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https://www.readbyqxmd.com/read/28204915/-acute-chest-pain-and-new-ecg-changes-in-pacemaker-patients-a%C3%A2-clinical-challenge
#1
Matthias Hoyme, Ralf Surber, P Christian Schulze, Dirk Prochnau
We report the case of a 82-year-old woman who was admitted to our institution with acute chest pain, nausea, and vomiting. Because of atrial fibrillation with intermittent bradycardia, a single-chamber pacemaker was implanted 4 years ago. The initial 12-lead ECG showed atrial fibrillation with a heart rate of 70 bpm, narrow QRS, and T‑wave inversions in the inferolateral leads. Coronary artery disease was excluded by immediate cardiac catheterization. A subsequent ECG three hours later showed a ventricular paced rhythm...
February 15, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28196021/the-changing-epidemiology-of-acute-pancreatitis-hospitalizations-a-decade-of-trends-and-the-impact-of-chronic-pancreatitis
#2
Somashekar G Krishna, Amrit K Kamboj, Phil A Hart, Alice Hinton, Darwin L Conwell
OBJECTIVES: The epidemiological trends contributing to increasing acute pancreatitis (AP) hospitalizations remain unknown. We sought to analyze etiological factors and outcomes of increasing AP hospitalizations. METHODS: Utilizing the Nationwide Inpatient Sample, retrospective analyses of adult (≥18 years) inpatient admissions with a primary diagnosis of AP (N = 2,016,045) were performed. Patient hospitalizations from 2009 to 2012 were compared with those from 2002 to 2005...
February 14, 2017: Pancreas
https://www.readbyqxmd.com/read/28192107/gastrointestinal-complications-of-obesity
#3
Michael Camilleri, Harmeet Malhi, Andres Acosta
Obesity is usually associated with morbidity related to diabetes mellitus and cardiovascular diseases. However, there are many gastrointestinal and hepatic diseases for which obesity is the direct cause [e.g. non-alcoholic fatty liver diseases (NAFLD)] or is a significant risk factor, such as reflux esophagitis and gallstones. When obesity is a risk factor, it may interact with other mechanisms and result in earlier presentation or complicated diseases. There are increased odds ratios or relative risks of several gastrointestinal complications of obesity: gastroesophageal reflux disease (GERD), erosive esophagitis, Barrett's esophagus, esophageal adenocarcinoma, erosive gastritis, gastric cancer, diarrhea, colonic diverticular disease, polyps, cancer, liver disease including NAFLD, cirrhosis, hepatocellular carcinoma, gallstones, acute pancreatitis, and pancreatic cancer...
February 9, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28159463/the-incidence-and-aetiology-of-acute-pancreatitis-across-europe
#4
REVIEW
Stephen E Roberts, Sian Morrison-Rees, Ann John, John G Williams, Tim H Brown, David G Samuel
BACKGROUND: Acute pancreatitis is increasingly one of the most important acute gastrointestinal conditions throughout much of the world, although incidence and aetiology varies across countries and regions. This study investigated regional and national patterns in the incidence and aetiology of acute pancreatitis, demographic patterns in incidence and trends over time in incidence across Europe. METHODS: A structured review of acute pancreatitis incidence and aetiology from studies of hospitalised patient case series, cohort studies or other population based studies from 1989 to 2015 and a review of trends in incidence from 1970 to 2015 across all 51 European states...
January 19, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28122906/updated-guideline-on-the-management-of-common-bile-duct-stones-cbds
#5
Earl Williams, Ian Beckingham, Ghassan El Sayed, Kurinchi Gurusamy, Richard Sturgess, George Webster, Tudor Young
Common bile duct stones (CBDS) are estimated to be present in 10-20% of individuals with symptomatic gallstones. They can result in a number of health problems, including pain, jaundice, infection and acute pancreatitis. A variety of imaging modalities can be employed to identify the condition, while management of confirmed cases of CBDS may involve endoscopic retrograde cholangiopancreatography, surgery and radiological methods of stone extraction. Clinicians are therefore confronted with a number of potentially valid options to diagnose and treat individuals with suspected CBDS...
January 25, 2017: Gut
https://www.readbyqxmd.com/read/28118676/short-term-outcome-of-total-clipless-laparoscopic-cholecystectomy-for-complicated-gallbladder-stones-in-cirrhotic-patients
#6
Mohamed I Kassem, Ehab M Hassouna
BACKGROUND: Cirrhotic patients have been known to be more affected with gallstones than their non-cirrhotic counterparts; since laparoscopy was introduced, it has been generally approved as the standard approach for cholecystectomies with the exception of end-stage cirrhosis. The purpose of this study was to evaluate the safety and efficacy of clipless laparoscopic cholecystectomy using the harmonic scalpel in complicated cholelithiasis in cirrhotic patients. METHODS: This prospective study was conducted on 62 cirrhotic patients presenting to the Gastrointestinal Surgery Unit in Alexandria Main University Hospital with complicated gallstones between March 2013 and March 2016...
January 24, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28105582/-control-of-opisthorchis-viverrini-infection-for-cholangiocarcinoma-prevention
#7
Y Buisson
The International Agency for Research on Cancer (IARC) has classified two liver flukes as carcinogenic to humans (Group 1): Opisthorchis viverrini in 1994 and Clonorchis sinensis in 2009. This review is focused on O. viverrini, the most studied of these two trematodes, which infects nearly 10 million people in Southeast Asia. The life cycle involves two intermediate hosts living in fresh water: a snail of the genus Bithynia and a ciprinid fish. The definitive hosts (human, cat, dog) become infected by ingesting raw fish containing metacercariae, the infective stage of the parasite...
January 19, 2017: Bulletin de la Société de Pathologie Exotique
https://www.readbyqxmd.com/read/28074277/patient-reported-outcomes-for-acute-gallstone-pathology
#8
Ed Parkin, Martyn Stott, Joy Brockbank, Simon Galloway, Ian Welch, Andrew Macdonald
BACKGROUND: A number of prominent surgical trials and clinical guidelines regard length of hospital stay and rates of daycase surgery as being of upmost importance following cholecystectomy. However, it is unclear whether these outcomes also matter to patients. This study aimed to identify the factors patients regard as most important when admitted with acute gallstone pathology. METHODS: A 41-item survey was produced by combining outcomes assessed in recent clinical trials with results from a preliminary patient questionnaire...
January 10, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28071655/effectiveness-of-guideline-recommended-cholecystectomy-to-prevent-recurrent-pancreatitis
#9
Ayesha Kamal, Eboselume Akhuemonkhan, Venkata S Akshintala, Vikesh K Singh, Anthony N Kalloo, Susan M Hutfless
OBJECTIVES: Cholecystectomy during or within 4 weeks of hospitalization for acute biliary pancreatitis is recommended by guidelines. We examined adherence to the guidelines for incident mild-to-moderate acute biliary pancreatitis and the effectiveness of cholecystectomy to prevent recurrent episodes of pancreatitis. METHODS: Individuals in the 2010-2013 MarketScan Commercial Claims & Encounters database with a hospitalization associated with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes of 577...
January 10, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28035552/small-gallstone-size-and-delayed-cholecystectomy-increase-the-risk-of-recurrent-pancreatobiliary-complications-after-resolved-acute-biliary-pancreatitis
#10
Sung Bum Kim, Tae Nyeun Kim, Hyun Hee Chung, Kook Hyun Kim
INTRODUCTION: Acute biliary pancreatitis (ABP) is a severe complication of gallstone disease with considerable mortality, and its recurrence rate is reported as 50-90% for ABP patients who do not undergo cholecystectomy. However, the incidence of and risk factors for recurrent pancreatobiliary complications after the initial improvement of ABP are not well established in the literature. The aims of this study were to determine the risk factors for recurrent pancreatobiliary complications and to compare the outcomes between early (within 2 weeks after onset of pancreatitis) and delayed cholecystectomy in patients with ABP...
December 29, 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28009683/diabetes-mellitus-is-associated-with-mortality-in-acute-pancreatitis
#11
Ji Hye Huh, Hosung Jeon, Sun Min Park, EunHee Choi, Geun Sook Lee, Jae Woo Kim, Kyong Joo Lee
BACKGROUND AND AIM: Predicting severe pancreatitis is important for early aggressive management of patients with acute pancreatitis (AP). Despite the established role of diabetes mellitus (DM) in the risk of AP, the impact of DM on the clinical outcome in AP has not been fully elucidated. The objective of this study was to assess the risk of mortality and severity in AP among patients with type-2 DM. METHODS: Patients diagnosed with first attacks of AP were enrolled from January 2013 to June 2015...
December 22, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27990758/factor-analysis-of-recurrent-biliary-events-in-long-term-follow-up-of-gallstone-pancreatitis
#12
Ji Min Lee, Woo Chul Chung, Hea Jung Sung, Yeon-Ji Kim, Gun Jung Youn, Yun Duk Jung, Sooa Choi, Eun Jung Jeon
OBJECTIVE: Recurrent attacks after acute gallstone pancreatitis (GSP) are a substantial problem with associated morbidity and mortality. The recommended therapies for recurrent attacks are cholecystectomy and endoscopic sphincterotomy (EST). This study aimed to evaluate the long-term results of cholecystectomy and EST after clinical improvement of GSP. METHODS: A consecutive series of patients who were admitted with GSP between January 2003 to December 2014 were analyzed...
December 18, 2016: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/27981825/laparo-endoscopic-rendez-vous-versus-sequential-delayed-approach-in-patients-with-choledocholithiasis
#13
Antonio Pesce, Gaetano LA Greca, Saverio Latteri, Vincenzo Guardabasso, Federica DI Marco, Michele DI Blasi, Domenico Russello, Stefano Puleo
BACKGROUND: To compare the efficacy and safety of synchronous laparoscopic cholecystectomy with laparo-endoscopic rendez-vous technique vs sequential "delayed" approach with the main goal to compare the conversion rate and post-operative complications. METHODS: Patients diagnosed as having gallstones and CBD stones or sludge were enrolled in this study. From January 2013 to June 2015, 43 consecutive patients were submitted to the sequential treatment (ERCP prior to laparoscopic cholecystectomy) and the next consecutive 46 patients were submitted to undergo the rendez-vous technique...
December 16, 2016: Minerva Chirurgica
https://www.readbyqxmd.com/read/27981822/early-cholecystectomy-for-non-severe-acute-gallstone-pancreatitis-easier-said-than-done
#14
Simone Guadagni, Ismail Cengeli, Matteo Palmeri, Luca Bastiani, Andrea Bertolucci, Matteo Modesti, Christian Galatioto, Massimo Chiarugi
BACKGROUND: Laparoscopic cholecystectomy (LC) carried out within 3 days after an attack of non severe acute gallstone pancreatitis (NSAGP) is recommended to reduce hospital stay and overall costs. Aim of the study was to evaluate factors that may delay a timely surgical management of NSAGP and the consequences of this deviation. METHODS: We reviewed the charts of patients admitted for NSAGP and managed by LC during the last 14 years. 316 patients entered the study, 98 of whom underwent early LC...
December 16, 2016: Minerva Chirurgica
https://www.readbyqxmd.com/read/27920645/autoimmune-pancreatitis-a-case-of-atypical-radiographic-findings
#15
Shawhin Karimi, Parth Bharill
Autoimmune pancreatitis (AIP) is a rare pancreatic disorder that can present as a manifestation of a broader systemic inflammatory disease known as immunoglobulin G4-related systemic disease (IGG4-RSD). AIP is divided into two subtypes based on clinical, radiological, and histological findings. The disease can be mistaken for pancreatic cancer because of overlapping clinical and radiological findings, but early recognition can help avoid unnecessary surgery. We present a case of a 65-year-old female with suspected acute gallstone pancreatitis found to have AIP based on serology, radiological findings, and response to steroids...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27906430/recurrent-acute-pancreatitis-in-bowel-malrotation
#16
G Alessandri, A Amodio, L Landoni, N De' Liguori Carino, C Bassi
OBJECTIVE: Recurrent acute pancreatitis is an uncommon diagnosis in teenagers. Excluded alcohol and biliary stones, more prevalent aetiologies in these group of patients are genetic pancreatitis, pancreatic duct system abnormalities, neoplasia, traumas and congenital abnormalities of the duodenum such as duodenal duplication or diverticulum. Two reported cases of recurrent pancreatitis associated to midgut malrotation were described in English literature. Bowel malrotation is a difficult diagnosis in a teenager or a young adult and a common delay is documented...
November 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27904310/laparoscopic-cholecystectomy-in-patients-with-history-of-gastrectomy
#17
Ming-Jie Zhang, Qiang Yan, Guo-Lei Zhang, Si-Yu Zhou, Wen-Bin Yuan, Hua-Ping Shen
BACKGROUND AND OBJECTIVES: Patients with previous gastrectomy have an increased incidence of gallstones and gallbladder morbidity requiring surgery. We investigated the possible risk factors that contribute to severe gallbladder disease in patients with previous gastrectomy and the role of laparoscopic cholecystectomy (LC) in the treatment of these patients. METHODS: In this retrospective study, we reviewed a database of patients who underwent LC in our hospital during the period January 1, 2010, through May 1, 2015...
October 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/27893641/routine-surveillance-cholangiography-after-percutaneous-cholecystostomy-delays-drain-removal-and-cholecystectomy
#18
Tyler J Loftus, Scott C Brakenridge, Frederick A Moore, Camille G Dessaigne, George A Sarosi, William J Zingarelli, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Philip A Efron, Alicia M Mohr
INTRODUCTION: Percutaneous cholecystostomy (PC) is often performed for patients with acute cholecystitis who are at high risk for operative morbidity and mortality. However, the necessity for routine cholangiography after PC remains unclear. We hypothesized that routine surveillance cholangiography (RSC) after PC would provide no benefit compared to on-demand cholangiography (ODC) triggered by signs or symptoms of biliary pathology. METHODS: We performed a 3-year retrospective cohort analysis of patients managed with PC for acute cholecystitis at two tertiary care hospitals...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27890867/obesity-related-digestive-diseases-and-their-pathophysiology
#19
REVIEW
Su Youn Nam
Obesity is a growing medical and public health problem worldwide. Many digestive diseases are related to obesity. In this article, the current state of our knowledge of obesity-related digestive diseases, their pathogenesis, and the medical and metabolic consequences of weight reduction are discussed. Obesity-related digestive diseases include gastroesophageal reflux disease, Barrett's esophagus, esophageal cancer, colon polyp and cancer, nonalcoholic fatty liver disease, hepatitis C-related disease, hepatocellular carcinoma, gallstone, cholangiocarcinoma, and pancreatic cancer...
November 29, 2016: Gut and Liver
https://www.readbyqxmd.com/read/27882764/-acute-pancreatitis-in-pregnancy-complicated-by-rupture-of%C3%A2-aneurysm-of-artery-lienalis
#20
E Hostinská, K Huml, R Pilka
OBJECTIVE: We present a case of pregnant woman with acute pacreatitis in 38th week comlicated by acute rupture of aneurysm of artery lienalis. DESIGN: Case report. SETTING: Department of Gynaecology and Obstetrics, Faculty Hospital and Palacky University, Olomouc. CASE REPORT: 28-years-old primipara in 38th week of gestation was admitted to our department for acute pancreatitis caused by gallstones. Subsequent conservative treatment was complicated by rupture of aneurysm of lienal artery and haemorrhagic shock...
2016: Ceská Gynekologie
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