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Pancreatic insufficiency

Adèle Coriati, Évelyne Labrèche, Marjolaine Mailhot, Hortensia Mircescu, Yves Berthiaume, Annick Lavoie, Rémi Rabasa-Lhoret
BACKGROUND & AIMS: Vitamin D (Vit D) deficiency in cystic fibrosis (CF) is partially secondary to exocrine pancreatic insufficiency. Our aim was to establish a Vit D3 supplementation protocol that will increase 25(OH)D to the recommended level (30 ng/mL). METHODS: Retrospective study of 200 patients (≥18 years) conducted from February 2007 to June 2014 at the CF clinic of the Centre Hospitalier de l'Université de Montréal. Vit D3 supplementation protocol was 1600 IU/day or 10,000 IU/week during the summer (May 1st to October 31st) and 3200 IU/day or 20,000 IU/week during the winter (November 1st to April 30th), in addition to the 1200 IU/day included in multivitamins...
October 8, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Norman Schöffel, Diana Rubin, David A Groneberg, Ralf-Marco Liehr
No abstract text is available yet for this article.
October 2016: MMW Fortschritte der Medizin
E Bellon, J R Izbicki, M Bockhorn
Chronic pancreatitis (CP) is an irreversible, inflammatory process, which is characterized by progressive fibrosis of the pancreas and leads to abdominal pain, endocrine and exocrine insufficiency. Surgical therapy is indicated by the absence of pain relief and local complications. The target of the surgical approach is to relieve the pancreatic and bile ducts and resection of the fibrotic and calcified parenchyma. Drainage procedures, such as the Partington-Rochelle method, are used in patients with isolated congestion of the pancreatic duct without further organ complications, such as inflammatory processes of the pancreatic head; however, patients with CP often have an inflammatory swelling of the pancreatic head...
October 18, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Hideaki Kaneto, Atsushi Obata, Tomohiko Kimura, Masashi Shimoda, Seizo Okauchi, Naoki Shimo, Taka-Aki Matsuoka, Kohei Kaku
Type 2 diabetes mellitus is characterized by insulin resistance in various insulin target tissues such as the liver, adipose tissue and skeletal muscle, and insufficient insulin secretion from pancreatic β-cells. Sodium-glucose co-transporter 2 (SGLT2) inhibitors which are newly developed anti-diabetic agents decrease blood glucose levels by enhancing urinary glucose excretion and thereby function in an insulin-independent manner. SGLT2 inhibitors exert beneficial effects for the reduction of insulin resistance as well as for the preservation of pancreatic β-cell function...
October 18, 2016: Journal of Diabetes
Dorota Gliwicz, Irena Jankowska, Aldona Wierzbicka, Anna Miśkiewicz-Chotnicka, Aleksandra Lisowska, Jarosław Walkowiak
Alagille syndrome (AGS) is often associated with symptoms of maldigestion, such as steatorrhea, hypotrophy and growth retardation. Exocrine pancreatic insufficiency was proposed as the underlying cause. We aimed to assess the exocrine pancreatic function with the use of different methods in AGS patients. Concentrations of fecal elastase-1 (FE1) and fecal lipase (FL) activities were measured in 33 children with AGS. The C-mixed triglyceride breath test (MTBT) in a subgroup comprising 15 patients. In all patients studied, FE1 concentrations and FL activities were normal...
October 17, 2016: Scientific Reports
Soumen Bera, Sanjay Lamba, Mubasher Rashid, Anuj K Sharma, Alexander B Medvinsky, Claudia Acquisti, Amit Chakraborty, Bai-Lian Li
Impaired glutamate dehydrogenase (GDH) sensitivity to its inhibitors causes excessive insulin secretion by pancreatic beta-cells and defective ammonia metabolism in the liver. These symptoms are commonly associated with hyperinsulinism/hyperammonemia syndrome (HI/HA), which causes recurrent hypoglycaemia in early infancy. Hepatic localization of GDH amination and deamination activities linked with the urea cycle is known to be involved in ammonia metabolism and detoxification. Although deamination activities of hepatic GDH in the periportal zones of liver lobules and its connection to the urea cycle have been exhaustively investigated, physiological roles of GDH amination activity observed at pericentral zones have often been overlooked...
October 17, 2016: Integrative Biology: Quantitative Biosciences From Nano to Macro
V Santos, A V Cardoso, C Lopes, P Azevedo, F Gamboa, A Amorim
: Cystic fibrosis (CF) is the most common autosomal recessive disease in Caucasians. Although most cases are diagnosed in childhood, diagnosis in adults is apparently increasing. OBJECTIVE: Evaluate the adult population with CF, comparing patients who were diagnosed before and after 18 years of age. METHODS: Retrospective analysis of patients followed in three main medical centres in Portugal in 2012. Comparison of two groups: G1 - patients diagnosed at <18 years and G2 - patients diagnosed at ≥18 years...
October 13, 2016: Revista Portuguesa de Pneumologia
Ryuta Shintakuya, Kenichiro Uemura, Yoshiaki Murakami, Naru Kondo, Naoya Nakagawa, Kazuhide Urabe, Keisuke Okano, Kazuo Awai, Toru Higaki, Taijiro Sueda
BACKGROUND/OBJECTIVES: The loss of skeletal muscle mass (sarcopenia) is associated with the poor prognosis of pancreatic cancer. It has been reported pancreatic exocrine insufficiency (PEI) is associated with serum nutritional markers in chronic pancreatitis. However, there has been no report about the relationship between sarcopenia and PEI. The aim of this study is to determine whether body composition, including skeletal muscle (SM), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), intramuscular adipose tissue content (IMAC), and serum nutritional markers are associated with pancreatic exocrine function in patients with pancreatic disease...
October 11, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Joseph F Levy, Marjorie A Rosenberg, Philip M Farrell
BACKGROUND: Previous estimates of the cost of care for pediatric Cystic fibrosis (CF) showed wide variation, without specific summary of pulmonary drug costs. METHODS: Enrolled CF children from the Wisconsin newborn screening trial were evaluated quarterly per protocol. Assessments systematically included all treatments, hospitalizations, and nutritional and pulmonary outcomes. Direct medical costs from hospital billing and medical records from 1989 to 2010 were used to describe costs by age-ranges and subgroups throughout follow-up...
October 14, 2016: Pediatric Pulmonology
Fabíula Francisca Abreu, Ana Carla Araujó de Souza, Simone Aparecida Teixeira, Antônio Garcia Soares, Daiane Franco Teixeira, Rosilene Calazans Soares, Marilia Trindade Santana, Sandra Lauton Santos, Soraia Kátia Pereira Costa, Marcelo Nicolas Muscará, Enilton Aparecido Camargo
INTRODUCTION: Acute pancreatitis (AP) may be severe and cause hospitalization or death, and the available treatment is insufficient to control pancreatic inflammation and pain. Rutin is a natural flavonoid with the potential to treat AP via anti-inflammatory, antinociceptive and antioxidant activities. AIM: This study investigated the beneficial effects of rutin on experimental AP induced by L-arginine administration in mice. METHODS: The L-arginine-induced AP model was used in Swiss mice (n = 6-8)...
October 13, 2016: Free Radical Research
Geert Roeyen, Miet Jansen, Laure Ruyssinck, Thiery Chapelle, Aude Vanlander, Bart Bracke, Vera Hartman, Dirk Ysebaert, Frederik Berrevoet
OBJECTIVE: Recently, pancreaticogastrostomy (PG) has attracted renewed interest as a reconstruction technique after pancreaticoduodenectomy (PD), as it may imply a lower risk of clinical pancreatic fistula than reconstruction by pancreaticojejunostomy (PJ). We hypothesise that pancreatic exocrine insufficiency (PEI) is more common during clinical follow-up after PG than it is after PJ. RESEARCH DESIGN AND METHODS: This study compares the prevalence of PEI in patients undergoing PD for malignancy with reconstruction by PG versus reconstruction by PJ...
October 7, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Michael Glenn O'Connor, Kelly Thomsen, Rebekah F Brown, Michael Laposata, Adam Seegmiller
BACKGROUND: Airway inflammation is a significant contributor to the morbidity of cystic fibrosis (CF) disease. One feature of this inflammation is the production of oxygenated metabolites, such as prostaglandins. Individuals with CF are known to have abnormal metabolism of fatty acids, typically resulting in reduced levels of linoleic acid (LA) and docosahexaenoic acid (DHA). METHODS: This is a randomized, double-blind, cross-over clinical trial of DHA supplementation with endpoints of plasma fatty acid levels and prostaglandin E metabolite (PGE-M) levels...
October 2016: Prostaglandins, Leukotrienes, and Essential Fatty Acids
Jean A Donet, Frank Czul, Nathalie A Peña, Jamie S Barkin
Autoimmune pancreatitis (AIP) is an uncommon disease that represents a diagnostic challenge unless it is considered as a cause of acute pancreatitis, pancreatic exocrine insufficiency and a pancreatic mass. This entity is under diagnosed and successful medical therapy is available. In this paper, we will describe a case of a 59 year-old, Hispanic woman diagnosed with autoimmune pancreatitis, a disease previously believed to affect typically older men. We will review the definition, types, clinical manifestations, radiological features, serology, histopathological findings, treatment strategies and diagnostic criteria of autoimmune pancreatitis...
July 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Olga Wysocka, Julita Kulbacka, Jolanta Saczko
Pancreatic cancer is one of the most aggressive and deadly malignancies. Despite better understanding of its biology and pathogenesis, contemporary treatment regimens are still insufficient. Along with the introduction of new treatment agents and combination therapy, the response rates are increasing, but these scores do not go with overall survival, and results are frequently conflicting. Therefore, contemporary medicine faces the challenge of expanding the knowledge base and practice on all grounds - pathology, factor risk, diagnosis, and finally surgical and palliative treatment of this disease...
2016: Przegla̜d Gastroenterologiczny
Marie Szymanowski, Maria Salomon Estebanez, Raja Padidela, Bing Han, Karolina Mosinska, Adam Stevens, Lena Damaj, Florence Pihan-Le Bars, Emilie Lascouts, Rachel Reynaud, Catherine Ferreira, Claire Bansept, Pascale de Lonlay, Cécile Saint-Martin, Mark J Dunne, Indraneel Banerjee, Jean-Baptiste Arnoux
CONTEXT: Congenital hyperinsulinism (CHI) is the commonest cause of persistent hypoglycemia in neonates and infants. In medically unresponsive CHI, subtotal pancreatectomy is performed to achieve euglycaemia with consequent diabetes in later life. Sirolimus, a mammalian target of rapamycin (mTOR) inhibitor has been reported to obviate the need for pancreatectomy, but experience is limited. OBJECTIVE: We have investigated the efficacy and adverse effect profile of mTOR inhibitors in the treatment of severe CHI...
October 3, 2016: Journal of Clinical Endocrinology and Metabolism
Anne Mößeler, Marion Schmicke, Martin Höltershinken, Martin Beyerbach, Josef Kamphues
Pancreatic exocrine insufficiency (PEI) is a disease of diverse aetiology-e.g., majority of patients suffering from cystic fibrosis (CF) show PEI congenitally. Malnutrition and malabsorption of nutrients impair growth and nutritional status. As reduced fat digestion leads to a deficiency of fat-soluble vitamins the supplementation is standard, but absorption is a critical point in PEI-patients. The pancreatic duct ligated (PL) pig is an established model for PEI in humans and has been proven to be a suitable model to compare different vitamin additives for supplementation...
2016: International Journal of Molecular Sciences
Jennifer A Campbell, David S Sanders, Katherine A Francis, Matthew Kurien, Sai Lee, Hatim Taha, Arvind Ramadas, Diamond Joy, Andrew D Hopper
BACKGROUND AND AIMS: Pancreatic exocrine insufficiency may be under recognised in gastroenterological practice. We aimed to identify the prevalence of pancreatic insufficiency in secondary care gastroenterology clinics and determine if co-morbidity or presenting symptoms could predict diagnosis. A secondary aim was to assess response to treatment. METHODS: A dual centre retrospective analysis was conducted in secondary care gastroenterology clinics. Patients tested for pancreatic exocrine insufficiency with faecal elastase-1 (FEL-1) between 2009 and 2013 were identified in two centres...
September 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
Emma Martínez-Moneo, Serena Stigliano, Aleksandra Hedström, Aleksandra Kaczka, Marko Malvik, Alexander Waldthaler, Patrick Maisonneuve, Peter Simon, Gabriele Capurso
BACKGROUND AND AIMS: Chronic pancreatitis (CP) patients are at risk for fat-soluble vitamins (A, D, E, K) deficiency, but available studies are small and heterogeneous. We conducted a systematic review and meta-analysis to determine the prevalence of fat-soluble vitamins deficiency in CP patients. METHODS: Medline was searched up to January 2016 for case series and case-control studies reporting prevalence of fat-soluble vitamin deficiency in CP patients. The prevalent deficiency rate was pooled for included studies, and deficiency rate between CP and controls, with relative odds ratio (OR) and 95% confidence interval (CI) calculated for case-control studies...
September 20, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Tsukasa Ikeura, Hideaki Miyoshi, Masaaki Shimatani, Kazushige Uchida, Makoto Takaoka, Kazuichi Okazaki
Autoimmune pancreatitis (AIP) has been considered a favorable-prognosis disease; however, currently, there is limited information on natural course of AIP during long-term follow-up. Recently published studies regarding the long-term outcomes of AIP has demonstrated the developments of pancreatic stone formation, exocrine insufficiency, and endocrine insufficiency are observed in 5%-41%, 34%-82%, and 38%-57% of patients having the disease. Furthermore, the incidence rate of developing pancreatic cancer ranges from 0% to 4...
September 14, 2016: World Journal of Gastroenterology: WJG
Ying Liang, Wenhui Yang, Yanhui Zhu, Yulin Yuan
Growing evidence from recent studies has revealed that microRNA-203 (miR-203) might be an attractive prognostic biomarker for cancer. But controversy still remains. The aim of this meta-analysis was to summarize available evidences and clarify the preliminary predictive value of miR-203 for prognosis in cancer patients. Eligible studies were identified through multiple research strategies in PubMed, EMBASE and Web of Science up to October 2015. Key statistics such as pooled hazard ratios (HR) with 95 % confidence intervals (CIs) were utilized to calculate patient survival...
2016: SpringerPlus
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