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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Following consideration of the nosological role of hyperglycemic states in psychiatry the case report of a fifty-five year-old patient is presented suffering from fatty cell degeneration of the liver and a relapsing pancreatitis due to chronic alcoholism. After a long period of abstinence without previously known diabetes mellitus a sudden ketoacidotic coma developed with maximum serum glucose level of 2020 mg%. Having emerged during coma treatment Wernicke's encephalopathy passed into Korsakoff's syndrome the main features of which remained unchanged for more than one year. In this case thiamine deficiency of different pathogenetical origin is discussed: defective exogeneous availability due to malabsorption; depletion of endogeneous thiamine stores due to enlarged requirements for glucose oxidation during coma therapy; antimetabolic effects to thiamine by nitroimidazole-derivatives administered parenterally.
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PMID:[Diabetic coma and Wernicke-Korsakoff syndrome. On the clinical significance of acquired thiamine deficiency]. 359 52

Sixty-four severe infections in hospitalized patients were treated with intravenous Timentin. Most patients (mean age: 50.5 years, range 18-85) had serious underlying conditions such as agranulocytosis, heart failure, cancer, diabetes mellitus, chronic alcoholism or other functional or anatomical abnormalities. Forty-three episodes were bacteriologically proved, and bacteraemia was diagnosed in 18. The sites of infection were: lower respiratory tract (10), upper respiratory tract (10), soft tissues (9), urinary tract (7), bones (6), peritoneal cavity (3), meninges (1) and pelvis (1). In addition, 13 episodes of fever and four of septicaemia in patients with agranulocytosis were treated with Timentin plus amikacin. Overall, 59% of the episodes were cured, 14% improved and 17% failed to respond. In 9% of cases the efficacy of the Timentin was unassessable mainly because of concurrent administration of other antimicrobials. Failure appeared to be more frequent in soft tissue and intra-abdominal infections, in patients infected with bacteria susceptible to Timentin but resistant to ticarcillin and in patients superinfected with Timentin-resistant strains. Major side effects were haemorrhagic diathesis with platelet dysfunction (1), severe water sodium overload (1), and possibly pancreatitis (1). Other side effects were mild: catheter-related phlebitis, and abnormal but clinically insignificant laboratory test results. Timentin appears to be an effective and safe broad-spectrum combination which compares favourably with third-generation cephalosporins in the treatment of severe hospital infections. More experience is needed to decide whether the somewhat lower response rate in patients infected with ticarcillin-resistant strains is significant.
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PMID:Clinical experience with Timentin in severe hospital infections. 363 28

One hundred and nine successive post mortem examinations have been performed with a peculiar attention to the gross and microscopic features of the sphincter of Oddi. Biliary lesions were present in 24 cases and pancreatic lesions in 7 cases. According to previous histologic descriptions, a group of 18 pathologic sphincters of Oddi was selected. Biliary lesions were not more common in this group (28 p. 100) than in the group with a normal sphincter of Oddi (21 p. 100) and inversely, there were no more lesions of the sphincter of Oddi in the group with biliary lesions (21 p. 100) than in the group without biliary lesions (15 p. 100). Chronic pancreatitis was more frequently associated with an abnormal sphincter of Oddi, but in these cases, another associated disease could explain pancreatitis (alcoholism, hemochromatosis). Pathologic lesions of the sphincter of Oddi are frequent and usually latent. These features are not simple anatomic variations because five cases were undoubtedly pathologic with an important thickening of the sphincter and a fibro-adenomatosic pattern. This study shows that sclerosing odditis does exist but is rare.
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PMID:[Lesions of the area of Oddi's sphincter: incidence and association with biliary and pancreatic lesions in a series of 109 autopsies]. 365 18

We had previously found a correlation between a recovering alcoholic's propensity to choose free sugar in his diet and his ability to remain sober. To determine if chronic hyperglycemia in itself is a predictor of sobriety, we examined the outcome of alcoholism treatment in 138 diabetics we could identify among 9000 alcoholism treatment outpatients. In general, the diabetics did no better or worse in alcoholism treatment than the whole clinic population, but a subset of the diabetics, those whose diabetes resulted from pancreatitis or pancreatectomy, did very badly. The implications of these findings for future research are discussed.
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PMID:The diabetic alcoholic: characteristics and treatment outcome. 367 41

The authors observed 329 consecutive cases of chronic calcifying pancreatitis (CCP) from January 1963 to January 1986. Alcoholism was the etiological agent in 282 cases (86%). In 34 patients (10%) no cause was detectable (idiopathic). Malnutrition was responsible for 10 cases (3%) and chronic familial pancreatitis was diagnosed in 3 cases (0.9%). The mean age at the apparent onset of symptoms was 36.5 +/- 10.5 for the alcoholics, 22.6 +/- 15.4 in the idiopathic cases and 7.3 +/- 3.0 for the nutritional etiology patients. Mean age differences are statistically significant for the 3 groups. Pancreatic calcifications were found in 224 alcohol-induced cases (79%), in 32 idiopathic cases (94%), in 8 patients with malnutrition (80%) and in one patient with familial pancreatitis (33%). All cases of nutritional etiology presented severe protein-caloric deficiencies with edema, and none complained of pain, but 9 had pancreatic insufficiency. Mean daily ethanol intake for the alcohol-addicted patients was 396.6 +/- 286 g (range 80-1664 g) with the onset of alcoholism at 19.1 +/- 6.8 yr old and 20.8 +/- 8.3 (4-44) yr of alcohol indulgence. Pancreatic carcinoma developed in 7 cases. Six cases of chronic pancreatitis were seen among relatives in the group with CCP of alcoholic etiology.
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PMID:Etiology of chronic calcifying pancreatitis in Brazil: a report of 329 consecutive cases. 368 Oct 31

To assess the role of alcohol and alcoholism in motor vehicle and other accidental deaths, New Jersey State Medical Examiner cases from Essex County aged 16 or older during a 4-year period, October 1981 to September 1985, were analyzed. Cases were classified as alcoholics according to the following criteria: (1) autopsy findings of liver change or pancreatitis due to alcoholism or (2) any case record report of drinking problems. There were 467 age-eligible cases whose certified manner of death was an accident for which the decedent may have had some responsibility. The study sample of 300 cases with blood or brain alcohol levels (BALs) obtained within 6 h after injury, including 96 motor vehicle drivers, 78 pedestrians in motor vehicle accidents, 38 fire victims, and 33 fall victims. In the study sample, 23% were classified as alcoholics, 47% had positive BALs, and 36% had levels of 0.10% or more. Alcoholics much more often than nonalcoholics had positive BALs and levels of 0.20% or more. Accidental nontraffic deaths were significantly more often associated with both alcohol use and alcoholism than were traffic deaths.
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PMID:Alcohol and alcoholism in traffic and other accidental deaths. 368 2

Mortality and morbidity from ischaemic heart disease (IHD) was studied in 5404 Finnish males aged 35-64 years who had been hospitalised for alcohol-related disease in 1972 without any admissions for IHD during that same period. By record-linkage, morbidity and mortality were followed up to the end of 1975. The mortality of patients with alcohol-related diseases was compared to 1120 patients with acute appendicitis by calculating indirectly age-standardised mortality ratios (SMR). The mortality and morbidity of 5963 patients with acute myocardial infarction or angina pectoris was also studied. The following SMRs for IHD mortality, non-fatal-IHD-hospitalisation and for mortality from all causes respectively, were found: acute myocardial infarction 11.6, 7.2 and 7.2; alcohol intoxication 6.0, 4.5 and 4.5; angina pectoris 5.2, 10.5 and 3.4; liver cirrhosis 2.2, 2.5 and 11.8; alcoholism 1.9, 1.9 and 3.6; pancreatitis 1.8, 1.2 and 4.4; alcohol psychosis 1.7, 2.5 and 4.2. IHD mortality and morbidity appeared to be more prevalent in patients hospitalised with alcohol intoxication than in patients with other alcohol-related diseases. This suggests that rapid drinking predisposes both to serious intoxication and to fatal disturbances of cardiac rhythm.
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PMID:Alcohol-related diseases associated with ischaemic heart disease: a three-year follow-up of middle-aged male hospital patients. 376 98

Acute recurrent pancreatitis in the absence of alcoholism and gallstones is a frustrating illness for both the patient and the physician. Over a 10 year period, 33 patients were operated on and found to have a duct of Wirsung entering the duodenum through the fibers of the sphincter of Oddi. Recurrent pancreatitis of sufficient intensity to require hospitalization had occurred an average of 4.2 times per patient, and each had experienced numerous episodes of abdominal pain of lesser severity. At least two attacks of pancreatitis that required hospitalization had occurred in all patients. All known causes of pancreatitis, including alcoholism, gallstones, hypercalcemia, hyperlipidemia, drug reactions, and pancreas divisum were excluded. Endoscopic retrograde cholangiopancreatography showed no ductal abnormalities. Twenty-eight of the patients had previously undergone cholecystectomy 8 months to 20 years before operation. A sphinteroplasty of the common bile duct and duct of Wirsung resulted in elimination of attacks of pancreatitis in all except two patients. Follow-up has been more than 5 years in 16 patients, more than 4 years in 10 patients, and more than 1 year in 5 patients. There have been no deaths. It appears that the entrance of the duct of Wirsung into the duodenum through a separate orifice through the fibers of the sphincter of Oddi causes recurrent acute pancreatitis. It seems likely that the problem is one of intermittent pancreatic duct obstruction. Normal pancreatic duct caliber is attributed to the intermittent nature of the obstruction. Enlargement of the orifice of the duct of Wirsung and division of the sphincter of Oddi relieved attacks of recurrent pancreatitis.
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PMID:Misplaced pancreatic duct orifice as a cause of recurrent acute pancreatitis. 381 90

This case report describes a false-positive hepatobiliary scan in a young woman suspected to have acute cholecystitis who apparently had none of the reasons stated in the literature for a false-positive scan. The literature review shows that the negative predictive value of hepatobiliary scanning for acute cholecystitis is nearly 100 percent, while the positive predictive value is also quite good if conditions known to cause false-positive scans are ruled out. Common causes of positive hepatobiliary scanning, other than acalculus cholecystitis, include chronic cholecystitis, cholecystitis, hepatitis, alcoholism, total parenteral nutrition, pancreatitis, prolonged fasting, and ingestion of food less than one hour prior to scanning. Whether the postpartum state affects the accuracy of hepatobiliary scanning is speculative.
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PMID:A false-positive hepatobiliary scan: case report and literature review. 381 64

Between 1978 and 1985, we conducted a prospective study of 21 patients who survived several attacks of pancreatitis and were diagnosed as having primary hyperlipidemia. None of the patients suffered from chronic alcoholism, primary diabetes, or cholelithiasis or was receiving prolonged steroid therapy. Lowering of plasma lipid values toward normal was achieved in all patients following a program of combined dietary and drug (bezafibrate) therapy. Five patients had recurrent episodes of pancreatitis during the treatment program. These patients were diagnosed subsequently as suffering from bulimia and were all given cognitive behavioral therapy. One patient died following an attack of pancreatitis. An underlying eating disorder should be suspected in patients who relapse after treatment for pancreatitis and hyperlipidemia. Multidisciplinary treatment should be used in these patients to improve therapeutic efficacy and uncover behavioral patterns that have a direct impact on their life expectancy.
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PMID:Bulimia. An underlying behavioral disorder in hyperlipidemic pancreatitis: a prospective multidisciplinary approach. 382 58


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