scholarly journals In support of the placental programming hypothesis: Placental endocrine insufficiency programs atypical behaviour in mothers and their offspring

2021 ◽  
Author(s):  
Rosalind M John
Keyword(s):  
Endocrine Insufficiency

Exocrine and endocrine insufficiency in autoimmune pancreatitis: does therapy matter?

Pancreatology ◽  
2020 ◽  
Vol 20 ◽  
pp. S33
Author(s):  
S. Nikolic ◽  
I. Dahlman ◽  
J. Löhr ◽  
M. Vujasinovic
Keyword(s):  
Autoimmune Pancreatitis ◽  
Endocrine Insufficiency

Risk factors for development of endocrine insufficiency in chronic pancreatitis

Pancreatology ◽  
2020 ◽  
Author(s):  
Mohsin Aslam ◽  
Nitin Jagtap ◽  
Arun Karyampudi ◽  
Rupjyoti Talukdar ◽  
D. Nageshwar Reddy
Keyword(s):  
Risk Factors ◽  
Chronic Pancreatitis ◽  
Endocrine Insufficiency

scholarly journals Endoscopic versus Surgical Intervention for Painful Obstructive Chronic Pancreatitis: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (12) ◽  
pp. 2636
Author(s):  
Ka Wing Ma ◽  
Hoonsub So ◽  
Euisoo Shin ◽  
Janice Hoi Man Mok ◽  
Kim Ho Kam Yuen ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Pain Relief ◽  
Meta Analysis ◽  
Small Sample ◽  
Cochrane Library ◽  
Endoscopic Drainage ◽  
Complication Rates ◽  
Surgical Drainage ◽  
Endocrine Insufficiency ◽  
Significant Difference

There is limited evidence on the standard care for painful obstructive chronic pancreatitis (CP), while comparisons of endoscopic and surgical modes for pain relief have yielded conflicting results from small sample sizes. We aimed to obtain a clear picture of the matter by a meta-analysis of these results. We searched the Pubmed, Embase, and Cochrane Library databases to identify studies comparing endoscopic and surgical treatments for painful obstructive CP. Pooled effects were calculated by the random effect model. Primary outcomes were overall pain relief (complete and partial), and secondary outcomes were complete and partial pain relief, complication rate, hospitalization duration, and endocrine insufficiency. Seven studies with 570 patients were included in the final analysis. Surgical drainage was associated with superior overall pain relief [OR 0.33, 95% CI 0.23–0.47, p < 0.001, I2 = 4%] and lesser incidence of endocrine insufficiency [OR 2.10, 95% CI 1.20–3.67, p = 0.01, I2 = 0%], but no significant difference in the subgroup of complete [OR 0.57, 95% CI 0.32–1.01, p = 0.054, I2 = 0%] or partial [OR 0.67, 95% CI 0.37–1.22, p = 0.19, I2 = 0%] pain relief, complication rates [OR 1.00, 95% CI 0.41–2.46, p = 0.99, I2 = 49%], and hospital stay [OR −0.54, 95% CI −1.23–0.15, p = 0.13, I2 = 87%] was found. Surgery is associated with significantly better overall pain relief and lesser endocrine insufficiency in patients with painful obstructive CP. However, considering the invasiveness of surgery, no significant differences in complete or partial pain relief, and heterogeneity of a few parameters between two groups, endoscopic drainage may be firstly performed and surgical drainage may be considered when endoscopic drainage fails.

scholarly journals A rare type of pinched inguinal hernia

2001 ◽  
Vol 82 (6) ◽  
pp. 459-460
Author(s):  
K. A. Koreyba
Keyword(s):  
Inguinal Hernia ◽  
Inguinal Canal ◽  
Malignant Degeneration ◽  
Undescended Testicle ◽  
Rare Type ◽  
Endocrine Insufficiency

Cryptorchidism is known to occur in 0.18-3.6% of the population. Impingement of an undescended testicle in the inguinal canal has been described in 1.9% of cases as one of the complications of cryptorchidism along with volvulus and malignant degeneration (up to 15-40%). In 20-80% of cases, cryptorchidism is combined with inguinal hernia. Endocrine insufficiency in cryptorchidism occurs in 4-5% of cases.

Chronic pancreatitis

2020 ◽  
pp. 3218-3227
Author(s):  
Marco J. Bruno ◽  
Djuna L. Cahen
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Pancreatitis ◽  
Pancreatic Enzyme ◽  
Exocrine Insufficiency ◽  
Endocrine Insufficiency ◽  
Diabetes Mellitus Diagnosis ◽  
Permanent Loss ◽  
Stimulation Tests ◽  
Enteric Coated ◽  
Pancreatic Duct Stricture

Chronic pancreatitis is a major source of morbidity, loss in quality of life, and healthcare expenditure. It is most commonly caused by chronic alcoholism in adults and cystic fibrosis in children, but there are many other causes. Patients typically present with severe abdominal pain, but this may vary and even be absent. Exo- and endocrine insufficiency usually occur late in the disease course and reflect permanent loss of pancreatic parenchyma due to ongoing inflammation and fibrosis, exocrine insufficiency manifesting as steatorrhea and weight loss due to fat maldigestion and endocrine insufficiency as diabetes mellitus. Diagnosis is confirmed by imaging investigations such as CT, MRI, and endoscopic ultrasonography. Endoscopic retrograde cholangiopancreatography to diagnose chronic pancreatitis is obsolete. Hormone stimulation tests (e.g. secretin–cholecystokinin stimulation test) to diagnose exocrine insufficiency are largely abandoned because of their complexity and burden to patients. They are replaced by faecal elastase testing, even though this test is less sensitive. Management focuses on the treatment of pain using a stepwise approach. Initially, nonopioid analgesics are prescribed. Next, when feasible, endoscopic therapy is initiated, including pancreatic stone fragmentation by extracorporeal shock-wave lithotripsy, endotherapy to remove stone fragments, and placement of plastic stents to dilate any concomitant pancreatic duct stricture. If that fails or when, for example, the pancreatic head is enlarged, surgical intervention is indicated. Medical management includes enteric-coated pancreatic enzyme preparations and treatment of diabetes mellitus, usually by means of insulin. Abstinence from alcohol and smoking cessation are important predictors of disease and treatment outcome.

Evaluation of Predictive Factors in Patients with Nonalcoholic Fatty Liver Disease after Pancreaticoduodenectomy

2014 ◽  
Vol 80 (5) ◽  
pp. 500-504 ◽  
Author(s):  
Yasuhiro Ito ◽  
Takeshi Kenmochi ◽  
Shintaro Shibutani ◽  
Tomohisa Egawa ◽  
Shinobu Hayashi ◽  
...  
Keyword(s):  
At Risk ◽  
Risk Factor ◽  
Liver Disease ◽  
Blood Loss ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Pancreatic Head ◽  
Nonalcoholic Fatty Liver ◽  
Endocrine Insufficiency

Patients who undergo pancreaticoduodenectomy (PD) are at risk of steatosis because resection of the pancreatic head causes pancreatic exocrine and endocrine insufficiency. We investigated the clinicopathological features and the risk factors of nonalcoholic fatty liver disease (NAFLD) after PD. This was a retrospective study of 100 patients who underwent PD between April 2007 and December 2012 in our institution. Preoperative demographic and clinical data, surgical procedures, pathological diagnosis, postoperative course findings, and complication details were collected prospectively. The patients were divided into the following two groups: Group A consisted of 12 patients who developed postoperative NAFLD, and Group B consisted of 88 patients who did not develop postoperative NAFLD. Pancreatic carcinoma and pancreatic texture showed similar findings. Additionally, we found that blood loss significantly correlated with the incidence of nonalcoholic steatohepatitis after PD. In multivariate analysis, only blood loss was identified as the most influential risk factor for NAFLD (hazard ratio, 1.0001; P = 0.016). Blood loss was identified as an independent risk factor for the development of NAFLD after PD. Further prospective studies are needed to identify factors that put patients at risk for NAFLD after PD. Continuing efforts should be made to improve patient outcomes and understand the pathogenesis of postpancreatectomy NASH.

Patterns and outcomes of traumatic pancreatic injuries: A retrospective review from a large multi-institutional healthcare system

Trauma ◽  
2017 ◽  
Vol 20 (1) ◽  
pp. 11-29 ◽  
Author(s):  
Toni Iurcotta ◽  
Poppy Addison ◽  
Leo I Amodu ◽  
Karina Fatakhova ◽  
Meredith Akerman ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Healthcare System ◽  
Injury Severity ◽  
Pancreatic Head ◽  
Pancreatic Injury ◽  
Pancreatic Injuries ◽  
Endocrine Insufficiency ◽  
Fluid Collections

Introduction Traumatic pancreatic injuries are rare, and morbidity and mortality information are often conflicting. To determine the frequency and outcomes of patients presenting with trauma to the pancreas, we reviewed data from a large multi-institutional healthcare system for mechanism of injury, intervention, subsequent complications, in-hospital morbidity rates, and mortality. Methods We performed a retrospective analysis of records of all pancreatic injury cases seen at four healthcare centers from 1990 to 2014. Descriptive measures are presented for continuous and categorical data. Mortality rates were obtained using the publicly accessible Social Security Death Master File. Results Of 69 patients with pancreatic injuries, median age was 24 years (range 1–88). Mechanisms of injury were blunt in 87% and penetrating in 11.8%. The median injury grade was 1. Most injuries involved the pancreatic head (24.6%). Median Injury Severity Score at presentation was 9. Thirty-seven (53.6%) patients required surgery. Twenty-five patients (36.2%) required total parenteral nutrition, 34 patients (49.3%) developed intra-abdominal fluid collections, 24 patients (34.8%) developed acute pancreatitis, and three (4.4%) developed endocrine insufficiency requiring insulin. Ten (14.5%) patients died. There were four (5.8%) readmissions and one re-operation (1.4%) within 30 days of discharge. Conclusion Traumatic pancreatic injuries occur most frequently in young healthy males with little or no comorbidities, and are generally associated with other acute injuries. Contrary to past reports, our results revealed a low mortality rate but significant morbidity, with the most common complications being intra-abdominal fluid collections, acute pancreatitis, and a need for total parenteral nutrition.

Sign in / Sign up

Export Citation Format

Share Document