Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]
-
In the current interview article, Dr. John A. ⋯ Williams is one of the world's leading physiologists working on signal transduction mechanisms in pancreatic acinar cells. He is worldwide recognized for his contribution to many areas of pancreatology, especially the understanding of GI hormone regulation of pancreatic exocrine function. and IAP.
-
High-mobility group box protein 1 (HMGB1), a late-acting proinflammatory cytokine, is secreted actively by inflammatory cells, and released passively from necrotic cells. From the aspect that both inflammation and necrosis are involved in the pathogenesis in acute pancreatitis, the aim of the study was a joint investigation of the plasma concentrations of HMGB1, its soluble receptor for advanced glycation end-products (sRAGE), and the circulating DNA as a marker of cell death. ⋯ A complex study of the plasma levels of HMGB1, sRAGE and circulating DNA can be informative in evaluations of acute pancreatitis with different levels of severity.
-
We evaluated the impact of the initial intravenous fluid resuscitation rate within the first 24 h of presentation to the emergency room on important outcomes in severe acute pancreatitis. ⋯ Patients with severe acute pancreatitis who do not receive at least one third of their initial 72-hour cumulative intravenous fluid volume during the first 24 h are at risk for greater mortality than those who are initially resuscitated more aggressively.
-
Randomized Controlled Trial
An open randomized comparison of clinical effectiveness of protocol-driven opioid analgesia, celiac plexus block or thoracoscopic splanchnicectomy for pain management in patients with pancreatic and other abdominal malignancies.
In inoperable malignancy, pain relief with opioids is often inadequate. Nerve block procedures may improve symptom control. Our aim was to assess celiac plexus block (CPB) and thoracoscopic splanchnicectomy (TS) in patients receiving appropriate medical management (MM). ⋯ Previous randomized studies have shown small differences in pain scores, but no difference in opioid consumption and quality of life. The absence of any benefit from interventions in the present study questions their value.
-
Acute pancreatitis (AP) is characterized by disturbed pancreatic microcirculation with tissue necrosis. Platelet and leukocyte activation contributes to microcirculatory disorders and inflammatory tissue infiltration. P-selectin mediates the adhesion of both activated platelets and leukocytes to the vessel wall. The aim of this study was to investigate the effect of P-selectin inhibition by monoclonal antibodies (AB) on experimental AP. ⋯ Inhibition of P-selectin reduces tissue damage in experimental AP. This is associated with a reduction in platelet- and leukocyte-endothelium interaction and an improvement in pancreatic microcirculation.