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https://www.readbyqxmd.com/read/29334556/decoding-grade-b-pancreatic-fistula-a-clinical-and-economical-analysis-and-subclassification-proposal
#1
Laura Maggino, Giuseppe Malleo, Claudio Bassi, Valentina Allegrini, Matthew T McMillan, Alex Borin, Bofeng Chen, Jeffrey A Drebin, Brett L Ecker, Douglas L Fraker, Major K Lee, Salvatore Paiella, Robert E Roses, Roberto Salvia, Charles M Vollmer
OBJECTIVE: The aim of this study was to describe characteristics and management approaches for grade B pancreatic fistula (B-POPF) and investigate whether it segregates into distinct subclasses. BACKGROUND: The 2016 ISGPS refined definition of B-POPF is predicated on various postoperative management approaches, ranging from prolonged drainage to interventional procedures, but the spectrum of clinical severity within this entity is yet undefined. METHODS: Pancreatectomies performed at 2 institutions from 2007 to 2016 were reviewed to identify B-POPFs and their treatment strategies...
January 12, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29310378/isolated-cerebral-aspergillosis-in-an-immunocompetent-woman-on-treatment-for-bacterial-infected-necrotizing-pancreatitis-a-case-report
#2
Shaoyang Zhang, Qinghui Fu, Qi Chen, Ting-Bo Liang
RATIONALE: Cerebral aspergillosis (CA) is a rare manifestation of invasive aspergillosis. It usually affects seriously immunocompromised hosts. Pancreatic bacterial or/and fungal infection is common in patients with severe acute pancreatitis. PATIENT CONCERNS: We report the first case of an immunocompetent woman with infected necrotizing pancreatitis due to multidrug resistant Acinetobacter baumannii who, in the course of treatment, developed isolated CA. DIAGNOSES: Magnetic resonance imaging, rather than computed tomography, revealed latent homolateral sinus disease-the possible source of the Aspergillus infection...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29303286/-cystic-fibrosis-in-adults
#3
Libor Fila
Cystic fibrosis (CF) is an inherited disease caused by mutations in the transmembrane conductance regulator (CFTR) gene. The disease leads to dysfunction of the exocrine glands with high concentration of chloride in the sweat and formation of abnormally viscous mucus in the respiratory, digestive and reproductive tract. Chronic sinopulmonary disease, exocrine pancreatic insufficiency, liver disease, intestinal obstruction, impaired nutritional status, salt loss syndrome and male infertility dominates in the clinical presentation...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29298133/epidemiology-and-risk-factors-for-isolation-of-multi-drug-resistant-organisms-in-patients-with-complicated-intra-abdominal-infections
#4
Francesco M Labricciosa, Massimo Sartelli, Lilian M Abbo, Pamela Barbadoro, Luca Ansaloni, Federico Coccolini, Fausto Catena
BACKGROUND: Patients with complicated intra-abdominal infections (cIAIs) caused by multi-drug-resistant organisms (MDROs) have been identified as being at increased risk for adverse outcomes. Prompt identification and stratification of these patients is essential in the clinical management, allowing the physician timely optimization of empiric antimicrobial therapy while awaiting results of intra-operative cultures to streamline antibiotic treatment. METHODS: The study is a secondary analysis from two prospective multi-center color surveillance studies...
January 3, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29282388/a-rare-case-of-intraductal-tubulopapillary-neoplasm-of-the-pancreas-rupturing-and-causing-acute-peritonitis
#5
Akira Umemura, Kazuyuki Ishida, Hiroyuki Nitta, Takeshi Takahara, Yasushi Hasegawa, Kenji Makabe, Akira Sasaki
An intraductal tubulopapillary neoplasm (ITPN) is a very rare pancreatic tumor. Here we report an extremely rare case of an ITPN rupturing and causing acute peritonitis. A 50-year-old woman presented with left flank pain and vomiting. A computed tomography (CT) scan revealed gigantic multilocular cysts in the pancreatic tail and massive fluid collection in the abdominal cavity. The serum, urine, and abdominal fluid amylase levels were highly elevated, so she was conservatively treated with intraperitoneal drainage and antibiotics for a diagnosis of ruptured pancreatic cysts...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29280782/management-of-acute-pancreatitis-in-the-pediatric-population-a-clinical-report-from-the-north-american-society-for-pediatric-gastroenterology-hepatology-and-nutrition-pancreas-committee
#6
Maisam Abu-El-Haija, Soma Kumar, Jose Antonio Quiros, Keshawadhana Balakrishnan, Bradley Barth, Samuel Bitton, John F Eisses, Elsie Jazmin Foglio, Victor Fox, Denease Francis, Alvin Jay Freeman, Tanja Gonska, Amit S Grover, Sohail Z Husain, Rakesh Kumar, Sameer Lapsia, Tom Lin, Quin Y Liu, Asim Maqbool, Zachary M Sellers, Flora Szabo, Aliye Uc, Steven L Werlin, Veronique D Morinville
BACKGROUND: Although the incidence of acute pancreatitis (AP) in children is increasing, management recommendations rely on adult published guidelines. Pediatric-specific recommendations are needed. METHODS: The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Pancreas committee performed a MEDLINE review using several preselected key terms relating to management considerations in adult and pediatric AP. The literature was summarized, quality of evidence reviewed, and statements of recommendations developed...
January 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29226107/cholangitis-diagnosis-treatment-and-prognosis
#7
REVIEW
Amir Houshang Mohammad Alizadeh
Cholangitis is a serious life-threatening situation affecting the hepatobiliary system. This review provides an update regarding the clinical and pathological features of various forms of cholangitis. A comprehensive search was performed in the PubMed, Scopus, and Web of Knowledge databases. It was found that the etiology and pathogenesis of cholangitis are heterogeneous. Cholangitis can be categorized as primary sclerosing (PSC), secondary (acute) cholangitis, and a recently characterized form, known as IgG4-associated cholangitis (IAC)...
December 28, 2017: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/29215543/fungal-infections-in-patients-with-infected-pancreatic-necrosis-and-pseudocysts-risk-factors-and-outcome
#8
Philipp A Reuken, Hanna Albig, Jürgen Rödel, Michael Hocke, Uwe Will, Andreas Stallmach, Tony Bruns
OBJECTIVES: Fungal infections in patients with acute pancreatitis are common and potentially life threatening. Data on fungal pancreatic infections are inconsistent. Therefore, the aim of this study was to identify risk factors for fungal infection and to determine their impact on survival. METHODS: This was a retrospective analysis of pathogen spectrum and outcome of infected pancreatic necrosis or pseudocysts from 3 German hospitals from 2002 to 2016. RESULTS: A total of 187 fine-needle aspirations were performed in 113 patients...
January 2018: Pancreas
https://www.readbyqxmd.com/read/29166257/raoultella-planticola-a-rare-cause-of-wound-infection
#9
Shana S Kalaria, Kristina Elliott, Neal Combs, Linda G Phillips
Raoultella planticola is a gram-negative, aerobic, rod bacterium commonly found in the environment, particularly in water, soil, and fish. This organism has been found to cause a variety of infections, such as necrotizing fasciitis, cystitis, cholecystitis, pancreatitis, hepatic disease, and soft tissue infections. The authors report the case of a 73-year-old-woman who presented with a R planticola wound infection of her left lower extremity after a dog scratch. She was treated successfully with local wound care using dehydrated human amnion/chorion and oral levofloxacin...
November 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29132521/gallbladder-dysfunction-cholecystitis-choledocholithiasis-cholangitis-and-biliary-dyskinesia
#10
REVIEW
Thad Wilkins, Edward Agabin, Jason Varghese, Asif Talukder
The prevalence of gallstones is 10% to 15% in adults. Individuals with acute cholecystitis present with right upper quadrant pain, fever, and leukocytosis. Management includes supportive care and cholecystectomy. The prevalence of choledocholithiasis is 10% to 20%, and serious complications include cholangitis and gallstone pancreatitis. The goal of management in individuals with choledocholithiasis consists of clearing common bile duct stones. Acute ascending cholangitis is a life-threatening condition involving acute inflammation and infection of the common bile duct...
December 2017: Primary Care
https://www.readbyqxmd.com/read/29100225/acute-pancreatitis-etiology-pathology-diagnosis-and-treatment
#11
Shirin Majidi, Adam Golembioski, Stephen L Wilson, Errington C Thompson
Acute pancreatitis is a fascinating disease. In the United States, the two most common etiologies of acute pancreatitis are gallstones and excessive alcohol consumption. The diagnosis of acute pancreatitis is made with a combination of history, physical examination, computed tomography scan, and laboratory evaluation. Differentiating patients who will have a benign course of their pancreatitis from patients who will have severe pancreatitis is challenging to the clinician. C-reactive protein, pro-calcitonin, and the Bedside Index for Severity of Acute Pancreatitis appeared to be the best tools for the early and accurate diagnosis of severe pancreatitis...
November 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/29056168/cystic-fibrosis-a-risk-condition-for-renal-disease
#12
Domenico Santoro, Adele Postorino, Cristina Lucanto, Stefano Costa, Simona Cristadoro, Salvatore Pellegrino, Giovanni Conti, Michele Buemi, Giuseppe Magazzù, Guido Bellinghieri
OBJECTIVE: Cystic fibrosis (CF) is the most common autosomal recessive disease affecting the Caucasian population, with a birth incidence ranging between 1:2,500 and 1:1,800. It is caused by mutations in the CF transmembrane regulator gene which is localized on 7 chromosomes. Renal disease is reported as a relatively rare complication in adult patient with CF. We evaluated proteinuria and chronic renal failure (CRF) in a population of patients with CF. METHODS: A retrospective study was carried out in a referral center for CF at University of Messina in Italy...
November 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/29031650/tigecycline-based-prolonged-salvage-therapy-in-patients-presenting-with-complex-bone-and-joint-infection
#13
J Wach, A Dinh, H Dutronc, O R Sipahi, A Candevir, F Valour, V Zeller, S Lustig, F Laurent, C Chidiac, T Ferry
OBJECTIVES: To assess the clinical experience of tigecycline-based salvage therapy in patients presenting with Bone and Joint Infections (BJI). PATIENTS AND METHODS: Multicenter retrospective cohort study in France and Turkey (2007-2014). RESULTS: Thirty-six patients (age 58.2±17.8 years; 21 men) were included. The most frequently isolated bacteria were Enterobacteriaceae and staphylococci. Tigecycline (50mg BID, mainly in combination (69...
October 12, 2017: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/29019583/management-of-infected-pancreatic-necrosis-state-of-the-art
#14
Roberto Rasslan, Fernando da Costa Ferreira Novo, Alberto Bitran, Edivaldo Massazo Utiyama, Samir Rasslan
Pancreatic necrosis occurs in 15% of acute pancreatitis. The presence of infection is the most important factor in the evolution of pancreatitis. The diagnosis of infection is still challenging. Mortality in infected necrosis is 20%; in the presence of organic dysfunction, mortality reaches 60%. In the last three decades, there has been a real revolution in the treatment of infected pancreatic necrosis. However, the challenges persist and there are many unsolved questions: antibiotic treatment alone, tomography-guided percutaneous drainage, endoscopic drainage, video-assisted extraperitoneal debridement, extraperitoneal access, open necrosectomy? A step up approach has been proposed, beginning with less invasive procedures and reserving the operative intervention for patients in which the previous procedure did not solve the problem definitively...
September 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28975036/marked-paraneoplastic-basophilia-accompanying-eosinophilia-in-a-cat-with-alimentary-t-cell-lymphoma
#15
Maria Balan, Aimee Hope, Joseph Cassidy, Maureen McCullough, Peter J O'Brien
CASE SUMMARY: A 5-year-old male neutered domestic shorthair cat was referred with a history of persistent pyrexia, pica, soft faeces, inappetence, intermittent vomiting, mild-to-moderate granulocytosis and mild hypercalcaemia. No significant improvement was noted after antibiotic and corticosteroid treatment, except that the hypercalcaemia resolved. Physical examination, including thoracic auscultation, and abdominal and peripheral lymph node palpation, were unremarkable. On admission, haematology revealed moderate leukocytosis (36...
July 2017: JFMS open reports
https://www.readbyqxmd.com/read/28969260/tamoxifen-induced-pancreatitis-an-unusual-complication-of-commonly-used-drug
#16
Pritam Suresh Chandra Kataria, Pradip Piraji Kendre, Apurva Ashok Patel, Murtaza Zoher Bohra, Nahush Tahiliani
Tamoxifen is a selective oestrogen receptor modulator used for the treatment of oestrogen/progesterone receptor positive breast cancer. It possess antagonistic or agonistic activity depending on the tissue location i.e., antagonistic action on breast but agonist action on endometrium and bones. The side effects of tamoxifen include hot flushes, gynaecologic symptoms (vaginal dryness, vaginal discharge), depression, forgetfulness, sleep alterations, weight gain, alteration of lipoprotein metabolism, thromboembolic disorder...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28912911/doxycycline-induced-acute-pancreatitis-a-rare-adverse-event
#17
Prashanth Rawla, Jeffrey Pradeep Raj
Doxycycline is a broad-spectrum antibiotic belonging to the tetracycline group which acts by inhibiting bacterial protein synthesis. It is considered to be a relatively safe drug. We report a case of doxycycline-induced acute pancreatitis (DIAP) in an adult female patient who was started on the usual therapeutic dose 1 week before for acne vulgaris. The WHO causality assessment was possible, and the Naranjo scale confirmed it as "definite" adverse drug reaction. A brief literature review on case reports previously reporting DIAP has also been summarized...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28912244/potential-role-of-intratumor-bacteria-in-mediating-tumor-resistance-to-the-chemotherapeutic-drug-gemcitabine
#18
Leore T Geller, Michal Barzily-Rokni, Tal Danino, Oliver H Jonas, Noam Shental, Deborah Nejman, Nancy Gavert, Yaara Zwang, Zachary A Cooper, Kevin Shee, Christoph A Thaiss, Alexandre Reuben, Jonathan Livny, Roi Avraham, Dennie T Frederick, Matteo Ligorio, Kelly Chatman, Stephen E Johnston, Carrie M Mosher, Alexander Brandis, Garold Fuks, Candice Gurbatri, Vancheswaran Gopalakrishnan, Michael Kim, Mark W Hurd, Matthew Katz, Jason Fleming, Anirban Maitra, David A Smith, Matt Skalak, Jeffrey Bu, Monia Michaud, Sunia A Trauger, Iris Barshack, Talia Golan, Judith Sandbank, Keith T Flaherty, Anna Mandinova, Wendy S Garrett, Sarah P Thayer, Cristina R Ferrone, Curtis Huttenhower, Sangeeta N Bhatia, Dirk Gevers, Jennifer A Wargo, Todd R Golub, Ravid Straussman
Growing evidence suggests that microbes can influence the efficacy of cancer therapies. By studying colon cancer models, we found that bacteria can metabolize the chemotherapeutic drug gemcitabine (2',2'-difluorodeoxycytidine) into its inactive form, 2',2'-difluorodeoxyuridine. Metabolism was dependent on the expression of a long isoform of the bacterial enzyme cytidine deaminase (CDDL), seen primarily in Gammaproteobacteria. In a colon cancer mouse model, gemcitabine resistance was induced by intratumor Gammaproteobacteria, dependent on bacterial CDDL expression, and abrogated by cotreatment with the antibiotic ciprofloxacin...
September 15, 2017: Science
https://www.readbyqxmd.com/read/28898917/technical-aspects-of-endoscopic-ultrasound-eus-guided-sampling-in-gastroenterology-european-society-of-gastrointestinal-endoscopy-esge-technical-guideline-march-2017
#19
Marcin Polkowski, Christian Jenssen, Philip Kaye, Silvia Carrara, Pierre Deprez, Angels Gines, Gloria Fernández-Esparrach, Pierre Eisendrath, Guruprasad P Aithal, Paolo Arcidiacono, Marc Barthet, Pedro Bastos, Adele Fornelli, Bertrand Napoleon, Julio Iglesias-Garcia, Andrada Seicean, Alberto Larghi, Cesare Hassan, Jeanin E van Hooft, Jean-Marc Dumonceau
For routine EUS-guided sampling of solid masses and lymph nodes (LNs) ESGE recommends 25G or 22G needles (high quality evidence, strong recommendation); fine needle aspiration (FNA) and fine needle biopsy (FNB) needles are equally recommended (high quality evidence, strong recommendation).When the primary aim of sampling is to obtain a core tissue specimen, ESGE suggests using 19G FNA or FNB needles or 22G FNB needles (low quality evidence, weak recommendation).ESGE recommends using 10-mL syringe suction for EUS-guided sampling of solid masses and LNs with 25G or 22G FNA needles (high quality evidence, strong recommendation) and other types of needles (low quality evidence, weak recommendation)...
October 2017: Endoscopy
https://www.readbyqxmd.com/read/28876571/duodenectomy-managing-the-fistula
#20
M Govender, O Matsevych, F Ghoor, N Singh, C Molenaar
BACKGROUND: Duodenectomy is rarely indicated, however, in certain circumstances may have be performed. Enterocutaneous fistula (ECF) is the main cause of serious adverse outcomes. Its management remains challenging. METHOD: Two cases of emergency duodenectomy are presented. The management of ECF is described and discussed. RESULTS: Case 1: A 22-year-old male presented in septic shock with perforated duodenal ulcer, suffered two cardiac arrests before index surgery...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
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