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Chronic pancreatitis pain

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https://www.readbyqxmd.com/read/28921009/radiation-overexposure-from-repeated-ct-scans-in-young-adults-with-acute-abdominal-pain
#1
Massimo Tonolini, Elena Valconi, Angelo Vanzulli, Roberto Bianco
PURPOSE: The purpose of this study is to assess the dose of ionizing radiation caused by repeated CT scans performed to investigate non-traumatic acute abdominal conditions in young adults. METHODS: Over 26 months, we collected a cohort of patients aged 18 to 45 years who were subject to at least one urgent contrast-enhanced abdomen/pelvis CT. Patients affected with urolithiasis, HIV infection, tumors, and vascular and chronic inflammatory bowel diseases were excluded...
September 18, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28918191/development-and-validation-of-a-chronic-pancreatitis-prognosis-score-in-2-independent-cohorts
#2
Georg Beyer, Ujjwal M Mahajan, Christoph Budde, Thomas J Bulla, Thomas Kohlmann, Louise Kuhlmann, Kerstin Schütte, Ali A Aghdassi, Eckhard Weber, Ulrich Weiss, Asbjørn M Drewes, Søren S Olesen, Markus M Lerch, Julia Mayerle
BACKGROUND & AIMS: The clinical course of chronic pancreatitis is unpredictable. There is no model to assess disease severity or progression or predict patient outcomes. METHODS: We performed a prospective study of 91 patients with chronic pancreatitis; data were collected from patients seen at academic centers in Europe, from January 2011 through April 2014. We analyzed correlations between clinical, laboratory, and imaging data with number of hospital readmissions and in-hospital days over the next 12 months; the parameters with the highest degree of correlation were to develop 3-stage chronic pancreatitis prognosis score (COPPS)...
September 14, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28914984/hypercalcemic-disorders-in-children
#3
REVIEW
Victoria J Stokes, Morten F Nielsen, Fadil M Hannan, Rajesh V Thakker
Hypercalcemia is defined as a serum calcium concentration that is greater than 2 standard deviations above the normal mean, which in children may vary with age and sex, reflecting changes in the normal physiology at each developmental stage. Hypercalcemic disorders in children may present with hypotonia, poor feeding, vomiting, constipation, abdominal pain, lethargy, polyuria, dehydration, failure to thrive and seizures. In severe cases renal failure, pancreatitis and reduced consciousness may also occur and older children and adolescents may present with psychiatric symptoms...
September 15, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28911142/deficient-endogenous-glucose-production-during-exercise-after-total-pancreatectomy-islet-autotransplantation
#4
Lindsey D Bogachus, Elizabeth Oseid, Melena Bellin, Adrian Vella, R Paul Robertson
Context: Total pancreatectomy followed by intrahepatic islet autotransplantation (TP/IAT) is performed to alleviate severe, unrelenting abdominal pain caused by chronic pancreatitis, to improve quality of life, and to prevent diabetes. Objective: To determine the cause of exercise-induced hypoglycemia that is a common complaint in TP/IAT recipients. Design: Participants completed 1 hour of steady-state exercise. Setting: Hospital research unit...
September 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28902786/diagnosing-chronic-pancreatitis-comparison-and-evaluation-of-different-diagnostic-tools
#5
Yama Issa, Hjalmar C van Santvoort, Susan van Dieren, Marc G Besselink, Marja A Boermeester, Usama Ahmed Ali
OBJECTIVES: This study aims to compare the M-ANNHEIM, Büchler, and Lüneburg diagnostic tools for chronic pancreatitis (CP). METHODS: A cross-sectional analysis of the development of CP was performed in a prospectively collected multicenter cohort including 669 patients after a first episode of acute pancreatitis. We compared the individual components of the M-ANNHEIM, Büchler, and Lüneburg tools, the agreement between tools, and estimated diagnostic accuracy using Bayesian latent-class analysis...
October 2017: Pancreas
https://www.readbyqxmd.com/read/28895017/total-pancreatectomy-with-islet-autotransplantation-for-acute-recurrent-and-chronic-pancreatitis
#6
REVIEW
Varvara A Kirchner, Ty B Dunn, Gregory J Beilman, Srinath Chinnakotla, Timothy L Pruett, Joshua J Wilhelm, Sarah J Schwarzenberg, Martin L Freeman, Melena D Bellin
PURPOSE OF REVIEW: The first total pancreatectomy and islet autotransplantation (TP-IAT) was performed for chronic pancreatitis in 1977 with the goal to ameliorate the pain and simultaneously preserve islet function. We reviewed the recent medical literature regarding indications, patient suitability, current outcomes, and challenges in TP-IAT. RECENT FINDINGS: Current indications for TP-IAT include intractable pain secondary to chronic pancreatitis (CP) or acute recurrent pancreatitis (ARP) with failed medical and endoscopic/surgical management...
September 11, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28885327/risk-factors-for-pain-after-frey-s-procedure-in-chronic-pancreatitis
#7
Shao-Jun Li, Chun-Lu Tan, Bo-le Tian
Pancreatic pain is the most frequent symptom of chronic pancreatitis (CP) and is difficult to treat. This retrospective study aimed to determine the risk factors for pain in CP.From January 2009 and March 2014, 75 consecutive patients with CP who underwent Frey's procedure were reviewed for this study. According to Izbicki pain scores, these patients were divided into 2 groups: (1) pain (Izbicki pain score of >10 after a decrease of >50%) and (2) pain-free (Izbicki pain score of ≤10). Demographic data, medical history, postoperative variables, and follow-up evaluations of the patients were documented...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28880010/chronic-pancreatitis
#8
REVIEW
Jorg Kleeff, David C Whitcomb, Tooru Shimosegawa, Irene Esposito, Markus M Lerch, Thomas Gress, Julia Mayerle, Asbjørn Mohr Drewes, Vinciane Rebours, Fatih Akisik, J Enrique Domínguez Muñoz, John P Neoptolemos
Chronic pancreatitis is defined as a pathological fibro-inflammatory syndrome of the pancreas in individuals with genetic, environmental and/or other risk factors who develop persistent pathological responses to parenchymal injury or stress. Potential causes can include toxic factors (such as alcohol or smoking), metabolic abnormalities, idiopathic mechanisms, genetics, autoimmune responses and obstructive mechanisms. The pathophysiology of chronic pancreatitis is fairly complex and includes acinar cell injury, acinar stress responses, duct dysfunction, persistent or altered inflammation, and/or neuro-immune crosstalk, but these mechanisms are not completely understood...
September 7, 2017: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/28858939/beyond-abdominal-pain-pain-beliefs-pain-affect-and-distress-as-determinants-of-quality-of-life-in-patients-with-chronic-pancreatitis
#9
Craig E Keller, Charles Mel Wilcox, Gregory D Gudleski, Stacey Branham, Jeffrey M Lackner
GOALS: To assess the relationship between pain, psychological processes, and quality of life (QOL) in chronic pancreatitis (CP). BACKGROUND: CP is a progressive inflammatory disorder of the pancreas characteristically resulting in abdominal pain and impairing QOL. Pain due to CP is poorly understood and frequently difficult to treat. This pain has historically been understood as a peripheral process originating from the pancreas itself, but a growing body of literature is revealing an important role offered by central influences...
August 30, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28857897/mri-assessed-pancreatic-morphology-and-exocrine-function-are-associated-with-disease-burden-in-chronic-pancreatitis
#10
Adnan Madzak, Søren Schou Olesen, Jakob Lykke Poulsen, Esben Bolvig Mark, Asbjørn Mohr Drewes, Jens Brøndum Frøkjær
BACKGROUND AND AIM: The aim of this study was to explore the association between morphological and functional secretin-stimulated MRI parameters with hospitalization, quality of life (QOL), and pain in patients with chronic pancreatitis (CP). PATIENTS AND METHODS: This prospective cohort study included 82 patients with CP. Data were obtained from clinical information, QOL, and pain as assessed by questionnaires (The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and modified Brief Pain Inventory short form)...
August 29, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28854965/adipose-stem-cells-from-chronic-pancreatitis-patients-improve-mouse-and-human-islet-survival-and-function
#11
Lili Song, Zhen Sun, Do-Sung Kim, Wenyu Gou, Charlie Strange, Huansheng Dong, Wanxing Cui, Gary Gilkeson, Katherine A Morgan, David B Adams, Hongjun Wang
BACKGROUND: Chronic pancreatitis has surgical options including total pancreatectomy to control pain. To avoid surgical diabetes, the explanted pancreas can have islets harvested and transplanted. Immediately following total pancreatectomy with islet autotransplantation (TP-IAT), many islet cells die due to isolation and transplantation stresses. The percentage of patients remaining insulin free after TP-IAT is therefore low. We determined whether cotransplantation of adipose-derived mesenchymal stem cells (ASCs) from chronic pancreatitis patients (CP-ASCs) would protect islets after transplantation...
August 30, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28844095/pancreatic-panniculitis-and-polyarthritis
#12
REVIEW
Sebastian Zundler, Deike Strobel, Bernhard Manger, Markus F Neurath, Dane Wildner
PURPOSE OF REVIEW: Polyarthritis can have numerous reasons and may thus constitute a challenge for differential diagnosis. One rare potential reason for sterile polyarthritis is underlying pancreatic disease with systemic hyperlipasemia, most often accompanied by painful skin lesions caused by a subcutaneous inflammatory process known as panniculitis. Systematic evidence on pancreatic panniculitis and polyarthritis is limited, particularly regarding its feature as facultative paraneoplasia with underlying intra- or even extra-pancreatic malignancy...
August 26, 2017: Current Rheumatology Reports
https://www.readbyqxmd.com/read/28835974/-hypercalcemic-crisis-and-hypocalcemic-tetany
#13
REVIEW
C Kasperk
A serum calcium level >3.5 mmol/l together with clinical symptoms such as muscle weakness, fatigue, nausea, vomiting, pancreatitis or even coma are characteristic for a hypercalcemic crisis (HC). Primary hyperparathyroidism (1HPT) and malignancy-associated hypercalcemia are the most frequent causal diseases for a HC. The analysis of serum levels for calcium, phosphorous, intact parathyroid hormone, electrophoresis and renal function parameters indicate which further radiological, scintigraphic or serum diagnostic steps are adequate to identify the cause of the patient's acute situation (i...
August 23, 2017: Der Internist
https://www.readbyqxmd.com/read/28821411/diagnosis-and-treatment-in-chronic-pancreatitis-an-international-survey-and-case-vignette-study
#14
Yama Issa, Hjalmar C van Santvoort, Paul Fockens, Marc G Besselink, Thomas L Bollen, Marco J Bruno, Marja A Boermeester
BACKGROUND: The aim of the study was to evaluate the current opinion and clinical decision-making process of international pancreatologists, and to systematically identify key study questions regarding the diagnosis and treatment of chronic pancreatitis (CP) for future research. METHODS: An online survey, including questions regarding the diagnosis and treatment of CP and several controversial clinical case vignettes, was send by e-mail to members of various international pancreatic associations: IHPBA, APA, EPC, ESGE and DPSG...
August 15, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28814218/diagnosis-and-management-of-pancreatic-exocrine-insufficiency
#15
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/28808857/the-surgeon-s-role-in-treating-chronic-pancreatitis-and-incidentally-discovered-pancreatic-lesions
#16
Vikrom K Dhar, Brent T Xia, Syed A Ahmad
Chronic pancreatitis and incidentally discovered pancreatic lesions present significant diagnostic and therapeutic challenges for surgeons. While both decompressive and resection procedures have been described for treatment of chronic pancreatitis, optimal management must be tailored to each patient's individual disease characteristics, parenchymal morphology, and ductal anatomy. Surgeons should strive to achieve long-lasting pain relief while preserving native pancreatic function. For patients with incidentally discovered pancreatic lesions, differentiating benign, pre-malignant, and malignant lesions is critical as earlier treatment is thought to result in improved survival...
August 14, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28796136/local-and-systemic-expression-of-immunomodulatory-factors-in-chronic-pancreatitis
#17
Hannah M Komar, Phil A Hart, Zobeida Cruz-Monserrate, Darwin L Conwell, Gregory B Lesinski
Inflammatory and fibrotic events that drive chronic pancreatitis (CP) are likely orchestrated via signaling of soluble cytokines and chemokines systemically and within the pancreas. However, a comprehensive summary of the expression of such factors during CP has not been reported to date. This information is important given continued interest in targeting cytokines that influence CP pathogenesis. Reported data on the expression change of soluble immunomodulatory factors in human CP patients were identified via a literature search using a single search term...
September 2017: Pancreas
https://www.readbyqxmd.com/read/28791598/opioid-medications-in-the-management-of-chronic-abdominal-pain
#18
REVIEW
Dajie Wang
PURPOSE OF REVIEW: Chronic abdominal pain is a complex medical condition. The causes of chronic abdominal pain are extremely diverse ranging from chronic pancreatitis, Crohn's disease, to chronic pain with no clear etiology. Treatment of chronic abdominal pain remains a challenge in our clinical practice. While current interventions with celiac plexus blocks and pain medications provide some relief for these patients, but these treatments are typically less efficacious and limited by various adverse effects...
August 8, 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28771447/chronic-pancreatitis
#19
Dennis Yang, Chris E Forsmark
PURPOSE OF REVIEW: Summarize key clinical advances in chronic pancreatitis reported in 2016. RECENT FINDINGS: Early diagnosis of chronic pancreatitis remains elusive. Recent studies suggest that endoscopic ultrasound may be less accurate than previously thought and new MRI techniques may be helpful. Genetic predisposition may independently affect the clinical course of chronic pancreatitis and the risk for pancreatic cancer. Cigarette smoking may have a greater negative impact on chronic pancreatitis than previously thought and moderate alcohol consumption may be protective...
September 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28765897/the-toll-like-receptor-4-antagonist-tak-242-protects-against-chronic-pancreatitis-in-rats
#20
Long-Fei Pan, Lei Yu, Li-Ming Wang, Jun-Tao He, Jiang-Li Sun, Xiao-Bo Wang, Zheng-Hai Bai, Hai Wang, Ting-Lin Yan, Hong-Hong Pei
Chronic pancreatitis is a progressive disease characterized by irreversible morphological changes to the pancreas, typically causing pain and permanent loss of function. It is a poorly understood disease with the pathogenesis remaining unclear. The authors' previous data demonstrated that the inhibition of Toll‑like receptor 4 (TLR4) using TLR4 antagonist kinase (TAK)‑242 attenuates taurocholate‑induced oxidative stress via the regulation of mitochondrial function in the pancreatic acinar cells of mice...
October 2017: Molecular Medicine Reports
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