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Magnetic Resonance Imaging Clinics of... Aug 2022This article presents the MR protocols, imaging features, diagnostic criteria, and complications of commonly encountered emergencies in pancreaticobiliary imaging, which... (Review)
Review
This article presents the MR protocols, imaging features, diagnostic criteria, and complications of commonly encountered emergencies in pancreaticobiliary imaging, which include pancreatic trauma, bile leak, acute cholecystitis, biliary obstruction, and pancreatitis. Various classifications and complications that can arise with these conditions, as well as artifacts that may mimic pathology, are also included. Finally, the emerging utility of abbreviated MR protocols is discussed.
Topics: Biliary Tract Diseases; Emergencies; Humans; Magnetic Resonance Imaging; Pancreatic Diseases; Pancreatitis
PubMed: 35995475
DOI: 10.1016/j.mric.2022.04.009 -
International Journal of Molecular... Mar 2022Common pancreatic diseases have caused significant economic and social burdens worldwide. The interstitial microenvironment is involved in and plays a crucial part in... (Review)
Review
Common pancreatic diseases have caused significant economic and social burdens worldwide. The interstitial microenvironment is involved in and plays a crucial part in the occurrence and progression of pancreatic diseases. Innate lymphoid cells (ILCs), an innate population of immune cells which have only gradually entered our visual field in the last 10 years, play an important role in maintaining tissue homeostasis, regulating metabolism, and participating in regeneration and repair. Recent evidence indicates that ILCs in the pancreas, as well as in other tissues, are also key players in pancreatic disease and health. Herein, we examined the possible functions of different ILC subsets in common pancreatic diseases, including diabetes mellitus, pancreatitis and pancreatic cancer, and discussed the potential practical implications of the relevant findings for future further treatment of these pancreatic diseases.
Topics: Homeostasis; Humans; Immunity, Innate; Lymphocytes; Pancreatic Diseases
PubMed: 35409105
DOI: 10.3390/ijms23073748 -
Pancreatology : Official Journal of the... Oct 2020Zinc is an essential trace element. Deficiencies are frequently seen with gastrointestinal diseases, including chronic pancreatitis, nutritional deficiency, and reduced... (Review)
Review
Zinc is an essential trace element. Deficiencies are frequently seen with gastrointestinal diseases, including chronic pancreatitis, nutritional deficiency, and reduced intestinal absorption. Additionally, reduced zinc levels have been linked to cellular changes associated with acute pancreatitis such as enhanced inflammation with increased macrophage activation and production of inflammatory cytokines such as IL-1β, impaired autophagy, and modulation of calcium homeostasis. Preliminary data suggest that zinc deficiency may lead to pancreatic injury in animal models. The purpose of this review is to explore the biologic effects of zinc deficiency that could impact pancreatic disease. MESH KEYWORDS: Malnutrition, inflammation, trace element.
Topics: Animals; Humans; Inflammation; Pancreas; Pancreatic Diseases; Zinc
PubMed: 32917512
DOI: 10.1016/j.pan.2020.08.016 -
Digestive Endoscopy : Official Journal... Jan 2024Endoscopic retrograde cholangiopancreatography (ERCP) is an advanced endoscopic technique used to diagnose and treat biliary and pancreatic diseases. It is one of the... (Review)
Review
Endoscopic retrograde cholangiopancreatography (ERCP) is an advanced endoscopic technique used to diagnose and treat biliary and pancreatic diseases. It is one of the most technically demanding endoscopic procedures. ERCP training programs must ensure trainees have adequate knowledge of the anatomy and physiology associated with biliopancreatic diseases. The variety of ERCP procedures included in training programs should provide sufficient basic training for novice trainees and advanced training for experienced endoscopists. The main endoscopic procedures should be trained in ascending order of difficulty. Incorporating models capable of simulating various clinical and anatomical conditions could provide an effective means of fulfilling training requirements, although they are not easily available due to expensive facilities and void of standard assessment. Competency assessment is crucial in ERCP training to ensure trainees can independently and safely perform ERCP. Because of the rapid advancement of diagnostic and therapeutic methods, postgraduate training is critical for ERCP practitioners. Once certificates are attained, practitioners are solely responsible for maintaining their competency, credentialing, and quality.
Topics: Humans; Cholangiopancreatography, Endoscopic Retrograde; Pancreatic Diseases
PubMed: 37792821
DOI: 10.1111/den.14702 -
Nutrition in Clinical Practice :... Oct 2019Nonalcoholic fatty pancreas disease (NAFPD) describes a phenotype of pancreatic steatosis (PS) that is not caused by alcohol consumption, viral infections, toxins, or... (Review)
Review
Nonalcoholic fatty pancreas disease (NAFPD) describes a phenotype of pancreatic steatosis (PS) that is not caused by alcohol consumption, viral infections, toxins, or congenital metabolic syndromes but is associated with insulin resistance, malnutrition, obesity, metabolic syndrome, or increasing age. NAFPD is a relatively new disease entity, as the clinical significance of fatty infiltration of pancreas has gained attention recently. Clinical consequences of NAFPD remain largely unknown despite clinical associations. This review aims to study similarities and differences between hepatic and PS and explore recent advances in NAFPD.
Topics: Humans; Insulin Resistance; Lipid Metabolism Disorders; Malnutrition; Metabolic Syndrome; Non-alcoholic Fatty Liver Disease; Obesity; Pancreas; Pancreatic Diseases; Risk Factors
PubMed: 31535735
DOI: 10.1002/ncp.10397 -
Seminars in Ultrasound, CT, and MR Dec 2019This article explores the technical background of dual-energy CT (DECT) imaging along with its basic principles, before turning to a review of the various DECT... (Review)
Review
This article explores the technical background of dual-energy CT (DECT) imaging along with its basic principles, before turning to a review of the various DECT applications specific to pancreatic imaging. In light of the most recent literature, we will review the constellation of DECT applications available for pancreatic imaging in both oncologic and non-oncologic applications. We emphasize the increased lesion conspicuity and the improved tissue characterization available with DECT post-processing tools. Finally, future clinical applications and opportunities for research will be overviewed.
Topics: Contrast Media; Diagnosis, Differential; Humans; Pancreatic Diseases; Radiographic Image Interpretation, Computer-Assisted; Radiography, Dual-Energy Scanned Projection; Tomography, X-Ray Computed
PubMed: 31806149
DOI: 10.1053/j.sult.2019.05.002 -
Frontiers in Endocrinology 2023To assess the prevalence of pancreatic steatosis and iron overload in non-alcoholic fatty liver disease (NAFLD) and their correlation with liver histology severity and...
OBJECTIVE
To assess the prevalence of pancreatic steatosis and iron overload in non-alcoholic fatty liver disease (NAFLD) and their correlation with liver histology severity and the risk of cardiometabolic diseases.
METHOD
A prospective, multicenter study including NAFLD patients with biopsy and paired Magnetic Resonance Imaging (MRI) was performed. Liver biopsies were evaluated according to NASH Clinical Research Network, hepatic iron storages were scored, and digital pathology quantified the tissue proportionate areas of fat and iron. MRI-biomarkers of fat fraction (PDFF) and iron accumulation (R2*) were obtained from the liver and pancreas. Different metabolic traits were evaluated, cardiovascular disease (CVD) risk was estimated with the atherosclerotic CVD score, and the severity of iron metabolism alteration was determined by grading metabolic hiperferritinemia (MHF). Associations between CVD, histology and MRI were investigated.
RESULTS
In total, 324 patients were included. MRI-determined pancreatic iron overload and moderate-to severe steatosis were present in 45% and 25%, respectively. Liver and pancreatic MRI-biomarkers showed a weak correlation (r=0.32 for PDFF, r=0.17 for R2*). Pancreatic PDFF increased with hepatic histologic steatosis grades and NASH diagnosis (<0.001). Prevalence of pancreatic steatosis and iron overload increased with the number of metabolic traits (<0.001). Liver R2* significantly correlated with MHF (AUC=0.77 [0.72-0.82]). MRI-determined pancreatic steatosis (OR=3.15 [1.63-6.09]), and iron overload (OR=2.39 [1.32-4.37]) were independently associated with high-risk CVD. Histologic diagnosis of NASH and advanced fibrosis were also associated with high-risk CVD.
CONCLUSION
Pancreatic steatosis and iron overload could be of utility in clinical decision-making and prognostication of NAFLD.
Topics: Humans; Non-alcoholic Fatty Liver Disease; Cardiovascular Diseases; Prospective Studies; Risk Factors; Lipid Metabolism Disorders; Pancreatic Diseases; Iron Overload; Iron; Heart Disease Risk Factors
PubMed: 37600695
DOI: 10.3389/fendo.2023.1213441 -
Molecular Medicine Reports Jul 2024As a pluripotent cell, activated pancreatic stellate cells (PSCs) can differentiate into various pancreatic parenchymal cells and participate in the secretion of... (Review)
Review
As a pluripotent cell, activated pancreatic stellate cells (PSCs) can differentiate into various pancreatic parenchymal cells and participate in the secretion of extracellular matrix and the repair of pancreatic damage. Additionally, PSCs characteristics allow them to contribute to pancreatic inflammation and carcinogenesis. Moreover, a detailed study of the pathogenesis of activated PSCs in pancreatic disease can offer promise for the development of innovative therapeutic strategies and improved patient prognoses. Therefore, the present study review aimed to examine the involvement of activated PSCs in pancreatic diseases and elucidate the underlying mechanisms to provide a viable therapeutic strategy for the management of pancreas‑related diseases.
Topics: Humans; Pancreatic Stellate Cells; Pancreas; Pancreatic Diseases; Animals; Extracellular Matrix; Cell Differentiation; Pancreatic Neoplasms
PubMed: 38695254
DOI: 10.3892/mmr.2024.13233 -
Nutrition in Clinical Practice :... Oct 2019The diagnosis of exocrine pancreatic insufficiency (EPI) can be difficult, as symptoms may be nonspecific. A delayed diagnosis of EPI can negatively impact health... (Review)
Review
The diagnosis of exocrine pancreatic insufficiency (EPI) can be difficult, as symptoms may be nonspecific. A delayed diagnosis of EPI can negatively impact health through poor weight gain, impaired growth, and malabsorption of nutrients. Because of active growth and development, children are more vulnerable to the consequences of untreated EPI. Pancreatic enzyme replacement therapy is the cornerstone of management and offers both symptomatic relief and improvement in clinical outcomes. Additionally, a high-energy diet with unrestricted fat and supplementation with fat-soluble vitamins is often required to optimize growth and prevent nutrition deficiencies. Cystic fibrosis (CF) is the most common condition in children that causes EPI, and improvement in nutrition management is associated with improved pulmonary function and increased survival. Currently, the management of other conditions leading to EPI in children is not well studied, and inferences from the CF literature are often necessary in caring for these patients.
Topics: Child; Cystic Fibrosis; Diet; Dietary Supplements; Disease Management; Enzyme Replacement Therapy; Exocrine Pancreatic Insufficiency; Female; Humans; Male; Nutrition Disorders; Nutrition Therapy; Pancreas
PubMed: 31535732
DOI: 10.1002/ncp.10388 -
Digestive Diseases and Sciences Nov 2020Despite the increased global recognition of pediatric pancreatic diseases, there are limited data on the utility of sophisticated endoscopic procedures such as... (Review)
Review
Despite the increased global recognition of pediatric pancreatic diseases, there are limited data on the utility of sophisticated endoscopic procedures such as endoscopic ultrasonography (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) in their management. Promising results of recent studies have highlighted the emerging therapeutic utility of EUS and ERCP in children. With these latest developments in mind, this article reviews the current literature regarding diagnostic and therapeutic uses, benefits, limitations, and clinical outcomes of EUS and ERCP in pediatric pancreatology.
Topics: Child; Cholangiopancreatography, Endoscopic Retrograde; Endosonography; Humans; Pancreatic Diseases
PubMed: 32757158
DOI: 10.1007/s10620-020-06513-x