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Chronic pancreatitis pain

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https://www.readbyqxmd.com/read/28089214/prevalence-of-chronic-pancreatitis-results-of-a-primary-care-physician-based-population-study
#1
Gabriele Capurso, Livia Archibugi, Piera Pasquali, Alessandro Aceti, Paolo Balducci, Patrizia Bianchi, Francesco Buono, Stefano Camerucci, Rosanna Cantarini, Sergio Centofanti, Patrizia Colantonio, Riccarda Cremaschi, Sergio Crescenzi, Caterina Di Mauro, Davide Di Renzi, Andrea Filabozzi, Alfonso Fiorillo, Giuseppe Giancaspro, Paola Giovannetti, Giuseppe Lanna, Claudio Medori, Emilio Merletti, Enzo Nunnari, Francesca Paris, Marco Pavone, Angela Piacenti, Almerindo Rossi, Maria Cristina Scamuffa, Giovanni Spinelli, Marco Taborchi, Biagio Valente, Antonella Villanova, Alberto Chiriatti, Gianfranco Delle Fave
BACKGROUND: Data on chronic pancreatitis prevalence are scanty and usually limited to hospital-based studies. AIM: Investigating chronic pancreatitis prevalence in primary care. METHODS: Participating primary care physicians reported the prevalence of chronic pancreatitis among their registered patients, environmental factors and disease characteristics. The data were centrally reviewed and chronic pancreatitis cases defined according to M-ANNHEIM criteria for diagnosis and severity and TIGAR-O classification for etiology...
December 27, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28079861/endoscopic-vs-surgical-interventions-for-painful-chronic-pancreatitis-what-is-needed-for-future-clinical-trials
#2
REVIEW
John A Windsor, Nageshwar D Reddy
The treatment of painful chronic pancreatitis remains controversial. The available evidence from two randomized controlled trials favor surgical intervention, whereas an endotherapy-first approach is widely practiced. Chronic pancreatitis is complex disease with different genetic and environmental factors, different pain mechanisms and different treatment modalities including medical, endoscopic, and surgical. The widely practiced step-up approach remains unproven. In designing future clinical trials there are some important pre-requisites including a more comprehensive pain assessment tool, the optimization of conservative medical treatment and interventional techniques...
January 12, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28078128/endoscopic-ultrasound-in-pancreatic-cancer-innovative-applications-beyond-the-basics
#3
REVIEW
Joseph Yoo, C Andrew Kistler, Linda Yan, Andrew Dargan, Ali A Siddiqui
Endoscopic ultrasound (EUS) has become a mainstay in assisting in the diagnosis and staging of pancreatic cancer. In addition, EUS provides a modality to treat chronic pain through celiac plexus neurolysis. Currently, there is growing data and utilization of EUS in more diverse and innovative applications aimed at providing more sophisticated diagnostic, prognostic and therapeutic options for patients with pancreatic cancer. EUS delivery of chemotherapy, viral and biological vectors and fiducial markers may eventually revolutionize the way clinicians approach the care of a patient with pancreatic cancer...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28075092/diabetes-mellitus-management-of-gastrointestinal-complications
#4
Beth Careyva, Brian Stello
Gastrointestinal disorders are common complications of diabetes mellitus and include gastroparesis, nonalcoholic fatty liver disease, gastroesophageal reflux disease, and chronic diarrhea. Symptoms of gastroparesis include early satiety, postprandial fullness, nausea, vomiting of undigested food, bloating, and abdominal pain. Gastroparesis is diagnosed based on clinical symptoms and a delay in gastric emptying in the absence of mechanical obstruction. Gastric emptying scintigraphy is the preferred diagnostic test...
December 15, 2016: American Family Physician
https://www.readbyqxmd.com/read/28060696/acute-pancreatitis-and-posterior-reversible-encephalopathy-syndrome-a-case-report
#5
Vítor Magno Pereira, Luís Marote Correia, Tiago Rodrigues, Gorete Serrão Faria
The posterior reversible encephalopathy syndrome is a neurological syndrome characterized by headache, confusion, visual disturbances and seizures associated with identifiable areas of cerebral edema on imaging studies. The authors report the case of a man, 33 years-old, leukodermic with a history of chronic alcohol and tobacco consumption, who is admitted to the emergency department for epigastric pain radiating to the back and vomiting with about six hours of evolution and an intense holocranial headache for two hours...
September 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28060186/acupuncture-for-pain-in-chronic-pancreatitis-a-single-blinded-randomized-crossover-trial
#6
Jacob Juel, Stefano Liguori, Aldo Liguori, Jakob L Poulsen, Massimiliano Valeriani, Carina Graversen, Søren S Olesen, Asbjørn M Drewes
OBJECTIVES: Many patients with painful chronic pancreatitis (CP) have insufficient effect of treatment, and the prevalence of adverse effects is high. Consequently, alternatives to conventional management are needed. We aimed to study the effect of acupuncture in painful CP. METHODS: This was a prospective, single-blinded, randomized crossover trial. Fifteen patients with CP were assigned to a session of acupuncture followed by sham stimulation or vice versa. Patients rated clinical pain scores daily on a 0 to 10 visual analogue scale (VAS) and completed the Patient Global Impression of Change...
February 2017: Pancreas
https://www.readbyqxmd.com/read/28058022/role-of-original-and-modified-frey-s-procedures-in-chronic-pancreatitis
#7
Chun-Lu Tan, Hao Zhang, Min Yang, Shao-Jun Li, Xu-Bao Liu, Ke-Zhou Li
AIM: To retrospectively review patients with chronic pancreatitis (CP) treated with Frey's procedures between January 2009 and January 2014. METHODS: A retrospective review was performed of patients with CP treated with Frey's procedures between January 2009 and January 2014 in the Department of Pancreatic Surgery. A cross-sectional study of postoperative pain relief, quality of life (QoL), and alcohol and nicotine abuse was performed by clinical interview, letters and telephone interview in January 2016...
December 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28050442/pancreatic-tuberculosis-a-puzzle-for-physicians-a-rare-case-and-review-of-literature
#8
Prashanth Ashok Kumar, Gursharan Singh, John Biku Joseph, S Swaminathan, L Venkatakrishnan
Pancreatic Tuberculosis is an uncommon form of extra pulmonary tuberculosis that resembles malignancy of pancreas and serve as a diagnostic challenge for physicians. Conservative management with Anti Tuberculosis Therapy (ATT) will suffice for pancreatic tuberculosis whereas a malignancy may require major surgeries which may lead to significant morbidity. Here, we discuss the case of a female patient who presented with abdominal pain and vomiting and is a known case of chronic calcific pancreatitis. Radiological findings were that of malignancy of the pancreas...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28049286/is-islet-transplantation-a-realistic-approach-to-curing-diabetes
#9
REVIEW
Sang-Man Jin, Kwang-Won Kim
Since the report of type 1 diabetes reversal in seven consecutive patients by the Edmonton protocol in 2000, pancreatic islet transplantation has been reappraised based on accumulated clinical evidence. Although initially expected to therapeutically target long-term insulin independence, islet transplantation is now indicated for more specific clinical benefits. With the long-awaited report of the first phase 3 clinical trial in 2016, allogeneic islet transplantation is now transitioning from an experimental to a proven therapy for type 1 diabetes with problematic hypoglycemia...
January 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28028304/zollinger-ellison-syndrome-an-unusual-case-of-chronic-diarrhoea-in-a-child
#10
R Goyal, U Debi, P Dey, K K Prasad, B R Thapa
Most cases of Zollinger-Ellison syndrome (ZES) are described in adults. It is a rare disorder in childhood. Most cases present with abdominal pain due to peptic ulceration and chronic diarrhoea not responding to general measures. The symptom complex is initially confused with other more common diseases, which lead to a delay in diagnosis. We present a rare case of a-12-year boy who initially presented with abdominal pain, diarrhoea, vomiting and progressive weight loss for over a two-year period before he was finally diagnosed as a case of ZES with the primary tumour in the pancreatic head and with multiple metastasis in both the liver and lymph nodes...
December 2016: Malaysian Journal of Pathology
https://www.readbyqxmd.com/read/28025771/early-experience-with-laparoscopic-frey-procedure-for-chronic-pancreatitis-a-case-series-and-review-of-literature
#11
Daniel J Kilburn, Adrian K H Chiow, Universe Leung, Mehan Siriwardhane, David J Cavallucci, Richard Bryant, Nicholas A O'Rourke
The Frey procedure has been demonstrated to be an effective surgical technique to treat patients with painful large duct chronic pancreatitis. More commonly reported as an open procedure, we report our experience with a minimally invasive approach to the Frey procedure. Four consecutive patients underwent a laparoscopic Frey procedure at our institution from January 2012 to July 2015. We herein report our technique and describe short- and medium-term outcomes. The median age was 40 years old. The median duration of pancreatic pain prior to surgery was 12 years...
December 26, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28024664/long-term-use-of-opioids-in-210-officially-registered-patients-with-chronic-noncancer-pain-in-taiwan-a-cross-sectional-study
#12
Tso-Chou Lin, Luo-Ping Ger, Joseph V Pergolizzi, Robert B Raffa, Ju-O Wang, Shung-Tai Ho
BACKGROUND/PURPOSE: Prescribing opioids for chronic noncancer pain has been strictly regulated for two decades in Taiwan. The aim of this study was to survey the patients' perspectives and potential drawbacks following long-term use of opioids. METHODS: An observational cross-sectional survey using the Taiwanese version of Brief Pain Inventory was conducted among outpatients with chronic noncancer pain registered by the Taiwan Food and Drug Administration. Patients were also asked about their sexual behavior, depression, opioid misuse behaviors, and use of complementary and alternative medicine...
December 23, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/27941156/efficacy-of-pancreatic-enzyme-replacement-therapy-in-chronic-pancreatitis-systematic-review-and-meta-analysis
#13
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/27926364/chronic-pancreatitis
#14
REVIEW
Michelle Stram, Shu Liu, Aatur D Singhi
Chronic pancreatitis is a debilitating condition often associated with severe abdominal pain and exocrine and endocrine dysfunction. The underlying cause is multifactorial and involves complex interaction of environmental, genetic, and/or other risk factors. The pathology is dependent on the underlying pathogenesis of the disease. This review describes the clinical, gross, and microscopic findings of the main subtypes of chronic pancreatitis: alcoholic chronic pancreatitis, obstructive chronic pancreatitis, paraduodenal ("groove") pancreatitis, pancreatic divisum, autoimmune pancreatitis, and genetic factors associated with chronic pancreatitis...
December 2016: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/27920643/elevated-lipase-during-initial-presentation-of-ulcerative-colitis-in-a-pediatric-patient-do-we-check-for-it
#15
Piyali Ray, Melissa R Van Arsdall
There are very few reports of elevated lipase in pediatric inflammatory bowel disease (IBD). Symptoms of pancreatitis may be masked by abdominal pain in pediatric IBD. During the initial presentation of IBD in our patient, lipase was elevated to more than 3 times the upper limit of normal. Normalization of values coincided with remission of IBD. This may be due to extraintestinal involvement of the pancreas as part of the inflammatory process or due to leakage of pancreatic enzymes from an inflamed gut or mediated by inflammatory cytokines...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27892226/an-overview-of-the-management-of-patients-with-chronic-pancreatitis
#16
Carolyn C Johnstone
Chronic pancreatitis is a complex inflammatory condition characterised by irreversible damage to the pancreas. This article explores the pathophysiology of this condition and its effects on pancreatic function. It outlines the causes and presenting features of chronic pancreatitis, as well as its effect on patients' quality of life and the changes to their lifestyle that are likely to be required. Chronic pancreatitis cannot be cured; therefore, treatment aims to control pain, manage problems associated with malabsorption, and assess and manage long-term complications that may develop, such as insulin dependence...
November 23, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27888869/latest-advances-in-chronic-pancreatitis
#17
J Enrique Domínguez-Muñoz
This article summarizes some of the recent and clinically relevant advances in chronic pancreatitis. These advances mainly concern the definition of the disease, the etiological diagnosis of idiopathic disease, the correlation between fibrosis degree and pancreatic secretion in the early stages of chronic pancreatitis, the treatment of the disease and of pain, the clinical relevance of pancreatic exocrine insufficiency, and the diagnosis of autoimmune pancreatitis. A new mechanistic definition of chronic pancreatitis has been proposed...
September 2016: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/27884691/aapt-diagnostic-criteria-for-chronic-cancer-pain-conditions
#18
REVIEW
Judith A Paice, Matt Mulvey, Michael Bennett, Patrick M Dougherty, John T Farrar, Patrick W Mantyh, Christine Miaskowski, Brian Schmidt, Thomas J Smith
: Chronic cancer pain is a serious complication of malignancy or its treatment. Currently, no comprehensive, universally accepted cancer pain classification system exists. Clarity in classification of common cancer pain syndromes would improve clinical assessment and management. Moreover, an evidence-based taxonomy would enhance cancer pain research efforts by providing consistent diagnostic criteria, ensuring comparability across clinical trials. As part of a collaborative effort between the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks (ACTTION) and the American Pain Society (APS), the ACTTION-APS Pain Taxonomy initiative worked to develop the characteristics of an optimal diagnostic system...
November 21, 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/27875360/outcomes-after-conservative-endoscopic-and-surgical-treatment-of-groove-pancreatitis-a-systematic-review
#19
Liesbeth M Kager, Selma J Lekkerkerker, Marianna Arvanitakis, Myriam Delhaye, Paul Fockens, Marja A Boermeester, Jeanin E van Hooft, Marc G Besselink
BACKGROUND: Groove pancreatitis (GP) is a focal form of chronic pancreatitis affecting the paraduodenal groove area, for which consensus on diagnosis and management is lacking. GOALS: We performed a systematic review of the literature to determine patient characteristics and imaging features of GP and to evaluate clinical outcomes after treatment. RESULTS: Eight studies were included reporting on 335 GP patients with a median age of 47 years (range, 34 to 64 y), with 90% male, 87% smokers, and 87% alcohol consumption, and 47 months (range, 15 to 122 mo) of follow-up...
November 21, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27857901/complete-agenesis-of-the-dorsal-pancreas-a-rare-clinical-entity
#20
Ambooken P Robert, Showkathali Iqbal, Mathew John
Complete agenesis of the dorsal pancreas (ADP) is an exceedingly rare congenital anomaly, compatible with life. The first case was reported in 1911 and so far around 100 cases have been reported in the world literature. Majority of the patients with this anomaly are asymptomatic or associated with abdominal pain, hyperglycemia, diabetes mellitus, and acute or chronic pancreatitis. We present a case report of a 34-year-old male with ADP, diagnosed incidentally during radiological evaluation for abdominal pain...
October 2016: International Journal of Applied and Basic Medical Research
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