Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:6.2.1.1 (ACS)
 78,556 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Presented in this paper is our experience in the diagnosis and management of abdominal compartment syndrome during severe acute pancreatitis. On the basis of the history of severe acute pancreatitis, after effective fluid resuscitation, if patients developed renal, pulmonary and cardiac insufficiency after abdominal expansion and abdominal wall tension, ACS should be considered. Cystometry could be performed to confirm the diagnosis. Emergency decompressive celiotomy and temporary abdominal closure with a 3 liter sterile plastic bag must be performed. It is also critical to prevent reperfusion syndrome. In 23 cases of ACS, 18 cases received emergency decompressive celiotomy and 5 cases did not. In the former, 3 patients died (16.7%) while in the later, 4 (80%) died. Total mortality rate was 33.3% (7/21). In 7 death cases, 4 patients developed acute obstructive suppurative cholangitis (AOSC). All the patients who received emergency decompressive celiotomy 5 h after confirmation of ACS survived. The definitive abdominal closure took place mostly 3 to 5 days after emergency decompressive celiotomy, with longest time being 8 days. 6 cases of ACS at infection stage were all attributed to infected necrosis in abdominal cavity and retroperitoneum. ACS could occur in SIRS stage and infection stage during SAP, and has different pathophysiological basis. Early diagnosis, emergency decompressive celiotomy and temporary abdominal closure with a 3L sterile plastic bag are the keys to the management of the condition.
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PMID:Diagnosis and management of severe acute pancreatitis complicated with abdominal compartment syndrome. 1501 46

Increased intra-abdominal pressure (IAP) has received growing attention in critically ill patients. Pathophysiologically, it deranges cardiovascular haemodynamics, respiratory and renal functions and may eventually lead to multi-organ failure. It is primarily seen in surgical intensive care units and is frequently associated with abdominal trauma but also occurs after elective abdominal surgery. Non-surgical intensivists ought to be aware that the syndrome is also seen in a wide spectrum of medical conditions, e.g. acute pancreatitis. An expert panel has recently set up definitions of intra-abdominal hypertension (IAH, sustained or repeated pathological elevation in IAP > or = 12 mmHg) and abdominal compartment syndrome (ACS, sustained IAP > 20 mmHg associated with a new organ dysfunction or failure). As clinical signs of IAH are unreliable, IAP should be measured non-invasively by the 'bladder technique'. It is hoped that the consensus definitions will contribute to a broader recognition and effective treatment of this life-threatening syndrome.
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PMID:Abdominal compartment syndrome. 1925 84

Takotsubo cardiomyopathy (TCM) is triggered by multiple physical and psychological stressors and frequently mimics acute coronary syndrome. Acute pancreatitis as a trigger for TCM has rarely been reported. We report a 55-year-old African American man with hypertension and alcohol abuse history, who presented with epigastric and sub-sternal pain and electrocardiogram demonstrating ischemic changes. Laboratory parameters revealed elevated troponin-I, amylase, lipase, and metabolic acidosis. He was diagnosed with acute pancreatitis and ACS. Coronary angiogram was unrevealing for coronary atherosclerosis and he was managed conservatively for acute pancreatitis and heart failure from TCM.
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PMID:Acute Pancreatitis-Induced Takotsubo Cardiomyopathy in an African American Male. 2650 80

Increasing the intestinal dissolution of orally administered poorly water-soluble drugs that have poor oral bioavailability to a therapeutically effective level has long been an elusive goal. In this work, an approach that can greatly enhance the oral bioavailability of a poorly water-soluble drug such as curcumin (CUR) is developed, using a "Transformers"-like nanocarrier system (TLNS) that can self-emulsify the drug molecules in the intestinal lumen to form nanoemulsions. Owing to its known anti-inflammation activity, the use of CUR in treating pancreatitis is evaluated herein. Structural changes of the TLNS in the intestinal environment to form the CUR-laden nanoemulsions are confirmed in vitro. The therapeutic efficacy of this TLNS is evaluated in rats with experimentally induced acute pancreatitis (AP). Notably, the CUR-laden nanoemulsions that are obtained using the proposed TLNS can passively target intestinal M cells, in which they are transcytosed and then transported into the pancreatic tissues via the intestinal lymphatic system. The pancreases in rats that are treated with the TLNS yield approximately 12 times stronger CUR signals than their counterparts receiving free CUR, potentially improving the recovery of AP. These findings demonstrate that the proposed TLNS can markedly increase the intestinal drug dissolution, making oral delivery a favorable noninvasive means of administering poorly water-soluble drugs.
ACS Nano 2018 07 24
PMID:An Intestinal "Transformers"-like Nanocarrier System for Enhancing the Oral Bioavailability of Poorly Water-Soluble Drugs. 2985 23