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

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

The composition of pancreatic calculi in patients with tropical pancreatitis is unknown. At present, except for malnutrition, there are no known etiologic factors for chronic calcific pancreatitis in the tropics. We report the results of an x-ray diffraction study of 41 stones from 26 patients obtained at autopsy in the Kerala state in India. Calcite was present in all stones, vaterite in 12%, and a central amorphous material in 30%. The latter may be analogous to the protein plugs as nuclei for stones described by Sarles et al in patients with alcoholic pancreatitis.
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PMID:X-ray diffraction studies of pancreatic calculi associated with nutritional pancreatitis. 369 63

Studies on diabetes mellitus in tropical zones indicate that its traditional link with overnutrition depends not only on the economic level, but also on some ethnic, social and cultural factors. At present, we insist on the unexpected relationship between diabetes mellitus and undernutrition either in some major infantile forms (described in India and Nigeria) with calcareous pancreatitis, or some less severe forms observed in Africa. This tropical diabetes mellitus occurs in some patients with normal weight or inferior to normal; it is not very ketogenic, responding to glucagon stimulation, and seems more frequent in the chronic malnutrition areas. So, it is tempting to utilize diabetes mellitus as an indicator of nutritional disorder or of dietary toxic factors. However, we ought to consider it within a multifactor surroundings associating genetic determinism and the other factors of tropical aggressiveness.
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PMID:[Tropical diabetes mellitus, a new nutritional indicator?]. 392 7

This study set out to investigate the alteration of amino acid (AA) and protein metabolism in patients with malnutrition, sepsis, acute pancreatitis and liver diseases. The results showed that in preoperative patients with malnutrition or protein catabolism (decreased levels of plasma proteins, increased urea production rate) the postoperative complications were significantly increased. An increased postoperative infusion of branched chain AA did not improve postoperative nitrogen retention nor plasma protein syntheses in patients with colon or rectum CA. Patients with sepsis or acute pancreatitis had drastically reduced levels of total muscular free AA, mainly due to a fall in muscle glutamine. In septic patients also the hepatic levels of free AA were decreased. These changes of AA metabolism found in clinical situation were not always reflected by results found in experimental rat models (sepsis, pancreatitis, burn injury). The parenteral administration of a synthetic dipeptide containing glutamine and alanine decreased the muscular decrease of glutamine and alanine and increased the hepatic uptake of these two AA in a catabolic dog model. In critically ill patients changes in amino acid and protein metabolism lead to a protein catabolic situation. Urea production rate and muscle glutamine levels seem to be closely related to the prognosis of catabolic patients.
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PMID:[Amino acid and protein metabolism in critically ill patients]. 393 9

The clinical features in a series of 24 patients with hypothermia treated at Mulago Hospital, Kampala, are described. Hypothermia developed in all when the environmental temperature did not fall below 16 degrees. There was a preponderance of males; 14 of the 24 cases were over 50 years old. The most common predisposing factors were severe undernutrition or malnutrition with wasting and almost complete absence of subcutaneous fat, and anaemia present in over two thirds of the patients. Hypoglycaemia appeared to be the immediate precipitating factor in at least five patients. Acute pancreatitis was found in three of the four patients who died unexpectedly 2-7 days after recovery from hypothermia; focal pancreatitis and fat necrosis was also present in six other cases. It is concluded that hypothermia is not uncommon, and is a dangerous complication amongst patients with severe under- or malnutrition, and can occur even under "tropical" conditions, when the environmental temperature does not fall below 16 degrees.
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PMID:Hypothermia in the tropics. A review of 24 cases. 443 62

Forty-five cases of pancreatic calcification are reported, and it is shown that in Western Nigeria this malady afflicts younger people than in Europe and the United States of America. Males and females seem about equally affected in Western Nigeria, whereas it predominantly affects males in France, Britain, and North America. Diabetes mellitus was the commonest complication in this series, and brought many patients to the doctor. In this series chronic relapsing pancreatitis was a rare cause; there was no history of alcoholism; and protein malnutrition was thought to be responsible for pancreatic calcification in over 90% of the patients.
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PMID:Pancreatic calcification: a report of 45 cases. 535 52

Seven of 10 patients with anorexia nervosa had ultrasonic and/or biochemical abnormalities of the pancreas. Seven patients had elevated amylase creatinine clearance ratios (greater than 4%), three patients had elevated serum amylase values (greater than 90 units/liter), and three patients had reduced echogenicity of the pancreas. There was no consistent association between presenting abdominal symptoms and abnormal ultrasonic and biochemical studies of the pancreas. After nutritional repletion, all studies reverted to normal. An eleventh patient, who was initially diagnosed as having anorexia nervosa but later found to have an astrocytoma of the medulla, had reduced echogenicity of the pancreas, suggesting malnutrition as the cause of these abnormal pancreatic studies. Pancreatic abnormalities due to protein-calorie malnutrition may be common in anorexia nervosa and must be differentiated from primary pancreatitis.
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PMID:Biochemical and ultrasonic abnormalities of the pancreas in anorexia nervosa. 618 45

Diabetes and carbohydrate intolerance can occur in pancreatitis. Although one-half of patients with acute pancreatitis will have some evidence of glucose intolerance during their acute illness, few will require insulin administration on either a short- or long-term basis. The diabetes seen in acute pancreatitis is likely due to a combination of factors, including alerted insulin secretion, increased glucagon release, and decreased glucose utilization by the liver and peripheral tissue. Chronic pancreatitis is often associated with diabetes mellitus, with the incidence as high as 70 percent when pancreatic calcification is present. These patients tend to be very sensitive to the effects of insulin and hypoglycemia. This is probably secondary to concurrent hepatic disease, malnutrition, and a relative decrease in glucagon reserves. The diabetes seen in chronic pancreatitis is associated with decreased insulin production. Finally, although the endocrine pancreas may influence the exocrine gland through a portal system, primary diabetes mellitus probably does not result in clinically significant alterations in pancreatic exocrine function.
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PMID:Diabetes mellitus and the exocrine pancreas. 636 37

The management of patients with gastrointestinal disease must include attention to nutritional status. It has been documented that morbidity and mortality previously considered common in these patients can be reduced significantly. Perhaps the largest contribution that advances in nutritional support have made is the reduction in the frequency of surgical intervention. Remission of inflammatory bowel disease, closure of fistulas, intestinal adaptation, and prevention of malnutrition in complicated pancreatitis with the use of nutritional therapies help to avoid the complications of operative procedures.
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PMID:Gastrointestinal disease: nutritional implications. 655 Aug 67

The effect of high nitrogen Criticare and Vivonex on nutritional repletion was evaluated in 12 patients with malnutrition secondary to pancreatic insufficiency. The patients were randomized to receive either Criticare HN or Vivonex HN for a total period of 9 days. Each patient received 3000 kcal/day of either preparation, in addition to 1000 kcal of solid food. A significant weight gain was encountered in the group of patients receiving Criticare HN. Increased blood urea nitrogen was encountered in both groups of patients. All patients tolerated both diets well without evidence of relapse of their pancreatitis. No significant complications were encountered. Our results indicate that Criticare HN is of superior nutritional value, but both preparations resulted in increased blood urea nitrogen retention.
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PMID:Comparative effects of Criticare HN and Vivonex HN in the treatment of malnutrition due to pancreatic insufficiency. 669 26


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