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Query: UMLS:C0030305 (
pancreatitis
)
16,014
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The systemic inflammatory response syndrome (SIRS) is the body's response to a multitude of chemical mediators. Conditions inciting the release of these mediators include bacterial sepsis, viremia,
pancreatitis
, trauma, neoplasia, heat
stroke
, and many others. The key to the successful management of SIRS lies in anticipation and not reaction. Resuscitation of the patient to supranormal levels, coupled with aggressive monitoring and support of target organs are essential.
...
PMID:Systemic inflammatory response syndrome: septic shock. 787 61
We conducted a retrospective analysis of 37 children with Escherichia coli O157:H7-associated hemolytic-uremic syndrome. The infection was traced to contaminated hamburgers at a fast-food restaurant chain. Within 5 days of the first confirmed case, the Washington State Department of Health identified the source and interrupted transmission of infection. Ninety-five percent of the children initially had severe hemorrhagic colitis. Nineteen patients (51%) had significant extrarenal abnormalities, including
pancreatitis
, colonic necrosis, glucose intolerance, coma,
stroke
, seizures, myocardial dysfunction, pericardial effusions, adult respiratory disease syndrome, and pleural effusions. Three deaths occurred, each in children with severe multisystem disease. At follow-up two children have significant impairment of renal function (glomerular filtration rate < 80 ml/min/per 1.73 Hm2); both of these children have a normal serum creatinine concentration. Hemolytic-uremic syndrome is the most common cause of acute renal failure in children, and this experience emphasizes the systemic nature of this disease. Clinicians should anticipate that multisystem involvement may occur in these patients, necessitating acute intervention or chronic follow-up. This outbreak of Hemolytic-uremic syndrome also highlights the microbiologic hazards of inadequately prepared food and emphasizes the importance of public health intervention in controlling Hemolytic-uremic syndrome.
...
PMID:Escherichia coli O 157:H7-associated hemolytic-uremic syndrome after ingestion of contaminated hamburgers. 793 69
Anatomical variations in aortic root pathology, including combinations of dissection, aneurysmal dilatation, annuloaortic ectasia, and valve disease, defy standardized repair and mandate application of various surgical reconstructions. To examine these techniques, and their influence on morbidity and mortality, we reviewed 53 consecutive patients undergoing aortic root procedures. Thirty-two patients underwent total root reconstruction. Of these, 21 underwent Bentall procedures, 9 had a modification thereof, and 2 underwent a Cabrol reconstruction. Less extensive pathology was corrected in 21 patients with a partial root reconstruction. These included aortic valve replacement (AVR) and a separate tube graft in 14 patients, AVR and primary aortic repair +/- wrapping in 4 individuals, and AVR and patch aortic root enlargement in 3 patients. Mean age was 53.2 years (range 20 to 79). Nearly 20% had undergone previous cardiac surgery and 7.5% were emergencies. Early mortality was 4%. Complications included dysrhythmias (48%), myocardial infarction (4%),
stroke
(4%), pneumonia (14%), and
pancreatitis
(2%). There were no reoperations for bleeding. Three late complications, one pseudoaneurysm and two perivalvular leaks, were successfully repaired. Late deaths (13.7%) were caused by congestive heart failure (3), myocardial infarction (MI) (1), cancer (1),
stroke
(1), and accidental fall (1). Kaplan-Meier analysis reveals 1-, 5-, and 10-year survivals of 98%, 81%, and 66%. Survival and mortality data did not differ between groups, and except for the incidence of atrial dysrhythmias, complication rates also were not significantly different. This series illustrates the need for and the successful application of a selective approach to aortic root reconstruction.
...
PMID:Selectivity in aortic root reconstruction. 799 93
The pancreatic lesions in 6- to 36-week-old spontaneously hypertensive rats (SHR),
stroke
prone SHR (SHRSP) and Wistar-Kyoto rats (WKY) were examined histopathologically. Inflammatory cell infiltration with hemorrhage and stromal fibrosis became evident in 12-week-old SHR and SHRSP together with acinar atrophy and/or degeneration and ductular proliferation. These changes in SHR and SHRSP were even more prominent at the age of 24 weeks and extremely severe at 36 weeks. In addition, in SHR and SHRSP over 12 weeks of age, small necrosis of acinar cells was found occasionally together with fibrosis and arteriosclerosis. Pancreatic arteriosclerosis was marked in SHR and SHRSP over 24 weeks of age at the level of arterioles < 200 microns in diameter. Adrenergic nerve fibers stained by fluorescence histochemistry were present around the pancreatic arteries and ducts and within the parenchyma, and they were denser in SHR and SHRSP than in WKY, indicating hyperinnervation of the sympathetic nervous system in SHR and SHRSP. It is suggested that the pancreatic ischemia caused by arteriosclerosis due to facilitation of the sympathetic nervous system is an important factor in the pathogenesis of the spontaneous
pancreatitis
of SHR and SHRSP.
...
PMID:Spontaneous pancreatitis in spontaneously hypertensive rats. 810 72
Hemodynamics studies were carried out from days 1-5 following the onset of illness in 7 patients with severe
pancreatitis
(group A) and in 7 patients with moderate
pancreatitis
(group B). Patients in both groups had a higher cardiac index (CI) and a lower systemic vascular resistance (SVR) than normal patients during 5 days of illness, and patients in group A had a higher CI of 5.38 +/- 0.841 x min/m2 and lower SVR of 889 +/- 234dyn.sec/cm5 than those in group B on day 4. Patients in group A had a lower pulmonary vascular resistance than normal patients on days 1, 3, and 4, but those in group B did not show this hemodynamic change. Group A patients had a higher pulmonary wedge pressure of 11.9 +/- 8.4mmHg and depressed left ventricular
stroke
work index of 59.8 +/- 17.8g.m/m2 as compared with group B (5.6 +/- 3.4mmHg, 77.7 +/- 23.6g./m2, respectively). These findings indicate that a hyperdynamic hemodynamic state may exist in the early stages of moderate and severe
pancreatitis
and myocardial depression may be evident in severe
pancreatitis
.
...
PMID:[Hemodynamic changes in acute pancreatitis]. 837 58
The integrity of the main pancreatic duct (MPD) was evaluated by endoscopic retrograde pancreatography (ERP) in a retrospective study of 105 patients with acute pancreatitis presenting over an 11-year period (1980-1991). The findings were compared with clinical outcome and the need to operate for local pancreatic complications. Patients were divided into two groups. Group 1 (n = 89) had either clinically mild
pancreatitis
or severe disease but no surgery for local complications, and < 25 per cent necrosis on contrast-enhanced computed tomography (CT) (n = 48). Group 2 patients (n = 16) had clinically severe
pancreatitis
and underwent surgery for local complications and/or had > or = 25 per cent necrosis on CT (n = 12), at surgery or post mortem. All 89 patients in group 1 had an intact MPD at ERP, which was performed a median of 6 (range 0-30) days after onset of
pancreatitis
; the median age was 63 (range 20-88) years and there were no deaths. The median age of patients in group 2 was 59 (range 26-85) years. ERP in this group was performed in four patients < 5 days after onset and all had an intact MPD; one died with necrosis and another from a
cerebrovascular accident
. ERP was performed > or = 5 days after onset in the other 12 patients; five had an intact MPD and two required surgery for pseudocyst drainage only; seven had a disrupted MPD and all required surgery for pancreatic necrosis (one death). It is concluded that an intact MPD was a feature of mild
pancreatitis
, whereas disruption occurred > 4 days after onset in patients with necrosis necessitating surgery.
...
PMID:Assessment of main pancreatic duct integrity by endoscopic retrograde pancreatography in patients with acute pancreatitis. 842 6
Alpers' syndrome is a progressive neurodegenerative disorder with liver disease that usually presents in the first few years of life. Only rarely have patients presented later in life with delayed onset of Alpers' syndrome. Herein we present a case of a 17-year-old male with a progressive 8-month course of severe headaches, multiple
stroke
-like episodes with visual deficits, and seizures that concluded with acute hemorrhagic
pancreatitis
. Neuropathological findings were characteristic for Alpers' syndrome: neurodegeneration and astrogliosis of the occipital cortices including the striate cortices, similar but less advanced changes in the parietal cortices, right Ammons horn sclerosis, degeneration of the posterior columns, and mild cerebellar Purkinje cell loss. Examination of the liver revealed extensive centrilobular hepatocyte necrosis. Skeletal muscle did not contain ragged red fibers, nor were there mitochondrial DNA point mutations characteristic for mitochondrial encephalomyopathy, lactic acidosis, and
stroke
-like episodes (MELAS).
...
PMID:Alpers' syndrome presenting with seizures and multiple stroke-like episodes in a 17-year-old male. 860 37
The purpose was 1) to prospectively determine the prevalence of adverse events necessitating intensive care unit (ICU) monitoring in gallstone
pancreatitis
(GP) and 2) To identify admission prognostic indicators that predict the need for ICU unit monitoring. Prospective laboratory data, physiologic parameters, and APACHE II scores were gathered on 102 patients with GP over 14 months. Adverse events were defined as cardiac, respiratory, or renal failure, gastrointestinal bleeding,
stroke
, sepsis, and necrotizing
pancreatitis
. Patients were divided into Group 1 (no adverse events, n=95) and Group 2 (adverse events, n=7). There were no deaths and 7 (7%) adverse events, including necrotizing
pancreatitis
(3), cholangitis (2), and cardiac (2). APACHE 11 > or = 5 (P < 0.005), blood urea nitrogen (BUN) > or = 12 mmol/L (P < 0.005), white blood cell count (WBC) > or = 14.5 x 10(9)/L, (P < 0.001), heart rate > or = 100 bpm (P < 0.001), and glucose > or = 150 mg/dL (P < 0.005) were each independent predictors of adverse events. The sensitivity and specificity of these criteria for predicting severe complications requiring ICU care varied from 71 to 86 per cent and 78 to 87 per cent, respectively. The prevalence of adverse events necessitating ICU care in GP patients is low. Glucose, BUN, WBC, heart rate, and APACHE II scores are independent predictors of adverse events necessitating ICU care. Single criteria predicting the need for ICU care on admission are readily available on admission.
...
PMID:Admission factors can predict the need for ICU monitoring in gallstone pancreatitis. 881 62
An A3243G point mutation of the mitochondrial tRNA(Leu(UUR)) gene was detected in a Caucasian family with maternal diabetes mellitus and signs of mitochondrial dysfunction such as muscular hypotonia, encephalopathy, lactic acidosis,
stroke
-like episodes (MELAS), neurosensory hearing loss, cardial pre-excitation, and short stature. Low levels (10 JDF) of islet cell antibodies (ICA) in insulin-treated diabetes of the mother and impaired glucose tolerance with high levels of ICA (80 JDF) in her older son indicated that mitochondrial diabetes mellitus may involve beta cell damage. Furthermore, exocrine pancreas cell damage may also occur since the
stroke
-like episodes of this son were combined with
pancreatitis
. In all family members HLA types and plasma antioxidants were determined. Normal concentrations of hydro- and lipophilic antioxidants (including ubiquinol-10) were found.
...
PMID:Islet cell antibodies in diabetes mellitus associated with a mitochondrial tRNA(Leu(UUR)) gene mutation. 881 38
Hemodynamic parameters of experimental acute necrotizing
pancreatitis
(AP) were monitored by means of echocardiography in rabbits. Left ventricular (LV) systolic and diastolic parameters were determined before and 1, 3, 6, 12, 18, and 24 hr after injection of taurocholic acid in the pancreatic duct in AP animals. Temporary LV dilatation was observed 6 hr after the AP induction [LV end-diastolic (ED) diameter from 1.16 +/- 0.04 to 1.22 +/- 0.04 cm, P < 0.05, ED volume from 2.98 +/- 0.34 to 3.57 +/- 0.75 ml, P < 0.05] without decrease in systolic function. Cardiac output (CO) and
stroke
volume (StV) was increased in both groups 3 hr after the operation (from 0.53 +/- 0.15 to 0.71 +/- 0.06 L/min, P < 0.05 in AP), but in the AP animals it remained high. However, 24 hr after AP induction, both the CO and the StV were decreased significantly. The LV diastolic function was impaired 1 hr after AP induction, but had recovered after 12 hr. In conclusion, an early diastolic impairment followed by LV enlargement could be noninvasively observed in experimental AP in rabbits.
...
PMID:Noninvasive monitoring of hemodynamic changes in acute pancreatitis in rabbits. 914 48
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