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

Neuropsychiatric and psychosomatic disorders occurring the exocrine pancreatic diseases are not rare, nevertheless didn't it seem to be very interesting in research and there exists no summarizing work of this disorders. Therefore we tried to give a comprehensive representation of those neuropsychiatric problems which are connected with the function of this organ. At first we give a description of psychopathology and pathogenesis of the functional pancreatic psychosis. The problematic of the reciprocal relationship of nervous system and pancreatitis, alcoholism and pancreatitis are demonstrated as well as the psychic disorders occurring the pancreas insufficiency, cystes of pancreas and congenital pancreatic diseases. Psychosomatic and mental disorders of pancreas carcinoma and mucoviscidosis are shown in detail. The question of the interrelation between pancreatic function and amyotrophic lateral sclerosis or parathyreotic diseases are discussed just as themes of neuropsychiatric pharmacotherapie and pancreatic function and mental disorders in pancreatic treatment.
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PMID:[Neuropsychiatric disorders of the diseases of exocrine pancreas (author's transl)]. 105 12

Gastrointestinal diseases are notoriously protean in their modes of expression. The patient's description of symptoms is particularly important, but psychologic, physiologic, and social factors can cause data-base unreliability. Many of the patients termed crocks have symptoms referable to the gastrointestinal system, and they are at considerable health risk, since they usually alienate health care personnel. Patients with pancreatitis usually have a history of heavy alcohol intake which also needs treatment. Behavioral disturbances are related to toxic psychosis. Pancreatic carcinoma has a higher incidence of associated psychiatric symptoms than other types of cancer. Biologic, psychologic, and environmental factors all interact dynamically to cause peptic ulcer disease. There is a high correlation between the severity of inflammatory bowel disease and degree of emotional disturbances.
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PMID:Psychosomatic aspects of gastrointestinal disease. 110 97

Alcohol sales in Stockholm County decreased by 18 per cent from 1976 to 1981. The socioeconomic status of inpatients treated for alcohol psychosis, alcoholism, alcohol intoxication, liver cirrhosis, and pancreatitis was studied by linking data from the National Housing and Population Censuses in 1975 and 1980 with the inpatient care registers for 1976 and 1981. In both years, all rates were highest for people outside the labor market and lowest among white collar employees. The employment rate for those aged 25-44 years and treated in 1981 for alcohol psychosis, alcoholism, and alcohol intoxication--already low in 1975--had drifted further downward by 1980. Total rates of inpatient treatment for alcohol-related diagnoses generally declined but the gap between blue collar workers and white collar workers widened. We conclude that the goal for national alcohol policy, suggested by the WHO--a reduction of per capita consumption--should be combined with additional measures that will reach all social groups.
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PMID:Changes in alcohol-related inpatient care in Stockholm County in relation to socioeconomic status during a period of decline in alcohol consumption. 276 19

Eighty-five corticosteroid dependent patients with respiratory diseases requiring alternate day prednisone were studied for certain adverse effects that have been reported to be associated with corticosteroid therapy. The mean age of the patients was 52 years, the average years of prednisone therapy was 5.3, and the mean dose of alternate day prednisone was 26.2 mg. In this group of 85 patients the prevalence of hypertension, peptic ulcer disease, pathologic fractures and psychosis was not statistically increased over that of the general population. None of the patients was diagnosed as having steroid-induced psychosis, pancreatitis or tuberculosis. One patient developed aseptic necrosis of the hip; however, she received daily prednisone for approximately 3.2 years before being converted to an alternate day schedule. Our results demonstrate that alternate day corticosteroid therapy can be used without significant risk of adverse effects in patients in whom it is essential for control of respiratory disease.
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PMID:Prevalence of adverse effects in corticosteroid dependent asthmatics. 339 24

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

The dibenzoepine derivative clozapine is seen as a prototype of an atypical neuroleptic, because clozapine has good antipsychotic efficacy but only minimal dopamine antagonistic properties in common animal paradigms. The latter is reflected by the observation that extrapyramidal symptoms during clozapine are a rare phenomenon. Furthermore, recent studies in the USA demonstrated a superior efficacy of clozapine in schizophrenic patients who are nonresponsive to classic neuroleptics. Therefore, the introduction of clozapine in the USA was performed in 1990 despite the well-known risk of agranulocytosis (1-2% during the first year of treatment); however, under restricted conditions regarding the mandatory weekly control of the white blood cell count. For the use of clozapine in Europe, it should be underlined that in 1992 the indication was restricted to "acute and chronic forms of schizophrenia" whereas formerly it was permitted to treat several other neuroleptic resistant syndromes with clozapine, e.g. severe psychotic excitement, aggressive behavior or manic or atypical psychosis. The usage of clozapine in these indications is now only permitted under the restricted legal conditions of a "therapeutic trial" in selected patients. However, several indications for which clozapine has been used successfully in Europe are currently re-investigated in the USA, hopefully leading to a redefinition and extension of the indication spectrum. On the other hand, the American multicenter trials lead to the conclusion that the treatment with clozapine is not furthermore the treatment of last choice but a serious therapeutic alternative which should be available for all schizophrenic patient in case of neuroleptic resistance or of severe side effects of standard neuroleptics. Clozapine treatment leads to an improvement of the quality of life in one third of these schizophrenics and, moreover, results in a marked reduction of costs mainly by reducing the rehospitalisation rates. On the other hand, the list of well-known side effects of clozapine (e.g. agranulocytosis, increased risk of seizures, initial sedation) has to be extended (e.g. transient leucocytosis or eosinophilia, rare but severe complications like cardiorespiratory arrest and "sudden death" during combination with benzodiazepines, case reports of pericarditis, pancreatitis or polyserositis). On the background of possible cardiorespiratory complications we recommend to start the first treatment with clozapine in high risk patients (e.g. those in older age or in case of organic brain impairment) only in restricted indications and only in centers with sufficient clozapine experience.
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PMID:[The atypical neuroleptic clozapine (Leponex)--current knowledge and recent clinical aspects]. 778 19

Traditional centrally acting antihypertensives have been associated with a high incidence of adverse effects and are no longer recommended as first-line therapy. The newer imidazoline receptor agonists must overcome this reputation if they are to gain recognition as potential first-line agents for hypertension. Methyldopa, a centrally acting alpha(2)-agonist, is characterized by a number of serious adverse reactions that limit its use. Although unpredictable idiosyncratic or hypersensitivity reactions are uncommon, these include hepatitis, myocarditis, and hemolytic anaemia. Less serious problems such as abnormal liver function tests, positive Coombs test, drug-induced fever, and pancreatitis also occur. Central side effects include drowsiness, fatigue, lethargy, sedation, depression, psychotic reactions, nasal stuffiness, impotence, and exacerbation of Parkinsonism. In hypertensive men, methyldopa is less well tolerated than either captopril or propranolol, and up to 20% of patients discontinue therapy because of adverse effects. Clonidine acts primarily as an alpha(2)-agonist but also acts as an agonist at imidazoline receptors in the rostroventrolateral medulla. It is equipotent to most other antihypertensives but is considerably less well-tolerated in comparative trials. The principal adverse effects of clonidine are drowsiness, sedation, lethargy and dry mouth. Reserpine acts primarily by depleting central catecholamine neurotransmitter stores. It was very extensively used in early hypertension trials, but its central side effects of sedation, nasal stuffiness, and severe depression are now considered so undesirable that the drug is seldom prescribed. The imidazoline (I1) agonists moxonidine and rilmenidine act selectively and have very little central alpha(2)-agonist activity. In comparative studies against placebo and other reference antihypertensives, the only adverse effect consistently associated with these drugs was dry mouth (approximate placebo-corrected incidence 10%). Sedation was not pronounced. Withdrawal syndromes are complex pathophysiologic processes and occur with a variety of antihypertensive drugs. Cessation of therapy with clonidine and, to a lesser extent, methyldopa may result in a severe withdrawal syndrome characterized by restlessness, sweating, anxiety, tremor, palpitations, and headache. There may be a rapid rise in blood pressure, often with a true "rebound" to higher than pretreatment levels. Plasma and urinary catecholamine levels are increased, and fatalities have been reported. It is important to stress that such a syndrome has not been recorded, in animal or human studies, with either moxonidine or rilmenidine.
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PMID:Aspects of tolerability of centrally acting antihypertensive drugs. 887 99

Besides the well-known adverse effects of clozapine, such as granulocytopenia, tiredness and hypersalivation, acute pancreatitis is known to be a very rare complication of the drug. In the literature a total of five case reports have been published so far. We report a case of asymptomatic pancreatitis subsequent to clozapine treatment at therapeutic doses in a 38-year-old male patient with chronic paranoid-hallucinatory schizophrenia. The patient was rehospitalized after an acute exacerbation of the psychosis subsequent to an attempt to change medication on an outpatient basis. Treatment with clozapine was initiated again. During phases of progressively increasing the clozapine dose, serum levels of amylase and lipase were increased; after maintaining daily doses of clozapine of 300 mg and/or 600 mg the pancreatic enzymes normalized quickly within a few days. The patient did not report any pancreas-related complaints, nor did specific diagnostic studies produce any indicative result, only a minor thickening of the head and body of the pancreas in the ultrasound. It is assumed that the phenomenon of subclinical, asymptomatic pancreatitis during increasing dosage of clozapine occurs more often than previously supposed. The monitoring of serum amylase levels during slow increase in clozapine is recommended; if leukocytosis or eosinophilia is present, the possibility of even a subclinical and asymptomatic pancreatitis should be considered.
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PMID:Asymptomatic pancreatitis associated with clozapine. 1033 68

(1) The reference treatment for mania is lithium. Lithium can be combined with a neuroleptic in patients who also have psychotic disorders (especially with aggressiveness). Carbamazepine is a second-line alternative. (2) Marketing authorisation has now been granted in France for disodium valproate (divalproate). (3) Disodium valproate is a complex composed of one molecule of sodium valproate and one molecule of valproic acid. Its effects are identical to those of valproate sodium. (4) The clinical file on disodium valproate mainly comprises two double-blind trials. In one trial involving 43 patients in whom lithium was ineffective or poorly tolerated, the efficacy of divalproate, measured using a validated scale, was significantly superior to that of the placebo. (5) The other trial, involving 179 patients, confirmed the efficacy of divalproate versus a placebo, and showed that divalproate was roughly as effective as lithium. (6) The efficacy of divalproate has not been compared with that of carbamazepine. It has not yet been demonstrated that carbamazepine remains effective when lithium is inadequate. (7) The adverse effect profile of divalproate mainly comprises gastrointestinal and neuropsychological disorders. A few cases of severe hepatitis and pancreatitis have also been reported. (8) In practice, in cases of lithium intolerance or inefficacy, divalproate is worth trying for patients with acute mania, before trying carbamazepine.
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PMID:Disodium valproate: new preparation. An alternative for acute mania after lithium failure or intolerance. 1171 80

This report concerns the case of a 29-year-old male patient suffering from severe psychotic illness who had been satisfactorily treated with clozapine for 4 months. Clozapine had also been successfully administered during a psychotic episode 5 years previously. Though symptoms of psychosis were successfully controlled following the most recent psychotic episode, a medical consultation assessed that exacerbation of pancreatitis warranted discontinuation of the current antipsychotic treatment regime. Following a series of unsuccessful courses of neuroleptic medication, a magnetic resonance cholangiopancreaticography (MRCP) revealed marked cholecystolithiasis suggesting a biliary pancreatitis. Clozapine treatment was readministered following cholecystectomy. After 4 weeks of antipsychotic treatment the patient was discharged from hospital on clozapine monotherapy.
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PMID:Clozapine: acquittal of the usual suspect. 1971 Dec 27


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