review of literature on clinical pancreatology - The Pancreapedia

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BrucellosisBrucellosis is an acute, subacute or chronical disease, from the zoonosis group, caused byvarious types <strong>of</strong> bacteria belonging to genus Brucellae. It is transmitted to humans fromdomestic animals: goats, sheep, cattle, pigs and dogs. The course <strong>of</strong> the disease may eitherbe asymptomatic, or produce a variety <strong>of</strong> clinical manifestations, ranging from light ones toextremely severe clinical forms. The aim <strong>of</strong> one study was to follow the clinical features <strong>of</strong>brucella infection in the hospital-treated patients, as well as its course and outcome. Theinvestigation included 15 patients, treated for brucella infection during the last two years(2004 and 2005). All patients were adults, their age ranged from 18 to 71, 50 on average.The epidemiological questionnaire was positive in all patients, confirming contacts with theailing animals, or consumption <strong>of</strong> cheese made from milk <strong>of</strong> diseased animals. They allexhibited the classic symptoms: increased body temperature and shiver, fever, sweating,malaise and headache, the so called flu like state. The serum agglutination test was positivein respect to brucellosis, the titre ranged from 1:80 to 1:1280. Eight patients sufferedexcessive back pain, accompanied with impeded walk. In half <strong>of</strong> them magnetic resonanceimaging confirmed the spondylodiscitis diagnosis. Three patients had clinical features <strong>of</strong>knee arthritis, two had bronchopneumonia, one pancreatitis, and one developed the signs <strong>of</strong>an acute kidney insufficiency. The outcome was favourable in all patients. They recuperatedor healed completely. In one patient a relapse occurred, leading to the chronic course <strong>of</strong> theillness. Although predominantly Mediterranean Brucellosis is a worldwide spread disease[220].LeptospirosisEven though leptospiral infection is not uncommon, it can have different rare presentations.Acute pancreatitis is one such rare gastrointestinal manifestation <strong>of</strong> acute pancreatitis. Apartfrom the typical clinical features; elevated serum lipase or elastase-1, along with radiologicalevidence and positive leptospiral serology confirms this rare association [221].Attempts to non-surgical treatmentEnteral nutritionAlthough the benefits <strong>of</strong> enteral nutrition in acute pancreatitis are well established, theoptimal composition <strong>of</strong> enteral feeding is largely unknown. The aim <strong>of</strong> one study was tocompare the tolerance and safety <strong>of</strong> enteral nutrition formulations in patients with acutepancreatitis. Electronic databases (Scopus, MEDLINE, Cochrane Controlled Clinical TrialsRegister) and the proceedings <strong>of</strong> major pancreatology conferences were searched. Twentyrandomized controlled trials, including 1070 patients, met the inclusion criteria. None <strong>of</strong> thefollowing was associated with a significant difference in feeding intolerance: the use <strong>of</strong>(semi)elemental versus polymeric formulation (relative risk 0.62; 95 percent confidenceinterval 0.10 to 3.97); supplementation <strong>of</strong> enteral nutrition with probiotics (relative risk 0.69;95 percent confidence interval 0.43 to 1.09); or immunonutrition (relative risk 1.60; 95percent confidence interval 0.31 to 8.29). The risk <strong>of</strong> infectious complications and death didnot differ significantly in any <strong>of</strong> the comparisons. It was concluded that the use <strong>of</strong> polymeric,compared with (semi)elemental, formulation does not lead to a significantly higher risk <strong>of</strong>feeding intolerance, infectious complications or death in patients with acute pancreatitis.Neither the supplementation <strong>of</strong> enteral nutrition with probiotics nor the use <strong>of</strong> immunonutritionsignificantly improves the clinical outcomes [222].Plasmapheresis <strong>of</strong> triglyceridesIt was presented case report shows hypertriglycerydemia treatment problem in 26-year-oldwoman with 2 episodes <strong>of</strong> acute pancreatitis history. Very high serum triglycerides
concentration and clinical symptoms suggested chylomicronemia syndrome with urgent needfor treatment. After a course <strong>of</strong> several subsequent therapeutic plasmapheresis triglyceridessignificantly decreased. Safety and effectiveness <strong>of</strong> this method was confirmed [223].Intravenous protease inhibitorsSevere acute pancreatitis is poor prognosis. Continuous regional arterial infusion <strong>of</strong> proteaseinhibitors and antibiotics were developed in Japan. It was evaluated whether arterial infusionboth celiac artery and superior mesenteric artery for this disease would reduce mortality.Seventeen patients were treated arterial infusion <strong>of</strong> protease inhibitor and antibiotics via bothceliac artery and superior mesenteric artery. Changes <strong>of</strong> Acute Physiology and ChronicHealth Evaluation II score and mortality were evaluated. Arterial infusion via two routesreduced the mortality rate and improved Acute Physiology and Chronic Health Evaluation IIscore. The overall mortality rate was 12 percent. The mortality rate in patients in those thatwere treated within 3 days after the onset was significantly lower than that in patients inwhom were treated without 3 days after the onset. Arterial infusion via superior mesentericartery might prevent both bacterial translocation and non-occlusive mesenteric ischemia.Continuous arterial infusion both celiac artery and superior mesenteric artery might beeffective for reducing mortality and preventing the development <strong>of</strong> pancreatitis, especiallywhen initiated within 3 days after the onset [224].Dialysis as a treatment for acute pancreatitisThe aim <strong>of</strong> one study was to study the therapeutic effects and the mechanism <strong>of</strong> combination<strong>of</strong> hem<strong>of</strong>iltration (HF) and peritoneal dialysis (PD) in the treatment <strong>of</strong> severe acutepancreatitis (SAP). Fifty-one cases <strong>of</strong> severe acute pancreatitis were randomly divided intothe HF+PD group (treated group, 36 patients) and the non-HF+PD group (control group, 15patients). Both groups were treated by the same traditional methods. The relief time <strong>of</strong>abdominal pain and abdominal distension, computed tomographic scores, acute physiologyand chronic health enquiry II scores, length <strong>of</strong> stay, cost <strong>of</strong> hospitalization, operability, andrecovery rate <strong>of</strong> the 2 groups were compared. The concentration <strong>of</strong> tumor necrosis factoralpha,IL-6, and IL-8 in serum and ascites volumes was determined before and aftertreatment. The mean time <strong>of</strong> abdominal pain relief, amelioration <strong>of</strong> abdominal distension,decrease <strong>of</strong> computed tomographic scores, acute physiology and chronic health enquiry IIscores, the mean length <strong>of</strong> stay, and cost <strong>of</strong> hospitalization <strong>of</strong> the treated group weresignificantly shorter or less than those <strong>of</strong> the control group. The aforementioned inflammatorycytokines, detected at the end <strong>of</strong> 1 day and 2 days after HF+PD treatment, were decreasedsignificantly compared with those observed in pretherapy and the control group. It wasconcluded that inflammatory cytokines, which overproduced in SAP, can be eliminatedeffectively from the blood and the ascites by HF+PD treatment [225].Peritoneal lavageThe evaluation <strong>of</strong> precocious and prolonged lavage and drainage by laparoscopic approachin the treatment <strong>of</strong> severe acute pancreatitis was studied 2006-2008 on a sample consisting<strong>of</strong> 35 subjects with the severe acute pancreatitis that was divided into two lots. One lot wasformed by 16 patients whom were applied the method mentioned ahead and in the B lot, 19patients, treated by conventional and known methods <strong>of</strong> treatment. The method proposed,completed about laparoscopic approach in a third day <strong>of</strong> admission, consists, after settinglesional balance, in lavage <strong>of</strong> peritoneal space and mounting two tubes drainage, onesubhepatic space and the other in Douglas space. Peritoneal lavage discontinuous withphysiological serum was done during 7 days. For an accurate assessment may weredetermined serum and peritoneal concentrations <strong>of</strong> interleukin 6. The duration <strong>of</strong> organicdysfunction was 8 days for A lot subjects and 18 days for B lot subjects. The mortality at A lot
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REVIEW OF LITERATURE ONCLINICAL PAN
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ABBREVIATIONAAPacute alcoholicABPac
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FMF AIPfocal mass-forming autoimmun
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ODPopen distal pancreatectomyOForga
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USUTDTVESDVTEZESWHOXIAPUnited State
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Ectopic pancreasCircumportal annula
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SymptomsEndocopic ultrasography (EU
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HSP27HuRIGF-1 receptorIntegrinesInt
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HemodialysisSerous cystadenomasSero
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CRPC-reactive proteinCRTchemoradiot
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ITNPintrathecal narcotics pumpJCGAI
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QSRquantitative systematic
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PANCREATIC HISTORYEarly conceptsPan
Page 27 and 28: derived from broadly Harveian anato
Page 29 and 30: acute appendicitis, intestinal obst
Page 31 and 32: dogma and its implied presence <str
Page 33 and 34: In the late 19th century, explorato
Page 35 and 36: performed. In 1880, Carl Thiersch <
Page 37 and 38: cancer was reported by Nestor Dimit
Page 39 and 40: Modern pancreatic historyHoward Reb
Page 41 and 42: PANCREATIC DEVELOPMENT, EMBRYOLOGY
Page 43 and 44: preparations. They were also employ
Page 45 and 46: pancreas can be diagnosed without t
Page 47 and 48: PANCREATIC PHYSIOLOGYSphincter <str
Page 49 and 50: acid profile and d
Page 51 and 52: hormones. The roles of</str
Page 53 and 54: ACUTE PANCREATITISAcute pancreatiti
Page 55 and 56: necrosis or a severe course, and lo
Page 57 and 58: of 245 cases <stro
Page 59 and 60: plasty of the mino
Page 61 and 62: no significant difference. The stro
Page 63 and 64: Urinary trypsinogen-2There is not a
Page 65 and 66: groups. None of th
Page 67 and 68: evaluated the presence or absence <
Page 69 and 70: adical, etc, further studies are st
Page 71 and 72: Precut at sphincterotomyPrecut is p
Page 73 and 74: indications [204].Hypercalcemia-ind
Page 75 and 76: endoscopic retrograde cholangiopanc
Page 77: (before ERCP), serum TAP was detect
Page 81 and 82: However, the recipients of<
Page 83 and 84: less safe for predominantly cephali
Page 85 and 86: increased mortality. Mortality in p
Page 87 and 88: Epidemiology and demographyChinaCHR
Page 89 and 90: for the first time the significance
Page 91 and 92: endoscopic ultrasound accurately de
Page 93 and 94: possible to at least reduce relapse
Page 95 and 96: etiologies have been proposed and a
Page 97 and 98: patients, can be performed with mod
Page 99 and 100: negative binomial model. One hundre
Page 101 and 102: Halofuginone did n
Page 103 and 104: years, the risk of
Page 105 and 106: patients with a proven exocrine pan
Page 107 and 108: high-risk patients [296].Cystic fib
Page 109 and 110: TNF-alpha promoter were performed.
Page 111 and 112: were validated in another series <s
Page 113 and 114: vascular invasion (14/15). Abnormal
Page 115 and 116: and other lymph nodes, salivary gla
Page 117 and 118: HEREDITARY PANCREATITISPatients wit
Page 119 and 120: Classification of
Page 121 and 122: historically, but recent life-style
Page 123 and 124: carcinogen exposure with cancer ris
Page 125 and 126: the risk of pancre
Page 127 and 128: conducted a cohort analysis <strong
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emain to be solved in screening for
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considered for women with Lynch syn
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Annexin A5Protein misfolding is a c
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CTNNB1To use fluorescence in situ h
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expression was not associated with
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(ECM) are not fully understood. In
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lines. However, the role of
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andomized to high-dose vitamin A, t
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Synuclein-gammaPerineural invasion
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interventions. Cancer nests were ma
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the optimal combination of<
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which is essential in tumor and nod
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provide conclusive evidence for the
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MD-CT is suitable for evaluating tu
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approved study and imaged during sh
Page 159 and 160:
Quantum dotsIt was reported the suc
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clearly have a very high incidence
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patients for operation and when cou
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demonstrated using the confocal mic
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cancer [468].To evaluate pancreatic
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pancreaticoduodenectomy (PD). The s
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safe option as an interposition gra
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a curative surgery, while double-by
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%), pseudocyst (3 %), and trauma (3
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procedure is failing to progress la
Page 179 and 180:
Glucos metabolism after pancreatect
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Quality of lifeOne
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was observed in the NACRT group. Th
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interval 0.80 to 0.96]. On subgroup
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ate in patients with pancreatic can
Page 189 and 190:
median survival time was 7 versus 7
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and the endoscopic ultrasound-guide
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local recurrence of1.5 cm (odds ratio 2.4), and
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adenocarcinoma must be addressed at
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Molecular biologyCD44v6The purpose
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IPMN were studied. Two-dimensional
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the NT-IPMN-Br group. Eleven patien
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metastatic neoplasms showing cystic
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Solid pseudopapillary neoplasms <st
Page 211 and 212:
The tumor cells were negative for p
Page 213 and 214:
Duodenal tumorsColorectal polyposis
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Colorectal carcinomaPancreatic meta
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It was described a case of<
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evaluation. The purpose of<
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perforation of a p
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the 28 had pancreatic duct injury <
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ENDOCRINE PANCREATIC TUMORSHistoryA
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25-111 pg/mL). Mean Hemoglobin A1C
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clinical features, misdiagnosis occ
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achieved in selected cases by tissu
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Overall survivalPancreatic neuroend
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REFERENCES001. Metter CC. History <
Page 237 and 238:
044. Fitz RH. The symptomatology an
Page 239 and 240:
089. McClusky DA, Skandalakis LJ, C
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126. Toouli J. Sphincter of
Page 243 and 244:
162. Deshpande AV, Thomas G, Shun A
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196. Park JH, Lee TH, Cheon SL, Sun
Page 247 and 248:
226. Botoi G, Andercou A. Early and
Page 249 and 250:
260. Nakamura H, Morifuji M, Muraka
Page 251 and 252:
292. Borak GD, Romagnuolo J, Alsola
Page 253 and 254:
324. Oh HC, Kim MH, Choi KS, Moon S
Page 255 and 256:
358. Koornstra JJ, Mourits MJ, Sijm
Page 257 and 258:
391. Chen JY, Amos CI, Merriman KW,
Page 259 and 260:
421. Horwhat JD, Gerke H, Acosta RD
Page 261 and 262:
451. Zamboni G, Capelli P, Scarpa A
Page 263 and 264:
483. Rosa F, Pacelli F, Papa V, Tor
Page 265 and 266:
517. Isayama H, Nakai Y, Togawa O,
Page 267 and 268:
545. Pino MS, Milella M, Gelibter A
Page 269 and 270:
576. Tanno S, Sasajima J, Koizumi K
Page 271 and 272:
605. Ayadi L, Ellouze S, Khabir A,
Page 273 and 274:
637. Nagar AM, Raut AA, Morani AC,
Page 275 and 276:
670. Lejonklou M, Edfeldt K, Johans
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