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Acute pancreatitis severity scores

James Buxbaum, Michael Quezada, Bradford Chong, Nikhil Gupta, Chung Yao Yu, Christianne Lane, Ben Da, Kenneth Leung, Ira Shulman, Stephen Pandol, Bechien Wu
OBJECTIVES: The Pancreatitis Activity Scoring System (PASS) has been derived by an international group of experts via a modified Delphi process. Our aim was to perform an external validation study to assess for concordance of the PASS score with high face validity clinical outcomes and determine specific meaningful thresholds to assist in application of this scoring system in a large prospectively ascertained cohort. METHODS: We analyzed data from a prospective cohort study of consecutive patients admitted to the Los Angeles County Hospital between March 2015 and March 2017...
March 15, 2018: American Journal of Gastroenterology
Manli Zhang, Lili Ding, Xinrui Wang, Jie Hou, Man Li, Yanfang Jiang, Xiuting He, Meizi Cui, Feng Hu, Xiuna Zhang, Jingyuan Yang, Xiaohe Guo, Huiying Zhao, Pujun Gao
BACKGROUND: Despite the role of monocytes in the pathogenesis of severe acute pancreatitis (SAP), it remains unclear how different subtypes of monocytes regulate and contribute to this pathogenesis. METHODS: We examined the numbers of different subsets of monocytes by flow cytometry in 21 SAP, 15 mild acute pancreatitis (MAP) and 13 healthy controls (HC). The concentrations of plasma cytokines were assessed by cytometric bead array. Disease severity was evaluated based on the acute physiology and chronic health evaluation (APACHE) II score and plasma C-reactive proteins (CRP) levels...
March 5, 2018: International Immunopharmacology
Angeliki Papapanagiotou, George Sgourakis, Stella Peristeraki, Dimitris Raptis, Kyriakos Karkoulias, Stergios Tezas, Panna Patel, Athanasios G Papavassiliou
OBJECTIVES: This pilot study aimed to determine the feasibility of serum values of osteonectin, adiponectin, transforming growth factor beta 1, and neurotensin being used in clinical practice to predict the severity of acute pancreatitis. METHODS: Blood samples were collected from 45 consecutive newly diagnosed acute pancreatitis patients and 30 matched healthy controls. The 2 groups were matched according to age, sex, weight, height, diabetes, smoking, and alcohol consumption...
April 2018: Pancreas
Yu Zhou, Liang Zhao, Fangchao Mei, Yupu Hong, He Xia, Teng Zuo, Youming Ding, Weixing Wang
Macrophage migration inhibitory factor (MIF) is an inflammatory cytokine involved in many acute and chronic inflammatory diseases. However, its role in acute lung injury associated with acute pancreatitis in pregnancy (APIP) has not yet been elucidated. The present study was undertaken to clarify the effect and potential mechanism of MIF antagonist (S,R)3‑(4‑hydroxyphenyl)‑4,5‑dihydro‑5‑isoxazole acetic acid methyl ester (ISO‑1) in the development of acute lung injury in rats with APIP. Eighteen late‑gestation SD rats were randomly assigned to three groups: Sham operation (SO) group, APIP group, and ISO‑1 group...
March 1, 2018: Molecular Medicine Reports
Alimujiang Abulimiti, Aierhati Husaiyin, Yalikun Sailai
Systemic inflammatory response syndrome (SIRS) prevention is key to severe acute pancreatitis (SAP) treatment and the assessment of high-volume hemofiltration (HVHF) for treating SAP accompanying multiple organ dysfunction syndromes.In this prospective controlled study, 40 SAP patients were divided into 2 groups: control (n = 22, treated with fasting, decompression, and intravenous somatostatin) and HVHF (n = 18, HVHF administration in addition to the treatment in the control group) groups; and were assessed for serum and urine amylase, WBC, C-reactive protein (CRP), and hepatic and renal functions...
January 2018: Medicine (Baltimore)
Ronggui Lin, Fei Chen, Shi Wen, Tianhong Teng, Yu Pan, Heguang Huang
Background: Impairment of the blood-brain barrier (BBB) in severe acute pancreatitis (SAP) could result in life-threatening pancreatic encephalopathy. Interleukin-10 (IL-10) is a classical cytokine that is well-known for its strong immunoregulatory and anti-inflammatory abilities. However, whether and how IL-10 protects the BBB in SAP are still unclear. Methods: This study includes in vivo experiments using a SAP rat model and in vitro experiments using an in vitro BBB model consisting of a monolayer of brain microvascular endothelial cells (BMECs)...
2018: Journal of Inflammation
Xiaohong Wang, Lei Chu, Chun Liu, Ronglong Wei, Xianglong Xue, Yuefen Xu, Mengjie Wu, Qing Miao
OBJECTIVES: To observe the therapeutic effects of Saussurea involucrata (Sau) injection against severe acute pancreatitis (SAP)-induced brain injury. METHODS: Sodium taurocholate-induced SAP-modeled rats were equally randomized into an SAP model group (SAP group) and a Sau treated group (Sau  +  S group). Healthy rats were equally randomized into a Sau treated group (Sau  +  H group) and a sham operation group (SO group). Serum amylase levels, endothelin-1 (ET-1) and nitric oxide (NO) contents were determined by optical turbidimetry, ELISA and nitrate reductase method respectively...
February 23, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Yina Chen, Qian Zhao, Qinfen Chen, Yuxue Zhang, Bule Shao, Yin Jin, Jiansheng Wu
The aim of the present study was to investigate the protective mechanism underlying of melatonin in severe acute pancreatitis (SAP). A total of 64 male Sprague‑Dawley rats were randomly divided into four groups: The sham operation (SO) group, SAP group, melatonin treatment (MLT) group and p38 inhibitor (SB203580) treatment (SB) group. Acute pancreatitis was induced by 5% taurocholate through retrograde infusion into the biliopancreatic ducts. The melatonin and SB203580 treatment groups were administered with MLT and SB 30 min before operation the induction of SAP...
February 16, 2018: Molecular Medicine Reports
Li Zhao, Xueqing Li, Zhimin Shi
OBJECTIVE: To observe the clinical therapeutic effects on severe acute pancreatitis (SAP) treated with electroacupuncture (EA), sparse-dense wave and 2 Hz/15 Hz, at Dachangshu (BL 25) and Shangjuxu (ST 37) assisting ulinastetin and explore the effective therapeutic method for SAP. METHODS: A total of 120 patients of SAP were randomized into an observation group and a control group, 60 cases in each one. In the control group, the routine western medicine was adopted with the intravenous drip with ulinastatin...
February 12, 2018: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
Yu-San Tee, Hsin-Yueh Fang, I-Ming Kuo, Yann-Sheng Lin, Song-Fong Huang, Ming-Chin Yu
Acute severe pancreatitis caused high mortality, and several scoring systems for predicting mortality are available. We evaluated the effectiveness of serial measurement of several scoring systems in patients with acute severe pancreatitis.We retrospectively obtained serial measurements of Ranson, Acute Physiology and Chronic Health Assessment (APACHE) II, and Sequential Organ Failure Assessment (SOFA) scores of 159 patients with acute severe pancreatitis.The overall mortality rate was 20%, and early mortality (in the first 2 weeks) occurred in 10 (7...
February 2018: Medicine (Baltimore)
Lu Yan, Qing-Fu Li, Yan-Ting Rong, Yong-Heng Chen, Zhao-Hong Huang, Zhi-Zhi Wang, Jie Peng
Acute pancreatitis (AP) is the acute inflammation of the pancreas. The morbidity of AP has increased in recent years. Certain patients eventually develop severe AP (SAP), which rapidly progresses to multiple organ dysfunction; the incidence of this occurring in patients with AP is 20-30%. To date, no specific drugs or methods exist to treat this disease. Rutaecarpine relaxes vascular smooth muscle by stimulating calcitonin gene-related peptide (CGRP) release via activation of vanilloid receptor subtype 1 (VR1)...
March 2018: Oncology Letters
Vandana Jain, Santosh Kumar, Naval K Vikram, Mani Kalaivani, Surya Prakash Bhatt, Rajni Sharma, Kumar Kabra Sushil
Background & objectives: Cystic fibrosis (CF) is a life-limiting genetic condition resulting in chronic respiratory infections, pancreatic enzyme insufficiency and associated complications. This pilot study was undertaken to assess the glucose tolerance and insulin secretion and sensitivity among Indian children with CF. Methods: Children with CF under regular follow up at the Paediatric Pulmonology Clinic of a tertiary care hospital in New Delhi, India, were enrolled...
October 2017: Indian Journal of Medical Research
Jian Lu, Yun Xie, Jiang Du, Mei Kang, Wei Jin, Yan Li, Hui Xie, Ruijie Cheng, Rui Tian, Ruilan Wang
INTRODUCTION: The purpose of our study is to evaluate the efficacy of penta-therapy for HL-SAP in a retrospective study. METHODS: Retrospective study between January 2007 and December 2016 in a hospital intensive care unit. HL-SAP patients were assigned to conventional treatment alone (the control group) or conventional treatment with the experimental protocol (the penta-therapy group) consists of blood purification, antihyperlipidemic agents, low-molecular weight heparin, insulin, covering the whole abdomen with Pixiao (a traditional Chinese medicine)...
February 3, 2018: American Journal of Emergency Medicine
Seung Kook Cho, Saehyun Jung, Kyong Joo Lee, Jae Woo Kim
BACKGROUND: Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) predict severity in various diseases. In this study, we evaluated the value of NLR and PLR as prognostic factors in acute pancreatitis (AP). METHODS: Patients with AP were prospectively enrolled from March 2014 to September 2016 at Yonsei University Wonju College of Medicine. NLR and PLR were obtained at admission and were compared with other known prognostic scoring systems...
January 25, 2018: BMC Gastroenterology
Mingwei Zheng, Xufeng Liu, Ning Li, Wei-Zhi Li
AIM: To evaluate the efficacy and safety of emergency endoscopic needle-knife precut papillotomy in acute severe cholangitis resulting from impacted common bile duct stones at duodenal papilla. METHODS: Between January 2010 and January 2015, 118 cases of acute severe cholangitis with impacted common bile duct stones at the native papilla underwent emergency endoscopic retrograde cholangiopancreatography (ERCP) and early needle-knife precut papillotomy in a tertiary referral center...
November 29, 2017: Digestive and Liver Disease
Jun Li, Rui Zhou, Bei-Bei Bie, Na Huang, Ying Guo, Hai-Yan Chen, Meng-Jiao Shi, Jun Yang, Jian Zhang, Zong-Fang Li
AIM: To investigate the effects of combined use of emodin and baicalein (CEB) at the cellular and organism levels in severe acute pancreatitis (SAP) and explore the underlying mechanism. METHODS: SAP was induced by retrograde infusion of 5% sodium taurocholate into the pancreatic duct in 48 male SD rats. Pancreatic histopathology score, serum amylase activity, and levels of tumour necrosis factor alpha (TNF-α), interleukin 6 (IL-6), and IL-10 were determined to assess the effects of CEB at 12 h after the surgery...
January 7, 2018: World Journal of Gastroenterology: WJG
Moustafa Younis, Matthew Hernandez, Mohamed Ray-Zack, Nadeem N Haddad, Asad Choudhry, Pooja Reddy, Martin D Zielinski
BACKGROUND: The AAST recently developed an emergency general surgery (EGS) disease grading system to measure anatomic severity. We aimed to validate this grading system for acute pancreatitis and compare cross sectional imaging-based AAST EGS grade and compare with several clinical prediction models. We hypothesize that increased AAST EGS grade would be associated with important physiological and clinical outcomes and is comparable to other severity grading methods. METHODS: Single institution retrospective review of adult patients admitted with acute pancreatitis during 10/2014-1/2016 was performed...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Enrique de-Madaria, Xavier Molero, Laia Bonjoch, Josefina Casas, Karina Cárdenas-Jaén, Andrea Montenegro, Daniel Closa
BACKGROUND: The early prediction of the severity of acute pancreatitis still represents a challenge for clinicians. Experimental studies have revealed the generation of specific halogenated lipids, in particular oleic acid chlorohydrin, in the early stages of acute pancreatitis. We hypothesized that the levels of circulating oleic acid chlorohydrin might be a useful early prognostic biomarker in acute pancreatitis in humans. METHODS: In a prospective, multicenter cohort study, plasma samples collected within 24 h after presentation in the emergency room from 59 patients with acute pancreatitis and from 9 healthy subjects were assessed for oleic acid chlorohydrin levels...
January 9, 2018: Annals of Intensive Care
Hui Zhang, Wenjuan Yang, Yueyue Li, Liangkai Hu, Ying Dai, Jianqing Chen, Shuqi Xu, Xuanfu Xu, Haiqiong Jiang
BACKGROUND: A various of pharmacological effects of astaxanthin has been confirmed. However, the mechanism underlying protective effect of astaxanthin on acute pancreatitis (AP) induced by cerulein still unclear. The present study is to investigate the mechanism underlying the effect of astaxanthin on autophagy and apoptosis via the JAK/STAT3 pathway. METHODS: Intraperitoneal injection of cerulein at hourly intervals followed by lipopolysaccharide injection were used in Balb/C mice...
January 9, 2018: International Immunopharmacology
Chao Cao, Chengfen Yin, Songtao Shou, Jun Wang, Lechang Yu, Xuening Li, Yanfen Chai
Acute lung injury (ALI) and its severe form, acute respiratory distress syndrome (ARDS), remain the leading causes of morbidity and mortality in intensive care units. Ulinastatin (UTI), a serine protease inhibitor, possesses anti-inflammatory properties and has been suggested to modulate lipopolysaccharide (LPS)-induced sepsis; thus, it is now widely used in the treatment of pancreatitis, sepsis, and septic shock. Toll-like receptor 4 (TLR4), an essential LPS signaling receptor, plays a critical role in the activation of innate immunity...
January 10, 2018: Shock
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