Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The medical records of 101 dogs with acute pancreatitis, diagnosed on the basis of medical histories of acute vomiting, with serum lipase or amylase activity greater than the reference range, or with gross signs of pancreatitis at surgery or histopathologic evidence at necropsy, were evaluated to identify potential risk factors for the development of acute pancreatitis. Age, sex, and breed of dogs with acute pancreatitis were compared with those from a reference population of 100 dogs admitted for other medical emergencies during the same period. Analysis of multiple regression models indicated that dogs > 7 years old were at increased risk for acute pancreatitis. Spayed dogs and castrated male dogs had an increased risk, compared with that of sexually intact males. Similarly, terrier and nonsporting breeds appeared to be at higher risk of developing acute pancreatitis than were other breed types. Most dogs in this study (63/101) had intercurrent diseases, including diabetes mellitus (n = 14), hyperadrenocorticism (n = 12), chronic renal failure (n = 8), neoplasia (n = 17), congestive heart failure (n = 6), and autoimmune disorders (n = 5). Fourteen dogs had undergone anesthesia or surgery in the week before admission; only 3 had undergone abdominal procedures. Recent medication use was listed in 52 of 101 cases. Antibiotics (n = 18) and corticosteroids (n = 18) were most frequently described. Anticancer chemotherapeutic agents (n = 5) and organophosphate insecticides (n = 5) also were listed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Risk factors associated with acute pancreatitis in dogs: 101 cases (1985-1990). 840 36

A 15-year-old girl had severe Raynaud's phenomenon and arthralgias. A high ANA-IF titer was found and undifferentiated connective tissue disease was diagnosed. After 7 years of moderately flaring disease the patient deteriorated and presented with congestive heart failure, pleuropericardial effusion, hemolytic uremic syndrome, proteinuria and moderate hypertension. Autoantibodies against DNA, Sm-protein, and very high titers against U1RNP were detected. Therapy with high steroid doses, a cyclophosphamide pulse and 4 weeks of plasmaphresis with plasma exchange improved the heart, but not the renal condition. Symptomatic pancreatitis became the dominant problem of a progressively consuming process that resulted in the death of the patient. Post-mortem examination revealed widespread vasculopathy with intima proliferation and only minimal fibrosis involving the kidneys, heart and other main organs, including the pancreas. Taken together, the clinical picture was of an overlap between scleroderma and systemic lupus erythemathosus; the serologic and histopathologic findings suggest a diagnosis of a severe form of mixed connective tissue disease (MCTD).
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PMID:Widespread vasculopathy with hemolytic uremic syndrome, perimyocarditis and cystic pancreatitis in a young woman with mixed connective tissue disease. Case report and review of the literature. 851 21

We report the case of a 38-year-old man who developed fatal, systemic amyloidosis following ankylosing spondylitis. He was admitted for symptoms of congestive heart failure. Based on parotid gland biopsy and echocardiography, he was diagnosed as having systemic amyloidosis following active ankylosing spondylitis. However, the clinical course was rapidly progressive and eventually the patient died of acute necrotizing pancreatitis. The association has been reported thus far in a limited number of cases worldwide. The literature has featured localized lesions and a benign clinical course of the amyloidosis. This case, the first report from Japan, indicates that the amyloidosis associated with ankylosing spondylitis might exhibit a rapidly progressive clinical course, thereby suggesting that in such a case, meticulous treatment is required.
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PMID:Systemic amyloidosis following ankylosing spondylitis associated with congestive heart failure. A case report. 855 73

A 40-year-old man with diabetes mellitus, congestive heart failure, alcoholic cirrhosis, and chronic pancreatitis had an exacerbation of pancreatitis due to alcohol abuse. His condition deteriorated rapidly with development of apparent sepsis; cultures were negative. He slowly improved with multiple antibiotic therapy and total parenteral nutrition. Serial imaging of the pancreas revealed edematous pancreatitis that evolved initially into a phlegmon and later into multiple pseudocysts. Intermittent fever prompted computed-tomography-directed percutaneous aspiration of the largest pancreatic fluid collection, yielding purulent material that grew only Candida albicans. Subsequently, disseminated candidiasis developed. Despite therapy with amphotericin B and aggressive supportive care, the patient died from multiple organ system failure.
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PMID:Infection of a pancreatic pseudocyst due to Candida albicans. 890 99

Carbohydrate-deficient transferrin (CDT) is reported to have a higher specificity in alcoholism than conventional markers. As the morbidity and mortality rates amongst chronic alcoholics are raised following trauma, the objective was to investigate if CDT could be used to predict prolonged intensive care unit (ICU) stay and an increased morbidity in patients with multiple injuries admitted to the ICU. In this prospective double-blind study, 66 traumatized male patients were transferred to the ICU following admission via the emergency room and operative management. Blood samples for CDT determination were taken upon admission to the emergency room, the ICU and on days 2 and 4 following admission. The patients were allocated a priori to two groups: high CDT group (CDT >20 U/l on admission to the emergency room) and low CDT group (CDT < or = 20 U/l). CDT values were determined by microanion-exchange chromatography and radioimmunoassay. Thirty-six patients had an elevated CDT value on admission to the emergency room. The high CDT group had a significantly prolonged ICU stay (median high CDT group: 13 davs; median low CDT group: 5 days). Major intercurrent complications, such as alcohol-withdrawal syndrome, tracheobronchitis, pneumonia, pancreatitis, sepsis, and congestive heart failure, were significantly increased in the high CDT group. The increased risk of pneumonia in the high CDT group may be related to the significantly increased period of mechanical ventilation. As high CDT values were associated with an increased risk of intercurrent complications and a prolonged ICU stay, it seems reasonable to use CDT as a marker in intensifying research work into preventing alcoholism-associated complications.
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PMID:Elevated carbohydrate-deficient transferrin predicts prolonged intensive care unit stay in traumatized men. 987 57

End-stage renal disease remains the primary indication for the use of peritoneal dialysis. The therapy, however, has been used for the treatment of various other clinical conditions. Evidence has accumulated to support the use of peritoneal dialysis to maintain euvolemia, to improve functional status, and to reduce hospitalizations in patients with intractable chronic congestive heart failure. The use of peritoneal dialysis as a modality for core rewarming in patients with severe hypothermia has been established; in selected circumstances, it is probably the therapy of choice. The field of oncology has borrowed heavily from the technique of peritoneal dialysis for administering intraperitoneal chemotherapy; even though the therapy remains largely experimental today, it has great future potential. While efficacious in the treatment of acute, diuretic-resistant volume overload in patients with congestive heart failure and in patients with severe, disabling psoriasis, the introduction of alternative methods of management have rendered the use of peritoneal dialysis obsolete. Finally, the role of peritoneal lavage in the management of patients with pancreatitis remains controversial and is no longer routinely used.
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PMID:Peritoneal dialysis in adult patients without end-stage renal disease. 1104 64

Cytokine PharmaSciences is developing semapimod (CNI-1493), a cytokine inhibitor and synthetic guanylhydrazone mitogen-activated protein kinase blocker, as a potential treatment for Crohn's disease and other inflammatory conditions. As of December 2001, a phase I study demonstrating the safety of the compound had been completed and phase II trials for psoriasis and Crohn's disease were ongoing. In April 2003, preclinical and early clinical studies were underway for a variety of indications, including congestive heart failure and pancreatitis.
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PMID:Semapimod. Cytokine. 1475 76

The peroxisome proliferator-activated receptor (PPAR) family of genes plays a major role in metabolic regulation. Unfortunately, the results of two recent, large event trials of PPAR agonists have been mixed. High rates of crossover to statin use confound the interpretation of the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial, which found a less than expected reduction in coronary and stroke events with fenofibrate. Of concern, nonsignificant increases in coronary and sudden deaths, thrombotic events, and pancreatitis occurred in the fenofibrate group. The PROspective pioglitAzone Clinical Trial In macroVascular Events (PROACTIVE) also found a reduction in coronary and stroke events with pioglitazone compared with placebo in a population with diabetes and cardiovascular disease, but this benefit was counterbalanced by an increase in congestive heart failure as well as symptomatic edema. Further research is needed to determine the role of PPAR agonists in the prevention of cardiovascular disease.
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PMID:Update on PPAR agonists: the clinical significance of FIELD and PROACTIVE. 1716 49

The hyperosmolar hyperglycemic nonketotic state (HHNS) is an acute metabolic complication occurring characteristically in elderly type-2 diabetic patients. It may account for 10 up to 47% of cases of severe hyperglycemia with or without ketoacidosis. Many factors associated with advanced age may explain the predilection of both elderly subjects in general and older diabetics in particular to develop hyperosmolar coma, including reduced glomerular filtration rate and elevated renal threshold for glucose (which fail to correct hyperglycemia by osmotic diuresis), lack of thirst appropriate to the state of hydratation and some iatrogenic factors. In HHNS the age of the patients is the best known prognostic indicator. The increased mortality rate in the elderly diabetics depends on the severity of precipitating acute diseases (gastrointestinal hemorrhage, cardiovascular accident, pneumonia, pancreatitis, etc.), but the frequent compromises of the hemodynamic state and renal function of aged subjects substantially contributes. However, the role of erroneous management is not negligible and difficulties may be encountered in conciliating correction of metabolic disorder with treatment of precipitating illness. Insulin, water and electrolytes are the most important therapeutical tools for the treatment of hyperglycemic emergencies. In HHNS, the aggressive fluid replacement with isotonic or hypotonic NaCl solutions have first priority. Such a type of strategy is difficult to perform in patients suffering from cerebral stroke (which needs of anti-edema therapy) or congestive heart failure (necessitating to avoid fluid excess). According to the literary data, in our experience these two precipitating factors are frequent causes of death. We outline the validity of prefixed protocols of management; on the other hand, we think that the pathophysiological understanding of HHNS in the single patient is essential to decide the proper corrections and to permit a successful outcome. The primary way aiming at diminishing mortality by HHNS is its prevention; it is fundamental to warrant an appropriate fluid intake and to utilize with caution some drugs (thiazides, steroids, phenytoin, etc.) in aged diabetics, especially when nephropathic or unable, or living in nursing homes.
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PMID:Diabetic non ketotic hyperosmolar state: a special care in aged patients. 1865 40

The management of a handful of non renal clinical conditions includes peritoneal dialysis (PD) as a therapeutic tool. Peritoneal lavage after abdominal surgery is still performed in infectious peritonitis and cases of necrotizing hemorrhagic pancreatitis. Use of PD in active psoriasis resulted in approximately 40 papers reporting mostly isolated cases and showing both therapeutic success and failure. That ambiguous picture persisted during controlled studies, and interest in treating psoriasis with PD faded over the last 20 years. As an emergency tool, PD has been also used in the treatment of metabolic crisis resulting from inborn errors of metabolism such as deficiency of any of the five enzymes of the urea cycle and other inherited disorders of organic and aminoacid metabolism such as maple syrup urine disease, citrullinemia, and propionic acidemia. Recent studies have shown that continuous hemofiltration therapies have more effective clearances than PD does. Similar observations were reported for the use of PD in drug poisoning. Peritoneal dialysis is still a valuable tool as a complementary measure in the treatment of hypothermia. Recently, prospective work in patients affected by end-stage congestive heart failure has shown that maintenance PD significantly lowers morbidity and mortality and substantially improves functional capabilities and quality of life in these otherwise terminally ill patients.
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PMID:Use of peritoneal dialysis and mesothelium in non primary renal conditions. 1988 8


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