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Acute Pancreatitis

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61. Lemierre's syndrome presented with acute pancreatitis Full Text available with Trip Pro

Lemierre's syndrome presented with acute pancreatitis Lemierre's syndrome is a rare clinical condition that is characterized by infected internal jugular vein thrombosis with metastatic septicemia. The most common causative agent is Fusobacterium necrophorum. A previously healthy 37-year-old woman presented to our emergency department with nausea, vomiting, and diarrhea. She was admitted to the general practice unit with a diagnosis of acute pancreatitis then was subsequently transferred (...) to the intensive care unit due to shock. Physical examination revealed tenderness on right side of the neck. Blood cultures were remarkable for F. necrophorum. Clinical symptoms led to subsequent ultrasound and computed tomography scan of the neck, confirming internal jugular vein thrombosis.The patient was treated with antibiotics for 6 weeks. Anticoagulation therapy was initiated.We report a case of Lemierre's syndrome that presented as acute pancreatitis. The high index of suspicion of this disease

2017 Acute medicine & surgery

62. Elevated triglycerides level in hospital stay as a risk factor of mortality in patients with severe acute pancreatitis. Full Text available with Trip Pro

Elevated triglycerides level in hospital stay as a risk factor of mortality in patients with severe acute pancreatitis. Hypertriglyceridaemia is one of the most common causes of severe acute pancreatitis (SAP). However, the association between elevated triglycerides (TG) level in hospital stay and outcome in SAP patients with normal TG level at admission has not been clearly demonstrated. This retrospective study assessed the serum TG levels of patients with SAP admitted to the intensive care

2018 PLoS ONE

63. A case of severe acute necrotizing pancreatitis in a 38-year-old woman postpartum due to a parathyroid adenoma Full Text available with Trip Pro

A case of severe acute necrotizing pancreatitis in a 38-year-old woman postpartum due to a parathyroid adenoma Lethal necrotizing pancreatitis postpartum due to primary hyperparathyroidism caused by a parathyroid adenoma can be considered as a rarity. Due to the unspecific clinical signs and uncommonness this disorder may be overseen very easily. The reported case illustrates the very importance of early diagnosis of this endocrine disorder in pregnancy in order to avoid a lethal course.

2017 GMS Interdisciplinary plastic and reconstructive surgery DGPW

64. Severity and outcomes of acute alcoholic pancreatitis in cannabis users Full Text available with Trip Pro

Severity and outcomes of acute alcoholic pancreatitis in cannabis users Cannabis is the most commonly and widely used illicit drug in the world and is also the most commonly used drug of abuse in alcohol drinkers. Experimental studies have shown conflicting results of the effects of cannabis on the severity of acute pancreatitis (AP). The purpose of this study is to ascertain the clinical effects of simultaneous alcohol and cannabis use on severity at presentation and outcomes of acute (...) alcoholic pancreatitis (AAP).A retrospective review was conducted on the patients discharged with principle or secondary diagnosis of AP using ICD-9 & ICD-10 codes during the time period from January 2006 to December 2015 at a large community-based hospital in Central Georgia. Patients with alcoholic pancreatitis with cannabis (CB+) and without cannabis (CB-) use were identified and were matched with sex and age.Our study findings showed that a greater percentage of CB+ patients did not have a systemic

2017 Translational gastroenterology and hepatology

65. Role of Clinical, Biochemical, and Imaging Parameters in predicting the Severity of Acute Pancreatitis Full Text available with Trip Pro

Role of Clinical, Biochemical, and Imaging Parameters in predicting the Severity of Acute Pancreatitis The assessment of the severity of acute pancreatitis (AP) is important for proper management of the disease and for its prognosis. The aim was to correlate clinical, biochemical, and imaging diagnostic parameters and evaluate their prognostic values in the early assessment of severity of AP.We prospectively studied 128 consecutive patients with AP. The predictors were clinical, biochemical (...) , and imaging diagnostic parameters. The outcome measure was the occurrence of complications. Abdominal sonogram, contrast-enhanced computer tomography, and pancreatitis-specific clinical and laboratory findings were done.According to the Atlanta classification, 84 patients (65.6%) had mild and 44 (34.4%) had severe AP. The severity markers were significantly different between the mild and the severe groups (p < 0.001). Leukocyte count, serum albumin level, C-reactive protein (CRP), Ranson, acute physiology

2017 Euroasian journal of hepato-gastroenterology

66. Pancreatitis

an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Pancreatitis (NG104) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 21Contents Contents Overview 4 Who is it for? 4 Recommendations 5 1.1 Information and support 5 1.2 Acute pancreatitis 7 1.3 Chronic pancreatitis 10 T erms used in this guideline 14 Putting (...) this guideline into practice 15 Context 17 Acute pancreatitis 17 Chronic pancreatitis 17 More information 18 Recommendations for research 19 1 Diagnosis of chronic pancreatitis 19 2 Speed of intravenous fluid resuscitation for people with acute pancreatitis 19 3 Pain management: chronic pancreatitis 20 4 Pain management: small duct disease 20 5 Management of type 3c diabetes 21 Pancreatitis (NG104) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

67. Early versus delayed laparoscopic cholecystectomy for acute gallstone pancreatitis. (Abstract)

Early versus delayed laparoscopic cholecystectomy for acute gallstone pancreatitis. Gallstones and alcohol account for more than 80% of acute pancreatitis. Cholecystectomy is the definitive treatment for gallstones. Laparoscopic cholecystectomy is the preferred route for performing cholecystectomy. The timing of laparoscopic cholecystectomy after an attack of acute biliary pancreatitis is controversial.To compare the benefits and harms of early versus delayed laparoscopic cholecystectomy (...) in people with acute biliary pancreatitis. For mild acute pancreatitis, we considered 'early' laparoscopic cholecystectomy to be laparoscopic cholecystectomy performed within three days of onset of symptoms. We considered all laparoscopic cholecystectomies performed beyond three days of onset of symptoms as 'delayed'. For severe acute pancreatitis, we considered 'early' laparoscopic cholecystectomy as laparoscopic cholecystectomy performed within the index admission. We considered all laparoscopic

2013 Cochrane

68. Acute pancreatitis: sometimes caused by medication

Acute pancreatitis: sometimes caused by medication Prescrire IN ENGLISH - Spotlight ''Acute pancreatitis: sometimes caused by medication'', 1 April 2014 {1} {1} {1} | | > > > Acute pancreatitis: sometimes caused by medication Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |   |   |   |   |   |  Spotlight Acute pancreatitis: sometimes caused by medication Many drugs expose (...) patients to sometimes severe damage to the pancreas. Acute pancreatitis generally causes severe abdominal pain, nausea and vomiting. Most patients recover with no local or general complications and without a recurrence. However, in some patients, necrosis of the pancreas or the surrounding tissue occurs, with sometimes fatal local and general complications. Treatment is chiefly of the symptoms, for lack of anything better. The most frequent known causes of acute pancreatitis are gallstones

2014 Prescrire

69. Fluid therapy in acute pancreatitis: anybody's guess Full Text available with Trip Pro

Fluid therapy in acute pancreatitis: anybody's guess Fluid therapy in acute pancreatitis: anybody's guess Fluid therapy in acute pancreatitis: anybody's guess Haydock MD, Mittal A, Wilms HR, Phillips A, Petrov MS, Windsor JA CRD summary The review concluded that fluid therapy is considered a cornerstone of the early management of patients with acute pancreatitis and yet the evidence on which it is based remains paltry and of poor quality. These conclusions are likely to be reliable. Authors (...) ' objectives To evaluate the effectiveness of fluid therapy for acute pancreatitis. Searching MEDLINE, EMBASE and The Cochrane Library were searched from 1990. There were no language restrictions. Search terms were reported but the most recent search dates were not. Reference lists of relevant publications were searched. Study selection Randomised or observational studies of fluid therapy in patients with acute pancreatitis were eligible for the review. Normal saline, hydroxyethyl starch, Ringer's lactate

2014 DARE.

70. PROCalcitonin-based algorithm for antibiotic use in Acute Pancreatitis (PROCAP): study protocol for a randomised controlled trial. Full Text available with Trip Pro

PROCalcitonin-based algorithm for antibiotic use in Acute Pancreatitis (PROCAP): study protocol for a randomised controlled trial. Differentiating infection from inflammation in acute pancreatitis is difficult, leading to overuse of antibiotics. Procalcitonin (PCT) measurement is a means of distinguishing infection from inflammation as levels rise rapidly in response to a pro-inflammatory stimulus of bacterial origin and normally fall after successful treatment. Algorithms based on PCT (...) measurement can differentiate bacterial sepsis from a systemic inflammatory response. The PROCalcitonin-based algorithm for antibiotic use in Acute Pancreatitis (PROCAP) trial tests the hypothesis that a PCT-based algorithm to guide initiation, continuation and discontinuation of antibiotics will lead to reduced antibiotic use in patients with acute pancreatitis and without an adverse effect on outcome.This is a single-centre, randomised, controlled, single-blind, two-arm pragmatic clinical and cost

2019 Trials Controlled trial quality: predicted high

71. Effects of euphorbia kansui on the serum levels of IL-6, TNF-α, NF-κB, sTNFR and IL-8 in patients with severe acute pancreatitis. (Abstract)

Effects of euphorbia kansui on the serum levels of IL-6, TNF-α, NF-κB, sTNFR and IL-8 in patients with severe acute pancreatitis. In this study, effects of euphorbia kansui on serum levels of inflammatory factors in patients with severe acute pancreatitis were investigated, and the mechanisms underlying the role of Euphorbia kansui in the treatment of severe acute pancreatitis were discussed. 36 patients hospitalized in the Third Affiliated Hospital of Wenzhou Medical University from March (...) 2017 to May 2018 due to severe acute pancreatitis were selected and divided into two groups using a randomized grouping method. ELISA (enzyme-linked immunosorbent assay) was used to detect expressions of various inflammatory cytokines, such as tumor necrosis factor α (TNF-α), soluble TNF receptors (sTNFR), nuclear factor-κB (NF-κB), interleukin-6 (IL-6), and interleukin-8 (IL-8), in the serum of patients at different time points. The results showed no significant difference between the two groups

2019 Journal of biological regulators and homeostatic agents Controlled trial quality: uncertain

72. Comparison of the Preference of Nutritional Support for Patients With Severe Acute Pancreatitis. (Abstract)

Comparison of the Preference of Nutritional Support for Patients With Severe Acute Pancreatitis. This study aimed to compare the preference of different methods of nutritional support for patients with severe acute pancreatitis (SAP). Patients with SAP were divided into the enteral nutrition group (EN group, 16 cases), total the parenteral nutrition group (TPN group, 14 cases), and the enteral plus total parenteral nutrition group (EN+TPN group, 15 cases). At 7 days after admisson, TPN and EN (...) +TPN groups showed significantly increased Ranson scores compared with the EN group (p < .05). At 14 and 21 days after admisson, TPN and EN+TPN groups exhibited significantly increased Acute Physology and Chronic Health Evaluation (APACHE) II scores, Ranson scores, and intra-abdominal pressure compared with the EN group (p < .05 or p < .01). The incidences of multiple organ dysfunction syndrome and its complication in the EN group were significantly lower than the TPN and EN+TPN groups (p < .05

2019 Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates Controlled trial quality: uncertain

73. Prevention of Infectious Complications in Acute Pancreatitis: Results of a Single-Center, Randomized, Controlled Trial. (Abstract)

Prevention of Infectious Complications in Acute Pancreatitis: Results of a Single-Center, Randomized, Controlled Trial. This study aimed to investigate the efficiency of imipenem to prevent infectious complications in predicted severe acute pancreatitis (AP).Consecutive AP patients were randomized to imipenem 3 × 500 mg intravenously daily or an identical placebo. Exclusion criteria were prior AP, chronic pancreatitis, active malignancy, immune deficiency, active infection, concomitant (...) antibiotic treatment, pregnancy, and patients younger than 18 years. Infectious complications including infected pancreatic necrosis, pneumonia, urinary tract infection, positive blood cultures, sepsis, and other infections were assessed as the primary outcome. Secondary outcomes included mortality, persistent organ failure, systemic inflammatory response syndrome, local complications, serious adverse events, and need for surgical intervention.Forty-nine patients were randomized to each group. Infectious

2019 Pancreas Controlled trial quality: predicted high

74. Serum D-dimer levels at admission for prediction of outcomes in acute pancreatitis. Full Text available with Trip Pro

Serum D-dimer levels at admission for prediction of outcomes in acute pancreatitis. Systemic alterations in coagulation are associated with complications of acute pancreatitis (AP). D-dimer, a fibrin degradation product, was recently described as a marker of pancreatitis outcome. Early prediction is essential for reducing mortality in AP. The present study aims to assess the relationship between elevated serum D-dimer levels and the severity of AP.We performed an observational retrospective (...) levels > 2.5 mg/L (934 patients had mild AP (MAP); 1086, moderately severe AP (MSAP); and 458, severe AP (SAP)). Patients with D-dimer levels > 2.5 mg/L (n = 1205) had higher incidences of SAP (75.5% vs. 24.5%), acute peripancreatic fluid collection (APFC) (53.3% vs. 46.7%), acute necrotic collection (ANC) (72.4% vs. 27.6%), pancreatic necrosis (PN) (65.2% vs. 34.8%), infected pancreatic necrosis (IPN) (77.7% vs. 22.8%), organ failure (OF) (68.5% vs. 31.5%), persistent organ failure (POF) (75.5% vs

2019 BMC Gastroenterology

75. Severity stratification and prognostic prediction of patients with acute pancreatitis at early phase: A retrospective study. Full Text available with Trip Pro

Severity stratification and prognostic prediction of patients with acute pancreatitis at early phase: A retrospective study. Severity stratification and prognostic prediction at early stage is crucial for reducing the rates of mortality of patients with acute pancreatitis (AP). We aim to investigate the predicting performance of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and red-cell distribution width (RDW) combined with severity scores (sequential organ failure (...) severity groups and the survival and death group. Receiver-operating characteristic (ROC) curves for SAP and 28-day mortality were calculated for each predictor using cut-off values. Area under the curve (AUC) analysis and logistic regression models were performed to compare the performance of laboratory biomarkers and severity scores.Our results showed that NLR, PLR, RDW, glucose, and BUN level of the SAP group were significantly increased compared to the mild acute pancreatitis (MAP) group

2019 Medicine

76. Acute pancreatitis with abdominal bloating and distension, normal lipase and amylase: A case report. Full Text available with Trip Pro

Acute pancreatitis with abdominal bloating and distension, normal lipase and amylase: A case report. Acute pancreatitis is an inflammatory disorder of the pancreas, and its correct diagnosis is an area of interest for clinicians. In accordance with the revised Atlanta classification, acute pancreatitis can be diagnosed if at least 2 of the following 3 criteria are fulfilled: abdominal pain; serum lipase (or amylase) activity at least 3 times the upper limit of normal; or characteristic findings (...) of acute pancreatitis on contrast-enhanced computed tomography (CT) or, less often, magnetic resonance imaging or transabdominal ultrasonography. Diagnostic imaging is essential in patients with no or slight enzyme elevation. If enzymes are normal in cases with abdominal distension, there is clinical doubt about the diagnosis of acute pancreatitis, so an early CT scan should be obtained and other life-threatening disorders excluded.A 50-year-old male presented with a 1-day history of abdominal bloating

2019 Medicine

77. New insights into acute pancreatitis. (Abstract)

New insights into acute pancreatitis. The incidence of acute pancreatitis continues to increase worldwide, and it is one of the most common gastrointestinal causes for hospital admission in the USA. In the past decade, substantial advancements have been made in our understanding of the pathophysiological mechanisms of acute pancreatitis. Studies have elucidated mechanisms of calcium-mediated acinar cell injury and death and the importance of store-operated calcium entry channels (...) to classify the severity of acute pancreatitis into prognostically meaningful groups, and several landmark clinical trials have informed management strategies in areas of nutritional support and interventions for infected pancreatic necrosis that have resulted in important changes to acute pancreatitis management paradigms. In this Review, we provide a summary of recent advances in acute pancreatitis with a special emphasis on pathophysiological mechanisms and clinical management of the disorder.

2019 Nature reviews. Gastroenterology & hepatology

78. Pharmacologic management and prevention of acute pancreatitis. (Abstract)

Pharmacologic management and prevention of acute pancreatitis. The present article will focus in pharmacologic agents that have been studied to improve acute pancreatitis outcomes, and to prevent the disease at different levels.Too little and too much early fluid resuscitation can be harmful. The optimal volume, rate, and duration of intravenous fluid therapy is still unknown. Nonopioid analgesics should be the first line of analgesia in patients with acute pancreatitis. A few pharmacologic (...) agents evaluated in acute pancreatitis have resulted in positive pilot trials; however, larger randomized clinical trials (RCTs) are needed before final conclusions. Statin use is associated with lower incidence of acute pancreatitis in the general population and ongoing studies are evaluating its preventive role in acute pancreatitis recurrences. The preventive role of rectal indomethacin in post-endoscopic retrograde cholangiopancreatography pancreatitis is indisputable, with subject selection

2019 Current opinion in gastroenterology

79. Acute pancreatitis and vasoplegic shock associated with leptospirosis - a case report and review of the literature. Full Text available with Trip Pro

Acute pancreatitis and vasoplegic shock associated with leptospirosis - a case report and review of the literature. Leptospirosis or Weil's disease is caused by pathogenic spirochete bacteria called Leptospira. It is considered the most common zoonosis in the world and is usually transmitted by urine of rodents and dogs with an incubation time of 7-14 days. The clinical spectrum ranges from a subclinical infection to a fulminant septic course.Here, we report the case of a German patient (...) with acute pancreatitis associated with Leptospira interrogans causing fulminant septic shock. The patient was successfully treated with intravenous antibiotics and left the hospital fully recovered after 18 days.To our knowledge, this is the first case of leptospirosis with acute pancreatitis as the leading clinical manifestation in Central Europe. Serologic and molecular genetic tests for leptospirosis should be considered, if no other causes for pancreatitis can be identified.

2019 BMC Infectious Diseases

80. MMP-2 and MMP-9 gene polymorphisms act as biological indicators for ulinastatin efficacy in patients with severe acute pancreatitis. Full Text available with Trip Pro

MMP-2 and MMP-9 gene polymorphisms act as biological indicators for ulinastatin efficacy in patients with severe acute pancreatitis. Severe acute pancreatitis (SAP) is a severe form of inflammatory disease with a high mortality rate. Ulinastatin, as a urinary trypsin inhibitor (UTI), is a glycoprotein playing a critical role in SAP. Consequently, we identified the hypothesis that both matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) gene polymorphisms might promote

2019 Medicine

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