-
Clinical Advances in Hematology &... May 2020Pancreatic adenocarcinoma is one of the most lethal cancers in oncology. Pancreatic cancer is the third most common cause of cancer-related mortality in the United... (Review)
Review
Pancreatic adenocarcinoma is one of the most lethal cancers in oncology. Pancreatic cancer is the third most common cause of cancer-related mortality in the United States. As the years have progressed, the importance of a multidisciplinary and multimodal approach to pancreatic cancer care has been recognized and is now recommended in all major society guidelines. A subset of pancreatic cancer, borderline resectable pancreatic cancer (BRPC), has emerged as a distinct clinical entity for which specialized treatment plans are now being developed. The medical oncologist, surgical oncologist, and radiation oncologist must work jointly to help deliver the best clinical outcome for the patient with pancreatic cancer. In this discussion, we describe the current state of surgical, locoregional therapies and systemic therapy in BRPC.
Topics: Adenocarcinoma; Antineoplastic Agents; Combined Modality Therapy; Humans; Pancreas; Pancreatic Neoplasms
PubMed: 32628656
DOI: No ID Found -
Journal of Ultrasound Sep 2019The pancreas is easily investigated in children thanks to the relative lack of fat tissue and the large left hepatic lobe with an optimal acoustic window. The use of... (Review)
Review
The pancreas is easily investigated in children thanks to the relative lack of fat tissue and the large left hepatic lobe with an optimal acoustic window. The use of high frequency, even linear transducers, usually results in detailed images of all pancreatic areas. A wide spectrum of pancreatic pathologic conditions can be identified and monitored at ultrasound although they are relatively uncommon during childhood compared to the adult. In this paper we briefly review the anatomy, technique, and sonographic aspects of normal and pathological pediatric pancreas.
Topics: Anatomic Variation; Child; Humans; Pancreas; Pancreatic Diseases; Reference Values; Ultrasonography
PubMed: 30552664
DOI: 10.1007/s40477-018-0348-8 -
Diabetic Medicine : a Journal of the... Dec 2023This review aims to introduce research in the pancreas to a broader audience. The pancreas is a heterocrine gland residing deep within our abdominal cavity. It is the... (Review)
Review
AIMS
This review aims to introduce research in the pancreas to a broader audience. The pancreas is a heterocrine gland residing deep within our abdominal cavity. It is the home to our islets, which play a pivotal role in regulating metabolic homeostasis. Due to its structure and location, it is an impossible organ to study, in molecular detail, in living humans, and yet, understanding the pancreas is critical if we aim to characterise the immunopathology of type 1 diabetes (T1D) and one day prevent the triggering of the autoimmune attack associated with ß-cell demise.
METHODS
Over a 100 years ago, we began studying pancreatic histology using cadaveric samples and clever adaptations to microscopes. As histologists, some may say nothing much has changed. Nevertheless, our microscopes can now interrogate multiple proteins at molecular resolution. Images of pancreas sections are no longer constrained to a single field of view and can capture a thousands and thousands of cells. AI-image-analysis packages can analyse these massive data sets offering breakthrough findings.
CONCLUSION
This narrative review will provide an overview of pancreatic anatomy, and the importance of research focused on the pancreas in T1D. It will range from histological breakthroughs to briefly discussing the challenges associated with characterising the organ. I shall briefly introduce a selection of the available global biobanks and touch on the distinct pancreatic endotypes that differ immunologically and in ß-cell behaviour. Finally, I will introduce the idea of developing a collaborative tool aimed at developing a cohesive framework for characterising heterogeneity and stratifying endotypes in T1D more readily.
Topics: Humans; Diabetes Mellitus, Type 1; Pancreas; Islets of Langerhans
PubMed: 37735524
DOI: 10.1111/dme.15228 -
International Journal of Environmental... Jun 2022There is an increasing consensus that exercise is a medicine and that regular exercise can effectively improve and prevent metabolic diseases such as diabetes. Islet... (Review)
Review
There is an increasing consensus that exercise is a medicine and that regular exercise can effectively improve and prevent metabolic diseases such as diabetes. Islet cells are the endocrine of the pancreas and vital to the development of diabetes. Decades of developmental research in exercise intervention and the health of islet cells confirmed that exercise exerts beneficial effects on the function, proliferation, and survival rate of islet cells. However, the precise exercise reference scheme is still elusive. To accomplish this goal, we searched and analyzed relevant articles, and concluded the precise exercise prescription treatments for various species such as humans, rats, and mice. Each exercise protocol is shown in the tables below. These exercise protocols form a rich pipeline of therapeutic development for exercise on the health of islet cells.
Topics: Animals; Exercise Therapy; Humans; Insulin; Insulin-Secreting Cells; Islets of Langerhans; Mice; Pancreas; Physical Conditioning, Animal; Rats
PubMed: 35742478
DOI: 10.3390/ijerph19127229 -
Injury Mar 2020Duodenopancreatic trauma is rare and presents high morbidity and mortality rates. Pancreaticoduodenectomy (PD) is the only possible treatment indicated for the most... (Review)
Review
INTRODUCTION
Duodenopancreatic trauma is rare and presents high morbidity and mortality rates. Pancreaticoduodenectomy (PD) is the only possible treatment indicated for the most complex injuries (grades IV and V). Although, it is commonly a one-stage procedure, damage control surgery corroborates with a two-stage PD performed on unstable trauma victims.
OBJECTIVES
Compare the mortality rate of one and two-stage PD in trauma patients.
MATERIALS AND METHODS
A systematic electronic search of PubMed, Elsevier, LILACS, Scielo, and Capes was conducted on all studies written in English, Portuguese and Spanish with no restriction to publication dates. Review articles, case reports, editorials, animal studies, pediatric and non-trauma scenarios were excluded.
RESULTS
We selected twenty-two publications, with a total of 149 duodenopancreatic trauma victims who underwent PD, with an overall mortality rate of 42 patients (28.2%). Two-stage PD was exclusively performed on unstable patients (N = 31) with a mortality rate of 38.7%. In a sample of 79 patients submitted to a one-stage PD, 38 patients (48.1%) were unstable with a mortality rate of 34.2%. One-stage PD for stable patients had a mortality rate of 14.6% DISCUSSION: Since 1983, hemodynamic state impacts on surgery methods and strategies for trauma patients. Prior to that, one stage PD was not restricted to stable patients.
CONCLUSION
There were no differences in mortality rates when comparing two and one-stage PD in hemodynamic unstable patients, who had duodenopancreatic lesions (grades IV or V).
Topics: Duodenum; Humans; Pancreas; Pancreaticoduodenectomy
PubMed: 32057460
DOI: 10.1016/j.injury.2020.01.018 -
Cell Stem Cell Apr 2023Understanding the origin of pancreatic β cells has profound implications for regenerative therapies in diabetes. For over a century, it was widely held that adult...
Understanding the origin of pancreatic β cells has profound implications for regenerative therapies in diabetes. For over a century, it was widely held that adult pancreatic duct cells act as endocrine progenitors, but lineage-tracing experiments challenged this dogma. Gribben et al. recently used two existing lineage-tracing models and single-cell RNA sequencing to conclude that adult pancreatic ducts contain endocrine progenitors that differentiate to insulin-expressing β cells at a physiologically important rate. We now offer an alternative interpretation of these experiments. Our data indicate that the two Cre lines that were used directly label adult islet somatostatin-producing ∂ cells, which precludes their use to assess whether β cells originate from duct cells. Furthermore, many labeled ∂ cells, which have an elongated neuron-like shape, were likely misclassified as β cells because insulin-somatostatin coimmunolocalizations were not used. We conclude that most evidence so far indicates that endocrine and exocrine lineage borders are rarely crossed in the adult pancreas.
Topics: Insulin-Secreting Cells; Evidence Gaps; Cell Differentiation; Pancreas; Pancreatic Ducts; Insulin; Somatostatin
PubMed: 37028408
DOI: 10.1016/j.stem.2023.03.003 -
Pancreatology : Official Journal of the... Mar 2022The dorsal pancreatic artery is the main artery of the body and tail of the pancreas. Its origin and branching is highly variable. The aim of this study was to perform a... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND/OBJECTIVES
The dorsal pancreatic artery is the main artery of the body and tail of the pancreas. Its origin and branching is highly variable. The aim of this study was to perform a meta-analysis to generate pooled prevalence data on the presence and origin of the dorsal pancreatic artery. Clinically important aspects of the dorsal pancreatic artery were summarised during the literature review.
METHODS
Major medical databases were searched. Data on the presence and point of origin of the dorsal pancreatic artery were extracted and quantitatively synthesised. The obtained data of anatomical based studies and computed tomography based studies were statistically analysed.
RESULTS
In total, 30 studies, comprising 2322 anatomical and computed tomography based cases were included. The dorsal pancreatic artery was present in 95.8% of cases. It originated from the splenic artery in 37.6% of cases, common hepatic artery in 18.3% of cases, coeliac trunk in 11.9% of cases and the superior mesenteric artery in 23.9% of cases. Other rare origins were present in 2.77% of cases. Multiple dorsal pancreatic arteries were found in 1,7% of cases. There was no significant difference in the presence or origin of the dorsal pancreatic artery between anatomical and computed tomography based studies.
CONCLUSION
The dorsal pancreatic artery is present in the vast majority of cases. Its origin and branching are highly variable. Multiplicity of the dorsal pancreatic artery is infrequent.
Topics: Celiac Artery; Humans; Mesenteric Artery, Superior; Pancreas; Splenic Artery; Tomography, X-Ray Computed
PubMed: 35177332
DOI: 10.1016/j.pan.2022.02.002 -
World Journal of Gastroenterology Mar 2023Pancreatic ductal adenocarcinoma is speculated to become the second leading cause of cancer-related mortality by 2030, a high mortality rate considering the number of... (Review)
Review
Pancreatic ductal adenocarcinoma is speculated to become the second leading cause of cancer-related mortality by 2030, a high mortality rate considering the number of cases. Surgery and chemotherapy are the main treatment options, but they are burdensome for patients. A clear histological diagnosis is needed to determine a treatment plan, and endoscopic ultrasound (EUS)-guided tissue acquisition (TA) is a suitable technique that does not worsen the cancer-specific prognosis even for lesions at risk of needle tract seeding. With the development of personalized medicine and precision treatment, there has been an increasing demand to increase cell counts and collect specimens while preserving tissue structure, leading to the development of the fine-needle biopsy (FNB) needle. EUS-FNB is rapidly replacing EUS-guided fine-needle aspiration (FNA) as the procedure of choice for EUS-TA of pancreatic cancer. However, EUS-FNA is sometimes necessary where the FNB needle cannot penetrate small hard lesions, so it is important clinicians are familiar with both. Given these recent dev-elopments, we present an up-to-date review of the role of EUS-TA in pancreatic cancer. Particularly, technical aspects, such as needle caliber, negative pressure, and puncture methods, for obtaining an adequate specimen in EUS-TA are discussed.
Topics: Humans; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Pancreatic Neoplasms; Pancreas; Endosonography
PubMed: 37032729
DOI: 10.3748/wjg.v29.i12.1863 -
Folia Medica Apr 2022Anomalies and variants of development of the pancreas are relatively frequent. These variations can often lead to misdiagnosis and unnecessary medical procedures....
Anomalies and variants of development of the pancreas are relatively frequent. These variations can often lead to misdiagnosis and unnecessary medical procedures. Although, pancreatic diseases are a constantly researched field, fundamental research is relatively understudied and re-evaluation of the pancreatic morphology is performed rarely.
Topics: Pancreas
PubMed: 35851771
DOI: 10.3897/folmed.64.e60567 -
The Journal of Trauma and Acute Care... Jan 2020
Topics: Abdominal Injuries; Accidents, Aviation; Adult; Hemorrhage; Humans; Male; Meta-Analysis as Topic; Pancreas; Pancreatectomy; Pancreatic Diseases; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 31804416
DOI: 10.1097/TA.0000000000002546