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

During 1984-88 a population-based case-control study was carried out in The Netherlands, in collaboration with the International Agency for Research on Cancer, to examine the possible relationship between aspects of medical history and exocrine pancreatic carcinoma in 176 cases and 487 controls. About 58% of patients were interviewed directly. We observed an inverse relationship between medical treatment for allergy-related conditions and the development of pancreatic cancer (30 cases vs. 130 controls, OR 0.57, 95% CI 0.36 to 0.90). A history of gallbladder problems, gallstones, cholecystectomy, stomach or duodenal ulcer, pancreatitis, appendicitis, diabetes or tonsillectomy was not related to risk. In direct responses, compared with once daily, a positive relationship was seen for stool frequency, 10 years ago, of less than once daily (18 cases vs. 40 controls, OR 2.10, 95% CI 1.09 to 4.04). In men, diabetes treated with insulin and diagnosed more than 1 year previously was significantly and positively related to risk (5 cases vs. 1 control, OR 11.66, 95% 1.28 to 105.95). In brief, the results of the present study suggest that a history of allergy-related conditions may protect, whereas a past stool frequency of less than once daily may enhance the risk of cancer of the pancreas. Other elements of the medical history were not consistently related to risk.
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PMID:Aspects of medical history and exocrine carcinoma of the pancreas: a population-based case-control study in The Netherlands. 150 Feb 22

1. Specific criteria for pancreas donation are few. A donor history of diabetes mellitus is an absolute contraindication, as well as any direct trauma to the pancreas with severe pancreatitis. Extracranial malignancy and active infection rule out retrieval of both pancreas and kidneys. 2. A combined pancreas/kidney transplant requires two completely separate instrument setups. The instruments used to implant the pancreas are considered contaminated by the segment of duodenum containing the pancreatic duct. 3. In addition to those questions routinely asked of a patient on admission to the operating room, the perioperative nurse needs to know when the patient last underwent dialysis and when the last dose of insulin was given. Lab work should be quickly reviewed with special notice given to the hematocrit, hemoglobulin, and glucose levels.
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PMID:Renal transplants. Kidney and pancreatic transplantation. 153 41

Twenty one specimens of the pancreas in the patients who underwent pancreatoduodenectomy or total pancreatectomy for pancreatoduodenal cancer were divided into 4 groups according to the extent of fibrosis (Grade 0-Grade III). Islet cells of serial sections were stained immunohistochemically with calculation of the proportion of B-cells, A-cells, D-cells and PP-cells in the islets of Langerhans. In the pancreatic tissue with the most severe fibrosis (Grade III), B-cell ratio was significantly decreased (p less than 0.01), whereas A-cell ratio was significantly increased (p less than 0.01). Based on the data of oral glucose tolerance test (OGTT) and insulin response test, some indices were calculated (delta IRI/delta BS, sigma IRI/sigma BS, sigma delta IRI/sigma delta BS). In Grade III, sigma delta IRI/sigma delta BS was significantly decreased. A significant positive correlation was observed between B-cell ratio and both delta IRI/delta BS or sigma delta IRI/sigma delta BS, whereas a significant negative correlation was seen between A-cell ratio and sigma delta IRI/sigma delta BS. The present study first demonstrates the significant correlation between the endocrine secretory function of the islets and quantitative changes of the endocrine cells of islets in chronic obstructive pancreatitis due to pancreatoduodenal cancer. The present data strongly suggest that it is possible to estimate the degree of fibrosis and quantitative changes of the islet cells in the patients with pancreatoduodenal cancer by means of calculating the above mentioned indices, especially sigma delta IRI/sigma delta BS.
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PMID:[Morphometric study on islet of Langerhans in relation to glucose tolerance in chronic obstructive pancreatitis due to pancreatoduodenal cancer]. 155 89

The frequency of diabetes is much higher in tropical calcific pancreatitis (TCP) as compared with alcoholic chronic pancreatitis. We report 97 patients with tropical calcific pancreatitis and compare the profile of 21 patients without diabetes (called TCP for the purpose of this report) with that of 76 patients with diabetes, called fibrocalculous pancreatic diabetes (FCPD) according to the World Health Organization (WHO) study group classification of diabetes. TCP patients were a decade younger and had marginally higher body mass indices (BMIs) as compared with the FCPD group. Of the TCP patients, 13 had abnormal glucose tolerance tests (GTT) and the others had normal GTT. Immunoreactive insulin (IRI) responses to glucose load in the TCP group did not differ significantly from that of the control group. This study shows the existence of early stages of glucose intolerance in TCP.
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PMID:Clinical and biochemical studies in the prediabetic phase of tropical calcific pancreatitis. 155 37

The secretory function of the pancreas is also impaired in acute destructive pancreatitis. A four- to five-fold increase of serum insulin and glucagon concentrations during the development of the disease is evidence in favor of the development of pancreonecrosis. Diabetic, type disorders of glucose tolerance were encountered in 38% of patients with acute pancreatitis, the clinical form of diabetes mellitus was found in 8.3% of the examined patients.
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PMID:[Pancreatic endocrine function in patients with acute pancreatitis]. 157 45

Acute fulminant pancreatitis is associated with significant morbidity and mortality. To examine the outcome of conservative and surgical treatment of this disorder, 36 patients who survived an initial episode were restudied after a mean of six years. Fifty three per cent had developed diabetes mellitus, half of whom required insulin therapy. Pancreatic resection was associated with a 100% frequency of diabetes, while only 26% of those treated with peritoneal lavage developed this (p less than 0.001). Insulin secretion and sensitivity were assessed using the hyperglycaemic glucose clamp technique. First phase insulin secretion was impaired in surgically treated patients (mean (SEM) 14 (5) microU/ml x 10 minutes) compared with conservatively treated patients and control subjects (144 (66) and 87 (12) microU/ml x 10 minutes, respectively; p less than 0.05). Second phase and 'maximal' insulin secretion were also impaired among the surgically treated patients compared with the conservatively treated patients and the controls. Insulin sensitivity was reduced among the surgically treated patients (2.88 (58) mg/kg.minute) when compared with conservatively treated patients and healthy control subjects (5.87 (1.02) and 6.45 (0.66) mg/kg.minute; p less than 0.05). Pancreatic resection is associated with a very high frequency of diabetes compared with peritoneal lavage, and these results favour conservative treatment of active fulminant pancreatitis whenever possible.
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PMID:Pancreatic surgery, not pancreatitis, is the primary cause of diabetes after acute fulminant pancreatitis. 162 70

After successful combined pancreaticoduodeno-renal transplant in an insulin-dependent diabetic, recurrent episodes of transplant pancreatitis were treated with Foley catheter drainage. The apparent cause of pancreatitis was increased pressure on the pancreatic duct due to infrequent voiding and a large bladder. A frequent voiding program partially relieved the pancreatitis, but final resolution necessitated conversion of the pancreaticoduodeno-cystostomy to a Roux-en-Y duodenojejunostomy at 6 months posttransplant. Both renal and pancreatic function are stable after 1 year, with no recurrence of pancreatitis since urinary undiversion. We believe pressure pancreatitis or urine reflux pancreatitis to be an infrequently reported cause of graft dysfunction in bladder-drained pancreas transplant recipients.
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PMID:Pancreatitis necessitating urinary undiversion in a bladder-drained pancreas transplant. 169 45

Availability of specific cholecystokinin (CCK) receptor antagonists has the potential for contributing to delineation of the role of CCK in the development of pancreatitis and, perhaps, development of new therapeutic agents for treatment of the disorder. The purpose of this study was to evaluate the effect of a potent CCK receptor antagonist, CR 1409, on bile reflux pancreatitis. The opossum pancreatic duct enters the common duct in such a position that it is possible to ligate the common duct distal to the pancreatic duct, resulting in bile refluxing into the pancreatic duct and producing pancreatitis. CR 1409 was administered to opossums at the time of distal common duct ligation and at the time of cystic- and common ducts ligations. In a separate group, CR 1409 administration was begun 24 hours following onset of pancreatitis. Control experiments were performed, in which CR-1409 was not administered. Serum amylase, pancreas gland weights, inflammation, and systemic venous insulin, glucagon, and CCK concentrations were evaluated. Bile duct ligation resulted in significant hyperamylasemia, pancreas gland edema, inflammation, hyperglucagonemia, hypercholecystokinemia, and hypoinsulinemia. CR 1409, administered at the onset of pancreatitis, significantly decreased amylase concentrations, gland weight, and inflammation, when compared to control values. Hormonal changes associated with pancreatitis were also significantly altered by CR 1409 administration. When administered 24 hours following onset of pancreatitis, CR 1409 was not effective in altering the pancreatitis produced by bile duct ligation. The results suggest that CCK plays a permissive or contributory role in the inflammatory process and in associated hormonal changes during development of bile reflux pancreatitis in the opossum.
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PMID:The effect of the CCK receptor antagonist CR 1409 on bile reflux pancreatitis in the opossum. 171 73

Non-insulin-dependent (type II) diabetes mellitus is an inherited metabolic disorder characterized by hyperglycemia with resistance to ketosis. The onset is usually after age 40 years. Patients are variably symptomatic and frequently obese, hyperlipidemic and hypertensive. Clinical, pathological and biochemical evidence suggests that the disease is caused by a combined defect of insulin secretion and insulin resistance. Goals in the treatment of hyperglycemia, dyslipidemia and hypertension should be appropriate to the patient's age, the status of diabetic complications and the safety of the regimen. Nonpharmacologic management includes meal planning to achieve a suitable weight, such that carbohydrates supply 50% to 60% of the daily energy intake, with limitation of saturated fats, cholesterol and salt when indicated, and physical activity appropriate to the patient's age and cardiovascular status. Follow-up should include regular visits with the physician, access to diabetes education, self-monitoring of the blood or urine glucose level and laboratory-based measurement of the plasma levels of glucose and glycated hemoglobin. If unacceptably high plasma glucose levels (e.g., 8 mmol/L or more before meals) persist the use of orally given hypoglycemic agents (a sulfonylurea agent or metformin or both) is indicated. Temporary insulin therapy may be needed during intercurrent illness, surgery or pregnancy. Long-term insulin therapy is recommended in patients with continuing symptoms or hyperglycemia despite treatment with diet modification and orally given hypoglycemic agents. The risk of pancreatitis may be reduced by treating severe hypertriglyceridemia (fasting serum level greater than 10 mmol/L) and atherosclerotic disease through dietary and, if necessary, pharmacologic management of dyslipidemia. Antihypertensive agents are available that have fewer adverse metabolic effects than thiazides and beta-adrenergic receptor blockers. New drugs are being developed that will enhance effective insulin secretion and action and inhibit the progress of complications.
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PMID:Non-insulin-dependent (type II) diabetes mellitus. 174 94

The aims of this study were to assess the prevalence of duodenal ulcer during chronic pancreatitis and the relationship between the occurrence of duodenal ulcer and the course of chronic pancreatitis. The population consisted of 264 men with chronic pancreatitis, 94 percent of which were of alcoholic origin. Duodenal ulcer occurred in 37 patients (14 percent). Fifteen patients with gastric or anastomotic ulcer were excluded. The 37 patients with duodenal ulcer were compared with 212 patients without ulcer. There was no significant difference between the two groups as regards the course of chronic pancreatitis except for insulin-dependent diabetes mellitus which was significantly more frequent in patients without duodenal ulcer (P less than 0.05). Eight patients with duodenal ulcer died but the cause of death was not related to their ulcer. All patients with duodenal ulcer and 92 percent of those without were smokers (not significant). Duodenal ulcer occurred in 25/37 patients (68 percent) before the clinical onset of chronic pancreatitis. The risk of duodenal ulcer occurrence was constant in 17-65 year old patients and independent of the time of chronic pancreatitis onset. We concluded that in men with chronic pancreatitis: a) prevalence of duodenal ulcer is 14 percent; b) duodenal ulcer occurred most often before clinical onset of chronic pancreatitis; c) duodenal ulcer occurs independently of the course of pancreatitis which cannot account for its high prevalence. Smoking may be a promoting factor.
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PMID:[Does chronic pancreatitis promote duodenal ulcer in men?]. 175 70


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