patients with AP between November 2011 and August 2013 were retrospectively analyzed. The extension and path of the inflammation spreading along the retroperitoneal interfascial plane on MRI were graded from grade 0 to grade 5...
June 2016: Quantitative Imaging in Medicine and Surgery
Jie Huang, Hong-Ping Qu, Yun-Feng Zheng, Xu-Wei Song, Lei Li, Zhi-Wei Xu, En-Qiang Mao, Er-Zhen Chen
BACKGROUND: The Atlanta criteria for acute pancreatitis (AP) has been revised recently. This study was to evaluate its practical value in classification of AP, the severity assessment and management. METHODS: The clinical features, severity classification, outcome and risk factors for mortality of 3212 AP patients who had been admitted in Ruijin Hospital from 2004 to 2011 were analyzed based on the revised Atlanta criteria (RAC) and the original Atlanta criteria (OAC)...
June 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Bing Zhao, Ying Chen, Wen Wu Sun, Wei Wei Chen, Li Ma, Zhi Tao Yang, Jun Huang, Er Zhen Chen, Jian Fei, En Qiang Mao
OBJECTIVE: To assess whether serum levels of S100A12 and soluble receptor for advanced glycation end products (sRAGE) could predict the severity of acute pancreatitis (AP). METHODS: We conducted a non-interventional pilot study, including 74 AP patients and 28 healthy volunteers serving as controls. AP patients were further divided into the mild (MAP, n = 22), moderately severe (MSAP, n = 30) and severe (SAP, n = 22) groups. Peripheral blood samples were collected within 72 h after the onset of AP for the determination of S100A12, sRAGE and C-reactive protein (CRP) levels...
July 2016: Journal of Digestive Diseases
O V Rotar
In 70 patients, suffering an acute necrotic pancreatitis (ANP), and 10 practically healthy persons a content of presepsin in a blood plasm, using immunochemiluminescent method and conducted bacteriological investigations, were analyzed. The infection occurrence is accompanied by plausible upgrading of a presepsin level in a blood plasm, depending on activity and severity of a septic process: in local infection--up to (677 ± 30) pg/ml, sepsis--up to (988 ± 47) pg/ml, severe sepsis--up to 2668 pg/ml; in an ANP without infection it have constituted (332 ± 38) pg/mI at average, in practically healthy persons--(184 ± 16) pg/mI...
January 2016: Klinichna Khirurhiia
Meng Yue Tang, Tian Wu Chen, Xiao Hua Huang, Xing Hui Li, Si Yue Wang, Nian Liu, Xiao Ming Zhang
BACKGROUND: To study gradient recalled echo (GRE) T2*-weighted imaging (T2*WI) for normal pancreas and acute pancreatitis (AP). METHODS: Fifty-one patients without any pancreatic disorders (control group) and 117 patients with AP were recruited. T2* values derived from T2*WI of the pancreas were measured for the two groups. The severity of AP was graded by the magnetic resonance severity index (MRSI) and the Acute Physiology and Chronic Healthy Evaluation II (APACHE II) scoring system...
April 2016: Quantitative Imaging in Medicine and Surgery
I Mikolasevic, S Milic, L Orlic, G Poropat, I Jakopcic, N Franjic, A Klanac, N Kristo, D Stimac
AIM: The aim of our study was to investigate the influence of metabolic syndrome on the course of acute pancreatitis determined by disease severity, the presence of local and systemic complications and survival rate. PATIENTS AND METHODS: 609 patients admitted to our hospital in the period from January 1, 2008 up to June 31, 2015 with the diagnosis of acute pancreatitis were analyzed. The diagnosis and the severity of acute pancreatitis were made according to the revised Atlanta classification criteria from 2012...
July 2016: European Journal of Internal Medicine
H Guo, D-W Suo, H-P Zhu, X-M Sun, J Chen
OBJECTIVE: Severe acute pancreatitis (SAP) can often be complicated by acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), leading to increased mortality. Early blood purification clears inflammatory cytokines and promotes immune function recovery. Here we evaluated the usefulness of this therapy in SAP complicated by ALI. PATIENTS AND METHODS: 32 patients received routine treatment (control group), whereas other 32 patients received routine treatment and early blood purification therapy (study group)...
March 2016: European Review for Medical and Pharmacological Sciences
Yong Jiang, Yong An, Danqian Jiang, Baoqiang Wu, Yue Yang, Donglin Sun
BACKGROUND: Acute pancreatitis (AP) is a common disease with a high fatality rate as a result of its unclear pathogenesis. Interleukin (IL)-33 plays a role in various inflammatory conditions but its role and regulatory mechanisms in AP is still unknown. METHODS: The serum levels of IL-33, sST2, TNF-α and IL-6 in AP patients were detected using ELISA. The correlations between IL-33 and TNF-α, sST2, IL-6, Ranson score and APACHE II score were investigated using Pearson correlation analysis...
2016: Annals of Clinical and Laboratory Science
Samagra Agarwal, John George, Rajesh Kumar Padhan, Padmaprakash K Vadiraja, Sanatan Behera, Ajmal Hasan, Rajan Dhingra, Shalimar, Pramod Kumar Garg
BACKGROUND: The trend in the outcome of patients with acute pancreatitis (AP) as a result of evolving management practices is not known. OBJECTIVE: To study and compare the outcomes of patients with AP at a tertiary care academic center over a period of 16 years. METHODS: In a retrospective study on a prospectively acquired database of patients with AP, we analyzed time trends of severity and mortality of AP. The influence of determinants of severity [APACHE II score, organ failure (OF), infected pancreatic necrosis (IPN)], and management strategy on the actual and predicted mortality was assessed...
March 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
James I C Kennedy, Kathryn J Askelund, Rakesh Premkumar, Anthony R J Phillips, Rinki Murphy, John A Windsor, Maxim S Petrov
Adipokines have many homeostatic roles, including modulation of glucose metabolism, but their role in the pathophysiology of hyperglycemia associated with acute and critical illnesses in general, and acute pancreatitis (AP) in particular, is largely unknown. This study aimed to investigate the relationship between a panel of adipokines and hyperglycemia in the early course of AP, as well as the role of adipokines as predictors of AP severity.Adiponectin, leptin, omentin, resistin, and visfatin were measured on a daily basis in the first 72 hours after hospital admission...
February 2016: Medicine (Baltimore)
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