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Pancreatic insufficiency

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https://www.readbyqxmd.com/read/29773761/surgical-treatment-of-pancreatic-cancer
#1
Wioletta Masiak-Segit, Karol Rawicz-Pruszyński, Magdalena Skórzewska, Wojciech P Polkowski
The only way to cure the patient with adenocarcinoma of the pancreas (RT) is surgical excision of the tumor. The standard surgical treatment of resectable pancreatic carcinoma is considered the classic pancreatoduodenectomy (PD) with the Kausch- Whipple procedure, or the pylorus-preserving PD with the Traverso-Longmire method. The most difficult technically and at the same time the most important PD stage from an oncological point of view is the separation of the head of the pancreas from the superior mesenteric artery...
April 30, 2018: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29773689/risk-factors-for-lung-disease-progression-in-children-with-cystic-fibrosis
#2
Marieke van Horck, Kim van de Kant, Bjorn Winkens, Geertjan Wesseling, Vincent Gulmans, Han Hendriks, Chris van der Grinten, Quirijn Jӧbsis, Edward Dompeling
To identify potential risk factors for lung disease progression in children with cystic fibrosis (CF), we studied the longitudinal data of all children with CF (aged ≥5 years) registered in the Dutch CF Registry (2009-2014). Lung disease progression was expressed as a decline in lung function (FEV1 %pred) and the pulmonary exacerbation rate (PEx). Potential risk factors at baseline included: sex, age, best FEV1%pred, best forced vital capacity (FVC)%pred, genotype, BMI z-score, pancreatic insufficiency, medication use (proton pump inhibitors [PPI], prophylactic antibiotics, and inhaled corticosteroids), CF-related diabetes, allergic bronchopulmonary aspergillosis, and colonisation with Pseudomonas aeruginosa The data of 545 children were analysed...
May 17, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29767474/mesenchymal-stromal-cells-from-shwachman-diamond-syndrome-patients-fail-to-recreate-a-bone-marrow-niche-in-vivo-and-exhibit-impaired-angiogenesis
#3
Donatella Bardelli, Erica Dander, Cristina Bugarin, Claudia Cappuzzello, Alice Pievani, Grazia Fazio, Paolo Pierani, Paola Corti, Piero Farruggia, Carlo Dufour, Simone Cesaro, Marco Cipolli, Andrea Biondi, Giovanna D'Amico
Shwachman-Diamond syndrome (SDS) is a rare multi-organ recessive disease mainly characterised by pancreatic insufficiency, skeletal defects, short stature and bone marrow failure (BMF). As in many other BMF syndromes, SDS patients are predisposed to develop a number of haematopoietic malignancies, particularly myelodysplastic syndrome and acute myeloid leukaemia. However, the mechanism of cancer predisposition in SDS patients is only partially understood. In light of the emerging role of mesenchymal stromal cells (MSCs) in the regulation of bone marrow homeostasis, we assessed the ability of MSCs derived from SDS patients (SDS-MSCs) to recreate a functional bone marrow niche, taking advantage of a murine heterotopic MSC transplant model...
May 16, 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29764411/contrast-enhanced-ultrasonography-of-the-pancreas-shows-impaired-perfusion-in-pancreas-insufficient-cystic-fibrosis-patients
#4
Trond Engjom, Kim Nylund, Friedemann Erchinger, Marcus Stangeland, Birger Norderud Lærum, Martin Mézl, Radovan Jiřík, Odd Helge Gilja, Georg Dimcevski
BACKGROUND: Perfusion assessment of the pancreas is challenging and poorly evaluated. Pancreatic affection is a prevalent feature of cystic fibrosis (CF). Little is known about pancreatic perfusion in CF. We aimed to assess pancreatic perfusion by contrast-enhanced ultrasound (CEUS) analysed in the bolus-and-burst model and software. METHODS: We performed contrast enhanced ultrasound of the pancreas in 25 CF patients and 20 healthy controls. Perfusion data was analysed using a dedicated perfusion model providing the mean capillary transit-time (MTT), blood flow (BF) and blood-volume (BV)...
May 15, 2018: BMC Medical Imaging
https://www.readbyqxmd.com/read/29761141/unexpected-height-loss-in-an-adolescent-with-cystic-fibrosis
#5
Anne Schendel, Jillian Mai, Rachel Espinosa, Carlye T Tomcyzk, Theresa A Laguna
This case report describes an adolescent with pancreatic insufficient cystic fibrosis, malnutrition, and cystic fibrosis-related diabetes found to have a loss in height at a routine outpatient clinic visit. He was subsequently admitted to the hospital for treatment of a pulmonary exacerbation and was found to have multiple, nontraumatic vertebral compression fractures. This report emphasizes the importance of routine review of growth charts and aggressive treatment of vitamin deficiencies and malnutrition in people with cystic fibrosis...
2018: Global Pediatric Health
https://www.readbyqxmd.com/read/29746344/nutritional-considerations-in-pediatric-pancreatitis-a-position-paper-from-the-naspghan-pancreas-committee-espghan-pancreas-working-group
#6
Maisam Abu-El-Haija, Aliye Uc, Steven L Werlin, A Jay Freeman, Miglena Georgieva, Danijela Jojkić - Pavkov, Daina Kalnins, Brigitte Kochavi, Bart G P Koot, Stephanie Van Biervliet, Jaroslaw Walkowiak, Michael Wilschanski, Veronique D Morinville
OBJECTIVES: Wide variations exist in how physicians manage the nutritional aspects of children affected by acute pancreatitis (AP), acute recurrent pancreatitis (ARP) and chronic (CP) pancreatitis. Better consensus for optimal management is needed. METHODS: This consensus statement on nutrition in pediatric pancreatic diseases was developed through a joint ESPGHAN-NASPGHAN working group that performed an evidence-based search of the literature on nutrition in AP, ARP, and CP with a focus on pediatrics...
May 8, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29744679/current-status-of-enhanced-recovery-after-surgery-eras-protocol-in-gastrointestinal-surgery
#7
REVIEW
Michał Pędziwiatr, Judene Mavrikis, Jan Witowski, Alexandros Adamos, Piotr Major, Michał Nowakowski, Andrzej Budzyński
Enhanced Recovery After Surgery (ERAS) is an evidence-based paradigm shift in perioperative care, proven to lower both recovery time and postoperative complication rates. The role of ERAS in several surgical disciplines was reviewed. In colorectal surgery, ERAS protocol is currently well established as the best care. In gastric surgery, 2014 saw an establishment of ERAS protocol for gastrectomies with resulting meta-analysis showing ERAS effectiveness. ERAS has also been shown to be beneficial in liver surgery with many centers starting implementation...
May 9, 2018: Medical Oncology
https://www.readbyqxmd.com/read/29743979/mesenchymal-stromal-cell-therapy-for-pancreatitis-a-systematic-review
#8
REVIEW
Sara M Ahmed, Mahmoud Morsi, Nehal I Ghoneim, Mohamed M Abdel-Daim, Nagwa El-Badri
Background: Based on animal studies, adult mesenchymal stromal cells (MSCs) are promising for the treatment of pancreatitis. However, the best type of this form of cell therapy and its mechanism of action remain unclear. Methods: We searched the PubMed, Web of Science, Scopus, Google Scholar, and Clinical Trials.gov websites for studies using MSCs as a therapy for both acute and chronic pancreatitis published until September 2017. Results: We identified 276 publications; of these publications, 18 met our inclusion criteria...
2018: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29742705/earlier-surgery-improves-outcomes-from-painful-chronic-pancreatitis
#9
Nengwen Ke, Dan Jia, Wei Huang, Quentin M Nunes, John A Windsor, Xubao Liu, Robert Sutton
The timing of surgery for painful chronic pancreatitis (CP) may affect outcomes.Clinical course, Izbicki pain scores, and pancreatic function were retrospectively compared and analyzed between patients undergoing either early or late surgery (< 3 or ≥ 3 years from diagnosis) for painful CP in a single center from 2007 to 2012.The early surgery group (n = 98) more frequently than the late group (n = 199) had abdominal pain with jaundice (22.4% vs 9.5%, P = .002) and pancreatic mass +/- ductal dilatation (47% vs 27%, P < ...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29737796/pancreatic-enzyme-replacement-therapy-pert-in-children-with-persistent-diarrhea-avoidance-of-elemental-diet-need-accessibility-and-costs
#10
Ariani Dewi Widodo, Rianto Setiabudy, Ina S Timan, Saptawati Bardosono, Widdy Winarta, Agus Firmansyah
BACKGROUND AND OBJECTIVES: Persistent diarrhea has been proven to cause pancreatic exocrine insufficiency, due to decreased stimulation to the pancreas caused by prolonged mucosal injury. Pancreatic enzyme replacement therapy (PERT) given in conjunction to regular treatment is thought to be beneficial in replacing this pancreatic enzyme deficiency, avoiding the need of elemental diet. This study aims to evaluate the benefit of PERT in chil-dren with persistent diarrhea. METHODS AND STUDY DESIGN: This is a randomized, two double-blind parallel group, placebo-controlled clinical trial to evaluate the effects of pancreatic enzyme supplementation in persistent diar-rhea...
2018: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29737600/stromal-barriers-to-nanomedicine-penetration-in-the-pancreatic-tumor-microenvironment
#11
REVIEW
Hiroyoshi Y Tanaka, Mitsunobu R Kano
Pancreatic cancer is known for its dismal prognosis despite efforts to improve therapeutic outcome. Recently, cancer nanomedicine, application of nanotechnology to cancer diagnosis and treatment, has gained interest for treatment of pancreatic cancer. The enhanced permeability and retention (EPR) effect that promotes selective accumulation of nanometer-sized molecules within tumors is the theoretical rationale of treatment. However, it is clear that EPR may be insufficient in pancreatic cancer due to stromal barriers within the tumor microenvironment (TME)...
May 8, 2018: Cancer Science
https://www.readbyqxmd.com/read/29736712/cell-based-methods-to-identify-inducers-of-human-pancreatic-beta-cell-proliferation
#12
Courtney A Ackeifi, Ethan A Swartz, Peng Wang
Diabetes is the result of the insufficiency or dysfunction of pancreatic beta cells alone or in combination with insulin resistance. The replacement or regeneration of beta cells can effectively reverse diabetes in humans and rodents. Therefore, the identification of novel small molecules that promote pancreatic beta-cell proliferation is an attractive approach for diabetic therapy. While numerous hormones, small molecules, and growth factors are able to drive rodent beta cells to replicate, only a few small molecules have demonstrated the ability to stimulate human beta-cell proliferation...
2018: Methods in Molecular Biology
https://www.readbyqxmd.com/read/29736106/a-novel-mitochondrial-dna-deletion-in-patient-with-pearson-syndrome
#13
Rame Khasawneh, Hala Alsokhni, Bayan Alzghoul, Asim Momani, Nazih Abualsheikh, Nazmi Kamal, Mousa Qatawneh
Introduction: Arteriovenous Pearson syndrome is a very rare multisystemic mitochondrial disease characterized by sideroblastic anemia and exocrine pancreatic insufficiency. It is usually fatal in infancy. Case report: We reported a four-month-old infant presented with fever and pancytopenia. Bone marrow examination showed hypoplastic changes and sideroblastic features. Molecular Study showed a novel hetroplasmic mitochondrial deletions (m. 10760 -m. 15889+) in multiple genes (ND4,ND5,ND6, CYTB)...
April 2018: Medical Archives
https://www.readbyqxmd.com/read/29729163/kallistatin-level-in-patients-with-combination-of-chronic-pancreatitis-and-aterosclerosis
#14
Elizaveta S Sirchak, Svetlana M Opalenyk, Natalia Yu Kurchak
OBJECTIVE: Introduction: The article is devoted to the optimization of complex diagnosis in patients with combination of chronic pancreatitis and atherosclerosis. The aim: To study the level of serum kallistatin in patients with combination of chronic pancreatitis and atherosclerosis. PATIENTS AND METHODS: Materials and methods: 89 patients with chronic pancreatitis were examined. The serum kallistatin level was determined by immunoassay using the Human Serpin A4 ELISA Kit from RayBiotech according to the application method...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29728096/impact-of-the-treatment-of-pancreatic-exocrine-insufficiency-on-survival-of-patients-with-unresectable-pancreatic-cancer-a-retrospective-analysis
#15
Juan Enrique Domínguez-Muñoz, Laura Nieto-Garcia, Javier López-Díaz, Jose Lariño-Noia, Ihab Abdulkader, Julio Iglesias-Garcia
BACKGROUND: Malnutrition and weight loss are commonly observed in patients with pancreatic cancer and contribute to poor survival. Pancreatic exocrine insufficiency (PEI), which can be caused by ductal obstruction by a tumor, causes maldigestion and malabsorption of nutrients, thus contributing to malnutrition in these patients. In this study, we evaluated the effects of pancreatic enzyme replacement therapy (PERT) on survival in patients with unresectable pancreatic cancer. METHODS: A retrospective analysis was conducted on a database of patients with unresectable, pathologically confirmed pancreatic cancer...
May 5, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29725970/predominant-improvement-of-alpha-cell-function-after-steroid-therapy-in-a-patient-with-autoimmune-pancreatitis-case-report
#16
Ken Takeshima, Hiroyuki Ariyasu, Hiroshi Iwakura, Shintaro Kawai, Shinsuke Uraki, Hidefumi Inaba, Machi Furuta, Kenji Warigaya, Shin-Ichi Murata, Takashi Akamizu
INTRODUCTION: Autoimmune pancreatitis (AIP) is a subset of inflammatory pancreatic disease, responsive to corticosteroid therapy. It is prone to being affected by diabetes mellitus, but the effectiveness of steroid therapy on pancreatic endocrine function is still controversial. We present a case of AIP, focusing on pancreatic endocrine function after steroid therapy. CASE REPORT: The patient was referred to our hospital with exacerbation of diabetic control and pancreatic swelling...
May 3, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29725251/glucagon-like-peptide-1-receptor-agonist-and-glucagon-increase-glucose-stimulated-insulin-secretion-in-beta-cells-via-distinct-adenylyl-cyclases
#17
Young-Sun Lee, Hee-Sook Jun
Diabetes mellitus is a chronic disease in which the pancreas no longer produces enough insulin. Pancreatic alpha cell mass increases in response to insufficient insulin secretion. However, the reason for this increase is not clear. It is possible that the increased alpha-cells may stimulate compensatory insulin release in response to the insufficient insulin such as insulin resistance. In this study, we investigated whether glucagon and glucagon-like peptide-1 (GLP-1), hormones produced by alpha cells, contribute to insulin secretion in INS-1 cells, a beta cell line...
2018: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/29700810/refining-the-phenotype-associated-with-biallelic-dnajc21-mutations
#18
G D'Amours, F Lopes, J Gauthier, V Saillour, C Nassif, R Wynn, N Alos, T Leblanc, Y Capri, S Nizard, E Lemyre, J L Michaud, V-A Pelletier, Y D Pastore, J-F Soucy
Inherited bone marrow failure syndromes (IBMFS) are caused by mutations in genes involved in genomic stability. Although they may be recognized by the association of typical clinical features, variable penetrance and expressivity are common, and clinical diagnosis is often challenging. DNAJC21, which is involved in ribosome biogenesis, was recently linked to bone marrow failure. However, the specific phenotype and natural history remain to be defined. We correlate molecular data, phenotype, and clinical history of five unreported affected children and all individuals reported in the literature...
April 26, 2018: Clinical Genetics
https://www.readbyqxmd.com/read/29688760/effects-of-an-antioxidant-enriched-multivitamin-in-cystic-fibrosis-randomized-controlled-multicenter-trial
#19
Scott D Sagel, Umer Khan, Raksha Jain, Gavin Graff, Cori L Daines, Jordan M Dunitz, Drucy Borowitz, David M Orenstein, Ibrahim Abdulhamid, Julie Noe, John P Clancy, Bonnie Slovis, Michael J Rock, Karen S McCoy, Steven Strausbaugh, Floyd R Livingston, Konstantinos A Papas, Michele L Shaffer
RATIONALE: Cystic fibrosis (CF) is characterized by dietary antioxidant deficiencies, which may contribute to an oxidant-antioxidant imbalance and oxidative stress. OBJECTIVES: Evaluate the effects of an oral antioxidant-enriched multivitamin supplement on antioxidant concentrations, markers of inflammation and oxidative stress, and clinical outcomes. METHODS: In this investigator-initiated, multicenter, randomized, double-blind, controlled trial, 73 pancreatic insufficient CF subjects 10 years of age and older with an FEV1 between 40-100% predicted were randomized to 16 weeks of an antioxidant-enriched multivitamin or control multivitamin without antioxidant enrichment...
April 24, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29687501/unique-challenges-of-cystic-fibrosis-related-diabetes
#20
REVIEW
N Bridges, R Rowe, R I G Holt
Individuals with cystic fibrosis and pancreatic insufficiency have a gradual decline in insulin secretion over time, which results in an increase in the prevalence of diabetes with age; up to 50% of adults with cystic fibrosis aged over 35-40 years have diabetes. Cystic fibrosis-related diabetes differs from Type 1 and Type 2 diabetes in several ways; there is a pattern of insulin deficiency with reduced and delayed insulin response to carbohydrates but a sparing of basal insulin that results in glucose abnormalities, which are frequently characterized by normal fasting glucose and postprandial hyperglycaemia...
April 23, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
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