scholarly journals Ketorolac and Predicted Severe Acute Pancreatitis: A Randomized, Controlled Clinical Trial

2020 ◽  
Author(s):  
Shaahin Shahbazi ◽  
Zahra Vahdat Shariatpanahi ◽  
Erfan Shahbazi
Keyword(s):  
Acute Pancreatitis ◽  
Serum Level ◽  
Organ Failure ◽  
Severe Acute Pancreatitis ◽  
Rank Test ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Study Group ◽  
Group Frequency ◽  
Hs Crp

Abstract Background: We evaluated effect of ketorolac on reducing the severity of acute pancreatitis.Methods: Fifty six adult patients, with predicted severe acute pancreatitis were randomly divided into two groups. The patients in the study group received intravenous ketorolac, 10 mg, 3 times daily from time of enrollment for a maximum of 5 days as needed along with standard medical treatment. Primary outcome measure was the change in the serum level of hs-CRP. Patients were also followed up in terms of hospitalization duration, need for ICU care, development of organ failure, persistent organ failure, pancreatic necrosis, nutritional assessment and mortality. The study was continued to gather clinical follow up information up to 4 months.Results: Serum level of hs-CRP was significantly lower in the ketorolac group than in the control group on days 3, 4, and 5. Organ failure, pseudocyst formation, acute necrotic collection and intensive care unit transfer occurred non-significantly more in the control group than in the ketorolac group. Median days of hospitalization were significantly lower in the study group than in the control group. Based on the Log rank test, survival within 4 months was marginally lower in the control group (P=0.076). The time to start feeding was significantly shorter in the study group than in the control group with no need to artificial enteral nutrition in the ketorolac group. Frequency of NPO (not per oral) was significantly lower in the ketorolac group.Conclusion: The use of ketorolac may improve feeding and clinical outcomes in severe acute pancreatitis.ClinicalTrials.gov: NCT02885441, Date: August 31, 2016

scholarly journals The effect of enteral nutrition on intra-abdominal pressure in severe acute pancreatitis patients

2017 ◽  
Author(s):  
Mingjie Zhang ◽  
Li-Ping Cao ◽  
Guoping Ding
Keyword(s):  
Acute Pancreatitis ◽  
Enteral Nutrition ◽  
Severe Acute Pancreatitis ◽  
Occurrence Rate ◽  
Control Group ◽  
Abdominal Pressure ◽  
Therapeutic Effects ◽  
Study Group ◽  
Time Operation ◽  
Operation Rate

Abstract BACKGROUND: To investigate the effect of enteral nutrition (EN) on intra-abdominal pressure (IAP) in severe acute pancreatitis (SAP) patients and the relationship between the decreasion of IAP and the the therapeutic effect of EN. METHODS: Eighty SAP patients were randomly divided into study group and control group (40 patients in each group). Patients in the study group received EN and Patients in the control group received total parenteral nutrition (TPN) for 7 days. Intra-cystic pressure (ICP) of the two groups was measured during treatment period. The outcomes of treatment were observed, APACHE Ⅱ scores, NB data were applied in analysis. RESULTS: The ICP data was lower in the study group than in the control group on days 4 and 5 of treatment (P < 0.05). On days 3-5 of treatment, the APACHE Ⅱ scores of the study group were lower than which of the control group (P < 0.05). Nitrogen balance (NB) date increased significantly in study group than in the control group (P < 0.05). abdominalgia relief time, operation rate were different between the two groups (P < 0.05). The abdominal compartment syndrome (ACS) occurrence rate of the two groups have no significant difference. The ICP data and APACHE Ⅱscores, abdominalgia relief time, operation rate of pancreas debridement show positive correlation (P < 0.05). ICP and NB date show negative correlation (P < 0.05). CONCLUSION: EN can decrease the IAP of SAP, which may be the reason for EN show preventive and therapeutic effects on SAP.

scholarly journals Combined effect of ultrasound-guided percutaneous abdominal paracentesis drainage and ulinastatin on severe acute pancreatitis

2021 ◽  
Vol 20 (10) ◽  
pp. 2187-2192
Author(s):  
Chuanmin Liu ◽  
Fei Yuan ◽  
Baowei Wang ◽  
Xuezhen Wang
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Study Groups ◽  
Control Group ◽  
Amylase Level ◽  
Study Group ◽  
Research Subjects ◽  
Ultrasound Guided ◽  
Beneficial Effects ◽  
Abdominal Paracentesis

Purpose: To study the clinical effect of a combination of ultrasound-guided percutaneous abdominal paracentesis drainage (APD) and ulinastatin on severe acute pancreatitis (AP).Methods: A total of 94 patients with severe AP in Intensive Care Unit, Jiaozhou Central Hospital, Qingdao, from December 2017 to December 2018 were selected as the research subjects. They were divided into control and study groups, with 47 patients in each group. Patients in the control group underwent laparotomy drainage, while patients in the study group underwent ultrasound-guidedpercutaneous APD. Patients in both groups received ulinastatin perfusion. Subsequently, clinical effectsand other relevant indicators were determined.Results: Overall response was significantly higher in the study group than in the control group (p < 0.05). The times taken for disappearance of postoperative symptoms, normalization of serum amylase level, and hospitalization were significantly shorter in the study group than in the control group (p < 0.05). For every indicator, the study group exhibited more benefits after than before treatment; however, post-treatment levels of blood glucose, hemodiastase and urinary amylase were better than those in the control group (p < 0.05). Incidence of postoperative complications was lower in the study group than in control group (p < 0.05).Conclusion: The combination of ultrasound-guided percutaneous APD with ulinastatin produces marked beneficial effects on severe AP patients. It facilitates the remission of adverse symptoms, and enhances  normalization of indicator levels. Moreover, it displays low incidence of complications, better prognosis and recovery, and absence of post-operation infections.

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 The effect of 8-week thera-band exercises on male swimmers’ 100 m freestyle swimming performance

2017 ◽  
Vol 14 (4) ◽  
pp. 3950 ◽  
Author(s):  
Ahmet Gönener ◽  
Utku Gönener ◽  
Ozan Yılmaz ◽  
Tuğçe Horoz ◽  
Deniz Demirci
Keyword(s):  
Swimming Performance ◽  
Training Programme ◽  
Rank Test ◽  
Control Group ◽  
Study Group ◽  
Test Results ◽  
Signed Rank ◽  
Post Test ◽  
Signed Rank Test ◽  
And Control

The aim of this study is to investigate 8 weeks Thera-Band trainings' effects on male swimmers' 100 m freestyle swimming performance.The study group is created by 20 (n = 20) licenced male athletes that had trained at least 3 days in a week and have been active in swimming sport at least 3 years in Gebze Genclerbirligi Swimming Club 20 (n = 20). Athletes were divided into experiment group (n = 10) and control group (n = 10) randomly. Training programme was applied to the study group for 55-60 minutes for 3 days on alternate days and times when the club does not have swimming training. 12 different Thera-Band trainings were applied for 40-45 mins and each set was 15 minutes.Mann-Whitney U test was used to analyze differences between groups and Wilcoxon signed rank test was applied for analyzing the differences of intra-groups. SPSS 21.0 Statistics package software was used for statistical analyzes. The results show that there are no significantly differences between experimental group's and control group's post test results. (p>0.05). Statistically significant differences are found as a result of intra-group comparison of the experimental group's pre-test and post-test results (p<0.05).Depending on the results obtained after reviewing the literature, it can be concluded that Thera-Band training is effective on the performance improvement of swimmers aged 13-15 years.

scholarly journals Assessment of Prophylactic Carbapenem Antibiotics Administration for Severe Acute Pancreatitis: An Updated Systematic Review and Meta-Analysis

Digestion ◽  
2022 ◽  
pp. 1-9
Author(s):  
Daxin Guo ◽  
Wei Dai ◽  
Jingyi Shen ◽  
Mengting Zhang ◽  
Yetan Shi ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Organ Failure ◽  
Severe Acute Pancreatitis ◽  
Pancreatic Pseudocyst ◽  
Meta Analysis ◽  
Fluid Collection ◽  
Cochrane Library ◽  
Intensive Care Unit Treatment ◽  
Significant Difference ◽  
And Control

<b><i>Background:</i></b> The effectiveness of prophylactic antibiotics in severe acute pancreatitis (SAP) remains a debatable issue. This meta-analysis aimed to determine the efficacy of prophylactic carbapenem antibiotics in SAP. <b><i>Methods:</i></b> This meta-analysis of prophylactic carbapenem antibiotics for SAP was conducted in PubMed, EMBASE, Web of Science, MEDLINE, and Cochrane Library up to February 2021. The related bibliographies were manually searched. The primary outcomes involved infected pancreatic or peripancreatic necrosis, mortality, complications, infections, and organ failure. <b><i>Results:</i></b> Seven articles comprised 5 randomized controlled trials and 2 retrospective observational studies, including 3,864 SAP participants. Prophylactic carbapenem antibiotics in SAP were associated with a statistically significant reduction in the incidence of infections (odds ratio [OR]: 0.27; <i>p</i> = 0.03) and complications (OR: 0.48; <i>p</i> = 0.009). Nevertheless, no statistically significant difference was demonstrated in the incidence of infected pancreatic or peripancreatic necrosis (OR: 0.74; <i>p</i> = 0.24), mortality (OR: 0.69; <i>p</i> = 0.17), extrapancreatic infection (OR: 0.64, <i>p</i> = 0.54), pulmonary infection (OR: 1.23; <i>p</i> = 0.69), blood infection (OR: 0.60; <i>p</i> = 0.35), urinary tract infection (OR: 0.97; <i>p</i> = 0.97), pancreatic pseudocyst (OR: 0.59; <i>p</i> = 0.28), fluid collection (OR: 0.91; <i>p</i> = 0.76), organ failure (OR: 0.63; <i>p</i> = 0.19), acute respiratory distress syndrome (OR: 0.80; <i>p</i> = 0.61), surgical intervention (OR: 0.97; <i>p</i> = 0.93), dialysis (OR: 2.34; <i>p</i> = 0.57), use of respirator or ventilator (OR: 1.90; <i>p</i> = 0.40), intensive care unit treatment (OR: 2.97; <i>p</i> = 0.18), and additional antibiotics (OR: 0.59; <i>p</i> = 0.28) between the experimental and control groups. <b><i>Conclusions:</i></b> It is not recommended to administer routine prophylactic carbapenem antibiotics in SAP.

scholarly journals Examining Metabolic Profiles in Opioid-‎Dependent Patients ‎

2020 ◽  
Vol 10 (3) ◽  
pp. 28681
Author(s):  
Nader Molavi ◽  
Amir Ghaderi ◽  
Hamid Reza Banafshe
Keyword(s):  
Control Group ◽  
Study Group ◽  
Metabolic Profiles ◽  
Opioid Use ◽  
Serum Samples ◽  
Social Burden ◽  
Study Results ◽  
Significant Difference ◽  
Hs Crp ◽  
Opioid Users

Background: Drug abuse is a social burden and a public health disorder. Previous evidence suggested numerous illicit substances (e.g., opioids, amphetamines, cocaine, & cannabis) affect immune system functions, oxidative stress mechanisms, inflammatory cytokines, and reactive oxygen species production. This study aimed to determine the extent of these metabolic parameters in opioid-dependent patients. We also compared these patients with a healthy control group. Methods: This study was conducted in Amirie Clinic, Kashan, Iran. Plasma and serum samples from 50 illicit opioid users (study group) and 50 non-opioid users (control group) were studied. Metabolic levels for MDA, NO, TAC, GSH, Insulin, HOMA-IR, and hs-CRP were assessed in both research groups (N=100). Results: There was a significant difference in the status of MDA (P=0.003), NO (P=0.01), TAC (P=0.003), GSH (P=0.001), insulin (P=0.04), HOMA-IR (P=0.02), and hs-CRP (P=0.001) between the study and control groups. Furthermore, there was a significant correlation among the duration of illicit opioid use and MDA concentrations (r=-0.424, P=0.002), as well as TAC levels (r=0.314, P=0.02). Conclusion: The study results suggested metabolic profiles were impaired in the study group, compared to the controls.  

MORTALITY IN SEVERE ACUTE PANCREATITIS WITHOUT ORGAN FAILURE IS LOW: A CASE FOR REVISING THE ATLANTA CLASSIFICATION.

Pancreas ◽  
2004 ◽  
Vol 29 (4) ◽  
pp. 332
Author(s):  
Vege Santhi Swaroop ◽  
Suresh T. Chari ◽  
Randall K. Pearson ◽  
Jonathan E. Clain ◽  
Bret T. Petersen ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Organ Failure ◽  
Severe Acute Pancreatitis

scholarly journals Oral Hygiene in a Sample of Children/Adolescents Living in Family-Homes from the Province of Milan (Italy): A Pilot Study

2020 ◽  
Vol 8 (2) ◽  
pp. 33 ◽  
Author(s):  
Alessandro Nota ◽  
Floriana Bosco ◽  
Shideh Ehsani ◽  
Francesca Giugliano ◽  
Giulia Moreo ◽  
...  
Keyword(s):  
Pilot Study ◽  
Oral Hygiene ◽  
Clinical Results ◽  
Plaque Index ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Study Group ◽  
Significant Difference ◽  
And Gender ◽  
Oral Hygiene Instructions

Objective: This pilot study is a prospective controlled clinical trial, designed to evaluate the short-term clinical results (the plaque index) of an educational/motivational program for home oral hygiene, directed to children and adolescents who live in family-homes. Methods: The setting of the project was the province of Milan (Italy), where two family-homes were selected. The study group included 26 children (16 females and 10 males) aged between 7 and 15 years, of Italian nationality, from the family-home communities. The control group included 26 children (15 females and 11 males, aged between 7 and 15 years) of Italian nationality, matched for age and gender distribution with the study group, that were not in a socially disadvantaged condition. Collection of the plaque index (PI) was performed at t0. Then, all basic oral hygiene instructions were given to all children/adolescents and their educators. Education and motivation were repeated in the same way after 4–7 weeks (T1), and after 10–12 weeks (T2). The PI was taken also at T1 and T2. Results: An improvement in the PI was generally found in both groups, but there was no statistically significant difference between the two groups over time. Multivariate analysis of variance (MANOVA) revealed a statistically significant effect of time [F (1, 52) = 90.73, p < 0.001], regardless of the assignment group, in consequence of which the plaque index presented a moderate and significant improvement. Conclusion: The present data confirm the validity of the educational/motivational program to improve oral hygiene in children/adolescents, regardless of the assignment group.

scholarly journals Is it necessary to adjust current creatine kinase reference ranges to reflect levels found in professional footballers?

2018 ◽  
Vol 4 (1) ◽  
pp. e000282 ◽  
Author(s):  
Jamie Mahmutyazicioglu ◽  
Julian Nash ◽  
Andrew Cleves ◽  
Len Nokes
Keyword(s):  
Creatine Kinase ◽  
Reference Range ◽  
Reference Interval ◽  
Rank Test ◽  
Control Group ◽  
Study Group ◽  
Reference Ranges ◽  
Military Population ◽  
Signed Rank ◽  
Signed Rank Test

ObjectiveWe aimed to explore the validity of applying current reference ranges of the enzyme creatine kinase (CK) when analysing the medical status of professional footballers and to offer a more functional CK reference range for professional footballers.MethodsA sample of 27 professional male footballers competing in The Football League Championship was analysed. The single sample Wilcoxon signed-rank test was used to compare the CK distribution of the study group with that of a control group of military personnel reported in the literature.ResultsThe median values for study group and the published control group were 284 U/L and 124 U/L, respectively (P<0.001) suggesting that the average CK activity of professional footballers is higher than that of the normal healthy military population.ConclusionEthnicity, sex, age and physical exercise are factors that likely influence CK levels among various populations. From our analysis, we recommend a new 95% reference interval of 64.9 U/L to 1971.7 U/L for professional footballers.

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