A Novel Strategy for Transmural Stent Removal in Necrotizing Pancreatitis Undergoing Endoscopic Transmural Necrosectomy

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Yong Zhu ◽  
Ling Ding ◽  
Liang Xia ◽  
Wenhua He ◽  
Huifang Xiong ◽  
...  
2021 ◽  
Author(s):  
Yong Zhu ◽  
Ling Ding ◽  
Liang Xia ◽  
Wenhua He ◽  
Huifang Xiong ◽  
...  

Abstract BackgroundAlthough metal stents have been widely used in the endoscopic step-up approach for necrotizing pancreatitis (NP), the exact timing of transmural stent removal has not been well studied. Here, we report a novel strategy for stent removal and compare it with the conventional strategy.MethodsThis retrospective, nested, case-control study analyzed all adult NP patients who underwent endoscopic transmural necrosectomy (ETN). Clinical outcomes were compared between case group (a novel strategy in which the stents were removed during the last necrosectomy when the ETN endpoint was achieved) and 1:1 necrosis extent matched control group (the conventional strategy in which the stents were removed after necrosectomy when clinical symptoms were relieved and collection was nearly completely resolved, as confirmed by imaging).ResultsBaseline characteristics was comparable between case group (n=37) and control group (n=37). Three (8.1%) patients in case group and one (2.7%) patient in control group needed additional ETN after stent removal (P >0.05). Nearly all patients (case: 97.3%; control: 94.6%) achieved clinical success. There was no difference in disease-related (case: 40.5%; control: 37.8%) or stent-related (case: 27.0%; control: 16.2%) complications. Case group had a trend of shorter length of stent placement (median: 20.0 days vs. 29.5 days, P >0.05).ConclusionsCompared to the convention strategy, the novel strategy of transmural stent removal during last necrosectomy avoids one endoscopy procedure and is feasible, with no need for additional ETN after stent removal, similar improvement in clinical outcomes, and no increase in complications. Prospective multicenter studies regarding the timing of transmural stent removal are needed to further validate our conclusions.


2019 ◽  
Vol 3 (1) ◽  
pp. 97-105
Author(s):  
Mary Zuccato ◽  
Dustin Shilling ◽  
David C. Fajgenbaum

Abstract There are ∼7000 rare diseases affecting 30 000 000 individuals in the U.S.A. 95% of these rare diseases do not have a single Food and Drug Administration-approved therapy. Relatively, limited progress has been made to develop new or repurpose existing therapies for these disorders, in part because traditional funding models are not as effective when applied to rare diseases. Due to the suboptimal research infrastructure and treatment options for Castleman disease, the Castleman Disease Collaborative Network (CDCN), founded in 2012, spearheaded a novel strategy for advancing biomedical research, the ‘Collaborative Network Approach’. At its heart, the Collaborative Network Approach leverages and integrates the entire community of stakeholders — patients, physicians and researchers — to identify and prioritize high-impact research questions. It then recruits the most qualified researchers to conduct these studies. In parallel, patients are empowered to fight back by supporting research through fundraising and providing their biospecimens and clinical data. This approach democratizes research, allowing the entire community to identify the most clinically relevant and pressing questions; any idea can be translated into a study rather than limiting research to the ideas proposed by researchers in grant applications. Preliminary results from the CDCN and other organizations that have followed its Collaborative Network Approach suggest that this model is generalizable across rare diseases.


Author(s):  
Taddese Mekonnen Ambay ◽  
Philipp Schick ◽  
Michael Grimm ◽  
Maximilian Sager ◽  
Felix Schneider ◽  
...  

2020 ◽  
Author(s):  
Ana Beloqui ◽  
Francesco Suriano ◽  
Matthias Hul ◽  
Yining Xu ◽  
Véronique Préat ◽  
...  

2008 ◽  
Vol 46 (05) ◽  
Author(s):  
G Biczó ◽  
P Hegyi ◽  
S Dósa ◽  
B Iványi ◽  
K Jármay ◽  
...  

2020 ◽  
Vol 3 (1) ◽  
pp. 58-76 ◽  
Author(s):  
Bohan Rong ◽  
Qiong Wu ◽  
Chao Sun

Melatonin is a well-known molecule for its involvement in circadian rhythm regulation and its contribution to protection against oxidative stress in organisms including unicellular alga, animals and plants. Currently, the bio-regulatory effects of melatonin on the physiology of various peripheral tissues have drawn a great attention of scientists. Although melatonin was previously defined as a neurohormone secreted from pineal gland, recently it has been identified that virtually, every cell has the capacity to synthesize melatonin and the locally generated melatonin has multiple pathophysiological functions, including regulations of obesity and metabolic syndromes. Herein, we focus on the effects of melatonin on fat deposition in various peripheral organs/tissues. The two important regulatory mechanisms related to the topic, i.e., the improvements of circadian rhythms and antioxidative capacity will be thoroughly discussed since they are linked to several biomarkers involved in obesity and energy imbalance, including metabolism and immunity. Furthermore, several other functions of melatonin which may serve to prevent or promote obesity and energy dysmetabolism-induced pathological states are also addressed. The organs of special interest include liver, pancreas, skeletal muscle, adipose tissue and the gut microbiota.


Sign in / Sign up

Export Citation Format

Share Document