scholarly journals The Role of Sphere Size in the Context of Pancreatin Therapy for Exocrine Pancreatic Insufficiency: A Systematic Review

2021 ◽  
Author(s):  
Karl-Uwe Petersen ◽  
Malfertheiner Peter ◽  
Mössner Joachim
Keyword(s):  
Systematic Review ◽  
Gastric Emptying ◽  
Scientific Evidence ◽  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Insufficiency ◽  
Current Guideline ◽  
Sphere Size ◽  
Enteric Coated ◽  
The Individual

While lipase content and appropriate acid protection of pancreatin preparations (PP) are well defined determinants of an effective therapy of exocrine pancreatic insufficiency, the optimal sphere size of PP has remained a matter of discussion. We performed a systematic review to assess the optimal sphere size of enteric coated pancreatin products that may best guarantee coordinated delivery of PP and food to the duodenum. PubMed was searched for studies on gastric emptying of indigestible spheres in the digestive phase, using overlapping search algorithms; identified sources were searched for further leads, extending the investigation to Google Scholar. Of 739 screened publications, 26 were included in the final assessment. Contrary to current guideline recommendations, no scientific evidence was found to support a 2 mm diameter threshold for gastric emptying of indigestible particles. There is no documented advantage of ≤2 mm spheres regarding duodenal delivery and restoring maldigestion. The evolving picture is that of a gradation of sizes, over which gastric emptying becomes slower and more variable as particle size increases. Even 7 mm particles may be emptied from the stomach in conjunction with nutrient uptake. In conclusion sphere size of PP is not the essential parameter for selecting an effective PP fitting all patients. A variety of brands offer different lipase contents and sphere sizes that allow the physician to tailor treatment to the individual patient`s needs.

Exocrine pancreatic insufficiency in patients with pancreatic or peri-ampullary cancer: A systematic review

Pancreatology ◽  
2014 ◽  
Vol 14 (3) ◽  
pp. S43 ◽  
Author(s):  
Dorine S.J. Tseng ◽  
C. Hjalmar ◽  
van Santvoort ◽  
H.M. Inne ◽  
Borel Rinkes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pancreatic Insufficiency ◽  
Ampullary Cancer ◽  
Exocrine Pancreatic Insufficiency

scholarly journals Evidence-based pancreatology 2018 (review of research results on diseases and exocrine pancreatic insufficiency)

2019 ◽  
Vol 43 (2) ◽  
pp. 4-14
Author(s):  
N. B. Gubergrits ◽  
N. V. Byelyayeva ◽  
A. Ye. Klochkov ◽  
G. M. Lukashevich ◽  
P. G. Fomenko ◽  
...  
Keyword(s):  
Enzyme Replacement Therapy ◽  
Replacement Therapy ◽  
Pancreatic Insufficiency ◽  
Bacterial Overgrowth ◽  
Exocrine Pancreatic Insufficiency ◽  
Pancreatic Tumors ◽  
Research Results ◽  
Enzyme Replacement ◽  
Pancreatic Pathology

The article presents a detailed review of the research results in the field of pancreatology published in 2018. Certain parts of the review are devoted to the pathogenesis, diagnostics, course of pancreatitis, its treatment, as well as autoimmune, hereditary pancreatitis, pancreatic pathology in children, as well as treatment. In studying the pathogenesis of pancreatitis, attention is paid to genetic markers of pancreatitis along with a role of bacterial overgrowth syndrome in the small intestine, both in terms of worsening of the course of pancreatitis and the lack of effectiveness of enzyme replacement therapy. The study of the role of alcohol abuse and smoking in the pathogenesis of pancreatic pathology is still in progress. Diagnostics is going on. Endosonography remains the most informative method. A number of studies have been devoted to the studying of exocrine and endocrine pancreatic insufficiency both upon pancreatitis, pancreatic tumors, and in functional dyspepsia and HIV infection. Autoimmune pancreatitis is increasingly being diagnosed, a number of studies are devoted to its diagnostics and treatment. Pancreatic diseases in children develop mainly on the background of genetic predisposition, while functional pancreatic insufficiency occurs in adult patients. The study of the peculiarities of the effect of enzyme replacement therapy continues. The immediate and remote results of the surgical treatment of pancreatic pathology are assessed.

scholarly journals Los criterios de Rosemont en ultrasonografía endoscópica: ¿son predictores de insuficiencia pancreática exocrina?

2021 ◽  
Vol 51 (2) ◽  
Author(s):  
Marianela Arramón ◽  
Agustina Redondo ◽  
Pablo Cura ◽  
Fernando Baldoni ◽  
Ana Brizio ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Endoscopic Ultrasonography ◽  
Pancreatic Insufficiency ◽  
Descriptive Study ◽  
Exocrine Pancreatic Insufficiency ◽  
Diagnostic Methods ◽  
Fat Quantification ◽  
Morphologic Characteristics ◽  
Morphologic Changes

Endoscopic ultrasonography is the method of choice for detection of morphologic changes related to chronic pancreatitis. There are criteria, in the literature, that evaluate morphologic changes by endoscopic ultrasonography suggestive of chronic pancreatitis. The most widely used are the Rosemont criteria. Currently, the most effective diagnostic methods for exocrine pancreatic insufficiency are fat quantification (disused) and the 13C-mixed triglyceride breath test, not available in our country. However, the probability of diagnosis of pancreatic insufficiency can be estimated over the base of symptoms, malnutrition parameters, faecal elastase and signs of chronic pancreatitis in images. The aim of this study was to determine the correlation, probability and severity of exocrine pancreatic insufficiency, according to Rosemont criteria, in patients with chronic pancreatitis. A retrospective descriptive study was performed. Data were collected from patients between April of 2017 and April of 2018. The data gathered was based on pancreatic morphologic characteristics according to Rosemont criteria and related to the diagnosis of exocrine pancreatic insufficiency diagnosis based on the levels of stool elastase. Twenty one patients with chronic pancreatitis were included. The presence of hyperechogenic foci > 2 mm with posterior acoustic shadowing was associated with the presence of severe exocrine pancreatic insufficiency (p < 0.001). In our study, the association between parenchymal morphologic findings of chronic pancreatitis was significant in predicting exocrine pancreatic insufficiency. The role of endoscopic ultrasonography in predicting functional compromise in patients with chronic pancreatitis is promising.

Gastric emptying of oil and aqueous meal components in pancreatic insufficiency: effects of posture and on appetite

1995 ◽  
Vol 268 (6) ◽  
pp. G925-G932 ◽  
Author(s):  
B. I. Carney ◽  
K. L. Jones ◽  
M. Horowitz ◽  
W. M. Sun ◽  
R. Penagini ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Aqueous Phase ◽  
Pancreatic Insufficiency ◽  
Normal Subjects ◽  
Exocrine Pancreatic Insufficiency ◽  
Exocrine Insufficiency ◽  
Left Lateral Decubitus Position ◽  
Before And After ◽  
Pancreatic Exocrine ◽  
Lateral Decubitus

The aims of this study were to evaluate the effects of posture on gastric emptying, intragastric distribution, and satiation after a meal containing oil and aqueous phases in patients with exocrine pancreatic insufficiency. Five patients with cystic fibrosis (CF) consumed 60 ml 99mTc-labeled (V)-thiocyanate olive oil and 290 ml 113mIn-labeled diethylenetriaminepentaacetic acid soup while sitting and while lying in the left lateral decubitus position. Hunger and fullness before and after the meal were recorded. Results were compared with those obtained in 11 normal volunteers. In both postures emptying of oil was faster (P < 0.01) in CF patients. Emptying of the aqueous phase was faster (P < 0.01) in CF patients in the decubitus position. In normal subjects there was no overall difference in emptying of oil between the two postures, whereas emptying of the aqueous phase was delayed (P < 0.01) in the decubitus position. In CF patients emptying of oil was faster (P < 0.01) in the decubitus position, and emptying of the aqueous phase was only slightly faster (P < 0.05) in the sitting position. For both postures there was greater retention (P < 0.05) of oil in the proximal stomach in normal subjects than CF patients. Hunger decreased (P < 0.05) after the meal in the control subjects, but there was no change in CF patients. These results indicate that in CF patients with pancreatic exocrine insufficiency 1) gastric emptying of nonhomogenized fat is faster than normal, 2) gravity affects gastric emptying of oil, and 3) effects of a fatty meal on hunger are reduced.

Exocrine pancreatic insufficiency following acute pancreatitis: Systematic review and meta-analysis

Pancreatology ◽  
2018 ◽  
Vol 18 (4) ◽  
pp. S102
Author(s):  
Daniel De la Iglesia-García ◽  
Wei Huang ◽  
Iria Baston-Rey ◽  
Cristina Calviño-Suarez ◽  
Jose Lariño-Noia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Acute Pancreatitis ◽  
Meta Analysis ◽  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Insufficiency

scholarly journals Systematic Review of Exocrine Pancreatic Insufficiency after Gastrectomy for Cancer

2017 ◽  
Vol 34 (5) ◽  
pp. 364-370 ◽  
Author(s):  
Jennifer Straatman ◽  
Jim Wiegel ◽  
Nicole van der Wielen ◽  
E.P. Jansma ◽  
Miguel A. Cuesta ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Insufficiency

scholarly journals Obesity and dental caries: systematic review

2013 ◽  
Vol 47 (4) ◽  
pp. 799-812 ◽  
Author(s):  
Alexandre Emidio Ribeiro Silva ◽  
Ana Maria Baptista Menezes ◽  
Flavio Fernando Demarco ◽  
Fabiana Vargas-Ferreira ◽  
Marco Aurelio Peres
Keyword(s):  
Systematic Review ◽  
Dental Caries ◽  
Observational Studies ◽  
Web Of Science ◽  
Scientific Evidence ◽  
Positive Association ◽  
Sufficient Evidence ◽  
Inverse Association

OBJECTIVE Identifying, through a systematic literature review, evidence of a possible association between obesity and dental caries. METHODS A search of articles published between 2005 and January 2012 was performed in the Medline/PubMed, LILACS and Web of Science databases. The quality of scientific evidence of the selected articles was assessed by the items proposed for observational studies in the Downs & Black instrument. RESULTS Initially, 537 references were found; after checking the titles and abstracts by two independent researchers, twenty-eight articles were selected for complete reading. Ten of them that assessed the primary and/or permanent dentition observed a positive association between obesity and dental caries and one study found an inverse association. According to the Downs & Black classification, thirteen articles with good scientific evidence were found. CONCLUSIONS The present review did not find sufficient evidence regarding the association between obesity and dental caries, and it did not clarify the possible role of diet and other possible effect modifiers on this association.

scholarly journals Exocrine pancreatic insufficiency in type 1 and type 2 diabetes mellitus: do we need to treat it? A systematic review

Pancreatology ◽  
2018 ◽  
Vol 18 (5) ◽  
pp. 559-565 ◽  
Author(s):  
Gábor Zsóri ◽  
Dóra Illés ◽  
Viktória Terzin ◽  
Emese Ivány ◽  
László Czakó
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Insufficiency
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