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https://www.readbyqxmd.com/read/27920640/intussuscepting-ampullary-adenoma-an-unusual-cause-of-gastric-outlet-obstruction-leading-to-cavitating-lung-lesions
#1
Simon J McCluney, Vickna Balarajah, Alex Giakoustidis, Joanne Chin-Aleong, Bryony Lovett, Hemant M Kocher
Ampullary adenomas are a rare clinical entity, occurring at a rate of 0.04-0.12% in the general population. They are premalignant lesions which have the capability to progress to malignancy, and they should be excised if they are causing immediate symptoms and/or are likely to degenerate to carcinoma. Intestinal intussusception in adults is rare and, unlike in children, is often due to a structural pathology. Intussuscepting duodenal/ampullary adenomas have been reported in the literature on 13 previous occasions, however never before with this presentation...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27917667/prophylactic-antibiotics-in-acute-pancreatitis-endless-debate
#2
M M Mourad, Rpt Evans, V Kalidindi, R Navaratnam, L Dvorkin, S R Bramhall
INTRODUCTION The development of pancreatic infection is associated with the development of a deteriorating disease with subsequent high morbidity and mortality. There is agreement that in mild pancreatitis there is no need to use antibiotics; in severe pancreatitis it would appear to be a logical choice to use antibiotics to prevent secondary pancreatic infection and decrease associated mortality. MATERIALS AND METHODS A non-systematic review of current evidence, meta-analyses and randomized controlled trials was conducted to assess the role of prophylactic antibiotics in acute pancreatitis and whether it might improve morbidity and mortality in pancreatitis...
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27826062/characteristics-aetiology-antimicrobial-resistance-and-outcomes-of-bacteraemic-cholangitis-in-patients-with-solid-tumours-a-prospective-cohort-study
#3
C Royo-Cebrecos, C Gudiol, J García, F Tubau, J Laporte, C Ardanuy, M Antonio, M Marin, J B Gornals, J Carratalà
OBJECTIVES: To asses the clinical features, aetiology, antimicrobial resistance and outcomes of bacteraemic cholangitis in patients with solid tumours (ST). METHODS: All consecutive episodes of bacteraemia in hospitalized patients were prospectively analysed (2006-2015). RESULTS: Of 1852 episodes of bacteraemia, 750 involved patients with ST. Among them, 173 episodes (23%) were due to cholangitis. The most frequent neoplasms were hepato-biliary-pancreatic tumours (68...
November 5, 2016: Journal of Infection
https://www.readbyqxmd.com/read/27825384/inhibiting-the-proton-pump-mechanisms-benefits-harms-and-questions
#4
Jeffrey K Aronson
Inhibition of the H(+)/K(+)-adenosine triphosphatase (the proton pump) is the final common mechanistic pathway in reducing gastric acid secretion pharmacologically. Proton pump inhibitors are widely used in upper gastrointestinal diseases, including gastric and duodenal ulcers, eradication of Helicobacter pylori in combination with antibiotics, gastroesophageal reflux disease, Zollinger-Ellison syndrome, eosinophilic esophagitis, and prevention of non-steroidal anti-inflammatory drug-induced peptic ulceration...
November 9, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27821030/prognostic-scores-in-acute-pancreatitis-a-review
#5
REVIEW
Z Balcı, M Ö Kılıç, K Şenol, A Erdoğan, M Tez
Predicting the course of an attack of acute pancreatitis still represents a challenge for the physicians.Some early interventions such as endoscopic retrograde cholangiopancreatography and sphincterotomy, admission to the intensive care unit, enteral feeding, and prophylactic antibiotics have been proven to decrease morbidity and mortality in patients of high-risk groups. However, acute pancreatitis has a potential of morbidity and mortality, and therefore early diagnosis and objective assessment of severity of the disease is fundamental...
July 2016: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/27777702/bruises-around-the-umbilicus-in-an-infant
#6
Sam Hassan, Ghassan Nakib, Mary J Saviour
The most common causes of umbilical discharge in infancy are infection and umbilical granuloma that may be treated by antibiotics and topical application of silver nitrate subsequently. If the umbilical discharge persists or if there is any abnormal discoloration around the umbilicus, it is important to investigate for underlying congenital abnormality that may be cured by surgical intervention. Unusual presentation of omphalomesenteric duct cyst has been reported in literature. We report, for the first time as far as our search is concerned, a case of a 16-month-old infant who presented initially with persistent umbilical discharge and finally with bruising around the umbilicus in keeping with Cullen's sign...
September 19, 2016: Pediatric Reports
https://www.readbyqxmd.com/read/27712874/variability-in-postoperative-resource-utilization-after-pancreaticoduodenectomy-who%C3%A2-is-responsible
#7
Audrey E Ertel, Koffi Wima, Richard S Hoehn, Alex L Chang, Samuel F Hohmann, Syed A Ahmad, Jeffrey J Sussman, Shimul A Shah, Daniel E Abbott
BACKGROUND: We aimed to quantify and predict variability that exists in resource utilization after pancreaticoduodenectomy and determine how such variability impacts postoperative outcomes. METHODS: The University HealthSystems Consortium database was queried for all pancreaticoduodenectomies performed between 2011-2013 (n = 9,737). A composite resource utilization score was created using z-scores of 8 clinically significant postoperative care delivery variables including number of laboratory tests, imaging tests, computed tomographic scans, days on antibiotics, anticoagulation, antiemetics, promotility agents, and total number of blood products transfused per patient...
December 2016: Surgery
https://www.readbyqxmd.com/read/27709245/cystic-fibrosis-a-clinical-view
#8
Carlo Castellani, Baroukh M Assael
Cystic fibrosis (CF), a monogenic disease caused by mutations in the CFTR gene on chromosome 7, is complex and greatly variable in clinical expression. Airways, pancreas, male genital system, intestine, liver, bone, and kidney are involved. The lack of CFTR or its impaired function causes fat malabsorption and chronic pulmonary infections leading to bronchiectasis and progressive lung damage. Previously considered lethal in infancy and childhood, CF has now attained median survivals of 50 years of age, mainly thanks to the early diagnosis through neonatal screening, recognition of mild forms, and an aggressive therapeutic attitude...
October 5, 2016: Cellular and Molecular Life Sciences: CMLS
https://www.readbyqxmd.com/read/27689072/the-role-of-pancreatic-stone-protein-in-diagnosis-of-early-onset-neonatal-sepsis
#9
Anwar A Rass, Mohamed A Talat, Mohamed A Arafa, Hosam F El-Saadany, Ezzat K Amin, Mohamed Mohamed Abdelsalam, Mona A Mansour, Naglaa A Khalifa, Lamiaa Mahmoud Kamel
Introduction. Early diagnosis and treatment of neonatal sepsis may help decrease neonatal mortality. Aim of the Study. To evaluate the role of pancreatic stone protein as a marker for early onset neonatal sepsis. Methods. A hospital-based prospective study was conducted on 104 (52 uninfected and 52 infected neonates) admitted to the Neonatal Intensive Care Unit (NICU) of Zagazig University hospitals during the period from April 2014 to April 2015. All newborns were subjected to full history taking, careful neonatal assessment, blood, C-reactive protein (CRP), and serum pancreatic stone protein...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27676699/how-does-aging-affect-presentation-and-management-of-biliary-stones
#10
Kuang-Chun Hu, Cheng-Hsin Chu, Horng-Yuan Wang, Wen-Hsiung Chang, Shee-Chan Lin, Chuan-Chuan Liu, Wei-Chih Liao, Chun-Jen Liu, Ming-Shiang Wu, Shou-Chuan Shih
Common bile duct (CBD) stones are common in elderly adults, but the effect of aging on the presentation of CBD stones remains to be evaluated. Recent studies have demonstrated that the clinical presentation of CBD stones may vary with age. Younger adults may present with classical biliary colic symptoms, whereas elderly adults may have no unapparent clinical features. Younger adults with CBD stones were significantly more likely to have abnormal liver function tests than those without. The sensitivity and accuracy of transabdominal ultrasound scans in screening for CBD stones increases with age...
November 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27613614/antibiotic-use-in-acute-pancreatitis-an-audit-of-current-practice-in-a-tertiary-centre
#11
Minas Baltatzis, J M Mason, Vishnu Chandrabalan, Panagiotis Stathakis, Ben McIntyre, Santhalingam Jegatheeswaran, Saurabh Jamdar, Derek A O'Reilly, Ajith K Siriwardena
INTRODUCTION: Intravenous antibiotic prophylaxis is not recommended in acute pancreatitis. According to current international guidelines antibiotics together with further intervention should be considered in the setting of infected necrosis. Appropriate antibiotic therapy particularly avoiding over-prescription is important. This study examines antibiotic use in acute pancreatitis in a tertiary centre using the current IAP/APA guidelines for reference. METHODS: Data were collected on a consecutive series of patients admitted with acute pancreatitis over a 12 month period...
August 30, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/27602425/clostridium-difficile-ribotype-033-colitis-in-a-patient-following-broad-spectrum-antibiotic-treatment-for-kpcproducing-klebsiella-pneumoniae-infection-italy
#12
Stefano Grandesso, Fabio Arena, Franklin Esoka Eseme, Sandro Panese, Lucia Henrici De Angelis, Patrizia Spigaglia, Fabrizio Barbanti, Gian Maria Rossolini
This report describes a case of Clostridium difficile ribotype 033 colitis in a patient treated with multiple antibiotics for KPC-producing Klebsiella pneumoniae pancreatitis. Diagnostic, clinical and therapeutic features are discussed. To the best of our knowledge, this is the first case of C. difficile ribotype 033 clinical infection reported from Italy.
September 2016: New Microbiologica
https://www.readbyqxmd.com/read/27576234/respiratory-conditions-update-cystic-fibrosis
#13
Lyle L Pritchard
Cystic fibrosis (CF) is an autosomal recessive genetic disease that occurs in approximately 1 in 2,500 white live births. It is less common in nonwhite individuals. A dysfunctional epithelial chloride channel leads to excessively thick mucus affecting multiple organ systems. Common issues include mucous plugging of the airway, lung inflammation, chronic pulmonary infections, intestinal malabsorption, and malnutrition. Universal screening of newborns for CF is recommended in many countries. CF can be diagnosed based on clinical evidence of disease along with genetic testing or other laboratory evidence of chloride channel dysfunction...
September 2016: FP Essentials
https://www.readbyqxmd.com/read/27559973/severe-acute-hemorrhagic-pancreatitis-secondary-to-cholelithiasis-as-a-rare-cause-of-sudden-unexpected-death-in-medico-legal-case-a-case-report
#14
Supawon Srettabunjong, Wiratchaya Limgitisupasin
INTRODUCTION: Acute pancreatitis (AP) is an uncommon disease with a wide clinical course varying from mild and self-limiting to severe with eventual death. However, death caused by AP is rare. Most cases of AP reported in the English-language literature are based on clinical data; few are medico-legal studies. CASE PRESENTATION: The author recently experienced a case of sudden unexpected death in a young man caused by extensive severe hemorrhagic AP secondary to cholelithiasis, not chronic alcoholism, which is a much more prominent etiology of AP in medico-legal perspectives...
August 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27549125/the-clinical-value-of-adipokines-in-predicting-the-severity-and-outcome-of-acute-pancreatitis
#15
Andrius Karpavicius, Zilvinas Dambrauskas, Audrius Gradauskas, Arturas Samuilis, Kristina Zviniene, Juozas Kupcinskas, Gintautas Brimas, Artur Meckovski, Audrius Sileikis, Kestutis Strupas
BACKGROUND: Recent data shows that patients with severe acute pancreatic might benefit from early intensive therapy, enteral nutrition and timely transfer to specialized centers. The early prophylactic use of antibiotics in AP remains controversial. The role and need for new markers in stratification of acute pancreatitis is also uncertain. This study aims to evaluate the prognostic usefulness of adipokines in prediction of the severity and outcome of acute pancreatitis (AP). METHODS: Prospective study was conducted in four clinical centers...
August 22, 2016: BMC Gastroenterology
https://www.readbyqxmd.com/read/27501071/-distal-pancreatectomy-with-autologous-fibrin-sealant-implementation-of-an-established-concept-of-tissue-sealing-in-pancreatic-surgery
#16
A M Luu, C Braumann, O Belyaev, M Janot, W Uhl, T Herzog
Background: Postoperative pancreatic fistulas (POPF) remain a major concern after distal pancreatectomy. Irrespective of the technique to close the pancreatic remnant, pancreatic fistulas will occur in approximately 30 % of patients undergoing distal pancreatectomy. For the first time ever, autologous fibrin sealant (Vivostat®) was used to additionally seal the pancreatic remnant after a distal pancreatectomy. The aim was to analyse whether this changes the postoperative outcome. Patients/Material and Methods: In 2015, a technical case series was performed in 15 patients who underwent distal pancreatectomy...
August 8, 2016: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/27436071/antibiotics-suppress-activation-of-intestinal-mucosal-mast-cells-and-reduce-dietary-lipid-absorption-in-sprague-dawley-rats
#17
Hirokazu Sato, Linda S Zhang, Kristina Martinez, Eugene B Chang, Qing Yang, Fei Wang, Philip N Howles, Ryota Hokari, Soichiro Miura, Patrick Tso
BACKGROUND & AIMS: The gut microbiota affects intestinal permeability and mucosal mast cell (MMCs) responses. Activation of MMCs has been associated with absorption of dietary fat. We investigated whether the gut microbiota contributes to the fat-induced activation of MMCs in rats, and how antibiotics might affect this process. METHODS: Adult male Sprague-Dawley rats were given streptomycin and penicillin for 4 days (n=6-8), to reduce the abundance of their gut flora, or normal drinking water (controls, n=6-8)...
July 16, 2016: Gastroenterology
https://www.readbyqxmd.com/read/27413564/scoliosis-surgery-in-cystic-fibrosis-surgical-considerations-and-the-multidisciplinary-approach-of-a-rare-case
#18
George I Mataliotakis, Athanasios I Tsirikos, Karen Pearson, Don S Urquhart, Carolyn Smith, Andrew Fall
Spinal deformity in patients with cystic fibrosis (CF) is usually mild requiring no treatment. These patients are rarely considered as surgical candidates for scoliosis correction, as the pulmonary condition and other comorbidities increase the risk of general anaesthesia and recovery. This paper reviews all the literature up to date with regard to scoliosis in patients with CF and reports this unique case of a 14-year-old Caucasian girl with progressive scoliosis, who was treated surgically at the age of 17...
2016: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/27370793/evaluation-of-antimicrobial-activity-and-probiotic-properties-of-wild-strain-pichia-kudriavzevii-isolated-from-frozen-idli-batter
#19
Ramachandran Chelliah, Sudha Rani Ramakrishnan, Prince R Prabhu, Usha Antony
The present research was undertaken to study the probiotic characteristics of Pichia kudriavzevii isolated from frozen idli batter. Polymerase chain reaction amplification with 18S rRNA primers confirmed Pichia kudriavzevii, a xylose-utilizing probiotic strain. It was resistant to physiological concentrations of bile salts, pepsin and pancreatic enzyme. It also showed efficient auto-aggregation as well as co-aggregation ability with four commercial probiotic yeasts and exhibited good hydrophobicity in xylene and toluene...
August 2016: Yeast
https://www.readbyqxmd.com/read/27331917/modern-management-of-irritable-bowel-syndrome-more-than-motility
#20
Jan Tack, Tim Vanuytsel, Maura Corsetti
In the treatment of irritable bowel syndrome (IBS), loperamide seems efficacious for diarrhea and ispaghula for constipation, while musculotropic spasmolytics may relieve abdominal pain. Antidepressants were found to be efficacious for abdominal pain, but their tolerance may be problematic and the therapeutic effect varied largely between trials. While meta-analyses suggest efficacy of probiotics as a group, the quality of the trials is often suboptimal and there is large variability. Lubiprostone, a chloride channel activator, and linaclotide, a guanylyl cyclase-C agonist, showed favorable effects on multiple symptoms in IBS with constipation...
2016: Digestive Diseases
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