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Gastrointestinal Endoscopy Clinics of... Apr 2023Children and adolescents are increasingly impacted by pancreatic disease. Interventional endoscopic procedures, including endoscopic retrograde cholangiopancreatography)... (Review)
Review
Children and adolescents are increasingly impacted by pancreatic disease. Interventional endoscopic procedures, including endoscopic retrograde cholangiopancreatography) and endoscopic ultrasonography, are integral to the diagnosis and management of many pancreatic diseases in the adult population. In the past decade, pediatric interventional endoscopic procedures have become more widely available, with invasive surgical procedures now being replaced by safer and less disruptive endoscopic interventions.
Topics: Adult; Child; Humans; Adolescent; Pancreas; Pancreatitis; Endoscopy; Cholangiopancreatography, Endoscopic Retrograde; Pancreatic Diseases; Endosonography
PubMed: 36948751
DOI: 10.1016/j.giec.2022.11.002 -
Advances in Clinical Chemistry 2022Diagnosis of chronic gastrointestinal and pancreatic diseases is challenging because patients generally present with nonspecific symptoms, such as abdominal pain and...
Diagnosis of chronic gastrointestinal and pancreatic diseases is challenging because patients generally present with nonspecific symptoms, such as abdominal pain and chronic diarrhea, some of which can last for many years. Although stool assays are more sensitive than serum assays, the former has unique limitations that healthcare providers should be aware of. One algorithm to screen for chronic gastrointestinal and pancreatic issues is to perform stool testing to assess inflammatory, watery (osmotic) and malabsorptive conditions. This chapter will discuss several stool-based screening tests, the major disorders they screen for and clinical performance. Sections on assay and sample limitations are also included. Stool testing can provide valuable diagnostic, prognostic and treatment response information if both the laboratory and clinician understand the benefits and limitations of these assays.
Topics: Diarrhea; Feces; Humans; Pancreatic Diseases; Prognosis
PubMed: 35659059
DOI: 10.1016/bs.acc.2021.09.008 -
Gastrointestinal Endoscopy Clinics of... Oct 2023In the last half century, endotherapy for pancreatic diseases has changed considerably. Although endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic... (Review)
Review
In the last half century, endotherapy for pancreatic diseases has changed considerably. Although endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) were introduced initially as diagnostic tools, they quickly evolved into therapeutic tools for preventing and managing complications of pancreatitis. More recently, therapeutic endoscopy has shown potential in palliation and cure of pancreatic neoplasms. This article discusses the changing landscape of pancreatic endotherapy as therapeutic ERCP and EUS were introduced and because they have evolved to treat different diseases.
Topics: Humans; Pancreas; Cholangiopancreatography, Endoscopic Retrograde; Endosonography; Pancreatitis; Pancreatic Diseases
PubMed: 37709404
DOI: 10.1016/j.giec.2023.03.012 -
Digestive Endoscopy : Official Journal... May 2022
Topics: Biliary Tract Diseases; Endoscopy; Humans; Pancreatic Diseases
PubMed: 34431144
DOI: 10.1111/den.14091 -
Minerva Gastroenterologica E Dietologica Mar 2020
Topics: Humans; Inflammatory Bowel Diseases; Pancreatic Diseases
PubMed: 32283880
DOI: 10.23736/S1121-421X.20.02668-9 -
Best Practice & Research. Clinical... 2022Endoscopic ultrasound (EUS) is an essential technique for the management of several diseases. Over the years, new technologies have been developed because to improve and... (Review)
Review
Endoscopic ultrasound (EUS) is an essential technique for the management of several diseases. Over the years, new technologies have been developed because to improve and overcome certain limitations related to EUS guided tissue acquisition. Among these new methods, EUS guided elastography and contrast enhanced EUS has arisen as the most widely recognized and available. We will review in this manuscript the different techniques of elastography and contrast enhancement. Nowadays, there are well establish indications for advance imaging, mainly for supporting the management of pancreatic diseases (diagnosis of chronic pancreatitis and differential diagnosis of solid and cystic pancreatic tumors) and characterization of lymph nodes. However, there are more data on new potential indications for the near future.
Topics: Humans; Endosonography; Pancreatic Diseases; Pancreatic Neoplasms; Pancreatitis, Chronic; Diagnosis, Differential
PubMed: 36577529
DOI: 10.1016/j.bpg.2022.101808 -
Biomedical Papers of the Medical... Dec 2022Although symptoms of pancreatic diseases such as pancreatitis, acute and chronic and, carcinoma of the pancreas are mainly gastrointestinal in nature, the... (Review)
Review
Although symptoms of pancreatic diseases such as pancreatitis, acute and chronic and, carcinoma of the pancreas are mainly gastrointestinal in nature, the extra-pancreatic symptoms are also important. These include skin symptoms, such as pancreatic panniculitis, acanthosis nigricans, livedo reticularis, necrolytic migratory erythema, cutaneous signs of hemorrhage, as in persons with severe acute pancreatitis, or the finding of cutaneous metastases of pancreatic carcinoma, which may be a sign of advanced disease. The pancreas is therefore one of those organs for which diagnosis and therapy are often multidisciplinary. In this review article, we summarize current knowledge of the possible skin manifestations of pancreatic disorders.
Topics: Humans; Acute Disease; Pancreatitis; Pancreatic Diseases; Skin Diseases; Skin; Pancreatic Neoplasms
PubMed: 35938387
DOI: 10.5507/bp.2022.035 -
Current Opinion in Gastroenterology Sep 2019Pancreatic steatosis is a clinical entity with emerging significance and impacts patient health in a multitude of ways. It has a high prevalence in the global population... (Review)
Review
PURPOSE OF REVIEW
Pancreatic steatosis is a clinical entity with emerging significance and impacts patient health in a multitude of ways. It has a high prevalence in the global population with predilections for different demographics by age, sex and ethnicity. Understanding the pathophysiology, clinical features and complications of this entity may be important to understanding the consequences of the ongoing obesity global epidemic.
RECENT FINDINGS
Obesity and metabolic syndrome contribute to metabolic derangements that result in lipid mishandling by adipocytes. Adipocytokine imbalances in circulation and in the pancreatic microenvironment cause chronic, low-grade inflammation. The resulting beta cell and acinar cell apoptosis leads to pancreatic endocrine and exocrine dysfunction. Furthermore, these adipocytokines regulate cell growth, differentiation, as well as angiogenesis and lymphatic spread. These consequences of adipocyte infiltration are thought to initiate carcinogenesis, leading to pancreatic intraepithelial neoplasia and pancreatic ductal adenocarcinoma.
SUMMARY
Obesity will lead to millions of deaths each year and pancreatic steatosis may be the key intermediate entity that leads to obesity-related complications. Enhancing our understanding may reveal strategies for preventing mortality and morbidity related to the global epidemic of obesity. Further research is needed to determine the pathophysiology, long-term complications and effective treatment strategies for this condition.
Topics: Adipose Tissue; Humans; Inflammation; Lipid Metabolism; Lipid Metabolism Disorders; Metabolic Syndrome; Obesity; Pancreas; Pancreatic Diseases; Risk Factors
PubMed: 31343416
DOI: 10.1097/MOG.0000000000000566 -
Pancreatology : Official Journal of the... Apr 2020Lipocalin-2 (LCN2) is a secreted molecule, expressed in various cell types, that is involved in the progression of numerous diseases and disorders. The biological... (Review)
Review
Lipocalin-2 (LCN2) is a secreted molecule, expressed in various cell types, that is involved in the progression of numerous diseases and disorders. The biological functions and expression levels of LCN2 in diseases including pancreatic cancer, pancreatitis (acute and chronic), and diabetes mellitus, suggest the potential role of LCN2 as a biomarker and/or therapeutic target. However, findings on the role of LCN2 in pancreatic diseases have been contradictory. In pancreatic cancer and pancreatitis, LCN2 has been identified as a potential biomarker; increased expression levels in various biological specimens correlate with the presence of the disease and may be able to differentiate cancer and chronic pancreatitis from healthy subjects. LCN2 is also known to be an adipokine; it is upregulated in obesity and is a common co-factor in the development of pancreatic diseases. Emerging research suggests LCN2 is elevated in type 2 diabetes mellitus, but the exact role of LCN2 in this disease is not clear. In this review, we summarize research on LCN2 as it relates to pancreatic diseases, highlighting the discrepancies in the literature. By explaining and clarifying the role of LCN2 in these disorders, we aim to promote research in developing novel diagnostic and treatment strategies to reduce the burden of pancreatic diseases.
Topics: Adipokines; Biomarkers; Gene Expression Regulation; Humans; Lipocalin-2; Pancreatic Diseases
PubMed: 31932215
DOI: 10.1016/j.pan.2020.01.002 -
Clinical Obstetrics and Gynecology Mar 2020The pancreas is an organ with both exocrine and endocrine functions that has a vital role in both digestion as well as glucose metabolism. Although pancreatic... (Review)
Review
The pancreas is an organ with both exocrine and endocrine functions that has a vital role in both digestion as well as glucose metabolism. Although pancreatic dysfunction and disorders are rare in pregnancy, they are becoming increasingly more common. Recognition of these disorders and understanding how they can affect pregnancy is imperative to allow for proper management. We provide an overview of the most common pancreatic disorders that are seen in pregnancy.
Topics: Cholangiopancreatography, Endoscopic Retrograde; Female; Humans; Pancreas; Pancreatic Diseases; Pregnancy; Pregnancy Complications
PubMed: 31789887
DOI: 10.1097/GRF.0000000000000503