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

Drug histories were taken from 100 patients in their first attack of acute pancreatitis, and each was matched with a control subject of the same sex who was admitted to hospital as an emergency with acute abdominal pain, whose serum-amylase was within the normal range, and whose age was within three years of the pancreatitis patient's. The major differences between the patient groups was in the use of cardiovascular agents, and this was primarily due to a statistically significant excess of diuretic takers among the pancreatitis patients. There was an associated excess of intake of digoxin and antihypertensive and anti-anginal agents, but neither difference was statistically significant. Other categories of drugs showed no substantial differences. The difference between the pancreatitic patients and controls is almost entirely accounted for by takers of cyclopenthiazide with potassium chloride and of frusemide, especially the former. Further clinical and experimental evidence is required before the role of diuretics and/or potassium chloride in causing acute pancreatitis can be determined.
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PMID:Drug-associated primary acute pancreatitis. 7 39

The clinical features at presentation of 53 patients admitted with primary acute pancreatitis due to gall stones were compared with those of 31 patients in whom the disease was due to other causes. Between these two groups 10 significant differences existed. By listing the frequency of symptoms and signs for each group a computer data base was prepared and incorporated into a program used in the differential diagnosis of acute abdominal pain. A program written to predict the presence of gall stones in patients with acute pancreatitis was accurate in 92% of the patients studied. A predictive index devised from the presence of three of the significantly differing clinical features correctly identified 82% of patients with gall-stone pancreatitis. Predicting the presence of gall stones on admission by analysing the presenting symptoms and signs with a computer had an accuracy comparable to that of ultrasonography or radiology and may be of value in the management of patients with acute pancreatitis.
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PMID:Prediction of gall-stone pancreatitis by computer. 37 32

A review of the pertinent radiologic findings of common alimentary tract disorders presenting with acute abdominal pain is presented. When the conventional plain abdominal films are not diagnostic, the use of special views and appropriate contract and ultrasound examinations on a urgent basis is encouraged. A more expenditious and accurate diagnosis of the cause of abdominal pain will inevitably reduce the morbidity and mortality of such entities as bowel perforation, infarction, and pancreatitis.
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PMID:Radiologic evaluation of acute abdominal pain arising from the alimentary tract. 68 7

To assess the diagnostic accuracy of a computer-aided-diagnosis system when implemented in different parts of the world, an automated system, which had established its reliability in Leeds, England, was transferred to Sherbrooke, Quebec. In this preliminary study two retrospective series, comprising 104 patients with acute abdominal pain and 101 patients with dyspepsia, were drawn from the files of the Centre Hospitalier Universitaire in Sherbrooke. The history and physical-examination sheet was analyzed, coded and tested against the Leeds data base on a WANG 2200 computer, and the results were compared with the final Sherbrooke pathologic diagnosis. Overall the computer made a correct diagnosis in 78.8% of cases of acute abdominal pain and 70% of cases of dyspepsia. Computer diagnoses of appendicitis were correct in 97% of cases and the system recognized 91% of the actual appendicitis cases. Similar figures for cholecystitis were 91% and for peptic ulcer, 87%. However, the "pick-up" rate by the computer of pancreatitis was only 25%. It is concluded that geographical differences in disease presentation will probably not impair the validity of the computer method used in this study. A comparison of various diagnostic methods and levels of competence will await a prospective trial of this method.
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PMID:Computer-aided diagnosis of gastroenterologic diseases in Sherbrooke: preliminary report. 76 27

This paper reports on a patient who was treated by percutaneous aspiration, instillation of a sclerosant (polidocanol) and cystogastric drainage for a post-acute pancreatic pseudocyst. Five weeks after admission to hospital for the first episode of an acute necrotizing pancreatitis, the 60-year-old man underwent a percutaneous, ultrasound-guided puncture and aspiration of a voluminous pancreatic pseudocyst. Ten days later, recurrent fluid collection led to a second puncture, combined with the injection of polidocanol (15 ml; 1%) into the cyst cavity. Since this treatment failed, a percutaneous cystogastric drain ("double--pigtail") was inserted five days later. After developing acute abdominal pain and incipient sepsis, the patient was sent for surgical intervention twelve days after the second treatment with percutaneous aspiration and injection of polidocanol. During the operation an infected pancreatic pseudocyst with extensive contaminated necrosis of the pancreas and duodenal perforation was found. Necrectomy was performed, followed by continuous lavage of the omental bursa. Intensive care therapy was necessary for one week. Duodenal leakage persisted for nearly three weeks, the stopped spontaneously. The patient was discharged in quite a good state of health after 33 days of postoperative treatment. Although spontaneous development of infected pancreatic pseudocysts and pancreatic abscesses in necrotizing pancreatitis is known, a possible involvement of the drainage procedures, especially in combination with the injection of a sclerosant must be considered.
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PMID:Infected pancreatic necrosis possibly due to combined percutaneous aspiration, cystogastric pseudocyst drainage and injection of a sclerosant. 205 2

We reported two cases of acute recurrent pancreatitis lasting for 8 and 10 years, respectively, and characterized by acute abdominal pain associated with an increased serum level of pancreatic enzymes and in one case transient enlargement of the pancreas on sonography and CT scan. Exocrine and endocrine pancreatic function remained normal. Pain attacks were associated with headache or typical migraine, myalgia, pruritus, and diarrhea. In one case only, the IgE serum level was increased. In both cases, the symptoms were reproduced in the 2 h following the consumption of some particular food and cured for years by the suppression of this food and the use of cromoglycate, but recurred 1 month to 3 years after this treatment was stopped, to be again healed by the same treatment. We suggest that these cases are due to food allergy and that food allergy could be a rare cause of acute recurrent pancreatitis. Responsible foods were beef (twice), milk, potato, fish, and eggs, which is in agreement with the frequency of food allergens in southwestern Europe.
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PMID:Is food allergy a cause of acute pancreatitis? 210 39

We evaluated the diagnostic value of serum amylase, isoamylase, and lipase for the diagnosis of acute pancreatitis from sera of patients with acute abdominal pain. Comparison was first made in condition A between 32 patients with image-proven pancreatitis and 414 patients with nonpancreatic acute abdomen (the control group), then in condition B, between 62 pancreatitis patients with or without image proof and the control group. We found (a) that patients with image-proven pancreatitis suffer a more severe clinical course than those without; (b) that the sensitivity, positive predictive value, and accuracy in condition B are higher than in condition A at any cutoff level; (c) that none of the enzyme assays is specific at the upper reference limit, but their diagnostic yields are much improved by raising cutoff levels to about three or four times the upper limit; and (d) that at these selected cutoff levels, amylase had a diagnostic value similar to p-isoamylase or lipase in both conditions (sensitivity 84% and 92% for amylase in conditions A and B, respectively; specificity 98% and 98%; positive predictive value 75% and 90%; negative predictive value 99% and 99%; accuracy 91% and 97%). In conclusion, at an appropriately selected cutoff level, amylase can be effectively used as the first-line test and isoamylase or lipase as adjunct tests for acute abdominal conditions.
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PMID:Serum amylase, isoamylase, and lipase in the acute abdomen. Their diagnostic value for acute pancreatitis. 168 29

55 patients with acute pancreatitis were treated at this institution between 1979 and 1984. The female/male ratio was 3:2. Biliary pancreatitis was found in 51%. In 15% alcohol was the cause, while in 34% the etiology remained unknown. The main symptoms were acute abdominal pain (100%), nausea and vomiting (51%), fever (35%), and peritoneal irritation (27%). Twenty-two patients were treated conservatively, while the remainder underwent surgery either in or after the acute phase of the disease. Hospital mortality was 0% for a Ranson Score up to 4.25% for 5/6 and 50% for greater than 6.
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PMID:[Clinical aspects of acute pancreatitis]. 275 4

Activity of the renin-angiotensin system was assessed in patients with acute pancreatitis. Measurements of active plasma renin and inactive plasma renin were made in normal subjects, patients with acute pancreatitis, and patients with acute abdominal pain syndromes exclusive of pancreatitis. Active plasma renin values were significantly increased in acute pancreatitis, nearly 500 percent higher than in the other two groups. Inactive plasma renin values were similar in the three groups. In a subgroup of patients with acute pancreatitis, measurements were made on presentation and after recovery. The elevated active plasma renin values on admission fell significantly with recovery, in parallel with changes in serum amylase values. Inactive plasma renin values changed variably; there was a significant inverse regression relationship between the changes in active and inactive plasma renin values with recovery. The results indicate that the renin-angiotensin system is activated in acute pancreatitis to a significantly greater extent than in other syndromes with acute abdominal pain. The increased active plasma renin in acute pancreatitis is most likely due to renal release secondary to the reduced circulating volume and hypotensive effect of this disease. However, changes in the relationship between active and inactive plasma renin in some patients suggest that activation of inactive renin by proteolytic enzymes released in acute pancreatitis might play an additional role.
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PMID:Activation of the renin system in acute pancreatitis. 354 44

Biochemical tests (serum glutamic pyruvic transaminase, serum glutamic oxaloacetic transaminase, alkaline phosphatase, gammaglutamyltranspeptidase, bilirubin, and serum amylase) were performed upon admission in 84 patients with suspected (36) or proven (48) acute pancreatitis at the time of the first episode of acute abdominal pain suspected clinically as acute pancreatitis. These parameters all increased significantly more in patients with gallstone pancreatitis. Among them, the SGPT was the most discriminant test between biliary and nonbiliary pancreatitis. The positive predictive value of SGPT was 92%, when the cutoff point was chosen at twice the upper limit of normal. In patients with increased SGPT, a SGOT-SGPT ratio less than 1 is the rule (88%) for those with gallstone pancreatitis. This enzymatic determination allowed us to select more accurately the patients suitable for morphological procedures to confirm the biliary origin of the pancreatitis.
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PMID:Early detection of biliary pancreatitis. 619 68


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