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Acute severe pancreatitis

James Buxbaum, Michael Quezada, Bradford Chong, Nikhil Gupta, Chung Yao Yu, Christianne Lane, Ben Da, Kenneth Leung, Ira Shulman, Stephen Pandol, Bechien Wu
OBJECTIVES: The Pancreatitis Activity Scoring System (PASS) has been derived by an international group of experts via a modified Delphi process. Our aim was to perform an external validation study to assess for concordance of the PASS score with high face validity clinical outcomes and determine specific meaningful thresholds to assist in application of this scoring system in a large prospectively ascertained cohort. METHODS: We analyzed data from a prospective cohort study of consecutive patients admitted to the Los Angeles County Hospital between March 2015 and March 2017...
March 15, 2018: American Journal of Gastroenterology
William Virgil Brown, Ira Goldberg, Barton Duell, Daniel Gaudet
Plasma triglyceride concentrations are normally below 150 mg/dL in the fasting state. However, these lipids can reach values of several thousand mg/dL. Elevations in this range are due to a massive retention of chylomicrons and usually result from multiple genetic variants with superimposed influences such as diabetes and immune disorders. Less commonly, major gene defects in lipoprotein metabolism can be the cause. These may present soon after birth with strong evidence of familial penetrance. The causes of this syndrome have been discussed in a Roundtable published in the most recent issue of this Journal...
March 5, 2018: Journal of Clinical Lipidology
X J Lyu, L Li, R Kong, B Sun
The retroperitoneum space comprises anterior pararenal space, perirenal space and posterior pararenal space. Pancreas is a retroperitoneal organ and located in the anterior pararenal space of the retroperitoneum. Left and right sides anterior pararenal space are potentially communicated, which contains many adipose tissues and a little connective tissues. The exacerbation of acute pancreatitis results in the lesion spreading into adjacent area of pancreas in the retroperitoneal space. In addition, the lesion could spread into bare area of stomach, posterior colonic region, subperitoneal space and pelvic retroperitoneal space through the same anatomical space or communicating space...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Koushik K Das, Steffen Heeg, Jason R Pitarresi, Maximilian Reichert, Basil Bakir, Shigetsugu Takano, Janel L Kopp, Anja Wahl-Feuerstein, Philip Hicks, Maike Sander, Anil K Rustgi
BACKGROUND: The plasticity of pancreatic acinar cells to undergo acinar to ductal metaplasia (ADM) has been demonstrated to contribute to the regeneration of the pancreas in response to injury. Sox9 is critical for ductal cell fate and important in the formation of ADM, most likely in concert with a complex hierarchy of, as yet, not fully elucidated transcription factors. RESULTS: Utilizing a mouse model of acute pancreatitis and three dimensional organoid culture of primary pancreatic ductal cells, we herein characterize the Ets-transcription factor Etv5 as a pivotal regulator of ductal cell identity and ADM that acts upstream of Sox9 and is essential for Sox9 expression in ADM...
March 13, 2018: Developmental Dynamics: An Official Publication of the American Association of Anatomists
Baris Zulfikaroglu, Ferruh Kemal Isman, Gul Bora, Ozgur Akgul, Necdet Ozalp
INTRODUCTION: Acute pancreatitis (AP) is a severe disease associated with significant morbidity and mortality. The overall outcome has improved, but specific treatment(s) remains elusive. The challenge is the early identification and treatment of patients who will develop severe acute pancreatitis. Therefore, the aim of the present study is to investigate plasma levels of tumor necrosis factor-like weak inducer of apoptosis (TWEAK) in the initial phase of predicted severe acute pancreatitis...
March 10, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Ivana Zitinic, Ivana Plavsic, Goran Poropat, Goran Hauser
Acute pancreatitis (AP) is a common gastrointestinal disease of varied etiology; however, the most common causes of AP are gallstones and alcohol abuse. AP has emerged as the most frequent complication after endoscopic retrograde cholangiopancreatography (ERCP). Post-ERCP pancreatitis is generally a clinically irrelevant condition; however, it can be severe or even fatal in up to 0.8% of cases. Different clinical courses and outcomes have been observed between mild and severe AP of different etiologies (i.e...
April 2018: Medical Hypotheses
Udaya Ralapanawa, Thilak Jayalath, Dhanusha Senadhira
BACKGROUND: Acute pancreatitis is an inflammatory condition with varying severity and a range of local and systemic complications. Here we report a patient with acute necrotizing pancreatitis complicated with a true non ST elevation myocardial infarction. CASE PRESENTATION: A 58 year old lady was admitted to our unit with acute onset epigastric pain and vomiting for 4 h duration. Following admission she complained of retrosternal tightening type of a chest pain...
March 9, 2018: BMC Research Notes
Mehmet Suat Yalçın, Adnan Tas, Banu Kara, Sehmus Olmez, Bunyamin Saritas
BACKGROUND: Acute pancreatitis (AP) is inflammation of the pancreas of various severity ranging from mild abdominal pain to mortality. AP may be classified as acute interstitial edematous pancreatitis (AEP) or acute necrotizing pancreatitis (ANP), according to the revised Atlanta criteria. Most of the patients with AP are AEP (75-85% of patients), while 15-25% of patients have ANP. The mortality rate is 3% in AEP and 15% in ANP. Thus, it is important to predict the severity of AP to decrease the morbidity and mortality...
February 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Yegor Tryliskyy, Gavin J Bryce
Acute pancreatitis is the most common and feared complication of endoscopic retrograde cholangiopancreatography (ERCP). The aim of the study was to review the current knowledge on the nomenclature, etiology, pathophysiology, clinical presentation, diagnostic workup, and risk stratification of post-ERCP pancreatitis (PEP). A structured search in PubMed and Scopus databases was performed using search terms related to the subject of diagnosis, pathophysiology, risk stratification of post-ERCP pancreatitis, including full text articles and abstracts in the English language...
January 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Ilaria Biasato, Renato Zanatta, Lorella Maniscalco, Rocchina Evangelista, Bryan Iotti, Selina Iussich
The unexpected demise of a 12-year-old male neutered English bulldog solicited a gross examination, which revealed a blood-filled space occurring in the proximal left subclavian artery (LSA). It originated about 1 cm from the branching point of the vessel and progressively dilated for 3 cm distal to this origin. Histopathological investigation showed that the tunica media of the LSA was more than 50% split, with the blood-filled space dissecting through the arterial wall. In the tunica media of the LSA, severe multifocal fragmentation and/or loss of the elastic fibers was observed...
March 5, 2018: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
Satyanarayan T Shanbhag, Bernard Choong, Maxim Petrov, Brett Delahunt, John A Windsor, Anthony R J Phillips
BACKGROUND: Critical illness including severe acute pancreatitis is associated with the multiple organ dysfunction syndrome. The "gut-lymph" hypothesis states that multiple organ dysfunction syndrome is due to release of toxic factors from the intestine into the mesenteric lymph. The aims of this study were to determine the effect of normotensive acute pancreatitis conditioned mesenteric lymph on cardiac function and whether external drainage of mesenteric lymph would protect the heart...
March 5, 2018: Surgery
Manli Zhang, Lili Ding, Xinrui Wang, Jie Hou, Man Li, Yanfang Jiang, Xiuting He, Meizi Cui, Feng Hu, Xiuna Zhang, Jingyuan Yang, Xiaohe Guo, Huiying Zhao, Pujun Gao
BACKGROUND: Despite the role of monocytes in the pathogenesis of severe acute pancreatitis (SAP), it remains unclear how different subtypes of monocytes regulate and contribute to this pathogenesis. METHODS: We examined the numbers of different subsets of monocytes by flow cytometry in 21 SAP, 15 mild acute pancreatitis (MAP) and 13 healthy controls (HC). The concentrations of plasma cytokines were assessed by cytometric bead array. Disease severity was evaluated based on the acute physiology and chronic health evaluation (APACHE) II score and plasma C-reactive proteins (CRP) levels...
March 5, 2018: International Immunopharmacology
Emad Qayed, Rushikesh Shah, Yara K Haddad
OBJECTIVES: Cholecystectomy is the definitive management of gallstone pancreatitis (GSP). The benefit of endoscopic retrograde cholangiopancreatography (ERCP) in patients who do not undergo cholecystectomy remains unclear. This study aims to evaluate the effect of ERCP on all-cause and pancreatitis readmissions in GSP. METHODS: Adult hospitalizations for GSP in the 2010-2014 National Readmissions Database were divided into the following 3 groups: (1) no cholecystectomy nor ERCP, (2) no cholecystectomy with ERCP, and (3) cholecystectomy group...
April 2018: Pancreas
Angeliki Papapanagiotou, George Sgourakis, Stella Peristeraki, Dimitris Raptis, Kyriakos Karkoulias, Stergios Tezas, Panna Patel, Athanasios G Papavassiliou
OBJECTIVES: This pilot study aimed to determine the feasibility of serum values of osteonectin, adiponectin, transforming growth factor beta 1, and neurotensin being used in clinical practice to predict the severity of acute pancreatitis. METHODS: Blood samples were collected from 45 consecutive newly diagnosed acute pancreatitis patients and 30 matched healthy controls. The 2 groups were matched according to age, sex, weight, height, diabetes, smoking, and alcohol consumption...
April 2018: Pancreas
Alexandra K Tsaroucha, Dimitrios Schizas, Michail G Vailas, Evangelia Rachmani, Prodromos Kanavidis, Vyron Asimakopoulos, Sotirios Vlachos, Maria Sotiropoulou, Michael S Pitiakoudis, Constantinos E Simopoulos
OBJECTIVES: Acute pancreatitis (AP) is commonly associated with the release of adhesion molecules such as E and P selectins. We designed the present study to evaluate the role of selectins as potential markers that could reflect the severity of the disease. METHODS: One hundred fifty patients with AP constituted the patient group, whereas 70 healthy volunteers established the control group. In both groups, blood samples were taken for measurements of E selectin, P selectin, caspase-cleaved cytokeratin 18, and total soluble cytokeratin 18 levels on admission and days 1, 2, 4, and 6...
April 2018: Pancreas
Antonio Rodriguez-Nicolas, Alba Martínez-Chamorro, Pilar Jiménez, Ana M Matas-Cobos, Eduardo Redondo-Cerezo, Francisco Ruiz-Cabello
OBJECTIVES: Acute pancreatitis (AP) is severe in up to 20% of patients, with a high mortality rate. Quantification of serum TH1 and TH2 cytokines may provide objective evidence to assess the severity of AP and predict its course. METHODS: One hundred seventeen patients were studied, measuring serum concentrations of interleukin (IL)1β, IL2, IL4, IL5, IL6, IL10, IL12p70, IL13, IL18, granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon (IFN) γ, and tumor necrosis factor (TNF) α...
April 2018: Pancreas
Prabin Sharma, Rodrigo Aguilar, Mark Abi Nader, Shaheryar Siddiqui, Ramkaji Baniya, Sanjeeb Sudarshan Bhandari, Carmen Elena Cervantes, Ricardo Correa, Amir Masoud
OBJECTIVE: This study aimed to assess the difference in overall outcomes between weekend admissions for acute pancreatitis (AP) and weekday admissions. METHODS: Between 2005 and 2012, data were extracted from the Nationwide Inpatient Sample on adult patients with AP. Exclusion criteria were applied for chronic pancreatitis and other pancreatic and biliary malignancies. In-hospital mortality, length of stay, hospitalization costs, comorbidities, complications, and intervention rates were compared between the weekend and weekday admissions...
April 2018: Pancreas
B J John, S Sambandam, P Garg, G Singh, B Edizer, M Kaur, R Baskaran, G Srinivasan, V Leelakrishnan, K Janarthan
INTRODUCTION: Patients with Acute Pancreatitis (AP) presenting with Systemic Inflammatory Response syndrome (SIRS) are more likely to have severe acute pancreatitis and are at increased risk of complications. Additionally, persistence of SIRS at 48 hrs after admission is associated with persistent organ failure and a worse outcome. We investigated the usefulness of SIRS as a criterion for referring patients to a tertiary pancreatic care centre. MATERIALS METHODS: Retrospective analyses of patients admitted with AP over a one year period...
July 2017: Acta Gastro-enterologica Belgica
Yu Zhou, Liang Zhao, Fangchao Mei, Yupu Hong, He Xia, Teng Zuo, Youming Ding, Weixing Wang
Macrophage migration inhibitory factor (MIF) is an inflammatory cytokine involved in many acute and chronic inflammatory diseases. However, its role in acute lung injury associated with acute pancreatitis in pregnancy (APIP) has not yet been elucidated. The present study was undertaken to clarify the effect and potential mechanism of MIF antagonist (S,R)3‑(4‑hydroxyphenyl)‑4,5‑dihydro‑5‑isoxazole acetic acid methyl ester (ISO‑1) in the development of acute lung injury in rats with APIP. Eighteen late‑gestation SD rats were randomly assigned to three groups: Sham operation (SO) group, APIP group, and ISO‑1 group...
March 1, 2018: Molecular Medicine Reports
Zhao-Peng Dong, Qian Wang, Zhen-Jie Zhang, Michael J Carr, Dong Li, Wei-Feng Shi
Globally, coxsackievirus B4 (CV-B4) has been continuously isolated and evidence suggests an association with the development of pancreatitis and type I diabetes. In addition, CV-B4 is also associated with myocarditis and severe central nervous system (CNS) complications, which remain poorly studied and understood. In the present study, we established an Institute for Cancer Research (ICR) mouse model of CV-B4 infection and examined whether CV-B4 infection resulted in a predisposition to myocarditis and CNS infection...
January 18, 2018: Zoological Research
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