scholarly journals Evidence-based pancreatology 2016–2017 (review of results of research on chronic pancreatitis)

2017 ◽  
Vol 36 (2) ◽  
pp. 5-10
Author(s):  
N. B. Gubergrits ◽  
N. V. Byelyayeva ◽  
G. M. Lukashevich ◽  
P. G. Fomenko ◽  
E. V. Berezhnaya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Pancreatitis ◽  
Pain Relief ◽  
Pancreatic Insufficiency ◽  
Pancreatic Fibrosis ◽  
Evidence Based ◽  
Imaging Methods

The article reviews the European recommendations on diagnostics and treatment of chronic pancreatitis, pain relief upon chronic pancreatitis. The results of evidenceased studies on risk factors of functional pancreatic insufficiency in patients with chronic pancreatitis, assessments of the informative value of various imaging methods, treatment of pancreatic insufficiency, markers of pancreatic fibrosis are analyzed. A conclusion is drawn on the need for further conduction of evidence-based research.

scholarly journals Pancreatology: debunked myths

2020 ◽  
Vol 48 (3) ◽  
pp. 44-53
Author(s):  
N. B. Gubergrits ◽  
N. V. Byelyayeva
Keyword(s):  
Chronic Pancreatitis ◽  
Replacement Therapy ◽  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Insufficiency ◽  
Overweight And Obesity ◽  
Evidence Based ◽  
Enzyme Preparations ◽  
Enzyme Replacement ◽  
European Guidelines ◽  
Relieve Pain

Enzyme replacement therapy is not always effective enough upon exocrine pancreatic insufficiency. One of the main reasons is myths — doctors’ misconceptions about the indications and rules of replacement therapy. In particular, there is an outdated opinion about the effectiveness of tablet enzyme preparations used for the relief of pancreatic pain. However, a number of evidence-based studies have proved that enzyme preparations are not effective enough to relieve pain in chronic pancreatitis, and thus should not be used for this purpose. This statement is recorded in the United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis, as well as in the recommendations of the American College of Gastroenterology. In addition, tablet preparations are characterized by asynchronism of the passage of the chyme and the tablet along the digestive tract. The second myth is that drugs without an acid-resistant coat start hydrolyzing the components of the chyme in the stomach, which ensures higher efficiency as compared to Creon. But in the absence of a coat, enzymes are inactivated in the acidic environment of the stomach and cannot have any effect at all. The third myth is that enzyme preparations always cause constipation. In fact, constipation occurs in no more than 10% of cases. They are usually associated with an overdose of the drug, concomitant pathology or insufficient compliance. The fourth myth is that prescribing the doses of enzyme preparations indicated in the European Guidelines causes addiction. It is crucial to know that such doses do not exceed 10% of the pancreas’s own capacities, therefore, they cannot significantly affect these capabilities, which is also demonstrated by evidence-based studies. The fifth myth is that patients gain weight because of enzyme preparations, and they should not be prescribed upon overweight and obesity. Numerous data firmly show that pancreatic insufficiency often occurs in such cases, and enzyme preparations are required. The sixth myth is that a drug with a different composition can be produced under the usual established product name. For example, NEO is added to the name to “mask” a drug with a new composition. Doctors should carefully monitor the composition of such drugs. The seventh myth is that a minimicrospherical preparation (Creon) is as effective as microspherical preparation. However, this statement turned out to be a myth as well. Minimicrospherical preparations are proved to be significantly more effective in clinical practice. Thus, the above-mentioned myths, like many others, are based on insufficient knowledge in the field of pancreatology.

scholarly journals 556 A Prospective Review of Risk Factors, Clinical Presentation and Management Outcomes for Chronic Pancreatitis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
B Akula ◽  
K Sugumar ◽  
A Deshpande
Keyword(s):  
Risk Factors ◽  
Chronic Pancreatitis ◽  
Pain Relief ◽  
Pancreatic Duct ◽  
Statistical Correlation ◽  
Pain Severity ◽  
Female Ratio ◽  
Pain Scores ◽  
Duct Diameter ◽  
Imaging Characteristics

Abstract Aim and objectives: To identify the risk factors, symptoms, and severity of Chronic pancreatitis (CP) on admission. To determine the relationship between pancreatic duct diameter and severity of pain and to assess extent of pain relief achieved by medical, endoscopic, and surgical intervention. Method 75 patients with CP were admitted over 2 years. Data collected included etiology, symptoms, pain scores and CT/MRCP findings. Patients were classified into mild, moderate, and severe category according to Cambridge classification. Type and response to treatment was recorded. Statistical correlation of the pancreatic duct diameter and pain severity as well as the comparison of pain scores after medical, surgical and endoscopy was performed using Chi square test (p value <0.05) Results Median age of presentation of CP was 43 years. Male: female ratio was 3:1. Alcohol was the etiology in 66 %, 99% presented with pain, 65 % belonged to severe category. There was no statistical correlation between pain severity and duct diameter. Pain relief following medical management was 66 %, endoscopic - 73% and surgical - 83 %. There was no correlation between Cambridge classification and pain severity. There was no statistical difference between pain relief offered by either of the three modalities. However, there was a statistically significant correlation between duct diameter and type of intervention. Conclusions There is no consensus on the best treatment modality for CP as pain relief was equivalent amongst all the modalities. Therefore, the choice of intervention for patients suffering from chronic pancreatitis should be based on imaging characteristics and symptomology.

scholarly journals Evidence-based pancreatology 2017/2018 (review of the results of studies on chronic pancreatitis and exocrine pancreatic insufficiency

2018 ◽  
Vol 40 (2) ◽  
pp. 12-20
Author(s):  
N. B. Gubergrits ◽  
N. V. Byelyayeva ◽  
G. M. Lukashevish ◽  
E. V. Berezhnaya
Keyword(s):  
Pancreatic Cancer ◽  
Cystic Fibrosis ◽  
Chronic Pancreatitis ◽  
Imaging Techniques ◽  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Insufficiency ◽  
Diagnosis And Treatment ◽  
Evidence Based

The article provides an overview of the European recommendations on the diagnosis and treatment of chronic pancreatitis. The results of evidence-based research related to the epidemiology, course of chronic pancreatitis, assessment of the informative value of various imaging techniques, reatment of pancreatic insufficiency upon chronic pancreatitis, cystic fibrosis, pancreatic cancer are analyzed. A conclusion is drawn about the need for further carrying out of evidence-based studies.

scholarly journals A clinical study on lateral pancreaticojejunostomy in a case of chronic pancreatitis

2021 ◽  
Vol 8 (5) ◽  
pp. 1617
Author(s):  
Suhas B. Manapure ◽  
Anil S. Munde ◽  
Ravibhushan J. Kasale ◽  
Pramod Lokare
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Pain Relief ◽  
Pancreatic Duct ◽  
Anastomotic Leak ◽  
Pancreatic Insufficiency ◽  
Drainage Procedure ◽  
Health Care Centre ◽  
Lateral Pancreaticojejunostomy

Lateral pancreaticojejunostomy is a seldom performed procedure in a peripheral tertiary health care centre. Very few numbers of cases are reported that undergoes surgical procedures for chronic pancreatitis. We report a such rare case in our institute that undergone pancreatic drainage procedure. A 70 year old poor patient was admitted in our institute with a complaint of chronic abdominal pain, subsequently diagnosed to be having chronic pancreatitis with complications with pancreatic duct calculus. Pancreatic drainage procedure, lateral pancreaticojejunostomy was performed and we analysed for the outcome of the procedure with regards to pain relief, anastomotic leak, quality of life and return to work. Patient recovered well post-operatively, reported pain relief, suffered no anastomotic leak and experienced improved quality of life. Lateral pancreaticojejunostomy provides excellent surgical choice for patients of chronic pancreatitis with pancreatic duct calculus with acceptable rates of pain relief, morbidity and mortality, without worsening pancreatic insufficiency. 

The Preschool Stuttering Screen for Health Care Professionals

2011 ◽  
Vol 21 (2) ◽  
pp. 59-62
Author(s):  
Joseph Donaher ◽  
Christina Deery ◽  
Sarah Vogel
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Differential Diagnosis ◽  
Preschool Children ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Evidence Based ◽  
Developmental Profile

Healthcare professionals require a thorough understanding of stuttering since they frequently play an important role in the identification and differential diagnosis of stuttering for preschool children. This paper introduces The Preschool Stuttering Screen for Healthcare Professionals (PSSHP) which highlights risk factors identified in the literature as being associated with persistent stuttering. By integrating the results of the checklist with a child’s developmental profile, healthcare professionals can make better-informed, evidence-based decisions for their patients.

Design and Development of a Web-based Delirium Preventive Application for Long-term Care Facilities: A Methodological Study (Preprint)

2020 ◽  
Author(s):  
Kyoung Ja Moon ◽  
Chang-Sik Son ◽  
Jong-Ha Lee ◽  
Mina Park
Keyword(s):  
Risk Factors ◽  
Long Term Care ◽  
Cloud System ◽  
Evidence Based ◽  
Methodological Study ◽  
Term Care ◽  
Web Based ◽  
Care Facilities ◽  
Delirium Prevention

BACKGROUND Long-term care facilities demonstrate low levels of knowledge and care for patients with delirium and are often not properly equipped with an electronic medical record system, thereby hindering systematic approaches to delirium monitoring. OBJECTIVE This study aims to develop a web-based delirium preventive application (app), with an integrated predictive model, for long-term care (LTC) facilities using artificial intelligence (AI). METHODS This methodological study was conducted to develop an app and link it with the Amazon cloud system. The app was developed based on an evidence-based literature review and the validity of the AI prediction model algorithm. Participants comprised 206 persons admitted to LTC facilities. The app was developed in 5 phases. First, through a review of evidence-based literature, risk factors for predicting delirium and non-pharmaceutical contents for preventive intervention were identified. Second, the app, consisting of several screens, was designed; this involved providing basic information, predicting the onset of delirium according to risk factors, assessing delirium, and intervening for prevention. Third, based on the existing data, predictive analysis was performed, and the algorithm developed through this was calculated at the site linked to the web through the Amazon cloud system and sent back to the app. Fourth, a pilot test using the developed app was conducted with 33 patients. Fifth, the app was finalized. RESULTS We developed the Web_DeliPREVENT_4LCF for patients of LTC facilities. This app provides information on delirium, inputs risk factors, predicts and informs the degree of delirium risk, and enables delirium measurement or delirium prevention interventions to be immediately implemented with a verified tool. CONCLUSIONS This web-based application is evidence-based and offers easy mobilization and care to patients with delirium in LTC facilities. Therefore, the use of this app improves the unrecognized of delirium and predicts the degree of delirium risk, thereby helping initiatives for delirium prevention and providing interventions. This would ultimately improve patient safety and quality of care. CLINICALTRIAL none

Nonsuicidal Self-Injury Among Youth

2018 ◽  
Author(s):  
Adam Bryant Miller ◽  
Maya Massing-Schaffer ◽  
Sarah Owens ◽  
Mitchell J. Prinstein
Keyword(s):  
Risk Factors ◽  
Applied Research ◽  
Evidence Based ◽  
Prevalence Rates ◽  
Evidence Based Treatment ◽  
The Past ◽  
Self Injury ◽  
Assessment Techniques ◽  
Basic And Applied Research ◽  
Nonsuicidal Self Injury

Nonsuicidal self-injury (NSSI) is direct, intentional harm to one’s own body performed without the intent to die. NSSI has a marked developmental onset reaching peak prevalence in adolescence. NSSI is present in the context of multiple psychological disorders and stands alone as a separate phenomenon. Research has accumulated over the past several decades regarding the course of NSSI. While great advances have been made, there remains a distinct need for basic and applied research in the area of NSSI. This chapter reviews prevalence rates, correlates and risk factors, and leading theories of NSSI. Further, it reviews assessment techniques and provides recommendations. Then, it presents the latest evidence-based treatment recommendations and provides a case example. Finally, cutting edge research and the next frontier of research in this area are outlined.

scholarly journals Sleep quality and COVID-19 outcomes: the evidence-based lessons in the framework of predictive, preventive and personalised (3P) medicine

2021 ◽  
Author(s):  
Kneginja Richter ◽  
Stefanie Kellner ◽  
Thomas Hillemacher ◽  
Olga Golubnitschaja
Keyword(s):  
Risk Factors ◽  
Sleep Quality ◽  
Sleep Disturbances ◽  
Acute Infection ◽  
Evidence Based ◽  
Physical And Mental Health ◽  
Mild Disease ◽  
Depth Analysis ◽  
Medical Approach ◽  
Poor Outcomes

AbstractSleep quality and duration play a pivotal role in maintaining physical and mental health. In turn, sleep shortage, deprivation and disorders are per evidence the risk factors and facilitators of a broad spectrum of disorders, amongst others including depression, stroke, chronic inflammation, cancers, immune defence insufficiency and individual predisposition to infection diseases with poor outcomes, for example, related to the COVID-19 pandemic. Keeping in mind that COVID-19-related global infection distribution is neither the first nor the last pandemic severely affecting societies around the globe to the costs of human lives accompanied with enormous economic burden, lessons by predictive, preventive and personalised (3P) medical approach are essential to learn and to follow being better prepared to defend against global pandemics. To this end, under extreme conditions such as the current COVID-19 pandemic, the reciprocal interrelationship between the sleep quality and individual outcomes becomes evident, namely, at the levels of disease predisposition, severe versus mild disease progression, development of disease complications, poor outcomes and related mortality for both - population and healthcare givers. The latter is the prominent example clearly demonstrating the causality of severe outcomes, when the long-lasting work overload and shift work rhythm evidently lead to the sleep shortage and/or deprivation that in turn causes immune response insufficiency and strong predisposition to the acute infection with complications. This article highlights and provides an in-depth analysis of the concerted risk factors related to the sleep disturbances under the COVID-19 pandemic followed by the evidence-based recommendations in the framework of predictive, preventive and personalised medical approach.

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