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Dinesh Edem, Jhansi Maradana, Priyanka Majety, Mc Anto Antony, Lakshmi Menon
Insulin autoimmune syndrome (IAS) or Hirata disease is a rare condition presenting as recurrent hypoglycemia, and associated with elevated insulin levels in the presence of insulin autoantibodies (IAAs) in patients who were never exposed to exogenous insulin and with no evidence of pancreatic abnormalities. IAS is much more frequent in East Asians, especially the Japanese population, compared to the lower incidence in Caucasians. However, it can be associated with other autoimmune diseases or drug use like methimazole and alpha-lipoic acid (ALA)...
April 2024: Curēus
#2
REVIEW
Michele R Modestino, Olimpia Iacono, Laura Ferrentino, Anna Lombardi, Umberto De Fortuna, Rita Verdoliva, Mariarosaria De Luca, Vincenzo Guardasole
Hypoglycaemic syndromes are rare in apparently healthy individuals and their diagnosis can be a difficult challenge for clinicians as there are no shared guidelines that suggest how to approach patients with a suspect hypoglycaemic disorder. Since hypoglycaemia symptoms are common and nonspecific, it's necessary to document the Whipple Triad (signs and/or symptoms compatible with hypoglycaemia; relief of symptoms following glucose administration; low plasma glucose levels) before starting any procedure. Once the triad is documented, a meticulous anamnesis and laboratory tests (blood glucose, insulin, proinsulin, C-peptide, β-hydroxybutyrate and anti-insulin antibodies) should be performed...
April 16, 2024: Journal of Basic and Clinical Physiology and Pharmacology
#3
JOURNAL ARTICLE
Mohamed Abdelgawad, Diana Wu, Omar Kamel, Sally Abdelgawad, Hishaam Ismael
No abstract text is available yet for this article.
April 14, 2024: American Surgeon
#4
JOURNAL ARTICLE
Julio Cuesta López, Benedetto Ielpo, Mar Iglesias, Fernando Burdío Pinilla, Patricia Sánchez-Velázquez
PURPOSE: Pancreatic ductal adenocarcinoma (PADC) still has nowadays a very impaired long-term survival. Most studies are focused on overall survival; however, local recurrence occurs about up to 50% of cases and seems to be highly related with margin resection status. We aim to analyze the impact of vascular resection margins on local recurrence (LR) and to assess its impact on overall and disease-free survival. METHODS: Eighty out of 191 patients who underwent pancreatoduodenectomy in a university hospital between 2006 and 2021 with PDAC diagnosis were analyzed and vascular margin status specifically addressed...
April 12, 2024: Langenbeck's Archives of Surgery
#5
JOURNAL ARTICLE
Bernardo Tourais Canhão, André Trigo, Joana Inês Madeira, Adélia Simão, João Madaleno
Whipple's disease is a multisystemic chronic infectious condition caused by Tropheryma whipplei ( T. whipplei ). Though characterised often by insidious weight loss, diarrhoea, and arthralgia, three other distinct manifestations can be observed, namely localised disease, acute infection and asymptomatic carriage. The diagnosis relies on histopathological examination of duodenal biopsies and polymerase chain reaction analysis of the 16S rRNA gene for T. whipplei. We report the case of a middle-aged man admitted for etiologic investigation of prolonged, migrating, and inflammatory arthralgias and subsequent development of gastrointestinal symptoms...
March 2024: Journal of the Royal College of Physicians of Edinburgh
#6
JOURNAL ARTICLE
Arsalan Nadeem, Aliaksei Salei
This case report presents the percutaneous extraction of a biliary stent in a patient with a history of liver transplant and Whipple procedure, suffering from benign biliary stricture post hepaticojejunostomy. After failed management with conventional benign biliary protocol, a fully covered WallFlex biliary stent was percutaneously placed and later removed using a balloon catheter technique. The procedure demonstrated anastomosis patency without complications, providing a drain-free option for complex anatomy where endoscopic management was not feasible...
April 10, 2024: BMJ Case Reports
#7
Jaafar Alsalman, Abdulaziz Alqourain, Mohammed Alyousef, Omran Aldandan, Ibrahim Alzahrani
INTRODUCTION: Ampullary neuroendocrine tumors (NETs) are usually diagnosed in the 5th-6th decades of life, and no cases were reported in <20 years of age. We report a rare case, presenting at a very young age, of well-differentiated NET involving the ampulla of Vater with lymph node metastasis. CASE PRESENTATION: An 18-year-old man presented with a 3-month history of upper abdominal pain and jaundice. Abdominal ultrasound showed a dilated common bile duct, and endoscopic retrograde cholangiopancreatography revealed two duodenal polypoid lesions, one of them overlying the ampulla of Vater, with an erythematous and ulcerated surface...
2024: Case Reports in Gastroenterology
#8
JOURNAL ARTICLE
W Taylor Martin, Morgan Bonds, Laura Fischer, Katherine T Morris, Zoona Sarwar, Kenneth Stewart, Tabitha Garwe, Alessandro Paniccia, Richard D Schulick, Ajay Jain, Barish H Edil
BACKGROUND: Historically, pancreaticoduodenectomy (PD) has been performed via a laparotomy, but increasingly, laparoscopic and robotic platforms are being employed for PD. Laparoscopic PD has a steep surgeon specific learning curve and programmatic elements that must be optimized. These factors may limit a surgeon who is proficient at laparoscopic PD to develop a program at another institution. We hypothesize that the learning curve for a surgeon transferring a program to a second institution is shorter than the initial laparoscopic PD learning curve for the same surgeon...
April 8, 2024: American Surgeon
#9
JOURNAL ARTICLE
Chi-Yin Liao, Carmen Gonzalez-Ferrer, Samuel Whipple, Naleen Raj Bhandari, Patrick M Peterson, Scott S Barker, Feng Wang
No abstract text is available yet for this article.
April 5, 2024: Journal of the National Comprehensive Cancer Network: JNCCN
#10
JOURNAL ARTICLE
Emily Nash Smyth, Samuel Whipple, Mark Guinter, Nadine Haddad, Wenxian Piao, Zhanglin Cui, Arjun Balar
No abstract text is available yet for this article.
April 5, 2024: Journal of the National Comprehensive Cancer Network: JNCCN
#11
Ling-Ling Xu, Jia-Xin Chen, Jing-Ping Cheng, Ni Luo
BACKGROUND: Insulin autoimmune syndrome (IAS) is a severe manifestation of spontaneous hypoglycemia. It is characterized by elevated levels of immune-reactive insulin and highly potent insulin autoantibodies (IAAs), which are induced by endogenous insulin circulating in the bloodstream. It is distinguished by recurring instances of spontaneous hypoglycemia, the presence of IAA within the body, a substantial elevation in serum insulin levels, and an absence of prior exogenous insulin administration...
March 26, 2024: World Journal of Clinical Cases
#12
JOURNAL ARTICLE
Konstantinos Bouchagier, Francesk Mulita, Georgios-Ioannis Verras, Steffen Nehr, Ioannis Perdikaris, Konstantinos Tasios, Andreas Antzoulas, Angelos Samaras, Serafeim Klimopoulos, Ioannis Maroulis
INTRODUCTION: Pancreaticoduodenectomy is a major procedure. Delayed gastric emptying (DGE) is a frequent postoperative complication that is attributed to several factors. AIM: To investigate the probable association between perineural infiltrations and DGE, and the effects on overall survival. MATERIAL AND METHODS: A total of 123 patients who underwent pancreaticoduodenectomy were enrolled in the study. Factors like the presence of perineural infiltrations and post-operative DGE along with age, gender, presence of postoperative fistula, and grade of fistula and postoperative haemorrhage were analysed, and survival analyses were conducted...
2024: Przegla̜d Gastroenterologiczny
#13
REVIEW
Hans G Beger
Currently, the most frequently used surgical treatment for symptomatic, benign, premalignant cystic and neuroendocrine neoplasms of the pancreatic head is the Whipple procedure or pylorus-preserving pancreatoduodenectomy (PD). However, when performed for treatment of benign tumors, PD is a multiorgan resection involving loss of pancreatic and extrapancreatic tissue and functions. PD for benign neoplasm is associated with the risk of considerable early postoperative complications and an in-hospital mortality of up to 5%...
April 3, 2024: Chirurgie (Heidelb)
#14
JOURNAL ARTICLE
Antoine Guérin, Marcela Moncada-Vélez, Katherine Jackson, Masato Ogishi, Jérémie Rosain, Mathieu Mancini, David Langlais, Andrea Nunez, Samantha Webster, Jesse Goyette, Taushif Khan, Nico Marr, Danielle T Avery, Geetha Rao, Tim Waterboer, Birgitta Michels, Esmeralda Neves, Cátia Iracema Morais, Jonathan London, Stéphanie Mestrallet, Pierre Quartier Dit Maire, Bénédicte Neven, Franck Rapaport, Yoann Seeleuthner, Atar Lev, Amos J Simon, Jorge Montoya, Ortal Barel, Julio Gómez-Rodríguez, Julio C Orrego, Anne-Sophie L'Honneur, Camille Soudée, Jessica Rojas, Alejandra C Velez, Irini Sereti, Benjamin Terrier, Nancy Marin, Luis F García, Laurent Abel, Stéphanie Boisson-Dupuis, Joel Reis, Antonio Marinho, Andrea Lisco, Emilia Faria, Christopher C Goodnow, Julia Vasconcelos, Vivien Béziat, Cindy S Ma, Raz Somech, Jean-Laurent Casanova, Jacinta Bustamante, Jose Luis Franco, Stuart G Tangye
CD4+ T cells are vital for host defense and immune regulation. However, the fundamental role of CD4 itself remains enigmatic. We report seven patients aged 5-61 years from five families of four ancestries with autosomal recessive CD4 deficiency and a range of infections, including recalcitrant warts and Whipple's disease. All patients are homozygous for rare deleterious CD4 variants impacting expression of the canonical CD4 isoform. A shorter expressed isoform that interacts with LCK, but not HLA class II, is affected by only one variant...
May 6, 2024: Journal of Experimental Medicine
#15
JOURNAL ARTICLE
Stig Ree Krüger, Espen Rigby Norvard, Kjersti Wik Larssen, Ursa Maierhofer, Helene Hestmann, Thomas Papathomas
No abstract text is available yet for this article.
March 29, 2024: International Journal of Infectious Diseases: IJID
#16
JOURNAL ARTICLE
Patricia K Bozeman, Emily Russo, Mary O Whipple
No abstract text is available yet for this article.
March 2024: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
#17
JOURNAL ARTICLE
Amber L Geng, Bhavana Thota, Sreekanth Yellanki, Hui Chen, Ryan Maguire, Harish Lavu, Wilbur Bowne, Charles J Yeo, Avinoam Nevler
BACKGROUND: Delayed gastric emptying (DGE) is a common complication after pancreaticoduodenectomy. There remains an active debate over the effect of gastrointestinal (GI) reconstruction techniques, such as antecolic (AC) or transmesocolic (TMC) reconstruction, on DGE rates. This study compared the rates of DGE between AC reconstruction and TMC reconstruction after pylorus-preserving pancreaticoduodenectomy (PPPD) and classic pancreaticoduodenectomy (PD). METHODS: This was a retrospective analysis of a prospectively maintained pancreatic surgery database in a single, high-volume center...
March 12, 2024: Journal of Gastrointestinal Surgery
#18
JOURNAL ARTICLE
A W J Wong, N H S Sim, J H Kam, R Rajarethinam, B K Tan, A Y H Tan
BACKGROUND: A pancreatic fistula is one of the most devastating complications following a Whipple's procedure. Fistula rates remain high despite various modifications to surgical techniques. We propose the use of a vascularised muscle flap in the primary prevention of pancreatic fistulas. METHOD: A distal pancreatectomy was performed on 5 pigs in our porcine model. A pancreaticojejunal (PJ) anastomotic leak was simulated. The pigs were divided into treatment (4 pigs) and control groups (1 pig)...
June 2024: JPRAS Open
#19
Carolina Saffioti, Marta Nebiolo, Roberta Caorsi, Alessio Mesini, Mariasavina Severino, Giacomo Brisca, Elio Castagnola, Marco Gattorno
We describe an atypical case of Whipple disease exclusively involving the spinal cord in an adolescent receiving immunosuppressive therapy for systemic lupus erythematosus. The diagnosis was particularly difficult since lupus and Whipple disease can present similar clinical features and the patient's prolonged contact with sewage was initially not mentioned. A literature review of the clinical, imaging, diagnostic, and therapeutic challenges of Whipple disease is also performed.
March 19, 2024: Infectious Disease Reports
#20
JOURNAL ARTICLE
Jacarri L Tollette, Ianto Lin Xi, Richard D Shlansky-Goldberg
No abstract text is available yet for this article.
April 2024: Journal of Vascular and Interventional Radiology: JVIR
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