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

Severe hemorrhagic pancreatitis developed in a patient with the acquired immunodeficiency syndrome (AIDS) during pentamidine isethionate treatment for Pneumocystis carinii pneumonia. Despite prompt withdrawal of administration of the drug, the patient died of complications of pancreatitis. Pentamidine is known to be toxic to pancreatic islet cells, causing both hypoglycemia and hyperglycemia in clinical use. However, it rarely causes symptomatic pancreatitis. A review of the literature indicates that this is the second report of fatal pancreatitis associated with pentamidine therapy.
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PMID:Pentamidine-associated fatal acute pancreatitis. 349 May 88

Twenty-one routine clinical and laboratory data in 161 patients with necrotizing pancreatitis (NP) undergoing surgical treatment were analyzed. The necrotic tissue at operation was bacterially infected in 41% of the patients. The goal of the study was to evaluate whether there was any special clinical feature in cases of an infection. The parameters were recorded during 48 h after admission as well as during 48 h before operation, and the frequencies submitted to both a univariate and a multivariate analysis (logistic regression model). In the period after admission, patients with infected necrosis significantly more often had a rectal temperature greater than 38.5 degrees C (p = 0.001). Before operation (i.e., after maximum conservative treatment), four findings were significantly related to an infection: rectal temperature greater than 38.5 degrees C, base excess greater than -4 mmol/L, hematocrit less than 35% (all p = 0.0001), and paO2 less than 60 mm Hg (p = 0.001). The multivariate analysis, which calculates and quantifies the mutual influence of factors, showed a combination of three findings (rectal temperature greater than 38.5 degrees C, base excess greater than -4 mmol/L, and hematocrit less than 35%) to be related to necrosis infection before operation. All three criteria in a patient imply a probability of infection of 83%. It is noteworthy that the sepsis indicators were equally distributed in patients with focal, extended, or subtotal/total infected necrosis, but correlated with the necrosis extent in sterile necrotizing pancreatitis. Moreover, all parameters not related to the pancreatic infection [e.g., hyperglycemia, hypocalcemia, rise of lactic dehydrogenase (LDH), and the white blood cell count] correlated with the three necrosis categories.
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PMID:Sepsis indicators in acute pancreatitis. 367 46

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 significance of megamitochondria in the alcoholic liver injury of humans was investigated as part of a large Veterans Administration cooperative study of the natural history of alcoholic hepatitis. Two hundred twenty patients were clinically stratified into the following three groups according to disease severity using serum bilirubin and prothrombin time as indicators: Group 1 (mild disease), serum bilirubin levels less than 5 mg/dl and prothrombin time prolonged for less than 4 s; group 2 (moderate disease), serum bilirubin levels greater than 5 mg/dl but prothrombin time prolonged for less than 4 s; and group 3 (severe disease), serum bilirubin levels greater than 5 mg/dl and prothrombin time prolonged for greater than 4 s. Megamitochondria were observed in 20% of the patients (45 of 220). Of these, 43 patients were in groups 1 and 2 of severity and only 1 patient belonged in group 3. The association of megamitochondria with cirrhosis was infrequent (33%, 15 of 45 patients). The differences in severity correlated with the differences in mortality: in patients with megamitochondria, only 1 had died at 6 mo compared with 40 deaths in patients without megamitochondria. By 12 mo, there were two deaths in patients with megamitochondria versus 51 deaths in those patients without. No complications were present in 72% of patients with megamitochondria versus 39% for those without. Infection, gastrointestinal bleeding, pancreatitis, hyperglycemia, azotemia, delirium tremens, seizures, and hepatic encephalopathy were all more common in patients without megamitochondria. The patients with megamitochondria appear to represent a subcategory of alcoholic hepatitis with a milder degree of clinical severity, lower incidence of cirrhosis, fewer complications, and good long-term survival.
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PMID:Significance of megamitochondria in alcoholic liver disease. 369 4

The authors make a retrospective analysis of 95 cases of acute pancreatitis hospitalized between 1975 and 1979. In 3,8% of all the cases the acute pancreatitis was associated with hyperlipoproteinemia. The study of the 4 patients involved revealed the primary origin of hyperlipoproteinemia as a result of alimentary abuse in 3 of the cases. In a fourth case the increased serum lipoproteins were due to prolonged use of contraceptives. From the clinical viewpoint, pancreatitis associated with hyperlipoproteinemia was more severe, with signs of shock and collapse, respiratory failure, high serum nitrogen an hyperglycemia. The blood and the serum had a lactescent aspect, with a thick layer of chylomicrons. The serum and blood values for lipids were higher than 4000 mg%. The increase in the amount of lipids was especially due to high triglycerides values. From the anatomopathologic viewpoint the 4 patients presented as acute cases of cholecysto-pancreatitis with major and extensive haemorrhagic necrosis which involved almost the entire pancreas. The evolution of the four patients was difficult. Two of the patients recovered after a long hospitalization, and had definitive sequels - insulin-dependent diabetes. The other two patients died following septic complications (bronchopneumonia and visceral gangrene), and hypovolemia due to upper digestive haemorrhage.
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PMID:[Hyperlipoproteinemia, a factor of severity in acute pancreatitis]. 646 Feb 73

Pancreatic transplantation is still partly experimental. Its role in halting the progression of secondary complications of insulin-dependent diabetics has not been completely defined. Although pancreaticoduodenal transplantation has been used since 1966, it was not until 1977 that modifications in the surgical technique allowed for encouraging results when segmental pancreatic transplantation was utilized. During the last year, we have performed five segmental pancreatic transplants in insulin-dependent, preuremic juvenile diabetics. Postoperatively these patients received immunosuppression consisting of azathioprine, prednisolone and antilymphoblast globulin (ALG). These patients were followed-up by serial pancreatic echograms and pancreatic scans. All patients except the first one became normoglycemic following transplantation. Serum insulin reached normal levels within a few days post-transplantation. Pancreatitis was evident in the immediate postoperative period. The last four patients showed evidence of rejection in the form of increasing blood sugar levels and need of insulin for control of hyperglycemia. Two of these patients were treated with ALG (10 doses) and local radiation to the graft (150 r x 3), and the other two patients were treated with high doses of oral and intravenous steroids. Postoperative pancreatitis and rejection are still the two main problems that are seen after pancreatic transplantation. Better immunosuppressive agents are needed to improve long-term results.
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PMID:Clinical segmental pancreatic transplantation. 675 36

The polyethylene glycol (PEG) adduct of Escherichia coli L-asparaginase was administered intravenously to 4 patients with chemotherapy refractory cancers. The PEG-enzyme in plasma exhibited a half-life of 16-25 days. Doses of 250IU/m2 or greater reduced plasma asparagine to undetectable levels for as long as enzyme was detectable in plasma. All doses of enzyme administered (250-1000 IU/m2) caused similar increases in plasma aspartate, i.e. no dose-response relationship. Pleural fluid and ascites contained detectable enzyme but at a value 10-15% of simultaneously drawn plasma levels. Toxicity in this small group of patients was minimal; nausea and transient fever predominated. There were no clinical signs of PEG-asparaginase-induced pancreatitis, renal dysfunction, hypocalcemia and hyperglycemia. No patient developed evidence of a PEG-asparaginase allergic reaction; no patient formed antibodies to asparaginase or PEG-asparaginase. Two patients with large cell lymphoma showed a partial response to treatment.
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PMID:Pharmacology of Escherichia coli-L-asparaginase polyethylene glycol adduct. 704 23

There are only 6 published reports of pancreatitis associated with oral contraception (OC). This article presents 1 additional case. A 28 year old white woman was hospitalized for severe abdominal pains; gastroenteritis was diagnosed and the patient treated with Compazine and Maalox. Because of the increasing severity of pains the patient was rehospitalized and pancreatitis secondary to hyperlipoproteinemia was diagnosed. OC treatment was suspended, and the patient was successfully treated with Cimetidine, antacids, and insulin for elevated glucose. Pancreatitis caused by OC is probably due to alterations in lipid metabolism, and related to the estrogen content of the preparation used. A major study done recently with 2 types of synthetic estrogens combined with 3 types of progestogens confirmed that hypertriglyceridemia induced by OC was estrogen dosage-related. It seems apparent that OC use in patients with intrinsic lipid abnormalities may be contraindicated; other risk patients are those who are obese, diabetic, or with family antecedents of diabetes or hyperlipidemia.
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PMID:Birth control pills and pancreatitis. 707 Jan 28

The authors report 9 cases of acute non traumatic pancreatitis in children. The most common symptom in their patients is atypical abdominal pain often associated with vomiting (5 cases) and shock (4 cases). Among laboratory investigations: --High serum amylase level (average: 1 045 UI/l) is constant, associated with hypocalcemia and hyperglycemia in 3 patients. --Radiographic findings on plain film of the abdomen are diagnostic in 4 cases. --Abdominal ultrasound is the most reliable test and positive in the only patient on which performed. Among etiologies, drug induced pancreatitis is the most common (5 cases) due to combined Prednisone-L-Asparaginase (4 patients): --A duodenal ulcer and a case of choletithiasis are reported. --In 2 patients no determinant factors are found. A good response to parenteral nutrition, gastric suction and antisecretory agents is observed in 7 cases. 2 leukemic patients died shortly after the acute episode.
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PMID:[Acute non-traumatic pancreatitis in childhood. Report of 9 cases (author's transl)]. 746 Jan 9

17 patients with acute necrotic pancreatitis were proved by CT or operation. These patients were randomly assigned to fat-glucose-based group (n = 9) and glucose-based group (n = 8). Their PN regimen consisted of nonprotein calories (NPC) 35-40KJ (146-167KJ)/kg/d and nitrogen 0.19-0.29g/kg/d. NPC was supplied by either dextrose or dextrose and intralipid. The PN duration was 2 weeks. The following measurements were performed: triglyceride, chorestrol, HDL, LDL, Apo-A, Apo-B and free fatty acids. The results showed that there was no hypertriglyceridemia developed after fat emulsion was administered for two weeks. It confirmed that fat emulsion could be rapidly oxidigzed. In our group, the patients with hyperglycemia were 64% at the admission time, and hyperglycemia was difficult to control in early period (10 days). But hyperglycemia was easly to control when patients received fat emulsion. There was no harmful effect on liver function during 2 weeks of intralipid administration. The data showed no difference between the two groups on conventional measurements, lysosomal enzymes and blood gas analysis. Intralipid infusion did not make ANP deterioration. These results indicated long-term intravenous intralipid in patients with ANP was safe and useful.
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PMID:[Effect of intralipid on patients with acute necrotic pancreatitis: a prospective clinical study]. 758 87


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