Pancreas
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The aim of this study was to assess the association of hemodynamic factors with 90-day mortality in critically ill patients with severe acute pancreatitis (SAP). ⋯ Advanced age, higher serum creatinine, and lower mean arterial pressure are associated with 90-day mortality in patients with SAP. In the subgroup of patients with SAP and shock, higher Acute Physiology and Chronic Health Evaluation II score, higher central venous pressure, and lower cardiac index predicted 90-day mortality.
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Randomized Controlled Trial
Early oral refeeding wisdom in patients with mild acute pancreatitis.
To evaluate the safety and efficacy of early oral refeeding (EORF) in patients with mild acute pancreatitis (AP) and to investigate the optimal duration to commence EORF. ⋯ In patients with mild AP, EORF, with the subjective feeling of hunger, is safe, feasible, and reduces LOH.
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Abdominal pain in chronic pancreatitis (CP) may be visceral or nonvisceral in origin. Differential nerve block (DNB) distinguishes visceral from nonvisceral pain. Endoscopic ultrasound and other imaging tests (eg, computed tomography and magnetic resonance cholangiopancreatography) are used to diagnose and stage CP. However, it is not known whether structural changes predict the presence of visceral pain, which may better respond to endoscopic, surgical, or visceral nerve interventions. We investigated the correlation of pancreatic structural abnormalities evident on imaging tests with the presence of visceral pain on DNB. ⋯ The severity of structural changes of CP found on imaging tests does not predict the presence of visceral pain.
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This study aimed to describe the mode of refeeding, frequency of intolerance, and related factors in mild acute pancreatitis (AP). ⋯ Intolerance to refeeding is an infrequent event. We have identified several factors independently associated with intolerance.
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Meta Analysis
Meta-analysis: the placebo rate of abdominal pain remission in clinical trials of chronic pancreatitis.
Treatment of the pain caused by chronic pancreatitis (CP) is not standardized. Knowledge of the response to placebo in this setting may aid the design of future trials. We aimed at investigating the placebo effect on abdominal pain remission rates in patients with CP. ⋯ This meta-analysis identifies for the first time the efficacy of placebo for pain in CP and variables determining it. These data provide a sound basis for designing future placebo-controlled randomized clinical trials for the treatment of pain in CP.