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Necrotizing pancreatitis

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https://www.readbyqxmd.com/read/28522995/dysbiosis-of-intestinal-microbiota-and-decreased-antimicrobial-peptide-level-in-paneth-cells-during-hypertriglyceridemia-related-acute-necrotizing-pancreatitis-in-rats
#1
Chunlan Huang, Jing Chen, Jingjing Wang, Hui Zhou, Yingying Lu, Lihong Lou, Junyuan Zheng, Ling Tian, Xingpeng Wang, Zhongwei Cao, Yue Zeng
Hypertriglyceridemia (HTG) aggravates the course of acute pancreatitis (AP). Intestinal barrier dysfunction is implicated in the pathogenesis of AP during which dysbiosis of intestinal microbiota contributes to the dysfunction in intestinal barrier. However, few studies focus on the changes in intestine during HTG-related acute necrotizing pancreatitis (ANP). Here, we investigated the changes in intestinal microbiota and Paneth cell antimicrobial peptides (AMPs) in HTG-related ANP (HANP) in rats. Rats fed a high-fat diet to induce HTG and ANP was induced by retrograde injection of 3...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28522361/clostridium-perfringens-a-bacterial-pathogen-gaining-recognition-in-necrotizing-pancreatitis
#2
Rakhi Biswas, Deepika K, Sujatha Sistla, Sarath Chandra Sistla, Anandhi Amaranathan
We report an interesting case of necrotizing pancreatitis due to Clostridium perfringens in an elderly man who came to the hospital with complaints of severe abdominal pain. The infection further worsened with the dissemination to other internal organs. The patient did not show any improvement despite intensive care and treatment. This emphasizies the fact that early diagnosis and appropriate treatment would reduce the morbidity associated with necrotizing pancreatitis.
May 15, 2017: Anaerobe
https://www.readbyqxmd.com/read/28516758/necrotizing-pancreatitis-current-management-and-therapies
#3
Christine Boumitri, Elizabeth Brown, Michel Kahaleh
Acute necrotizing pancreatitis accounts for 10% of acute pancreatitis (AP) cases and is associated with a higher mortality and morbidity. Necrosis within the first 4 weeks of disease onset is defined as an acute necrotic collection (ANC), while walled off pancreatic necrosis (WOPN) develops after 4 weeks of disease onset. An infected or symptomatic WOPN requires drainage. The management of pancreatic necrosis has shifted away from open necrosectomy, as it is associated with a high morbidity, to less invasive techniques...
May 16, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28514287/concurrent-igg4-related-tubulointerstitial-nephritis-and-igg4-myeloperoxidase-anti-neutrophil-cytoplasmic-antibody-positive-crescentic-glomerulonephritis-a-case-report
#4
Tao Su, Li Yang, Zhao Cui, Su-Xia Wang, Ming-Hui Zhao
RATIONALE: IgG4-related disease (IgG4-RD) is a newly recognized systemic disease. The typical pathological finding in the kidney is abundant IgG4-positive plasma cell infiltration with characteristic storiform fibrosis in the interstitium. Antibodies of the IgG4 subclass have been linked to certain autoimmune diseases including antiproteinase 3 (PR3) anti-neutrophil cytoplasmic antibody (ANCA) of the IgG4 subclass. Here, we report a rare case of kidney injury with concurrent typical IgG4-related tubulointerstitial nephritis and IgG4 subclass of myeloperoxidase (MPO) ANCA-positive necrotizing crescentic glomerulonephritis...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28503840/a-critical-note-on-treatment-of-a-severe-diltiazem-intoxication-high-dose-calcium-and-glucagon-infusions
#5
N M Van Veggel, G J Van der Veen, T C Jansen, E M Westerman
The morbidity and mortality of a severe calcium channel blocker intoxication is high due to serious toxic cardiac effects. Its treatment is supported by low-quality evidence from heterogeneous literature. We describe a case of a severe diltiazem intoxication and critically appraise the efficacy and role of high-dose calcium and glucagon infusions. A 53-year-old woman was admitted to the emergency department with a cardiogenic shock with complete AV block, not responding to atropine, isoprenaline and an external pacemaker...
May 15, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28489122/minimally-invasive-endoscopic-treatment-of-necrotizing-pancreatitis-a-case-report-with-images-and-review-of-the-literature
#6
Cassia Lemos Moura, Priscila Pulita Azevedo Barros, Cristiane Mota Oliveira, Rogerio Colaiácovo, Juliana Marques Drigo, Augusto Pincke Cruz Carbonari, Tercio de Campos, Lucio Giovani Batista Rossini
Necrotizing pancreatitis with fluid collections can occur as a complication of acute pancreatitis. The management of these patients depends on the severity and involves multiple medical treatment modalities, as clinical intensive care and surgical intervention. In this article, we show a severe case of walled-off pancreatic necrosis that was conducted by endoscopic drainage with great clinical outcome.
March 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28487729/severity-treatment-and-outcome-of-acute-pancreatitis-in-thailand-the-first-comprehensive-review-using-revised-atlanta-classification
#7
Supot Pongprasobchai, Peeradon Vibhatavata, Piyaporn Apisarnthanarak
Background. Severity and outcome of acute pancreatitis (AP) in Thailand are unknown. Methods. A retrospective study of 250 patients with AP during 2011-2014 was performed. Severity, treatment, and outcome were evaluated. Severity was classified by revised Atlanta classification. Results. The mean age was 58 years and 56% were men. Etiologies were gallstones (45%), alcohol (16%), postendoscopic retrograde cholangiopancreatography (14%), and idiopathic (15%). Overall, 72%, 16%, and 12% of patients had mild, moderately severe, and severe AP, respectively...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28487603/endoscopic-management-of-pancreatic-fluid-collections-revisited
#8
REVIEW
Zaheer Nabi, Jahangeer Basha, D Nageshwar Reddy
The development of pancreatic fluid collections (PFC) is one of the most common complications of acute severe pancreatitis. Most of the acute pancreatic fluid collections resolve and do not require endoscopic drainage. However, a substantial proportion of acute necrotic collections get walled off and may require drainage. Endoscopic drainage of PFC is now the preferred mode of drainage due to reduced morbidity and mortality as compared to surgical or percutaneous drainage. With the introduction of new metal stents, the efficiency of endoscopic drainage has improved and the task of direct endoscopic necrosectomy has become easier...
April 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28464580/-analysis-of-the-spectrum-and-resistance-of-pathogen-causing-sepsis-in-patients-with-severe-acute-pancreatitis
#9
H X Ma, L He, S W Cai, X L Xin, H D Shi, L Zhou, X J Shi
Objective: To investigate the characteristics of spectrum and drug resistance of pathogens causing sepsis in patients with severe acute pancreatitis(SAP). Methods: The clinical data of 63 SAP patients with sepsis admitted in Department of Hepatobiliary, People's Liberation Army General Hospital from January 2014 to December 2015 were retrospectively studied. There were 47 males and 16 females, aged from 22 to 73 years, with an average age of (52±11)years. Samples were collected mainly from: (1)pancreatic and peripancreatic necrosis and abdominal drainage; (2)bile; (3) blood or deep venous catheter; (4) sputum and tracheal catheter and thoracic drainage; (5) urine...
May 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28459079/pancreatic-fungal-ball-presenting-as-pseudomass
#10
Naomi Chou, Rebecca Burbridge, Sarah Karram
Fungal infections of the pancreas have been shown to occur most commonly in the setting of necrotizing pancreatitis, pancreatic cysts, or pancreatic abscesses. Pancreatic fungal infections are rare without these predisposing factors, and may present similarly to pancreatic neoplasm. We report the case of a 48-year-old man who presented with epigastric abdominal pain, nausea, vomiting, and weight loss, with a potential mass in the head of the pancreas. The mass was resected via the Whipple procedure and was found to be a fungal collection with inflammatory cells and no malignancy...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28457332/comparison-between-minimally-invasive-and-open-surgical-treatment-in-necrotizing-pancreatitis
#11
Marek Wroński, Włodzimierz Cebulski, Bartosz Witkowski, Mieczysław Jankowski, Andrzej Kluciński, Ireneusz W Krasnodębski, Maciej Słodkowski
BACKGROUND: Minimal access techniques have gained popularity for the management of necrotizing pancreatitis, but only a few studies compared open necrosectomy with a less invasive treatment. The aim of this study was to evaluate the outcomes of minimally invasive treatment for necrotizing pancreatitis in comparison with open necrosectomy. MATERIALS AND METHODS: This retrospective study included 70 patients who underwent minimally invasive intervention or open surgical debridement for necrotizing pancreatitis between January 2007 and December 2014...
April 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28452889/surgical-management-of-pancreatic-necrosis-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#12
Nathan T Mowery, Brandon R Bruns, Heather MacNew, Suresh Agarwal, Toby Enniss, Mansoor Khan, Weidun Alan Guo, Jeremy W Cannon, Matthew Lissauer, Therese M Duane, Amy N Hildreth, Peter Pappas, Lynn Gries, Meghann Kaiser, Bryce Robinson
BACKGROUND: Pancreatic or peripancreatic tissue necrosis confers substantial morbidity and mortality. New modalities have created a wide variation in approaches and timing of interventions for necrotizing pancreatitis. As acute care surgery evolves, its practitioners are increasingly being called upon to manage these complex patients. METHODS: A systematic review of the MEDLINE database using PubMed was performed. English language articles regarding pancreatic necrosis from 1980 to 2014 were included...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28441432/dysbiosis-of-intestinal-microbiota-and-decrease-in-paneth-cell-antimicrobial-peptide-level-during-acute-necrotizing-pancreatitis-in-rats
#13
Jing Chen, Chunlan Huang, Jingjing Wang, Hui Zhou, Yingying Lu, Lihong Lou, Junyuan Zheng, Ling Tian, Xingpeng Wang, Zhongwei Cao, Yue Zeng
OBJECTIVES: Intestinal barrier dysfunction plays an important role in acute necrotizing pancreatitis (ANP) and intestinal microbiota dysbiosis was involved in intestinal barrier failure. Paneth cells protect intestinal barrier and are associated with intestinal microbiota. Here, we investigated changes in intestinal microbiota and antimicrobial peptides of Paneth cells in ileum during ANP. METHODS: Rats with ANP were established by retrograde injection of 3.5% sodium taurocholate into biliopancreatic duct and sacrificed at 24h and 48h, respectively...
2017: PloS One
https://www.readbyqxmd.com/read/28440506/association-between-high-mobility-group-box%C3%A2-1-protein-expression-and-cell-death-in-acute-pancreatitis
#14
Enjun Gao, Yanfeng Jiang, Zhituo Li, Dongbo Xue, Weihui Zhang
The present study used caerulein stimulation of AR42J rat pancreatic cells as an in vitro acute pancreatitis (AP) model to investigate proteins differentially expressed in apoptosis and necrosis. AR42J cells were stimulated with 10‑8mol/l caerulein and incubated for 24 h. Apoptosis and necrosis were detected using flow cytometry. The sorted Annexin V‑positive cells (apoptotic) and the Annexin V/propidium iodide double‑positive cells (necrotic) were analysed using proteomics. Results showed that numerous proteins were differentially expressed in these 2 groups...
June 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28435257/effects-of-arginine-glycine-aspartic-acid-peptide-conjugated-quantum-dots-induced-photodynamic-therapy-on-pancreatic-carcinoma-in-vivo
#15
Ming-Ming Li, Jia Cao, Jia-Chun Yang, Yu-Jie Shen, Xiao-Lei Cai, Yuan-Wen Chen, Chun-Ying Qu, Yi Zhang, Feng Shen, Lei-Ming Xu
Quantum dots (QDs) conjugated with integrin antagonist arginine-glycine-aspartic acid (RGD) peptides (QDs-RGD) are novel nanomaterials with a unique optical property: a high molar extinction coefficient. Previously, we have shown that QDs-RGD demonstrate a photodynamic therapy (PDT) effect as new photosensitizers for the pancreatic cancer cell line SW1990 in vitro. Here, we investigate the application of QDs-RGD in mice bearing pancreatic tumors using PDT. To ensure that more photosensitizers accumulated in tumors, QDs-RGD were injected intratumorally...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28423506/granulocyte-colony-stimulating-factor-enhances-the-therapeutic-efficacy-of-bone-marrow-mesenchymal-stem-cell-transplantation-in-rats-with-experimental-acute-pancreatitis
#16
Bo Qu, Yanjie Chu, Fang Zhu, Beibei Wang, Ting Liu, Bo Yu, Shizhu Jin
INTRODUCTION: Acute pancreatitis (AP) is one of the most common diseases involving necrotic inflammation. Bone marrow mesenchymal stem cells (BMMSCs) have the potential of multi-directional differentiation and self-renewal for tissue repair. It remains less clear if granulocyte colony-stimulating factor (G-CSF) can improve the therapeutic effect of BMMSC transplant in AP. Therefore, we explored this issue in a rat model of experimental AP. RESULTS: Transplanted PKH26-positive BMMSCs were present in the injured pancreatic tissue, with some cells co-expressed pancreatic cellular markers, including Pax-4, Ngn3 and Nkx-6...
March 28, 2017: Oncotarget
https://www.readbyqxmd.com/read/28411344/the-effect-of-a-novel-minimally-invasive-strategy-for-infected-necrotizing-pancreatitis
#17
Zhihui Tong, Xiao Shen, Lu Ke, Gang Li, Jing Zhou, Yiyuan Pan, Baiqiang Li, Dongliang Yang, Weiqin Li, Jieshou Li
BACKGROUND: Step-up approach consisting of multiple minimally invasive techniques has gradually become the mainstream for managing infected pancreatic necrosis (IPN). In the present study, we aimed to compare the safety and efficacy of a novel four-step approach and the conventional approach in managing IPN. METHODS: According to the treatment strategy, consecutive patients fulfilling the inclusion criteria were put into two time intervals to conduct a before-and-after comparison: the conventional group (2010-2011) and the novel four-step group (2012-2013)...
April 14, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28409111/a-rare-case-of-raoultella-planticola-pneumonia-an-emerging-pathogen
#18
Donevan Westerveld, Jonathan Hussain, Almotasembellah Aljaafareh, Ali Ataya
Raoultella planticola (R. planticola), considered an environmental organism, is a gram negative, motile, bacillus with phenotypic similarities to the genus Klebsiella. The organism remains a rare cause of human infection with a few cases reported in the literature. However, since its description in 1981 there have been increasing rates of infections caused by R. planticola with reports of conjunctivitis, liver abscess, cholangitis, pancreatitis, and necrotizing fasciitis. More concerning are reports of carbapenemase-producing isolates which have led to the only 2 mortalities associated with R...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28399882/liver-necrosis-shortly-after-pancreaticoduodenectomy-with-resection-of-the-replaced-left-hepatic-artery
#19
Michihiro Yamamoto, Masazumi Zaima, Hidekazu Yamamoto, Hideki Harada, Junichiro Kawamura, Masahiro Yamada, Tekefumi Yazawa, Junya Kawasoe
BACKGROUND: Surgeons, in general, underestimate the replaced left hepatic artery (rLHA) that arises from the left gastric artery (LGA), compared with the replaced right hepatic artery (rRHA), especially in standard gastric cancer surgery. During pancreaticoduodenectomy (PD), preservation of the rRHA arising from the superior mesenteric artery (SMA) is widely accepted to prevent critical postoperative complications, such as liver necrosis, bile duct ischemia, and biliary anastomotic leakage...
April 11, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28397026/fistulojejunostomy-versus-distal-pancreatectomy-for-the-management-of-the-disconnected-pancreas-remnant-following-necrotizing-pancreatitis
#20
Vikrom K Dhar, Jeffrey M Sutton, Brent T Xia, Nick C Levinsky, Gregory C Wilson, Milton Smith, Kyuran A Choe, Jonathan Moulton, Doan Vu, Ross Ristagno, Jeffrey J Sussman, Michael J Edwards, Daniel E Abbott, Syed A Ahmad
BACKGROUND: A disconnected distal pancreas (DDP) remnant is a morbid sequela of necrotizing pancreatitis. Definitive surgical management can be accomplished by either fistulojejunostomy (FJ) or distal pancreatectomy (DP). It is unclear which operative approach is superior with regard to short- and long-term outcomes. METHODS: Between 2002 and 2014, patients undergoing either FJ or DP for DDP were retrospectively identified at a center specializing in pancreatic diseases...
April 10, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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