scholarly journals Parenteral nutrition versus enteral nutrition in severe acute pancreatitis

2010 ◽  
Vol 25 (5) ◽  
pp. 449-454 ◽  
Author(s):  
Josiel Paiva Vieira ◽  
Gutemberg Fernandes de Araújo ◽  
José Raimundo Araújo de Azevedo ◽  
Alberto Goldenberg ◽  
Marcelo Moura Linhares
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Nutritional Support ◽  
Average Length ◽  
Infectious Complications ◽  
Pancreatic Tissue ◽  
Septic Complications ◽  
Disease Etiology ◽  
The Difference ◽  
Length Of Hospitalization

PURPOSE: To compare the effect of parenteral versus enteral nutritional support in severe acute pancreatitis, with respect to efficacy, safety, morbidity, mortality and length of hospitalization. METHODS: The study was comprised of 31 patients, divided into a parenteral group (n=16) and an enteral group (n=15), who met severity criteria for abdominal tomography (Balthazar classes C, D, and E). The patients were compared by demographics, disease etiology, antibiotic prophylaxis, use or not of somatostatin, nutritional support, complications and disease progression. RESULTS: There was no statistical difference in the average duration of nutritional support, somatostatin, or antibiotics in the two groups. Imipenem was the drug of choice for prophylaxis of pancreatic infections in both groups. More complications occurred in the parenteral group, although the difference was not statistically significant (p=0.10). Infectious complications, such as catheter sepsis and infections of the pancreatic tissue, were significantly more frequent in the parenteral group (p=0.006). There was no difference in average length of hospitalization in the two groups. There were three deaths in the parenteral group and none in the enteral group. CONCLUSION: Enteral nutritional support is associated with fewer septic complications compared to parenteral nutritional support.

scholarly journals PROCALCITONIN IN EARLY PREDICTION OF ACUTE SEVERE PANCREATITIS

2020 ◽  
Vol 73 (7) ◽  
pp. 1370-1372
Author(s):  
Volodymyr V. Kasian ◽  
Volodymyr D. Sheiko ◽  
Tetiana V. Mamontova ◽  
Liudmyla E. Vesnina ◽  
Oksana A. Shlykova
Keyword(s):  
Acute Pancreatitis ◽  
Early Period ◽  
Infectious Complications ◽  
Pancreatic Tissue ◽  
Screening Methods ◽  
Oral Antibiotic ◽  
Septic Complications ◽  
Key Words Acute Pancreatitis ◽  
Surgical Department ◽  
Significant Difference

The aim of the study was to analyze the prognostic potential of procalcitonin in acute pancreatitis complicated by ascites-peritonitis. Materials and methods: The study analyzed the results of a comprehensive examination and treatment of 18 patients with acute pancreatitis complicated by enzymatic ascites-peritonitis, including 13 patients who were treated in the surgical department of KP “Poltava Regional Clinical Hospital. MV Sklifosovsky POR “, and 5 patients of other emergency hospitals in Poltava, in the period from 2017 to 2019. In addition to standard screening methods, these patients were additionally tested for procalcitonin to predict an adverse course in the early period. Results: To assess the relationship between the presence of elevated procalcitonin levels at the time of hospitalization of 0.5 ng / ml and above and unsatisfactory treatment results, differences were assessed using an accurate Fisher test. When comparing differences in the development of infectious complications in the dynamics of the disease in patients of the study group depending on the presence of elevated concentrations of procalcitonin or its absence at the time of hospitalization, a significant difference was found (p <0.05). Conclusions: In our opinion, the use of procalcitonin as a predictor of infectious complications in the dynamics of the disease will determine the category of patients in whom reducing the risk of flora translocation through the use of early oral antibiotic prophylaxis and parenteral drugs tropic to pancreatic tissue may reduce the incidence of purulent complications. In another category of patients, antibacterial therapy is not advisable due to the low risk of purulent-septic complications. KEY WORDS: acute pancreatitis, procalcitonin, ascites-peritonitis, severity of the condition

Exosomes Derived from Human Umbilical Cord Mesenchymal Stem Cells (huMSCs) Carrying MicroRNA-342 Relieve Protect Severe Acute Pancreatitis Injury (SAP)

2021 ◽  
Vol 11 (9) ◽  
pp. 1838-1843
Author(s):  
Xiaohong Zhou ◽  
Xuzhong Hao ◽  
Feifei He
Keyword(s):  
Stem Cells ◽  
Acute Pancreatitis ◽  
Mesenchymal Stem Cells ◽  
Umbilical Cord ◽  
Severe Acute Pancreatitis ◽  
Pancreatic Tissue ◽  
Inflammatory Factors ◽  
Control Group ◽  
Human Umbilical Cord Blood ◽  
Human Umbilical Cord

To investigate whether exosomes (exo) derived from human umbilical cord mesenchymal stem cells (huMSCs) and microRNA (miRNA)-342 have a protective effect on severe acute pancreatitis (SAP). Human umbilical cord blood was collected to extract huMSC-exo. With sham-operated mice as control group (n = 10), the other mice were induced to SAP model (n = 20), while 10 of the SAP mice received treatment with huMSC-exo. ELISA was performed to determine amylase and TAP level as well as inflammatory factors and HE staining to evaluate pathological changes of pancreatic tissue. The expression of miR-342 and Shh, Ptchl, and Smo in the Hh signal pathway was detected using RT-qPCR. The expression of miR-342 and the mRNA expression of Shh, Ptchl, and Smo was higher than that in model group (p < 0.05). The level of serum amylase, trypsinogen, and IFN-γ,Fasl, and IL-6 was upregulated in pancreas tissues of SAP mice relative to healthy mice, but their levels were decreased upon treatment with huMSC-exo and slightly higher than those of the control group, just not significantly. Collectively, the huMSC-exo may activate the Hh signaling pathway by regulating the expression of miR-342 increasing the expression of Shh, Ptchl, and Smo, and thereby healing of damaged pancreatic tissues in SAP.

scholarly journals CT Image Changes of Severe Acute Pancreatitis Based on Smart Electronic Medical Augmented Reality in Nursing Practice

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Defen Zhang ◽  
Shifang Mao ◽  
Siyou Lan ◽  
Chengli Zhou ◽  
Xiaoyan Liu
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Pancreatic Juice ◽  
Nursing Practice ◽  
Imaging System ◽  
Pancreatic Tissue ◽  
Ct Imaging ◽  
Pancreatic Ducts ◽  
Ct Image ◽  
Internal Drainage

Severe acute pancreatitis (SAP) is traditionally treated with chemical analysis. Faced with the increasing maturity of CT imaging technology, it is necessary to use more advantageous CT imaging to treat SAP. In this article, 72 SAP patients admitted to the Affiliated Hospital of Southwest Medical University were selected for study, of which 62 were severely ill, 8 were exacerbated, and 2 changed from severe to mild. This article combines the patient’s case records and related CT images during treatment from the perspective of nursing and conducts nursing research on the application of CT image changes in severe acute pancreatitis in nursing practice. CT image processing uses CT imaging system workstation (DICOM). The results of the study showed that, in the care of patients, 21 cases had recurrence after internal drainage, and the cure rate was 91.1%. Internal drainage is an effective way to treat SAP. The higher the incidence of pancreatitis, the more likely it is to relapse after SAP internal drainage, which may be related to repeated episodes of pancreatitis and repeated inflammation of the pancreas and pancreatic duct damage. 4 of the relapsed cases in this article are postchronic pancreatitis SAP, and the relapsed cases account for 50% of the chronic pancreatic cases. This may be due to chronic fibrosis of the branched and main pancreatic ducts, continuous abnormal pancreatic juice drainage. Therefore, it is necessary to further explore the prognosis of different causes of SAP. In terms of complication care, the overall complication rate was 16.6%. One patient died of postoperative hemorrhage. Analysis of the causes of cyst recurrence and complications may be closely related to the mechanism of the occurrence and development of SAP. The initiating factor of SAP is that the pancreatic tissue is damaged due to inflammation, trauma, or microcirculation disorder, and then the pancreatic juice leaks out of the pancreas, wrapping the pancreatic juice; it takes a certain time for the capsule of fibrous knot tissue to form and strengthen.

Anterior Tibiotalar Spurs: A Comparison of Open versus Arthroscopic Debridement

Foot & Ankle ◽  
1992 ◽  
Vol 13 (3) ◽  
pp. 125-129 ◽  
Author(s):  
Pierce E. Scranton ◽  
John E. McDermott
Keyword(s):  
Recovery Time ◽  
Operative Time ◽  
Average Length ◽  
Arthroscopic Debridement ◽  
Group A ◽  
Grade Ii ◽  
Spur Formation ◽  
The Difference ◽  
Open Versus ◽  
Length Of Hospitalization

We compared the difference in operative time, hospitalization and recovery time in two groups of patients who underwent open or arthroscopic resection of anterior, tibiotalar, impinging spurs. The operative time was approximately the same, but the average length of hospitalization and time to recovery were shorter in the arthroscopic group. A classification system is proposed that grades the degree of spur formation and assists in predicting the length of recovery time and whether the patient is a candidate for open or arthroscopic spur resection. In this series, grade I spur patients recovered and resumed full activity at 5.0 weeks, grade II at 5.6 weeks, grade III at 6.4 weeks, and grade IV at 10.0 weeks postoperatively. Grade IV patients are not suitable candidates for an arthroscopic debridement.

Impact Of Undesirable Effects Of The Parenteral Nutrition On The Nutritional Support And The Disease Progression

2012 ◽  
Vol 4 ◽  
Author(s):  
Shpata Vjollca ◽  
Kuneshka Loreta ◽  
Kurti Floreta ◽  
Ohri Ilir
Keyword(s):  
Acute Pancreatitis ◽  
Case Report ◽  
Parenteral Nutrition ◽  
Disease Progression ◽  
Severe Acute Pancreatitis ◽  
Nutritional Support ◽  
Negative Impact ◽  
Necrotizing Pancreatitis ◽  
Negative Energy ◽  
Protein Catabolism

We report the case of a 52-year old man with severe acute pancreatitis. In this case report we discuss the undesirable effects of parenteral nutrition and the importance of nutritional support at patients with severe necrotizing pancreatitis. Severe acute pancreatitis is usually accompanied by systemic inflammatory response syndrome, which results in hypermetabolism with prominent protein catabolism. Providing nutrition to these patients is of paramount importance. An adequate nutritional support is crucial in patients with severe and complicated pancreatitis. A negative energy balance has a negative impact on the nutritional status and the disease progression.

scholarly journals DIFFERENTIAL DIAGNOSIS OF STERILE AND I NFECTED PANCREONECROSIS

2021 ◽  
pp. 31-35
Author(s):  
V. V. Boyko ◽  
V. M. Lykhman ◽  
A. O. Merkulov ◽  
D. O. Myroshnychenko ◽  
S. V. Tkach ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Differential Diagnosis ◽  
Pancreatic Necrosis ◽  
Clinical Laboratory ◽  
Practical Importance ◽  
Modern Medicine ◽  
Infectious Complications ◽  
Infected Pancreatic Necrosis ◽  
Septic Complications ◽  
Great Practical Importance

Summary. Introduction. The search for objective methods for diagnosing the form and severity of acute pancreatitis, accurate prediction and timely prevention of infectious complications in this surgical pathology is of great practical importance for modern medicine. Materials and methods. According to clinical, morphological and bacteriological data, groups of patients were selected. The first group included 33 patients with sterile pancreatic necrosis (SP), the second group consisted of 29 patients with infected pancreatic necrosis (IP). Results and discussion. The program of differential diagnosis of sterile and infected pancreatic necrosis with calculation of the index of differential diagnosis (IDD) for each clinical-laboratory and instrumental indicator used in this system is developed. The development and evaluation of diagnostic possibilities of the method of verification of purulent-septic complications of acute pancreatitis and the transition of a sterile form of pancreatic necrosis to an infected one was carried out. Conclusions. The use of the developed method of diagnosis of sterile and infected pancreatic necrosis with the calculation of the index of differential diagnosis allowed in 93% of cases to distinguish sterile pancreatic necrosis from infected and timely determine the scope and tactics of treatment.

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