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

A case of eruptive xanthomas during two successive pregnancies is reported. These xanthomas developed in association with marked hypertriglyceridemia; complications included severe pancreatitis and acute respiratory distress syndrome. This patient most likely had combined familial hyperlipidemia which usually causes only a modest elevation in plasma lipid levels. However, with the added stimulus of estrogens during pregnancy, hypertriglyceridemia and secondary complications developed.
 ...
PMID:Eruptive xanthomas during pregnancy. 151 92

One hundred sixty eight patients with suspected serious pancreatitis were examined by dynamic CT. According to clinical data 103 of the patients had an oedematous pancreatitis (OP) and 65 a haemorrhagic-necrotizing pancreatitis (HP). Contrast enhancement (CE) of the pancreas was measured by dynamic CT during the first 24 hours after admission to the hospital. A control study was performed in 48 hours, if the finding on the primary CT was not definite or there was a discrepancy between CT and the clinical finding. Patients with HP showed significantly lower CE during the first minute after bolus injection of contrast material than patients with either normal pancreas or those who had OP. Only 4 out of 65 patients with HP showed normal (over 40 HU) and 8 out of 103 patients with OP showed low (less than 30 HU) CE. The method seems to be the most reliable method available to differentiate HP from OP. Before giving contrast material to the patients severe hypovolemia and respiratory distress should be excluded and treated.
 ...
PMID:CT evaluation of acute pancreatitis: 8 years clinical experience and experimental evidence. 166 48

Severe acute pancreatitis is highly controversial on its diagnostic criteria, the optimum time for surgery, the selection of surgical procedures, and the prevention and treatment of complications. We treated 40 patients with severe acute pancreatitis from July 1983 to July 1988. The comparison of clinical and laboratory data of severe acute pancreatitis and mild acute pancreatitis showed that in some patients neither Ranson's nor Bank's criteria are reliable in classifying or predicting the severity of the disease. The coexistence of acute peritonitis and bloody ascites with elevated amylase level is very helpful to identify the local conditions of pancreatic necrosis and hemorrhage. We suggest early operation (within 48 hours) be applied in severe acute pancreatitis. In our series, five types of surgical procedures were used. We consider that proper treatment of acute respiratory distress syndrome (ARDS) is most important in the management of severe pancreatitis.
 ...
PMID:A retrospective study on diagnosis and treatment of severe acute pancreatitis. 211 71

Hyperlipoproteinemia associated with acute pancreatitis is a rare complication during pregnancy. Acute pancreatitis may occur when physiologic hyperlipoproteinemia of pregnancy superimposes on primary or secondary hyperlipoproteinemia. In the meantime, acute pancreatitis may unmask hyperlipoproteinemia and the pattern of lipoprotein electrophoresis may evolve from Fredrickson type III to type IV or type V during acute pancreatitis. We reported a case and reviewed the literature. A 28 years old woman, G4P3, was admitted to our hospital in the sixth month of pregnancy because of epigastralgia and vomiting for 10 days and respiratory distress for one day. Laboratory examination revealed amylase 551 U/L, lipase 1073 U/L, blood sugar 873 g/dl, triglyceride 1298 mg/dl and cholesterol 1044 mg/dl. Abdominal sonogram revealed diffuse edematous change of the pancreas and minimal ascites. The symptoms and signs subsided gradually after supportive treatment that included nothing per os, fluid and electrolyte balance, antacid and analgesics. Unfortunately , intrauterine fetal death was found on the twentieth day after admission. The blood levels of triglyceride and sugar were still elevated 3 weeks after discharge. The most important observation was a broad beta lipoprotein band found in lipoprotein electrophoresis in the acute stage of this case. The broad beta band disappeared and Fredrickson type IV was found in the late stage of pancreatitis. The pattern of lipoprotein electrophoresis changed to Fredrickson type V 3 weeks later.
 ...
PMID:[Hyperlipoproteinemia associated acute pancreatitis complicating with pregnancy--a case report]. 270 Jan 32

Emergency surgery is the only effective treatment of ruptured abdominal aortic aneurysms, even though morbidity and mortality rates remain high. We have studied the feasibility of left retroperitoneal aortic exposure in these cases in an effort to reduce postoperative complications. Over a 33 month period, 29 patients underwent emergency surgery for either a ruptured or symptomatic infrarenal abdominal aortic aneurysm. Of 13 patients with ruptured aneurysms, 4 underwent repair through a midline transperitoneal approach (3 deaths) whereas the remaining 9 were repaired through the retroperitoneal exposure (1 death). Supraceliac aortic clamping through the same incision prior to aneurysm exposure maintained hemodynamic integrity. The remaining 16 patients with symptomatic aneurysms were all treated through the retroperitoneal exposure (3 deaths). In the retroperitoneal groups, the cause of death was cardiac in two patients, hypertensive stroke in one, and necrotizing pancreatitis in one. Morbidity consisted of prolonged intubation, respiratory distress syndrome, and thrombophlebitis in one patient each and acute tubular necrosis in two patients. We believe that the left retroperitoneal approach is a useful option in the emergent treatment of abdominal aortic aneurysms.
 ...
PMID:Selective use of retroperitoneal aortic exposure in the emergency treatment of ruptured and symptomatic abdominal aortic aneurysms. 340 Aug 6

The therapeutic goals for fluid replacement in 9 patients were studied. Five cases in sepsis, 2 in necrotizing pancreatitis and 2 in fat embolism were treated as dehydration or hypovolemia. Fluid replacement was performed with the view of obtaining the amelioration of circulation and urine output, even if CVP or PCWP had been elevated on admission. The values of CVP and PCWP, renal function and pulmonary function were assessed retrospectively. Out of 9 patients, one died of refractory shock, brain edema due to fat embolism and remaining one after recovery of shock. Out of 6 survivors, 2 showed oliguric renal failure, and 2 nonoliguric renal failure. The volume of administered fluid ranged from 5445 ml/10 hrs to 15820 ml/14 hrs and speeds of fluid administration were 545 ml/hr to 1248 ml/hr. CVP value on admission ranged from 4.0 to 22.0 cmH2O (3.0 to 16.3 mmHg), mean value 14.0 +/- 6.5 cmH2O. Through the course, the highest CVP and PCWP ranged from 12.5 to 26.5 (mean 19.8) mmHg and 14 to 36 (mean 20.9) mmHg, respectively. Out of 9 patients, 8 were suffering from respiratory distress, however, 7 recovered by PEEP except for one refractory shock. High values of CVP or PCWP could be recognized even if in hypovolemic shock and/or septic shock. Maintenance of higher values (18-20 mmHg) in CVP and/or PCWP during fluid resuscitation might be recommended because adequate fluid resuscitation could sustain the renal function, and result in good outcome.
 ...
PMID:[Therapeutic goals for fluid management in profound shock]. 382 15

For medical treatment of acute pancreatitis, only very few effective measures can be recommended. To put the gland to rest, the patient has to be maintained in a fasting state. Additionally, Cimetidine should be administered intravenously. A properly functioning nasogastric tube is an efficacious method of inducing the pancreas to rest. To maintain an adequate blood volume and in protecting the microcirculation of pancreas, the use of intravenous fluids that include colloids, is important. Sufficient replacement of electrolytes evidently seems to be indicated. Drug therapy consists of the administration of analgetics and of an adjuvant use of calcitonine or somatostatine, for reducing the pancreatic flow. Aprotinine given early and in sufficient amounts is to be recommended. Antibiotic prophylaxis should be utilized only when pancreatitis associated with biliary tract disease or postoperative pancreatitis seems to be apparent. Whenever systemic hypotension and shock occurs, plasma or dextran, together with sufficient but controlled amounts of intravenous fluids, must be administered. In acute renal failure dopamine has been used with success. Peritoneal dialysis or hemodialysis as an ultimate measure, has to be considered. In the case of respiratory distress syndrome, oxygen by nasal catheter must be applied.
 ...
PMID:[Medical treatment of acute pancreatitis (author's transl)]. 615 71

Diagnosing acute abdominal emergencies during spinal shock can be extremely difficult. Generally, the abdominal examination of an acutely cord-injured patient will not change with abdominal pathology. Loss of sensory, motor, and reflex functions mask typical signs. Nine hundred and forty-five medical charts were retrospectively examined to determine the incidence, causes, and risk factors for acute abdominal pathology during the first four weeks after spinal cord injury. Time of greatest risk was also investigated. Intraabdominal pathology was seen in 4.7% of the cases. Patients with complete cord lesions above the T5 level were most at risk. Respiratory distress was an additional risk factor for peptic ulcer disease. Decadron was found to be associated with pancreatitis but not with ulcers. Both pancreatitis and upper gastrointestinal hemorrhage appeared as early as three days postinjury. Findings of this study, as well as an understanding of the pathophysiology, symptomatology, and proper diagnostic workup assist in making the critical diagnosis.
 ...
PMID:Acute abdominal emergencies during the first four weeks after spinal cord injury. 633 58

Three hundred sixty Sprague-Dawley rats were allocated into four groups, according to different content of a 24-h i.v. infusion performed 1 h after intrabiliary injection of enterokinase/sodium taurocholate to induce acute pancreatitis (AP): (1) Saline; (2) 5 micrograms/kg/h nafamostat mesilate (FUT-175); (3) 10 micrograms/kg/h FUT-175; and (4) 25 micrograms/kg/h FUT-175. Peritoneal fluid was removed and exchanged with 1 mL 3.33 M fluorescein-isothiocyanate-conjugated (FITC) dextrans of 4000-40,000 Dalton. Serial blood samples were withdrawn and examined for FITC-dextrans, phospholipase A2 (PLA2), blood gases, amylase, and lipase. As compared to control (55%), FUT-175 brought about a lower (5 micrograms/kg/h: 25%) or no mortality (10 and 25 micrograms/kg/h), and a milder histological and biochemical evidence of AP. Untreated animals with PLA2 values over two times the standard deviation showed a respiratory distress. Further, unlike group 1, FUT-175 doses as low as 5 micrograms/kg prevented the increase in peritoneal permeability to small-size molecules (up to 20,000 Dalton). In a second experiment under the same drug protocol, 1000 U/mL of PLA2 and 2 mL of pancreatitis ascites were instilled ip. Peritoneal permeability to FITC-dextrans up to 30,000 Dalton and to PLA2 significantly increased in the saline group and in the 5 micrograms/kg FUT-175 group. However, 10 micrograms/kg and 25 micrograms/kg FUT-175 doses prevented such phenomenon. In conclusion, FUT-175 proves to be a potent antiprotease molecule with a biochemical activity also against PLA2 in vivo and prevents significant transperitoneal-blood access of pancreatic enzymes.
 ...
PMID:Nafamostat mesilate on the course of acute pancreatitis. Protective effect on peritoneal permeability and relation with supervening pulmonary distress. 752 62

During August 1989-August 1994 at the referral-based obstetric practice of MacKay Memorial Hospital in Taipei, Taiwan, obstetricians saw 8 pregnant women with acute pancreatitis. All but 1 patient had gallstones and/or hyperlipidemia. None had ever been diagnosed with pancreatitis or gallstones in the past. None suffered from alcoholism. One woman was lost to follow-up at 33 weeks gestation. No pregnant woman died. Magnesium sulfate and nifedipine controlled preterm labor in 2 patients. Two women underwent cesarean section (fetal distress and elective). Pancreatitis struck all but 1 during the 3rd trimester of pregnancy. One woman presented at 23 weeks gestation with loss of consciousness, abnormally low volume of circulating plasma in the body, upper gastrointestinal bleeding, and a dead fetus. She also had diabetes mellitus which had gone untreated for 2 years. After spontaneous delivery of the dead fetus, she developed metabolic encephalopathy, sepsis, respiratory distress, and acute renal failure. She completely recovered and left the hospital 62 days after arriving. Physicians instituted conservative treatment for pancreatitis and a fat-restricted diet for hyperlipidemia. Labor was induced in 3 women after determining fetal lung maturity. Pancreatitis symptoms diminished after delivery. At 2 weeks postpartum, they underwent cholecystectomy. In fact, all but 3 women underwent cholecystectomy. Five patients had a fever greater than 38 degrees Celsius upon admission. Three patients were jaundiced. All 8 patients experienced nausea and/or vomiting and abdominal pain. Six women had low serum calcium levels. Only 1 had a serum lactic dehydrogenase level above 350 IU/L. Primiparous women were just as likely to develop pancreatitis during pregnancy as multiparous women. These findings suggest that early diagnosis and prompt treatment of acute pancreatitis are essential to a favorable outcome.
 ...
PMID:Acute pancreatitis in pregnancy. 766 Jul 65


1 2 3 4 5 6 7 Next >>