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Chronic pancreatitis pain

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https://www.readbyqxmd.com/read/28524909/nonpharmacologic-pain-interventions-a-review-of-evidence-based-practices-for-reducing-chronic-cancer-pain%C3%A2
#1
Linda H Eaton, Jeannine M Brant, Karen McLeod, Chao Yeh
BACKGROUND: Pain is a common issue for patients with cancer and can be challenging to manage effectively. Healthcare professionals need to be knowledgeable about evidence-based nonpharmacologic interventions.
. OBJECTIVES: This systematic review critically appraises the strength and quality of the empirical evidence for nonpharmacologic interventions in reducing chronic cancer pain.
. METHODS: Intervention studies were critically appraised and summarized by an Oncology Nursing Society Putting Evidence Into Practice team of RNs, advanced practice nurses, and nurse scientists...
June 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28523574/medical-management-of-pain-in-chronic-pancreatitis
#2
REVIEW
Vikesh K Singh, Asbjørn M Drewes
The medical management of pain in chronic pancreatitis continues to pose significant challenges for clinicians caring for these patients. There are increasing data, suggesting that pain in chronic pancreatitis is largely due to peripheral and central sensitization that evolves, over time, as a result of nociceptive afferent associated with chronic inflammation and fibrosis of the pancreas. In many instances, patients rapidly progress to requiring opioid analgesics for the adequate treatment of pain despite the unequivocal risks associated with the long-term use of these drugs...
May 18, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28522204/peg-interferon-plus-nucleotide-analogue-treatment-versus-no-treatment-in-patients-with-chronic-hepatitis-b-with-a-low-viral-load-a-randomised-controlled-open-label-trial
#3
Annikki de Niet, Louis Jansen, Femke Stelma, Sophie B Willemse, Sjoerd D Kuiken, Sebastiaan Weijer, Carin M J van Nieuwkerk, Hans L Zaaijer, Richard Molenkamp, R Bart Takkenberg, Maarten Koot, Joanne Verheij, Ulrich Beuers, Hendrik W Reesink
BACKGROUND: Antiviral treatment is currently not recommended for patients with chronic hepatitis B with a low viral load. However, they might benefit from acquiring a functional cure (hepatitis B surface antigen [HBsAg] loss with or without formation of antibodies against hepatitis B surface antigen [anti-HBs]). We assessed HBsAg loss during peg-interferon-alfa-2a (peg-IFN) and nucleotide analogue combination therapy in patients with chronic hepatitis B with a low viral load. METHODS: In this randomised controlled, open-label trial, patients were enrolled from the Academic Medical Center (AMC), Amsterdam, Netherlands...
May 15, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28520452/-relapsing-autoimmune-pancreatitis-type-1-case-report
#4
Alena Ondrejková, Bohuslav Kianička, Hana Nechutová, Lukáš Hruška, Ivo Novotný, Miroslav Souček
Autoimmune pancreatitis (AIP) is a rare form of chronic pancreatitis, classified into 2 subtypes - AIP type 1 and AIP type 2. We present a case of a 31-years-old female admitted to our institution with upper abdominal pain and obstructive jaundice. Endoscopic retrograde cholangiopancreatoscopy (ERCP) revealed stenosis of intrapancreatic distal bile duct. Diffuse parenchymal enlargement and typical features of AIP were shown by computed tomography (CT) and endoscopic ultrasonography (EUS). The patient´s serum IgG4 was elevated at 3...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28512098/a-rare-case-of-thrombotic-microangiopathy-triggered-by-acute-pancreatitis
#5
Kevin Singh, Ahmed Jamal Nadeem, Behzad Doratotaj
Thrombotic microangiopathy (TMA) occurring after acute pancreatitis is rarely described. Without prompt intervention, TMA can be, and often is, lethal, so prompt recognition is important. Here, we present a case of a 61-year-old woman with a history of alcohol misuse who presented with epigastric pain, nausea and vomiting after binge drinking. Elevated serum lipase and imaging were suggestive of acute-on-chronic pancreatitis. Although the patient's symptoms of acute pancreatitis subsided, her anaemia, thrombocytopenia and acute kidney injury worsened...
May 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28496202/inhibition-of-jak-stat-signaling-reduces-the-activation-of-pancreatic-stellate-cells-in-vitro-and-limits-caerulein-induced-chronic-pancreatitis-in-vivo
#6
Hannah M Komar, Gregory Serpa, Claire Kerscher, Erin Schwoegl, Thomas A Mace, Ming Jin, Ming-Chen Yang, Ching-Shih Chen, Mark Bloomston, Michael C Ostrowski, Phil A Hart, Darwin L Conwell, Gregory B Lesinski
Chronic pancreatitis (CP) is a fibro-inflammatory disease leading to pain, maldigestion, and pancreatic insufficiency. No therapeutic options exist due to a limited understanding of the biology of CP pathology. Recent findings implicate pancreatic stellate cells (PSC) as prominent mediators of inflammatory and fibrotic processes during CP. Here, we utilized primary and immortalized PSC obtained from mice and patients with CP or pancreatic cancer to examine the effect of Jak/STAT and MAPK pathway inhibition in vitro...
May 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28493932/safety-and-tolerability-of-high-dose-ulinastatin-after-2-hour-intravenous-infusion-in-adult-healthy-chinese-volunteers-a-randomized-double-blind-placebo-controlled-ascending-dose-study
#7
Qian Chen, Chaoying Hu, Ye Liu, Yun Liu, Wei Wang, Hongchao Zheng, Lianchen Rong, Jingying Jia, Shixuan Sun, Chen Yu, Yan Mei Liu
Ulinastatin, is a broad-spectrum protease inhibitor purified from human urine, inhibits endogenous proteases such as trypsin, α-chymotrypsin, hyaluronidase, and plasmin. It is widely being used at increasingly higher doses for the treatment of acute or chronic pancreatitis, severe infection, and acute organ failure. We aimed to evaluate the safety and tolerability of high-dose ulinastatin in healthy volunteers in our single center, randomized, double-blind, placebo-controlled, single-dose escalation study...
2017: PloS One
https://www.readbyqxmd.com/read/28488091/outcomes-of-endoscopic-retrograde-cholangiopancreatography-ercp-and-sphincterotomy-for-suspected-sphincter-of-oddi-dysfunction-sod-post-roux-en-y-gastric-bypass
#8
Chin Hong Lim, Cyrus Jahansouz, Martin L Freeman, Daniel B Leslie, Sayeed Ikramuddin, Stuart K Amateau
BACKGROUND: Sphincter of Oddi dysfunction (SOD) is thought to be a cause of chronic abdominal pain post Roux-en-Y gastric bypass, and current practice of performing endoscopic retrograde cholangiopancreatography (ERCP) with or without sphincterotomy is not supported by evidence. In addition to the complexity and risks of the procedure in patients with Roux-en-Y anatomy, the outcomes are uncertain and debatable. We performed a retrospective review and analysis of post-gastric bypass patients who had undergone ERCP with sphincterotomy to determine the effectiveness in patients with suspected SOD...
May 9, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28483526/inhibition-of-the-high-affinity-choline-transporter-enhances-hyperalgesia-in-a-rat-model-of-chronic-pancreatitis
#9
Dan Luo, Lei Chen, Baoping Yu
BACKGROUND: The mechanisms underlying chronic and persistent pain associated with chronic pancreatitis (CP) are not completely understood. The cholinergic system is one of the major neural pathways of the pancreas. Meanwhile, this system plays an important role in chronic pain. We hypothesized that the high affinity choline transporter CHT1, which is a main determinant of cholinergic signaling capacity, is involved in regulating pain associated with CP. METHODS: CP was induced by intraductal injection of 2% trinitrobenzene sulfonic acid (TNBS) in Sprague-Dawley rats...
June 17, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28482873/clinical-impact-of-duodenal-pancreatic-heterotopia-is-there-a-need-for-surgical-treatment
#10
Alexander Betzler, Soeren T Mees, Josefine Pump, Sebastian Schölch, Carolin Zimmermann, Daniela E Aust, Jürgen Weitz, Thilo Welsch, Marius Distler
BACKGROUND: Pancreatic heterotopia (PH) is defined as ectopic pancreatic tissue outside the normal pancreas and its vasculature and duct system. Most frequently, PH is detected incidentally by histopathological examination. The aim of the present study was to analyze a large single-center series of duodenal PH with respect to the clinical presentation. METHODS: A prospective pancreatic database was retrospectively analyzed for cases of PH of the duodenum. All pancreatic and duodenal resections performed between January 2000 and October 2015 were included and screened for histopathologically proven duodenal PH...
May 8, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28482390/-clinical-analysis-of-11-children-with-pancreatic-cystic-fibrosis
#11
G L Wang, C N Zhao, J Zhou, F H Yu, H Q Shen, J Zhang, S Y Zhao, X W Xu
Objective: To increase the recognition of pancreatic cystic fibrosis (PCF) in children and facilitate diagnosing and treatment of this rare entity. Method: This is a retrospective analysis of children who presented to Beijing Children's Hospital affiliated to Capital Medical University from January 2010 to December 2015. We describe their clinical features, laboratory testing and management. Result: Eleven children were diagnosed with PCF by genetic testing or sweat chloride test during these 5 years, including 4 boys and 7 girls...
May 4, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28475277/a-stepwise-procedure-for-removal-of-an-embedded-self-expandable-metallic-stent-by-dual-knife
#12
Ya-Wei Bi, Zhao-Shen Li, Liang-Hao Hu
Benign biliary stricture (BBS) occurs in 7.3%-30.0% patients with chronic pancreatitis(1, 2) . In the management of BBS, fully covered self-expandable metallic stent (FCSEMS) is currently well used(3-5) . However, proximal migration of FCSEMS occurs in 10.0% recipients and is much more difficult to manage(5) . A 44-year-old man was admitted with abdominal pain and recurred obstructive jaundice a month after removal of last biliary plastic stents. This article is protected by copyright. All rights reserved.
May 5, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28472975/visceral-artery-pseudoaneurysms-two-case-reports-and-a%C3%A2-review-of-the-literature
#13
Amna Abdelgabar, Olivier d'Archambeau, Joachim Maes, Filip Van den Brande, Peter Cools, Roger R Rutsaert
BACKGROUND: Visceral artery pseudoaneurysms are relatively rare but have a high mortality rate in case of rupture. Their detection in the last decades is rising due to an increased use of computed tomography and angiography. However, due to the nonspecific nature of the clinical symptoms and signs, diagnosis is often delayed or missed. We describe two cases of patients presenting with nonspecific abdominal complaints and anemia leading to a diagnosis of visceral pseudoaneurysm. Both cases are successfully treated with a different endovascular intervention...
May 4, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28471312/the-scandinavian-baltic-pancreatic-club-sbpc-database-design-rationale-and-characterisation-of-the-study-cohort
#14
Søren S Olesen, Jakob L Poulsen, Asbjørn M Drewes, Jens B Frøkjær, Johanna Laukkarinen, Mikael Parhiala, Iben Rix, Srdan Novovic, Björn Lindkvist, Louise Bexander, Georg Dimcevski, Trond Engjom, Friedemann Erchinger, Ingfrid S Haldorsen, Aldis Pukitis, Imanta Ozola-Zālīte, Stephan Haas, Miroslav Vujasinovic, J Matthias Löhr, Antanas Gulbinas, Nanna M Jensen, Maiken T Jørgensen, Camilla Nøjgaard
OBJECTIVES: Chronic pancreatitis (CP) is a multifaceted disease associated with several risk factors and a complex clinical presentation. We established the Scandinavian Baltic Pancreatic Club (SBPC) Database to characterise and study the natural history of CP in a Northern European cohort. Here, we describe the design of the database and characteristics of the study cohort. METHODS: Nine centres from six different countries in the Scandinavian-Baltic region joined the database...
May 4, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28435316/subanesthetic-ketamine-for-pain-management-in-hospitalized-children-adolescents-and-young-adults-a-single-center-cohort-study
#15
Kathy A Sheehy, Caroline Lippold, Amy L Rice, Raissa Nobrega, Julia C Finkel, Zenaide Mn Quezado
BACKGROUND: Subanesthetic doses of ketamine, an N-methyl-d-aspartate receptor antagonist used as an adjuvant to opioid for the treatment of pain in adults with acute and chronic pain, have been shown, in some instances, to improve pain intensity and to decrease opioid intake. However, less is known about the role of ketamine in pain management in children, adolescents, and young adults. PURPOSE: We examined the effects of subanesthetic ketamine on pain intensity and opioid intake in children, adolescents, and young adults with acute and chronic pain syndromes treated in an inpatient setting...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28414683/recurrent-hypertriglyceridemic-pancreatitis-htgp-and-the-use-of-insulin-drip-as-treatment
#16
T Tran, N Lee
INTRODUCTION: Chronic pancreatitis by definition is a recurrent episode of acute pancreatitis and is commonly associated with alcoholism in the US. Another cause of chronic pancreatitis is hypertriglyceridemia (HTGP);, occurring in 1-5 percent of cases. The incidence of HTGP is higher in patients with diabetes and HIV, usually requiring triglyceride levels > 1000 mg/dL. CASE: A 33 year old man with uncontrolled type 1 diabetes and recurrent pancreatitis, first diagnosed 5 years prior, presented as a transfer from an outside hospital for a recurrent episode of HTGP...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28406494/laser-capture-microdissection-of-pancreatic-acinar-cells-to-identify-proteomic-alterations-in-a-murine-model-of-caerulein-induced-pancreatitis
#17
John P Shapiro, Hannah M Komar, Baris Hancioglu, Lianbo Yu, Ming Jin, Yuko Ogata, Phil A Hart, Zobeida Cruz-Monserrate, Gregory B Lesinski, Darwin L Conwell
OBJECTIVES: Chronic pancreatitis (CP) is characterized by inflammation and fibrosis of the pancreas, leading to pain, parenchymal damage, and loss of exocrine and endocrine function. There are currently no curative therapies; diagnosis remains difficult and aspects of pathogenesis remain unclear. Thus, there is a need to identify novel biomarkers to improve diagnosis and understand pathophysiology. We hypothesize that pancreatic acinar regions contain proteomic signatures relevant to disease processes, including secreted proteins that could be detected in biofluids...
April 13, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28403504/extracorporeal-shock-wave-lithotripsy-is-safe-and-effective-for-pediatric-patients-with-chronic-pancreatitis
#18
Dan Wang, Ya-Wei Bi, Jun-Tao Ji, Lei Xin, Jun Pan, Zhuan Liao, Ting-Ting Du, Jin-Huan Lin, Di Zhang, Xiang-Peng Zeng, Bo Ye, Wen-Bin Zou, Hui Chen, Ting Xie, Bai-Rong Li, Zhao-Hong Zheng, Zhao-Shen Li, Liang-Hao Hu
Background and aims Pancreatic extracorporeal shock wave lithotripsy (P-ESWL) is recommended as the first-line treatment for pancreatic stones. However, how well P-ESWL performs in pediatric patients remains unclear. We aimed to evaluate the safety and efficacy of P-ESWL for pediatric patients with chronic pancreatitis. Methods This prospective observational study was conducted in patients with painful chronic pancreatitis who underwent P-ESWL. Patients aged under 18 years were included in the pediatric group; patients aged over 18 years who underwent P-ESWL in the same period were assigned to the control group...
May 2017: Endoscopy
https://www.readbyqxmd.com/read/28393988/-chronic-pancreatitis-retrospective-review-of-121-cases
#19
Zoltán Berger F, Carla Mancilla A
BACKGROUND: Chronic pancreatitis (CP) is a rare disease in Chile, without a clear explanation for this low prevalence. AIM: To analyze the characteristics of our patients with pancreatitis. MATERIAL AND METHODS: Retrospective analysis of a database of patients with pancreatitis of a clinical hospital. Morphological proof of diagnosis (calcifications/calculi, alterations of ducts, local complication or histology) was obtained for every patient...
December 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28381387/long-term-outcome-of-patients-with-chronic-pancreatitis-treated-with-micronutrient-antioxidant-therapy
#20
Sukitha Namal Rupasinghe, Ajith K Siriwardena
BACKGROUND: Micronutrient antioxidant therapy did not relieve pain in a European randomized trial of patients with chronic pancreatitis without malnutrition. However, intervention was undertaken only for 6 months leaving unanswered the question of whether long-term antioxidant therapy may modulate chronic pancreatitis. The aim of this study is to assess the outcome of long-term use of micronutrient antioxidant therapy in patients with chronic pancreatitis. METHODS: This is a single center clinical cohort report of patients with chronic pancreatitis prescribed micronutrient antioxidant therapy and followed for up to 10 years...
April 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
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