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Acute severe pancreatitis

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https://www.readbyqxmd.com/read/28431202/pharmacological-interventions-for-acute-pancreatitis
#1
REVIEW
Elisabetta Moggia, Rahul Koti, Ajay P Belgaumkar, Federico Fazio, Stephen P Pereira, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: In people with acute pancreatitis, it is unclear what the role should be for medical treatment as an addition to supportive care such as fluid and electrolyte balance and organ support in people with organ failure. OBJECTIVES: To assess the effects of different pharmacological interventions in people with acute pancreatitis. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2016, Issue 9), MEDLINE, Embase, Science Citation Index Expanded, and trial registers to October 2016 to identify randomised controlled trials (RCTs)...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28431198/serum-amylase-and-lipase-and-urinary-trypsinogen-and-amylase-for-diagnosis-of-acute-pancreatitis
#2
REVIEW
Gianluca Rompianesi, Angus Hann, Oluyemi Komolafe, Stephen P Pereira, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: The treatment of people with acute abdominal pain differs if they have acute pancreatitis. It is important to know the diagnostic accuracy of serum amylase, serum lipase, urinary trypsinogen-2, and urinary amylase for the diagnosis of acute pancreatitis, so that an informed decision can be made as to whether the person with abdominal pain has acute pancreatitis. There is currently no Cochrane review of the diagnostic test accuracy of serum amylase, serum lipase, urinary trypsinogen-2, and urinary amylase for the diagnosis of acute pancreatitis...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28430933/acute-pancreatitis-impact-of-alcohol-consumption-and-seasonal-factors
#3
Sara Bertilsson, Anders Håkansson, Evangelos Kalaitzakis
Aims: We aimed to evaluate the potential relation between the incidence of (alcoholic and non-alcoholic) acute pancreatitis (AP) and alcohol consumption in the general population, and whether the occurrence of AP shows any seasonal variation, particularly in relation to periods with expected increased alcohol consumption. Methods: All patients with first-time AP between 2003 and 2012 in a well-defined area in Sweden were retrospectively identified. Data on AP aetiology (alcoholic and non-alcoholic) and severity were registered...
May 1, 2017: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
https://www.readbyqxmd.com/read/28430136/therapeutic-effect-of-low-doses-of-acenocoumarol-in-the-course-of-ischemia-reperfusion-induced-acute-pancreatitis-in-rats
#4
Zygmunt Warzecha, Paweł Sendur, Piotr Ceranowicz, Jakub Cieszkowski, Marcin Dembiński, Ryszard Sendur, Joanna Bonior, Jolanta Jaworek, Tadeusz Ambroży, Rafał Olszanecki, Beata Kuśnierz-Cabala, Kaczmarzyk Tomasz, Romana Tomaszewska, Artur Dembiński
Intravascular activation of coagulation is observed in acute pancreatitis and is related to the severity of this inflammation. The aim of our study was to evaluate the impact of acenocoumarol therapy on the course of acute pancreatitis induced in male rats by pancreatic ischemia followed by reperfusion. Acenocoumarol at a dose of 50, 100, or 150 µg/kg/dose was administered intragastrically once a day, starting the first dose 24 h after the initiation of pancreatic reperfusion. RESULTS: Histological examination showed that treatment with acenocoumarol reduces pancreatic edema, necrosis, and hemorrhages in rats with pancreatitis...
April 21, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28428720/can-mean-platelet-volume-play-a-role-in-evaluating-the-severity-of-acute-pancreatitis
#5
Jing-Jing Lei, Li Zhou, Qi Liu, Can Xiong, Chun-Fang Xu
AIM: To investigate serum mean platelet volume (MPV) levels in acute pancreatitis (AP) patients and assess whether MPV effectively predicts the disease severity of AP. METHODS: We included 117 consecutive patients with AP as the AP group and 34 consecutive patients with colorectal polyps (before endoscopic treatment) as the control group. Complete blood counts, liver function, platelet indices (MPV), coagulation parameters, lactate dehydrogenase (LDH) and C-reactive protein (CRP) were measured on days 1, 2, 3 and 7 after admission...
April 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28425682/mild-acute-biliary-pancreatitis-the-timing-of-cholecystectomy-should-not-exceed-index-admission
#6
Luca Degrate, Davide P Bernasconi, Paola Meroni, Mattia Garancini, Daniele Macchini, Fabrizio Romano, Fabio Uggeri, Luca Gianotti
BACKGROUND: Laparoscopic cholecystectomy (LC) to treat mild biliary acute pancreatitis (MBAP) during index admission is recommended. However, the optimal surgical timing is controversial, considering that patients are actually often discharged from hospital and readmitted for elective cholecystectomy. Moreover, previous studies showed an uneven patients' stratification for pancreatitis severity. The aim of this study was to determine the outcome of patients homogenously categorised for MBAP according to the newest pancreatitis classifications, undergoing cholecystectomy with different timing...
April 19, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28421699/hepatic-infarction-from-portal-vein-thrombosis-a-fatal-consequence-of-acute-pancreatitis
#7
Somak Das, Sudeepta Kumar Swain, Anand Ramamurthy
Acute pancreatitis is potentially fatal and in its severe form is often associated with pancreatic necrosis and higher mortality. The inflammatory response causes peripancreatic and pancreatic necrosis, and in severe cases results in multiple organ damage through vascular insult either in form of arterial spasm, arterial thrombosis or splanchnic thrombosis [1].
April 19, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28419583/a-comparison-of-multi-factor-scoring-systems-and-single-serum-markers-for-the-early-prediction-of-the-severity-of-acute-pancreatitis
#8
Wen-Hua He, Yin Zhu, Yong Zhu, Qi Jin, Hong-Rong Xu, Zhi-Juan Xion, Min Yu, Liang Xia, Pi Liu, Nong-Hua Lu
BACKGROUND: The purpose of this study was to clarify whether the current scoring systems and single serum markers used in pancreatitis remain applicable for the early prediction of infected pancreatic necrosis (IPN), the severity and mortality of acute pancreatitis (AP) in accordance with the revised Atlanta and determinant-based classifications. METHODS: Demographic, clinical, and laboratory data from 708 consecutive patients with AP were prospectively collected between January 2011 and December 2012...
April 17, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28418115/aggravation-of-diabetes-and-incompletely-deficient-insulin-secretion-in-a-case-with-type-1-diabetes-resistant-hla-drb1-15-02-treated-with-nivolumab
#9
Kimio Matsumura, Kaoru Nagasawa, Yoichi Oshima, Shouta Kikuno, Kyohei Hayashi, Akihiro Nishimura, Minoru Okubo, Hironori Uruga, Kazuma Kishi, Tetsuro Kobayashi, Yasumichi Mori
Anti-programmed cell death-1 (PD-1) antibody therapy induces various adverse effects especially in endocrine systems. Several cases of acute onset insulin-dependent diabetes after anti-PD-1 antibody therapy have been reported. Many of these cases have a susceptible HLA genotype for type 1 diabetes possibly suggesting that human leukocyte antigen (HLA) might be involved in the onset of diabetes with anti PD-1 therapy. We describe an atypical case of hyperglycemia after anti PD-1 antibody administration. A 68-year-old Japanese man with pancreatic diabetes and steroid diabetes was administered nivolumab three times for chemoresistant adenocarcinoma of the lung...
April 18, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28414683/recurrent-hypertriglyceridemic-pancreatitis-htgp-and-the-use-of-insulin-drip-as-treatment
#10
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/28413626/non-infectious-chemotherapy-associated-acute-toxicities-during-childhood-acute-lymphoblastic-leukemia-therapy
#11
REVIEW
Kjeld Schmiegelow, Klaus Müller, Signe Sloth Mogensen, Pernille Rudebeck Mogensen, Benjamin Ole Wolthers, Ulrik Kristoffer Stoltze, Ruta Tuckuviene, Thomas Frandsen
During chemotherapy for childhood acute lymphoblastic leukemia, all organs can be affected by severe acute side effects, the most common being opportunistic infections, mucositis, central or peripheral neuropathy (or both), bone toxicities (including osteonecrosis), thromboembolism, sinusoidal obstruction syndrome, endocrinopathies (especially steroid-induced adrenal insufficiency and hyperglycemia), high-dose methotrexate-induced nephrotoxicity, asparaginase-associated hypersensitivity, pancreatitis, and hyperlipidemia...
2017: F1000Research
https://www.readbyqxmd.com/read/28411344/the-effect-of-a-novel-minimally-invasive-strategy-for-infected-necrotizing-pancreatitis
#12
Zhihui Tong, Xiao Shen, Lu Ke, Gang Li, Jing Zhou, Yiyuan Pan, Baiqiang Li, Dongliang Yang, Weiqin Li, Jieshou Li
BACKGROUND: Step-up approach consisting of multiple minimally invasive techniques has gradually become the mainstream for managing infected pancreatic necrosis (IPN). In the present study, we aimed to compare the safety and efficacy of a novel four-step approach and the conventional approach in managing IPN. METHODS: According to the treatment strategy, consecutive patients fulfilling the inclusion criteria were put into two time intervals to conduct a before-and-after comparison: the conventional group (2010-2011) and the novel four-step group (2012-2013)...
April 14, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28403081/evaluation-of-extrapancreatic-inflammation-on-abdominal-computed-tomography-as-an-early-predictor-of-organ-failure-in-acute-pancreatitis-as-defined-by-the-revised-atlanta-classification
#13
Chenyang Chen, Zixing Huang, Hang Li, Bin Song, Fang Yuan
The aim of the study was to determine whether extrapancreatic inflammation on computed tomography (EPIC) is helpful in predicting organ failure in the early phase of acute pancreatitis (AP) as defined by the 2012 revised Atlanta classification.Patients (n = 208) who underwent abdominal computed tomography (CT) within 24 hours after AP onset and admission were retrospectively identified. Each patient's EPIC score, Balthazar score, bedside index of severity in acute pancreatitis (BISAP), and systemic inflammatory response syndrome (SIRS) score were obtained...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28398922/characterization-of-cardiac-dysfunction-by-echocardiography-in-early-severe-acute-pancreatitis
#14
Ragesh Babu Thandassery, Nikhil Choudhary, Ajay Bahl, Rakesh Kochhar
OBJECTIVE: Persistent organ failure is a feature of severe acute pancreatitis (SAP) and the leading cause of death. Although usually defined by hypotension, cardiovascular dysfunction (CD) in early SAP has not been well characterized. We aim to characterize CD in patients with SAP and hypotension and determine its impact on clinical outcome. METHODS: Patients with SAP and hypotension were studied to define the frequency, nature, and prognostic significance of CD characterized by echocardiography and classified as systolic, diastolic, or combined dysfunction...
May 2017: Pancreas
https://www.readbyqxmd.com/read/28396512/pro-inflammatory-cytokine-driven-pi3k-akt-sp1-signaling-and-h2s-production-facilitates-the-pathogenesis-of-severe-acute-pancreatitis
#15
Ying Liu, Ribin Liao, Zhanrong Qiang, Cheng Zhang
Severe acute pancreatitis (SAP) is a disease usually associated with systemic organ dysfunction or pancreatic necrosis. Most patients with SAP suffer from defective intestinal motility in the early phase of the disease. Additionally, SAP-induced inflammation produces hydrogen sulfide (H2S) that impairs the gastrointestinal (GI) system. However, the exact mechanism of H2S in the regulation of SAP is yet to be elucidated. In this paper, we use a rat model of SAP to evaluate the role of H2S on intestinal motility by counting the number of bowel movements and investigating the effect of H2S on inflammation...
April 10, 2017: Bioscience Reports
https://www.readbyqxmd.com/read/28393988/-chronic-pancreatitis-retrospective-review-of-121-cases
#16
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/28391671/endoscopic-ultrasound-guided-management-of-pancreatic-fluid-collections-update-and-review-of-the-literature
#17
REVIEW
Ali Alali, Jeffrey Mosko, Gary May, Christopher Teshima
Severe acute pancreatitis is often complicated by the development of pancreatic fluid collections (PFCs), which may be associated with significant morbidity and mortality. It is crucial to accurately classify these collections as a pseudocyst or walled-off necrosis (WON) given significant differences in outcomes and management. Interventions for PFCs have increasingly shifted to less invasive strategies, with endoscopic ultrasound (EUS)-guided methods being shown to be safer and equally effective as more invasive surgical techniques...
March 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28388866/analysis-of-factors-influencing-survival-in-patients-with-severe-acute-pancreatitis
#18
Yeon Ji Kim, Dae Bum Kim, Woo Chul Chung, Ji Min Lee, Gun Jung Youn, Yun Duk Jung, Sooa Choi, Jung Hwan Oh
OBJECTIVE: Acute pancreatitis (AP) ranges from a mild and self-limiting disease to a fulminant illness with significant morbidity and mortality. Severe acute pancreatitis (SAP) is defined as persistent organ failure lasting for 48 h. We aimed to determine the factors that predict survival and mortality in patients with SAP. METHODS: We reviewed a consecutive series of patients who were admitted with acute pancreatitis between January 2003 and January 2013. A total of 1213 cases involving 660 patients were evaluated, and 68 cases with SAP were selected for the study...
April 7, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28384928/accuracy-and-predictability-of-panc-3-scoring-system-over-apache-ii-in-acute-pancreatitis-a-prospective-study
#19
Surag Kajoor Rathnakar, Vikram Hubbanageri Vishnu, Shridhar Muniyappa, Arun Prasath
INTRODUCTION: Acute Pancreatitis (AP) is one of the common conditions encountered in the emergency room. The course of the disease ranges from mild form to severe acute form. Most of these episodes are mild and spontaneously subsiding within 3 to 5 days. In contrast, Severe Acute Pancreatitis (SAP) occurring in around 15-20% of all cases, mortality can range between 10 to 85% across various centres and countries. In such a situation we need an indicator which can predict the outcome of an attack, as severe or mild, as early as possible and such an indicator should be sensitive and specific enough to trust upon...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28381378/severe-acute-pancreatitis-pathogenesis-diagnosis-and-surgical-management
#20
Mark Portelli, Christopher David Jones
BACKGROUND: Severe acute pancreatitis is a subtype of acute pancreatitis, associated with multiple organ failure and systemic inflammatory response syndrome. In this qualitative review we looked at the principles of pathogenesis, classification and surgical management of severe acute pancreatitis. We also looked at the current shift in paradigm in the management of severe acute pancreatitis since the guideline developed by the British Society of Gastroenterology. DATA SOURCES: Studies published between 1st January 1991 and 31st December 2015 were identified with PubMed, MEDLINE, EMBASE and Google Scholar online search engines using the following Medical Subject Headings: "acute pancreatitis, necrosis, mortality, pathogenesis, incidence" and the terms "open necrosectomy and minimally invasive necrosectomy"...
April 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
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