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1.
Medicine (Baltimore) ; 100(8): e24730, 2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33663085

RESUMO

ABSTRACT: This study aims to investigate the effect of applying enhanced recovery after surgery methods (ERAS) in perioperative nursing of choledocholithiasis following endoscopic retrograde cholangiopancreatography (ERCP) for treatment of biliary calculus.Clinical data from 161 patients who underwent ERCP surgery in Wuhan Union Hospital from January 2017 to December 2019 were retrospectively analyzed. A total of 78 patients received perioperative nursing using the ERAS concept (experimental group) and 83 patients received conventional perioperative nursing (control group). Group differences were compared for the time to first postoperative ambulation, exhausting time, time to first defecation and eating, intraoperative blood loss, postoperative complication incidence (pancreatitis, cholangitis, hemorrhage), white blood cell (WBC), and serum amylase (AMS) values at 24 hours, duration of nasobiliary duct indwelling, length of hospital stay, and hospitalization expenses.No significant between-group differences were noted for demographic characteristics (age, sex, BMI, ASA score, and comorbidity) (P > .05). Time to first ambulation, exhausting time, time to defecation and eating, and nasobiliary drainage time were shorter in the experimental group than the control group, and the differences were statistically significant (P < .05). There was no significant between-group difference in postoperative WBC values at 24 hours (P > .05), but the experimental group's AMS values at 24 hours postoperation were significantly lower than those of the controls (154.93 ±â€Š190.01 vs 241.97 ±â€Š482.64, P = .031). Postoperative complications incidence was 9.1% in the experimental group, which was significantly lower than the 20.4% in the control group, and this difference was statistically significant (P = .039). Compared with the control group, nasobiliary drainage time (26.53 ±â€Š7.43 hours vs 37.56 ±â€Š9.91 hours, P < .001), hospital stay (8.32 ±â€Š1.55 days vs 4.56 ±â€Š1.38 days, P < .001), and hospitalization expenses (36800 ±â€Š11900 Yuan vs 28900 ±â€Š6500 Yuan, P = .016) were significantly lower in the experimental group.ERAS is a safe and effective perioperative nursing application in ERCP for treating choledocholithiasis. It can effectively accelerate patients' recovery and reduce the incidence of complications; therefore, it is worthy of being applied and promoted in clinical nursing.


Assuntos
Colangiopancreatografia Retrógrada Endoscópica/métodos , Colangiopancreatografia Retrógrada Endoscópica/enfermagem , Coledocolitíase/cirurgia , Recuperação Pós-Cirúrgica Melhorada , Adulto , Idoso , Idoso de 80 Anos ou mais , Amilases/sangue , Deambulação Precoce , Feminino , Custos Hospitalares/estatística & dados numéricos , Humanos , Tempo de Internação/estatística & dados numéricos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos
3.
J Zoo Wildl Med ; 51(4): 933-947, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33480574

RESUMO

The blue iguana (Cyclura lewisi) is an endangered rock iguana species native to Grand Cayman, in the Cayman Islands. Health assessments were conducted on captive and free-roaming iguanas in 2001 and 2003-2014 and were performed in the summer wet season (June-July) of 2003-2004 and 2010-2014 and in the winter dry season (November-December) of 2001 and 2005-2009. Morphometric data were recorded from iguanas when blood samples were collected: 903 samples were collected and data from 890 samples from 775 iguanas were included. Samples were analyzed for hematology, plasma biochemistry, protein electrophoresis, mineral panels, 25-hydroxyvitamin D, and testosterone. Reference intervals were created for captive subadults, captive adults, and free-roaming adults when data were sufficient. Significant differences among these groups were described, as were differences on the basis of sex, season, and origin (captive vs free-roaming). In captive iguanas, most analytes were significantly different between subadults and adults, mature heterophils and copper were significantly higher in the dry season, zinc levels were significantly higher in the wet season, and cholesterol and triglycerides were significantly higher in adult females than adult males. Testosterone in adult males was significantly higher in the dry season. These results will aid in future health assessments and disease investigations in wild and captive populations of blue iguanas and are of comparative value for other Cyclura species that are free-roaming, captive, and, especially, in similar conservation release programs.


Assuntos
Proteínas Sanguíneas/química , Eletroforese/veterinária , Contagem de Eritrócitos/veterinária , Hematócrito/veterinária , Iguanas/sangue , Contagem de Leucócitos/veterinária , Amilases/sangue , Animais , Aspartato Aminotransferases/sangue , Glicemia , Nitrogênio da Ureia Sanguínea , Cloretos/sangue , Colesterol/sangue , Creatina Quinase/sangue , Creatinina/sangue , Eletrólitos/sangue , L-Lactato Desidrogenase/sangue , Minerais/sangue , Valores de Referência , Índias Ocidentais
4.
J Zoo Wildl Med ; 51(4): 948-957, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33480575

RESUMO

The evaluation of laboratory blood analytes is an important tool for health assessment in avian medicine. Unfortunately, there is a lack of suitable reference values for many zoo bird species. The goal of the present study was to establish reference intervals for a wide range of blood analytes in healthy black-headed ibis (Threskiornis melanocephalus) kept in a zoologic garden. Lithium heparinized blood samples from 15 individuals were collected, and 18 different clinical chemistry analytes were measured. New are especially the minimum and maximum values for bile acid (2.38-49.4 µmol/L), cholinesterase (439-1260 U/L), vitamin A (0.65-1.70 mg/L), vitamin E (26.3-52.5 mg/L), and capillary zone electrophoresis (prealbumin, 10.2-23.4%; albumin, 35.9-44.1%; A/G ratio, 1.07-1.69; α-, 15.7-20.0%; ß-, 13.5-19.1%; γ-globulin, 6.08-11.3%). The measured values for clinical chemistry, vitamin, electrophoresis, and hematologic analytes are a basis for further studies and for diagnostics and clinical treatment in this ibis species.


Assuntos
Aves/sangue , Glicemia , Proteínas Sanguíneas/química , Eletroforese/veterinária , Vitaminas/sangue , Amilases/sangue , Animais , Colesterol/sangue , Colinesterases/sangue , Creatina Quinase/sangue , Minerais/sangue , Triglicerídeos/sangue
5.
Medicine (Baltimore) ; 99(43): e22887, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33120833

RESUMO

Hyperlipemia is a well-established etiology of acute pancreatitis. However, few data are available in the medical literature about the management of triglyceride levels in the outpatient setting in patients with hypertriglyceridemic acute pancreatitis (HTG-AP). We evaluated the blood triglyceride levels and followed the triglyceride management of patients with HTG-AP.This retrospective study enrolled patients with HTG-AP from January 2013 to March 2019 in the Affiliated Hospital of Southwest Medical of University. By reviewing the hospitalization records and the follow-up data, the clinical features, blood triglyceride levels, use of lipid-lowering medications and rate of blood triglyceride levels monitoring after hospital discharge were analyzed.A total of 133 patients (46 women, 87 men; median age at presentation 37.4 years) diagnosed with HTG-AP were enrolled in the study. Thirty-two patients (24.1%) presented with recurrent acute pancreatitis (RAP). Patients who had RAP were younger and had higher blood triglyceride levels than those with a single attack (P < .05). No difference in serum amylase levels, hospitalization duration or mortality rate were observed between non-recurrent acute pancreatitis and RAP patients. Lipid monitoring was only observed in 12.8% of patients and 10 patients (7.5%) took medications to control their blood triglyceride levels after hospital discharge. The follow-up of triglyceride levels in the outpatient setting were higher in RAP patients than in patients with non-recurrent acute pancreatitis (P < .05). Among the patients who measured their triglyceride levels after discharge, 83.3% of patients with RAP had at least 1 follow-up triglyceride level that was higher than 500 mg/dL, while no patients had an HTG-AP attack with a triglyceride level higher than 500 mg/dL.Triglyceride levels after hospital discharge higher than 500 mg/dL may be associated with an increased risk of relapse of clinical acute pancreatitis events. Inappropriate management for triglyceride control in the outpatient setting may be associated with an increased risk of relapse of clinical HTG-AP events.


Assuntos
Hiperlipidemias/complicações , Hipertrigliceridemia/tratamento farmacológico , Hipolipemiantes/uso terapêutico , Pancreatite/etiologia , Adulto , Amilases/sangue , Estudos de Casos e Controles , China/epidemiologia , Feminino , Seguimentos , Hospitalização/estatística & dados numéricos , Humanos , Hipertrigliceridemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Mortalidade , Pacientes Ambulatoriais/estatística & dados numéricos , Pancreatite/diagnóstico , Alta do Paciente , Recidiva , Estudos Retrospectivos , Triglicerídeos/sangue
6.
Lancet ; 396(10252): 726-734, 2020 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-32891214

RESUMO

Acute pancreatitis is an unpredictable and potentially lethal disease. The prognosis mainly depends on the development of organ failure and secondary infection of pancreatic or peripancreatic necrosis. In the past 10 years, treatment of acute pancreatitis has moved towards a multidisciplinary, tailored, and minimally invasive approach. Despite improvements in treatment and critical care, severe acute pancreatitis is still associated with high mortality rates. In this Seminar, we outline the latest evidence on diagnostic and therapeutic strategies for acute pancreatitis.


Assuntos
Antibacterianos/uso terapêutico , Colangiopancreatografia Retrógrada Endoscópica , Drenagem , Hidratação , Apoio Nutricional , Pancreatite/diagnóstico , Pancreatite/terapia , Amilases/sangue , Colecistectomia , Diabetes Mellitus/etiologia , Diabetes Mellitus/terapia , Insuficiência Pancreática Exócrina/etiologia , Insuficiência Pancreática Exócrina/terapia , Cálculos Biliares/complicações , Cálculos Biliares/cirurgia , Humanos , Lipase/sangue , Imagem por Ressonância Magnética , Pancreatite/sangue , Pancreatite/etiologia , Pancreatite Necrosante Aguda/diagnóstico , Pancreatite Necrosante Aguda/etiologia , Pancreatite Necrosante Aguda/terapia , Pancreatite Alcoólica/diagnóstico , Pancreatite Alcoólica/terapia , Prevenção Secundária , Stents , Tomografia Computadorizada por Raios X , Ultrassonografia
7.
Pediatrics ; 146(3)2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32788268

RESUMO

BACKGROUND: Studies have increasingly challenged the traditional management of acute pancreatitis (AP) with bowel rest. However, these studies used a low-fat diet or transgastric feeding and only included adults. Aiming to generate higher-quality prospective pediatric data, we compared the traditional approach of fasting and intravenous fluids and early enteral feeding with standard diet or formula. METHODS: Randomized controlled trial of children (2-18 years) with mild-moderate AP. Patients were randomly assigned 1:1 to initial fasting and intravenous fluids or an immediate, unrestricted diet. Pain scores, blood measures, and cross-sectional imaging were recorded throughout admission and follow-up. The primary outcome was time to discharge, and secondary outcomes were clinical and biochemical resolution and local and systemic complication rates. RESULTS: Of 33 patients (17 [52%] boys, mean age of 11.5 [±4.8] years), 18 (55%) were randomly assigned to early feeding and 15 (45%) were randomly assigned to initial fasting. We recorded the median (interquartile range [IQR]) time to discharge (2.6 [IQR 2.0 to 4.0] vs 2.9 [IQR 1.8 to 5.6]; P = .95), reduction in serum lipase levels by day 2 (58% [IQR 2% to 85%] vs 48% [IQR 3% to 71%]; P = .65), and readmission rates (1 of 18 [6%] vs 2 of 15 [13%]; P = .22) between the early feeding and fasting cohorts, respectively. Immediate or delayed complication rates did not differ. Patients randomly assigned to early feeding had weight gain of 1.3 kg (IQR 0.29 to 3.6) at follow-up, compared with weight loss of 0.8 kg (IQR -2.1 to 0.7) in fasted patients (P = .028). CONCLUSIONS: This is the first randomized controlled trial in pediatric AP. There was no difference between early commencement of a standard oral diet and initial fast in any of the major outcome measures.


Assuntos
Dieta/normas , Nutrição Enteral , Jejum , Hidratação/métodos , Fórmulas Infantis , Pancreatite/terapia , Doença Aguda , Adolescente , Amilases/sangue , Criança , Pré-Escolar , Feminino , Humanos , Lipase/sangue , Masculino , Avaliação de Resultados em Cuidados de Saúde , Pancreatite/sangue , Readmissão do Paciente/estatística & dados numéricos , Estudos Prospectivos , Ganho de Peso
8.
BMC Oral Health ; 20(1): 184, 2020 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-32615964

RESUMO

BACKGROUND: Late diagnosis of a salivary fistula increases the risk of wound infection and scarring. The purpose of the present study was to identify a quantitative predictor of postoperative salivary fistula for cases treated with surgery. METHODS: Demographic, intraoperative and postoperative parameters for 57 cases that received surgery for benign parotid tumours were recorded from June 2017 to June 2018, of which 18 cases developed salivary fistulas. These data were analysed using univariate and binary logistic regression analyses as well as receiver operating curve analysis. RESULTS: Drain fluid amylase concentration was positively correlated with salivary fistula development (p <  0.001), with an odds ratio of 1.14 for a 1 KU/L increase in concentration and an optimal receiver operating curve cut-off value of 51,100 U/L for predicting salivary fistula development. Cases wherein the parotid-masseteric fascia remained intact were associated with a lower risk of salivary fistula development (p = 0.006). CONCLUSION: Drain fluid amylase concentration may be a valuable predictor of postoperative salivary fistula in cases with benign parotid tumours.


Assuntos
Amilases , Glândula Parótida/cirurgia , Neoplasias Parotídeas/cirurgia , Complicações Pós-Operatórias , Fístula das Glândulas Salivares/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Amilases/sangue , Drenagem , Humanos , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Pancreaticoduodenectomia/efeitos adversos , Glândula Parótida/patologia , Valor Preditivo dos Testes , Resultado do Tratamento , Adulto Jovem
9.
Am J Trop Med Hyg ; 103(3): 1154-1155, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32662399

RESUMO

A 32-year-old medical practitioner presented to the emergency department with complaints of severe abdominal pain, fever, and vomiting, 1 week after the diagnosis of COVID-19. The patient did not report any comorbid conditions, alcohol usage, or gallstone disease. Laboratory and radiological investigations revealed the diagnosis of acute pancreatitis. He underwent conservative management and was discharged after 3 days of hospital admission. This case highlights a possible association between COVID-19 and acute pancreatitis, and the need for clinicians to carefully evaluate patients presenting with gastrointestinal complaints during the current pandemic.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Pancreatite/etiologia , Pneumonia Viral/complicações , Adulto , Amilases/sangue , Humanos , Masculino , Pancreatite/diagnóstico , Pandemias
11.
Intern Med ; 59(11): 1427-1431, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32475908

RESUMO

A 65-year-old woman presented to a hospital with complaints of dyspnea and lumbar pain. Chest computed tomography (CT) showed left pleural effusion. Thoracentesis showed pleural effusion with elevated levels of amylase. Enhanced CT showed fluid accumulation from the thoracic crus of the diaphragm to the left iliopsoas muscle. Based on the postoperative notes following left nephrectomy performed 29 years ago, we suspected that the internal pancreatic fistula had resulted from the postoperative scar. Conservative management was performed. However, occlusion of the pancreatic fistula failed. Subsequently, she underwent pancreatic body tail spleen merger resection, and the pleural effusion disappeared.


Assuntos
Nefrectomia/efeitos adversos , Fístula Pancreática/etiologia , Fístula Pancreática/cirurgia , Derrame Pleural/etiologia , Derrame Pleural/cirurgia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Idoso , Amilases/sangue , Exsudatos e Transudatos , Feminino , Humanos , Japão , Fístula Pancreática/diagnóstico por imagem , Derrame Pleural/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Resultado do Tratamento
12.
Pancreatology ; 20(4): 665-667, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32387082

RESUMO

BACKGROUND/OBJECTIVES: Abdominal pain is one of the known symptoms associated with coronavirus disease 2019. Little is known about the development of acute pancreatitis as a complication of severe acute respiratory syndrome coronavirus 2 infection. This case report describes the presentation of acute pancreatitis in two of three family members with severe COVID-19 infection. METHODS: Data were collected from three family members admitted with COVID-19 to the intensive care unit in March 2020. This study was reviewed and approved by the local data and ethics committee (31-1521-253). RESULTS: Two of the three family members were diagnosed with acute pancreatitis associated with SARS-CoV-2. Other causes of acute pancreatitis were excluded for both patients (including alcohol, biliary obstruction/gall stones, drugs, trauma, hypertriglyceridemia, hypercalcemia, and hypotension). CONCLUSIONS: These cases highlight acute pancreatitis as a complication associated with COVID-19 and underlines the importance of measuring pancreas-specific plasma amylase in patients with COVID-19 and abdominal pain.


Assuntos
Infecções por Coronavirus/complicações , Pancreatite/etiologia , Pneumonia Viral/complicações , Dor Abdominal/etiologia , Doença Aguda , Idoso , Amilases/sangue , Infecções por Coronavirus/sangue , Infecções por Coronavirus/diagnóstico por imagem , Cuidados Críticos , Evolução Fatal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatite/sangue , Pancreatite/diagnóstico por imagem , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/diagnóstico por imagem , Radiografia , Tórax/diagnóstico por imagem , Ultrassonografia
13.
PLoS One ; 15(4): e0228122, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32243441

RESUMO

The present study aimed to specify diagnostics for peritonsillar abscesses (PTAs) and to clarify the role of minor salivary glands. This prospective cohort study included 112 patients with acute tonsillitis (AT) and PTA recruited at a tertiary hospital emergency department between February and October 2017. All patients completed a questionnaire concerning their current disease. Serum amylase (S-Amyl) and C-reactive protein (S-CRP) levels, tonsillar findings, and pus aspirate samples and throat cultures were analyzed. Eight of 58 PTA patients (13.8%) had no signs of tonsillar infection. The absence of tonsillar erythema and exudate was associated with low S-CRP (p<0.001) and older age (p<0.001). We also observed an inverse correlation between S-Amyl and S-CRP levels (AT, r = -0.519; PTA, r = -0.353). Therefore, we observed a group of PTA patients without signs of tonsillar infection who had significantly lower S-CRP levels than other PTA patients. These findings support that PTA may be caused by an etiology other than AT. Variations in the S-Amyl levels and a negative correlation between S-Amyl and S-CRP levels may indicate that minor salivary glands are involved in PTA development.


Assuntos
Abscesso Peritonsilar/epidemiologia , Glândulas Salivares Menores/microbiologia , Infecções Estreptocócicas/epidemiologia , Streptococcus pyogenes/isolamento & purificação , Tonsilite/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Amilases/sangue , Proteína C-Reativa/análise , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tonsila Palatina/microbiologia , Abscesso Peritonsilar/diagnóstico , Abscesso Peritonsilar/microbiologia , Abscesso Peritonsilar/patologia , Prevalência , Estudos Prospectivos , Glândulas Salivares Menores/patologia , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/patologia , Tonsilite/sangue , Tonsilite/epidemiologia , Tonsilite/microbiologia , Adulto Jovem
15.
Life Sci ; 245: 117385, 2020 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-32014425

RESUMO

AIM: The influence of thyroid hormones on exocrine pancreas function is poorly understood, and limited to the postnatal development period. Here, we evaluated the effects of hypo- and hyperthyroidism on the morphology and enzyme content of this tissue. MAIN METHODS: To induce hypothyroidism male Wistar rats were subjected to a thyroidectomy (Tx) or sham operated (SO). After 40 days, some of the Tx and SO rats were treated with T3 for 7 days. Following euthanization, the pancreas was removed and evaluated for morphology, as well as amylase, lipase and trypsin content, using histological and immunoreactive techniques analyses, respectively. Serum amylase levels were also evaluated. KEY FINDINGS: The pancreatic acinar cells of Tx rats were smaller, exhibited reduced Haematoxyllin stained areas, and contained lower amylase and lipase levels, indicative of low cell activity. Tx rats also presented higher collagen levels, and high trypsin content in pancreatic extracts. Interestingly, T3 administration reversed the observed acinar cell alterations and restored pancreatic enzyme content, by augmenting amylase and lipase and attenuating trypsin levels, but failed to change collagen content. Increased levels of lipase and decreased trypsin were also observed in T3-treated SO rats. SIGNIFICANCE: Thyroid hormones play an important role in acinar cell morphology and function. In the hypothyroid state there is a decrease in pancreatic enzyme levels that is restored with T3 treatment. In addition to participating in insulin sensitivity and glycemic control, THs also modulate enzyme expression and activity in the exocrine pancreas, consequently, delivering metabolic substrates to specific organs and tissues.


Assuntos
Pâncreas Exócrino/patologia , Hormônios Tireóideos/fisiologia , Amilases/sangue , Animais , Western Blotting , Hipertireoidismo/complicações , Hipertireoidismo/patologia , Hipotireoidismo/complicações , Hipotireoidismo/patologia , Masculino , Pâncreas Exócrino/efeitos dos fármacos , Pâncreas Exócrino/fisiopatologia , Ratos , Ratos Wistar , Tireoidectomia , Tireotropina/sangue , Tri-Iodotironina/farmacologia
16.
Int J Surg ; 76: 53-58, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32109648

RESUMO

BACKROUND: C-reactive protein (CRP) and procalcitonin (PCT) have shown to be reliable predictors of inflammatory complications and anastomotic leak after colorectal surgery. Their predictive value after partial pancreaticoduodenectomy (PD) remains unclear. MATERIALS AND METHODS: All consecutive pancreaticoduodenectomies (2009-2018) at our hospital were included. Drain amylase was evaluated on postoperative day (POD) 1, serum CRP and PCT were evaluated on POD 1-3. Receiver-operating characteristics curves were performed and significant cut-off values were tested using logistic regression. RESULTS: Among 188 patients who underwent partial PD, clinically relevant pancreatic fistulas (POPF) occurred in 30 (16%) patients, including 20 (10.6%) with Grade B and 10 (5.3%) patients with Grade C. Postoperative complications (Clavien-Dindo ≥ III) were reported in 46 (24.5%) patients, including Grade IIIa in 16 (8.5%), IIIb in 18 (9.6%), IVa in 3 (1.6%), IVb in 2 (1.1%) and V in 7 (3.7%) patients. Drain amylase on POD 1 showed the largest area under the curve (0.872, p < 0.001), followed by CRP (0.803, p < 0.001) and PCT on POD 3 (0.651, p < 0.011). Drain amylase on POD 1 > 303 U/l (OR 0.045, 95% CI 0.010-0.195, p < 0.001), CRP > 203 mg/l (OR 0.098, 95% CI 0.041-0.235, p < 0.001) and PCT > 0.85 µg/l (OR 0.393, 95%CI 0.178-0.869, p = 0.02) were significant predictors of relevant POPF in the univariate analysis. CRP > 203 mg/l (OR 0.098, 95% CI 0.024-0.403, p = 0.001) and drain amylase > 303 U/l (OR 0.064, 95% CI 0.007-0.554, p = 0.01) remained independent predictors in the multivariable analysis. The combination of drain amylase on POD 1 and CRP on POD 3 had a sensitivity and specificity of 87.4% and 90.9% to predict relevant POPF. CONCLUSION: Drain amylase on POD 1 and CRP on POD 3 can accurately predict clinically relevant POPF after partial pancreaticoduodenectomy. The accuracy of PCT on POD 3 is limited.


Assuntos
Amilases , Proteína C-Reativa , Fístula Pancreática , Pancreaticoduodenectomia , Idoso , Amilases/sangue , Biomarcadores/análise , Proteína C-Reativa/análise , Drenagem/efeitos adversos , Feminino , Humanos , Jejunostomia/efeitos adversos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Pancreatectomia/efeitos adversos , Fístula Pancreática/diagnóstico , Pancreaticoduodenectomia/efeitos adversos , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Curva ROC , Sensibilidade e Especificidade
17.
Mymensingh Med J ; 29(1): 21-31, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31915331

RESUMO

This cross sectional study was done to compare serum levels of amylase and lipase between predialysis and maintenance haemodialysis chronic kidney disease (CKD) patients and also to find out their relationship between degrees of renal impairment in Mymensingh Medical College Hospital and National Institute of Kidney Diseases and Urology, Dhaka, Bangladesh from May 2016 to April 2017. A total of 80 patients were included purposively as study subjects and made into two groups namely predialysis CKD group comprising 50 patients and other as maintenance haemodialysis group comprising of 30 patients. Among the predialysis group majority of the CKD was caused by glomerulonephritis (48%) followed by diabetes (26%), HTN (2%) and large portion undiagnosed (24%) whereas in the haemodialysis group ESRD was caused by diabetes (46%) followed by glomerulonephritis (16%), HTN (13%) and undiagnosed (23%). This study showed that mean serum amylase (158±718U/L vs. 111±41U/L) did not significantly differ between study groups except being above reference level but serum lipase (739±888U/L vs. 434±214U/L) was significantly higher in the predialysis group. There was a correlation between rising serum creatinine with serum amylase and lipase.


Assuntos
Amilases/sangue , Lipase/sangue , Insuficiência Renal Crônica/enzimologia , Adulto , Bangladesh , Biomarcadores/sangue , Creatinina/sangue , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Diálise Renal , Insuficiência Renal Crônica/sangue , Insuficiência Renal Crônica/terapia
18.
Life Sci ; 241: 117118, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31790686

RESUMO

AIMS: Acute pancreatitis (AP) is usually complicated with multiple organ insufficiency, including renal injury. Hyperlipidemia is regarded as a risk factor to induce AP. High-fat diet-induced hyperlipidemic pancreatitis (HP) increased nowadays and showed more severe symptoms and complications than other AP. However, detailed mechanisms or mediators involved in HP complicated with acute renal injury were less studied. Here, we aimed to study how miR-214 expresses in the HP and whether miR-214 has functions to regulate pathological kidney damages induced by HP. MAIN METHODS: Sprague-Dawley rats were adopted to establish HP model complicated with acute renal injury through long-term high-fat diet and sodium taurocholic injection. Models were injected with LV-rno-miR-214-3p or LV-anti-rno-miR-214-3p to exogenously regulate miR-214-3p to study its impacts on HP via a series of molecular and histological experiments. KEY FINDINGS: MiR-214-3p was found to be up-regulated in the kidney, pancreas and serum of HP rats and also could intensify the pathological alterations, kidney and pancreas damages and fibrosis induced by HP. Inflammatory response in HP was enhanced when miR-214-3p was overexpressed. Besides, miR-214-3p up-regulation was showed to inhibit PTEN expression but increased P-Akt levels in the HP kidney, which might be a possible mechanism to induce severe symptoms of pancreatitis. Knockdown of miR-214-3p showed opposite effects. SIGNIFICANCE: MiR-214-3p is indicated to exacerbate the tissue damages and inflammatory response caused by HP complicated with acute renal injury, which may provide a novel therapeutic perspective targeting miR-214-3p to treat HP with acute renal injury.


Assuntos
Lesão Renal Aguda/genética , Hiperlipidemias/complicações , MicroRNAs/genética , Pancreatite/complicações , Lesão Renal Aguda/etiologia , Lesão Renal Aguda/patologia , Amilases/sangue , Animais , Modelos Animais de Doenças , Regulação da Expressão Gênica , Hiperlipidemias/genética , Rim/patologia , Lipídeos/sangue , Lipídeos/genética , Masculino , PTEN Fosfo-Hidrolase/genética , PTEN Fosfo-Hidrolase/metabolismo , Pancreatite/genética , Pancreatite/patologia , Ratos Sprague-Dawley
19.
Diabetes Res Clin Pract ; 159: 107974, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31811884

RESUMO

AIMS: While there is plentiful evidence on elevated serum levels of amylase, lipase, and trypsin in acute illness, low serum levels of these digestive enzymes have been studied infrequently. The aim was to systematically review published studies on the relationship between low serum levels of amylase, lipase, or trypsin and metabolic disorders. METHODS: The search was conducted in MEDLINE and Scopus databases. Studies in humans were included if they reported on the association between serum levels of amylase, lipase, or trypsin within normal range and metabolic disorders. Random-effects meta-analysis was conducted. RESULTS: A total of 20 studies encompassing 20,916 participants were included. Compared with healthy individuals, individuals with type 2 diabetes mellitus (mean difference = -5.3; p < 0.001), metabolic syndrome (mean difference = -5.1; p < 0.001), and overweight/obesity (mean difference = -0.8; p = 0.02) had significantly lower serum levels of amylase. Both individuals with type 1 diabetes mellitus (mean difference = -1.8; p < 0.001) and type 2 diabetes mellitus (mean difference = -0.8; p < 0.001) had significantly lower serum levels of lipase compared with healthy individuals. Data on serum trypsin were not suitable for meta-analysis. In the pooled analysis, individuals with type 2 diabetes mellitus had 3.1-times lower serum levels of amylase, 2.9-times lower serum levels of lipase, and 2.5-times lower serum levels of trypsin levels than the upper limits of normal for the three digestive enzymes. CONCLUSION: Low serum levels of amylase and lipase are significantly associated with type 2 diabetes mellitus, type 1 diabetes mellitus, excess adiposity, and metabolic syndrome. The role of digestive enzymes in the pathogenesis of metabolic disorders warrants further investigations.


Assuntos
Amilases/sangue , Biomarcadores/sangue , Lipase/sangue , Doenças Metabólicas/diagnóstico , Tripsina/sangue , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Humanos , Doenças Metabólicas/sangue , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico , Obesidade/sangue , Obesidade/diagnóstico , Sobrepeso/sangue , Sobrepeso/diagnóstico
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