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Acute severe pancreatitis

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https://www.readbyqxmd.com/read/28522995/dysbiosis-of-intestinal-microbiota-and-decreased-antimicrobial-peptide-level-in-paneth-cells-during-hypertriglyceridemia-related-acute-necrotizing-pancreatitis-in-rats
#1
Chunlan Huang, Jing Chen, Jingjing Wang, Hui Zhou, Yingying Lu, Lihong Lou, Junyuan Zheng, Ling Tian, Xingpeng Wang, Zhongwei Cao, Yue Zeng
Hypertriglyceridemia (HTG) aggravates the course of acute pancreatitis (AP). Intestinal barrier dysfunction is implicated in the pathogenesis of AP during which dysbiosis of intestinal microbiota contributes to the dysfunction in intestinal barrier. However, few studies focus on the changes in intestine during HTG-related acute necrotizing pancreatitis (ANP). Here, we investigated the changes in intestinal microbiota and Paneth cell antimicrobial peptides (AMPs) in HTG-related ANP (HANP) in rats. Rats fed a high-fat diet to induce HTG and ANP was induced by retrograde injection of 3...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28522901/transition-of-early-phase-treatment-for-acute-pancreatitis-an-analysis-of-nationwide-epidemiological-survey
#2
EDITORIAL
Shin Hamada, Atsushi Masamune, Tooru Shimosegawa
Treatment of acute pancreatitis (AP) is one of the critical challenges to the field of gastroenterology because of its high mortality rate and high medical costs associated with the treatment of severe cases. Early-phase treatments for AP have been optimized in Japan, and clinical guidelines have been provided. However, changes in early-phase treatments and the relationship between treatment strategy and clinical outcome remain unclear. Retrospective analysis of nationwide epidemiological data shows that time for AP diagnosis has shortened, and the amount of initial fluid resuscitation has increased over time, indicating the compliance with guidelines...
April 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28516251/-severe-hypertriglyceridemia-diagnostics-and-new-treatment-principles
#3
U Kassner, M Dippel, E Steinhagen-Thiessen
Severe hypertriglyceridemia is defined at a plasma triglyceride (TG) concentration of >885 mg/dl and may result - in particular when clinical symptoms appear before the age of 40 - from "large variant" mutations in genes which influence the function of the lipoprotein lipase (LPL). For diagnosis, secondary factors have to be excluded and treated before further genetic tests are considered. Typical symptoms in almost all patients are recurrent, sometimes severe abdominal pain attacks, which can result in acute pancreatitis, the most important, sometimes life-threatening complication...
May 17, 2017: Der Internist
https://www.readbyqxmd.com/read/28516111/transhiatal-herniation-of-the-pancreas-a-rare-cause-of-acute-pancreatitis
#4
Jeremy Wang, Adarsh M Thaker, Wael Noor El-Nachef, Rabindra R Watson
Transhiatal herniation of the pancreas is rare. Acute pancreatitis secondary to this phenomenon is particularly unusual. A 102-year-old woman presented with 1 day of severe chest pain, vomiting, dyspnea, and diaphoresis. Serum lipase was elevated, and computed tomography angiogram of the chest and magnetic resonance cholangiopancreatography revealed a hiatal hernia containing the pancreas, with associated findings of pancreatitis. Pancreatitis in this setting may be due to repetitive trauma or ischemia from sliding, intermittent folding of the pancreatic duct, or pancreatic incarceration...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28514841/endoscopic-management-of-pancreatic-fluid-collections-in-children
#5
REVIEW
Zaheer Nabi, Rupjyoti Talukdar, D Nageshwar Reddy
The incidence of acute pancreatitis in children has increased over the last few decades. The development of pancreatic fluid collection is not uncommon after severe acute pancreatitis, although its natural course in children and adolescents is poorly understood. Asymptomatic fluid collections can be safely observed without any intervention. However, the presence of clinically significant symptoms warrants the drainage of these fluid collections. Endoscopic management of pancreatic fluid collection is safe and effective in adults...
May 19, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28513459/effects-of-granulocyte-colony-stimulating-factor-on-opsonin-receptor-expression-and-neutrophil-antibacterial-activity-in-a-mouse-model-of-severe-acute-pancreatitis
#6
Tuo Hong-Fang, Peng Yan-Hui, Bao Lei, Zhang Wan-Xing
The antimicrobial function of neutrophils, which is dependent on opsonin receptors, deteriorates in severe acute pancreatitis (SAP). Granulocyte colony-stimulating factor (G-CSF) putatively enhanced levels of the opsonin receptors CD11b and CD32/16 in healthy human subjects, and provided protection against infection in animal models of SAP. A statistically convincing study of the effect of G-CSF on CD32/16 expression in an SAP model is lacking. We used a mouse model of SAP to investigate the association between G-CSF administration and CD32/16 levels on neutrophils and bacterial translocation...
May 9, 2017: Postȩpy Higieny i Medycyny Doświadczalnej
https://www.readbyqxmd.com/read/28510290/retrospective-evaluation-of-the-impact-of-early-enteral-nutrition-on-clinical-outcomes-in-dogs-with-pancreatitis-34-cases-2010-2013
#7
Jessica P Harris, Nolie K Parnell, Emily H Griffith, Korinn E Saker
OBJECTIVE: To evaluate the effect of early enteral nutritional therapy on time to return to voluntary intake, maximum food consumption, incidence of gastrointestinal intolerance (GI), and total hospitalization time for dogs with acute pancreatitis. DESIGN AND SETTING: Retrospective analysis of dogs with pancreatitis at a veterinary teaching hospital between 2010 and 2013. ANIMALS: Thirty-four client-owned dogs diagnosed with acute or acute-on-chronic pancreatitis...
May 16, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28507751/validation-of-the-efficacy-of-the-prognostic-factor-score-in-the-japanese-severity-criteria-for-severe-acute-pancreatitis-a-large-multicenter-study
#8
Tsukasa Ikeura, Masayasu Horibe, Masamitsu Sanui, Mitsuhito Sasaki, Yasuyuki Kuwagata, Kenichiro Nishi, Shuji Kariya, Hirotaka Sawano, Takashi Goto, Tsuyoshi Hamada, Takuya Oda, Hideto Yasuda, Yuki Ogura, Dai Miyazaki, Kaoru Hirose, Katsuya Kitamura, Nobutaka Chiba, Tetsu Ozaki, Takahiro Yamashita, Toshitaka Koinuma, Taku Oshima, Tomonori Yamamoto, Morihisa Hirota, Satoshi Yamamoto, Kyoji Oe, Tetsuya Ito, Eisuke Iwasaki, Takanori Kanai, Kazuichi Okazaki, Toshihiko Mayumi
BACKGROUND: The Japanese severity criteria for acute pancreatitis (AP), which consist of a prognostic factor score and contrast-enhanced computed tomography grade, have been widely used in Japan. OBJECTIVE: This large multicenter retrospective study was conducted to validate the predictive value of the prognostic factor score for mortality and complications in severe AP patients in comparison to the Acute Physiology and Chronic Health Evaluation II (APACHE II) score...
April 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28507728/therapeutic-plasmapheresis-for-hypertriglyceridemia-associated-acute-pancreatitis-case-series-and-review-of-the-literature
#9
REVIEW
Kiran Joglekar, Ben Brannick, Dipen Kadaria, Amik Sodhi
BACKGROUND: Severe hypertriglyceridemia (HTG) is the third leading cause of acute pancreatitis (AP) in the United States. The current standard of care includes management of HTG using pharmacological therapy. More recently, plasmapheresis has been proposed as a therapeutic tool for decreasing triglyceride (TG) levels, especially in critically ill patients. Few studies are available to ascertain overall benefits of plasmapheresis over traditional management. OBJECTIVE: To analyze the outcomes of patients treated with plasmapheresis for severe HTG-associated pancreatitis...
April 2017: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28505667/early-versus-delayed-feeding-in-patients-with-acute-pancreatitis-a-systematic-review
#10
Valerie M Vaughn, Dmitry Shuster, Mary A M Rogers, Jason Mann, Marisa L Conte, Sanjay Saint, Vineet Chopra
Background: Acute pancreatitis is among the most common and costly reasons for hospitalization in the United States. Bowel rest, pain control, and intravenous fluids are the cornerstones of treatment, but early feeding might also be beneficial. Purpose: To compare length of hospital stay, mortality, and readmission in adults hospitalized with pancreatitis who received early versus delayed feeding. Data Sources: MEDLINE via Ovid, EMBASE, the Cochrane Library, CINAHL, and Web of Science through January 2017...
May 16, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28503840/a-critical-note-on-treatment-of-a-severe-diltiazem-intoxication-high-dose-calcium-and-glucagon-infusions
#11
N M Van Veggel, G J Van der Veen, T C Jansen, E M Westerman
The morbidity and mortality of a severe calcium channel blocker intoxication is high due to serious toxic cardiac effects. Its treatment is supported by low-quality evidence from heterogeneous literature. We describe a case of a severe diltiazem intoxication and critically appraise the efficacy and role of high-dose calcium and glucagon infusions. A 53-year-old woman was admitted to the emergency department with a cardiogenic shock with complete AV block, not responding to atropine, isoprenaline and an external pacemaker...
May 15, 2017: Basic & Clinical Pharmacology & Toxicology
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
#12
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/28492369/c-reactive-protein-levels-together-with-the-ranson-scoring-system-to-differentiate-the-mild-and-severe-forms-of-acute-pancreatitis
#13
EDITORIAL
Yücel Üstündağ, Ülkü Sarıtaş
No abstract text is available yet for this article.
May 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28489679/ipilimumab-associated-cholestatic-hepatitis-a-case-report-and-literature-review
#14
Sümeyra Yildirim, Kemal Deniz, Ender Doğan, Mevlüt Başkol, Şebnem Gürsoy, Metin Özkan
Ipilimumab is a monoclonal antibody that exerts its effects by inhibiting the cytotoxic T-lymphocyte-associated protein 4 receptor on cytotoxic T lymphocytes. It is frequently used for the treatment of unresectable or metastatic melanoma. Ipilimumab may lead to several immune-related disease including colitis, thyroiditis, pneumonia, hepatitis, or pancreatitis as a side effect. Limited number of cases with hepatic damage as an ipilimumab-related adverse event has been reported in the literature. This agent has been implicated in causing acute hepatitis-like liver injury...
May 5, 2017: Melanoma Research
https://www.readbyqxmd.com/read/28489122/minimally-invasive-endoscopic-treatment-of-necrotizing-pancreatitis-a-case-report-with-images-and-review-of-the-literature
#15
Cassia Lemos Moura, Priscila Pulita Azevedo Barros, Cristiane Mota Oliveira, Rogerio Colaiácovo, Juliana Marques Drigo, Augusto Pincke Cruz Carbonari, Tercio de Campos, Lucio Giovani Batista Rossini
Necrotizing pancreatitis with fluid collections can occur as a complication of acute pancreatitis. The management of these patients depends on the severity and involves multiple medical treatment modalities, as clinical intensive care and surgical intervention. In this article, we show a severe case of walled-off pancreatic necrosis that was conducted by endoscopic drainage with great clinical outcome.
March 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28487848/blood-urea-nitrogen-as-a-predictor-of-severe-acute-pancreatitis-based-on-the-revised-atlanta-criteria-timing-of-measurement-and-cutoff-points
#16
Suhan Lin, Wandong Hong, Zarrin Basharat, Qipin Wang, Jingye Pan, Mengtao Zhou
Background and Aims. This study evaluated the prognostic accuracy of BUN for severe acute pancreatitis (SAP) and in-hospital mortality (IHM) in terms of the best timing for BUN measurement and the optimal BUN cutoff points. Methods. BUN determinants at the time of admission and 24 hrs after hospital admission were recorded and analyzed statistically. The ability of BUN in predicting the SAP and the occurrence of IHM were assessed using the area under the receiver-operating characteristic (ROC) curve. Results...
2017: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28487796/hyperparathyroidism-in-pregnancy-leading-to-pancreatitis-and-preeclampsia-with-severe-features
#17
Andrew G Dale, Bradley D Holbrook, Lauren Sobel, Valerie J Rappaport
Background. Hyperparathyroidism is underdiagnosed in pregnancy, yet early diagnosis is necessary for the potentially severe sequelae of hypercalcemia for both the woman and fetus. Case. A 31-year-old, gravida 3, para 0-0-2-0 at 32 weeks and 3 days of gestation, presented with preeclampsia with severe features concomitant with acute pancreatitis and known diabetes mellitus type 2. She was stabilized and delivered. In the postpartum period, her total calcium level remained elevated. Ionized calcium levels and parathyroid hormone levels were also elevated, and she was diagnosed with hyperparathyroidism...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28487729/severity-treatment-and-outcome-of-acute-pancreatitis-in-thailand-the-first-comprehensive-review-using-revised-atlanta-classification
#18
Supot Pongprasobchai, Peeradon Vibhatavata, Piyaporn Apisarnthanarak
Background. Severity and outcome of acute pancreatitis (AP) in Thailand are unknown. Methods. A retrospective study of 250 patients with AP during 2011-2014 was performed. Severity, treatment, and outcome were evaluated. Severity was classified by revised Atlanta classification. Results. The mean age was 58 years and 56% were men. Etiologies were gallstones (45%), alcohol (16%), postendoscopic retrograde cholangiopancreatography (14%), and idiopathic (15%). Overall, 72%, 16%, and 12% of patients had mild, moderately severe, and severe AP, respectively...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28487653/chinese-herbal-medicines-attenuate-acute-pancreatitis-pharmacological-activities-and-mechanisms
#19
REVIEW
Hong Xiang, Qingkai Zhang, Bing Qi, Xufeng Tao, Shilin Xia, Huiyi Song, Jialin Qu, Dong Shang
Acute pancreatitis (AP) is a commonly occurring gastrointestinal disorder. An increase in the annual incidence of AP has been observed, and it causes acute hospitalization and high mortality. The diagnosis and treatment guidelines for AP recommend conservative medical treatments focused on reducing pancreatic secretion and secondary injury, as a primary therapeutic approach. Unfortunately, the existing treatment options have limited impact on the incidence and severity of AP due to the complex and multifaceted pathological process of this disease...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28487603/endoscopic-management-of-pancreatic-fluid-collections-revisited
#20
REVIEW
Zaheer Nabi, Jahangeer Basha, D Nageshwar Reddy
The development of pancreatic fluid collections (PFC) is one of the most common complications of acute severe pancreatitis. Most of the acute pancreatic fluid collections resolve and do not require endoscopic drainage. However, a substantial proportion of acute necrotic collections get walled off and may require drainage. Endoscopic drainage of PFC is now the preferred mode of drainage due to reduced morbidity and mortality as compared to surgical or percutaneous drainage. With the introduction of new metal stents, the efficiency of endoscopic drainage has improved and the task of direct endoscopic necrosectomy has become easier...
April 21, 2017: World Journal of Gastroenterology: WJG
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