1,721,004 research outputs found
The epidemiology and socioeconomic impact of chronic pancreatitis
No full textEpidemiological studies have been published worldwide in recent decades describing the incidence, mortality, aetiology and trends of chronic pancreatitis. Accumulated evidence suggests that chronic pancreatitis is increasing in incidence and hospital admission rates are rising accordingly. Alcoholic chronic pancreatitis was previously more common in the developed world than elsewhere, but is now increasing worldwide due to growing per capita alcohol consumption in each nation. Supporting alcohol and smoking cessation in individual patients is essential to slow disease progression and improve overall health, as most patients will die of cirrhosis, cardiovascular disease or smoking related cancers rather than chronic pancreatitis. The socioeconomic impact of chronic pancreatitis is difficult to quantify as little data exists, however given the rising incidence the costs to health care and society are likely to increase. This chapter will describe the epidemiology and aetiology of chronic pancreatitis worldwide and discusses the factors that influence its socioeconomic impact
CD117/KIT expression in pancreatic adenocarcinoma
No full textObjective: CD117/KIT overexpression is common in neoplasms such as gastrointestinal stromal tumors and predicts clinical response to tyrosine kinase inhibitors. Pancreatic adenocarcinoma has a poor prognosis, and therefore, targeted molecular therapymay be beneficial. Marked differences in the incidence of CD117/KIT expression have been reported in pancreatic adenocarcinoma. The aim of this study was to test the hypothesis that CD117/KIT expression is unusual in pancreatic adenocarcinoma. Methods: CD117/KIT immunohistochemistry was performed on 23 archival pancreatic adenocarcinoma samples using 2 primary antibodies. Results: Satisfactory internal and external positive control labeling was achieved for both primary antibodies. No tumor cell labeling was identified using one primary antibody, whereas all cases showed cytoplasmic CD117/KIT staining with the second. However, CD117/KIT expression was also identified using the latter within nuclei and benign pancreatic epithelium, suggesting that artifactual staining was occurring. Conclusions: Pancreatic adenocarcinoma does not express CD117/KIT as assessed using the primary immunohistochemical antibody usually used in our laboratory for CD117/KIT detection. The variation in reported incidence of CD117/KIT expression in pancreatic adenocarcinoma is because of methodological differences in immunohistochemical technique. Ideally, immunohistochemical studies of this molecule should be combined with mutational status testing of the c-kit gene
Acute pancreatitis as the first presentation of Wegener's granulomatosis
No full textContext Wegener’s granulomatosis is a systemic vasculitis with prominent involvement of the respiratory tract and kidney. An association between acute pancreatitis and Wegener's granulomatosis is rarely reported and is even rarer as the first presentation. This can result in diagnostic difficulty and may allow severe pancreatitis to develop with potentially poor outcome.Case report We report a rare case with fatal outcome of vasculitis consistent with Wegener’s granulomatosis presenting as acute pancreatitis in a 20-year-old female. The patient was admitted with worsening abdominal pain associated with nausea and loss of appetite. Accepted causes of acute pancreatitis were excluded and granulomatous vasculitis of the pancreas was confirmed from immunological profile, computed tomography and histology. As the disease progressed the patient experienced cutaneous, pulmonary, renal and severe gut involvement. Thirteen months from diagnosis the patient died of multi-organ failure despite appropriate surgical and immunosuppressive therapy.Conclusion Vasculitic disease of the pancreas is rare but should be considered when other causes have been appropriately ruled out. Careful radiological, immunological and histological diagnosis is necessary and early immunosuppressant therapy in conjunction with advice from immunologists is essential to avoid the poor outcome reported in this and other case reports.<br/
Malondialdehyde and superoxide dismutase as potential markers of severity in acute pancreatitis
No full textContext: Release of oxygen free radicals is increased in acute pancreatitis, but whether this can be used to predict clinical severity is not known.Objective: This study assesses whether plasma concentrations of malondialdehyde (a marker of lipid peroxidation) and superoxide dismutase (an oxygen free radical scavenger) can be used to predict severity of acute pancreatitis.Patients: Fifty-one patients with acute pancreatitis and two control groups were recruited.Main outcome measures: Plasma levels of malondialdehyde and erythrocyte content of superoxide dismutase were measured at 0, 12, 24, 48, 72, 96 and 120 hours after admission. Acute physiology and chronic health evaluation (APACHE) II, Glasgow and Ranson scores were calculated. Acute pancreatitis severity was defined by Atlanta criteria. Premorbid antioxidant intake was assessed by dietary questionnaire.Results Levels: of malondialdehyde were raised in acute pancreatitis patients and increased in patients with severe compared with mild acute pancreatitis; 12 hours after admission plasma malondialdehyde was 4.42±0.54 µmol/L and 2.95±0.24 µmol/L in severe and mild pancreatitis, respectively (mean±SEM; P=0.007). Plasma malondialdehyde greater than 2.75 µmol/L at 12 hours after admission had high overall accuracy for predicting severe acute pancreatitis. Superoxide dismutase levels were found to decrease in acute pancreatitis but no substantial significant difference was demonstrated between severe and mild acute pancreatitis patients. There was no difference in pre-morbid antioxidant dietary intake between the mild and severe pancreatitis groups.Conclusion: Plasma malondialdehyde may be a helpful additional marker of severity in the very early stages of acute pancreatitis.<br/
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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