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

In most countries primary acute pancreatitis is a rare disease. However, its incidence has been increasing for several decades and many patients do not survive their first attack. During the 15 years (1969-83) 493 patients with the disease were admitted to Nottingham's two District General Hospitals. The geographical distribution of the disease within the study area was determined using 62 electoral wards and two patient cohorts namely 214 1969-76 admissions (1971 census base) and 279 1977-83 admissions (1981 census base). The incidence of the disease increased from 27 per annum to 40 per annum in the two cohorts. Most of the alcohol associated patients (18 first cohort: 38 second cohort) were young or middle aged males. For gallstone and 'non-gallstone' associated groups the incidence rose sharply with increasing age for both sexes. For both cohorts there were large statistically significant variations in the distribution of pancreatitis within the study area. Moreover, the spatial distribution was very similar for both cohorts with most of the highest rate wards clustering in a U-shaped area east of the city centre. Investigation of environmental factors suggested that this high-rate area coincides with the region served by the Burton Joyce domestic drinking water supply. Examination of the residential histories of the 493 patients showed that 25.6% had moved home less than five years prior to their first attack. Analysis of these moves confirmed that many patients had moved to suburban areas from two major inner city housing renewal schemes located within the high-rate Burton Joyce water supply area. Re-calculation of incidence rates of pancreatitis by former address for the six water supply areas established that only the Burton Joyce area had significantly high numbers of cases for both cohorts.
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PMID:The epidemiology of primary acute pancreatitis in Greater Nottingham: 1969-1983. 335 57

Increased endothelial permeability is postulated in patients with pancreatic inflammatory disease. As a result, a deficit in total circulating blood volume may occur as fluid is sequestered within the extravascular space. To counteract this fluid sequestration, exogenous fluid is administered, which results in expansion of total body water. The object of this study was to determine whether the fluid sequestration and potential total body water increase observed in patients with the diagnosis of pancreatitis affects the pharmacokinetics--and thus dosing requirements--of the water-soluble aminoglycoside gentamicin. Data collected from a clinical pharmacokinetic monitoring service were analyzed in 17 patients with primary diagnoses of acute pancreatitis and 17 closely matched controls. Volume of distribution corrected for total body weight (p = 0.029), volume of distribution corrected for ideal body weight (p = 0.031), and total body gentamicin clearance (p = 0.05) were determined to differ statistically in pancreatitis patients from those values calculated in control patients. Patients with pancreatic inflammatory disease, on the basis of these pharmacokinetic parameter estimates, were found to require approximately a 25% greater dose than controls in order to achieve therapeutic peak serum gentamicin concentrations.
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PMID:Gentamicin dosing requirements in patients with acute pancreatitis. 336 89

The late course of bile-induced acute experimental pancreatitis was studied in alcoholic and non-alcoholic rats. Addition of alcohol to the drinking water did, however, not influence any of the factors (see below) studied. Six hours after induction of pancreatitis the animals displayed a sixfold increase of S-amylase levels. The late mortality in the whole group of animals was 19% after 6 weeks and 71% after 12 weeks. Rats surviving 6 weeks had a marked reduction of pancreatic wet weight and of pancreatic protein, amylase, phospholipase A2, and S-glucose as compared with healthy controls. S-amylase was similar in all groups studied after 6 weeks. At light microscopy similar changes were seen after 6 and 12 weeks--that is, extensive atrophy of the exocrine pancreas with preserved islets of Langerhans. Only slight fibrosis and slight increase of inflammatory cells were seen, and no protein plugs were detected. The normal liver architecture was generally preserved, but pancreatic rats showed various degrees of bile duct proliferation. Although the morphologic findings do not correspond well with those seen in human chronic pancreatitis, we feel that they represent an integrated late phenomenon of the bile-induced pancreatitis per se, even though partial obstruction of the bile-pancreatic duct may be a co-factor.
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PMID:Pancreatic atrophy follows bile-induced acute pancreatitis in the rat. 338 98

Eight patients with severe acute necrotizing pancreatitis had a new removable drainage device applied which allowed for massive lavage drainage with water tightness and easy repeated abdominal and retroperitoneal revisions. The lavage clears the enzymes and the toxic products that continuously soil the abdomen and affect all other systems. Simultaneously, it acts as a peritoneal dialysis. There were no complications and the 50 per cent survival rate at three months compares favorably with that of corresponding instances in another study (p less than 0.02).
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PMID:A new abdominal drain for overflowing lavage in instances of severe pancreatitis with persistent peritoneal contamination. 362 42

Sixty-four severe infections in hospitalized patients were treated with intravenous Timentin. Most patients (mean age: 50.5 years, range 18-85) had serious underlying conditions such as agranulocytosis, heart failure, cancer, diabetes mellitus, chronic alcoholism or other functional or anatomical abnormalities. Forty-three episodes were bacteriologically proved, and bacteraemia was diagnosed in 18. The sites of infection were: lower respiratory tract (10), upper respiratory tract (10), soft tissues (9), urinary tract (7), bones (6), peritoneal cavity (3), meninges (1) and pelvis (1). In addition, 13 episodes of fever and four of septicaemia in patients with agranulocytosis were treated with Timentin plus amikacin. Overall, 59% of the episodes were cured, 14% improved and 17% failed to respond. In 9% of cases the efficacy of the Timentin was unassessable mainly because of concurrent administration of other antimicrobials. Failure appeared to be more frequent in soft tissue and intra-abdominal infections, in patients infected with bacteria susceptible to Timentin but resistant to ticarcillin and in patients superinfected with Timentin-resistant strains. Major side effects were haemorrhagic diathesis with platelet dysfunction (1), severe water sodium overload (1), and possibly pancreatitis (1). Other side effects were mild: catheter-related phlebitis, and abnormal but clinically insignificant laboratory test results. Timentin appears to be an effective and safe broad-spectrum combination which compares favourably with third-generation cephalosporins in the treatment of severe hospital infections. More experience is needed to decide whether the somewhat lower response rate in patients infected with ticarcillin-resistant strains is significant.
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PMID:Clinical experience with Timentin in severe hospital infections. 363 28

Alcohol is recognized as one etiological factor in pancreatitis and according to recent studies, phospholipase A2 (PLA2) may be an important factor in the pathogenesis of this disease. However, the effect of chronic ethanol ingestion on PLA2 activity has not been studied in pancreatitis. To clarify the possible relation of these two factors 48 male Wistar rats received 15% (v/v) ethanol in drinking water for 12 weeks and 48 rats served as controls drinking tap water. Blood samples were collected from the control animals by puncturing the abdominal aorta. Experimental pancreatitis was induced by intraductal retrograde infusion of normal rat bile and blood samples collected 24 hr after the infusion. PLA2 activities in the plasma were measured by using the substrate with a 3H-labeled fatty acid in position 2. PLA2 activities in the control group were 11.2 +/- 1.3 (mean +/- SE) nmole/ml/min and 21.7 +/- 3.5 twenty-four hours later (P less than 0.05). In alcoholic rats the activities were 11.1 +/- 1.4 and 54.0 +/- 10.3, respectively (P less than 0.003). The increase of the activities was greater in alcoholic rats and the difference between the groups statistically significant (P less than 0.025). The mortality rate was 4.2% among the control animals and 29.2% in the alcoholic groups (P less than 0.026). The results of this study suggest that chronic alcohol ingestion makes the pancreas vulnerable to severe pancreatitis with high mortality. This is associated with significantly increased activities of PLA2.
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PMID:Long-term ethanol ingestion causes an increase of phospholipase A2 activity in acute experimental pancreatitis in rats. 377 96

Ethyl alcohol may adversely affect pancreatic function by perturbing sphincter of Oddi (SO) or duodenal motor activity. The aim of this study was to identify the effect of ingested alcohol on the SO, duodenal, and gastric myoelectric activity in conscious opossums. In five adult opossums bipolar stranded stainless-steel wire electrodes were implanted on the SO, gastric antrum, and duodenum. After a 2-week recovery period, each animal underwent eight 8-hr recording sessions while fasted and awake. After two fasting cycles of the migrating myoelectric complex, animals were randomly fed either 10 ml of a 30% ethyl alcohol solution or 10 ml of water via an esophageal tube, and recordings continued for 4-6 hr. During the control state, cyclical myoelectric spike activity was recorded from the SO, gastric antrum, and duodenum with a mean +/- SD cycle length of 7.35 +/- 15.0 min, 74.3 +/- 10.1 min, and 94.8 +/- 8.7 min, respectively. With alcohol, SO and duodenal cycle lengths were unchanged while gastric cycle length decreased. However, alcohol effected a significant increase in peak SO spike burst frequency with no corresponding change in gastric or duodenal spike burst frequency. An equivalent volume of water had no influence on sphincter of Oddi myoelectric activity. It is concluded that ingested alcohol induces increased myoelectric activity from the opossum SO, independent of changes in activity of the duodenum or stomach. Since the SO plays a major role in metering bile and pancreatic flow into the duodenum, this may be a factor in alcohol-induced pancreatitis.
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PMID:Effect of alcohol on cyclical myoelectric activity of the opossum sphincter of Oddi. 399 30

The partial saturation (PS) (90 degree-data collection) and saturation recovery (SR) [(90 degree-dephase)n-90 degree-data collection] sequences are described. The early data collection of the PS sequence is of value in demonstrating tissues with a short T2 such as articular cartilage and the annulus fibrosus. The PS sequence also highlights flow and this may provide specific information in vascular lesions. Appropriate choice of echo time enables chemical shift effects to be seen in normal tissues such as breast and bone marrow as well as a variety of diseases such as bone marrow infiltration, pancreatitis, and fatty infiltration of the liver in which there is mixed lipid and water. The SR sequence can be used to control flow effects as well as to calculate values of T1. Although PS and SR sequences display less T1 and T2 dependent contrast than conventional highly T1 and T2 dependent inversion recovery and spin echo sequences, they may still be of clinical value when the mechanism of contrast formation is change in proton density, chemical shift effects, flow effects, or detection of short T2 tissue components.
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PMID:Clinical use of the partial saturation and saturation recovery sequences in MR imaging. 405 31

The favorable clinical effects of water-soluble form of chlorophyll-a in the treatment of patients with chronic relapsing pancreatitis are described. 1) 34 cases were treated with chlorophyll-a infusion and fairly favorable effect was obtained in 23 cases and some favorable effect, in 9 cases. 2) The most disgusting symptom of pancreatitis, the abdominal pain disappeared in a week or so with infusion of 5--20 mg of chlorophyll-a per day for 1--2 weeks, in all the effective cases. 3) Patients have become well controlled by intermittent administration of chlorophyll-a, even when they had recurrences. 4) 5 cases which had difficulty in the treatment by trasylol, were also successfully treated with chlorophyll-a. 5) In all the cases treated with chlorophyll-a, no unfavorable side-effect, such as of allergic, or photosensitive, or hepatotoxic nature, was hitherto observed.
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PMID:Therapeutic effect of chlorophyll-a in the treatment of patients with chronic pancreatitis. 615 29

Acute hemorrhagic pancreatitis was produced in pig to study serum concentration of elastase and its physiological role. Pancreatitis was induced in two groups of young pigs by the injection of autologous bile. One group was injected with autologous bile (0.5 ml/kg) at high pressure, and the second group was injected as low pressure (100 cm H2O). Then femoral blood, portal blood and thoracic lymph were sampled at scheduled time intervals. The control level of immunoreactive elastase was around 90 ng/ml in each site, which significantly increased beginning 15 min after bile injection; the level of immunoreactive elastase was higher in the thoracic lymph duct than in the femoral and portal vein. The total and free elastase of both groups in pancreatic tissue were significantly decreased in pancreatitis, and an abundance of immunoreactive elastase was found in the ascites. The increasing pattern of immunoreactive elastase and amylase after bile injection was very similar. Therefore, the level of immunoreactive elastase was considered to be inadequate to determine the grade of severity of pancreatitis as well as the level of amylase which is already known.
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PMID:Studies on porcine pancreatic elastase activity. II. Immunoreactive elastase level during acute hemorrhagic pancreatitis in pigs. 615 22


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