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1.
Acta Biomed ; 91(3): e2020005, 2020 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-32921703

RESUMO

ackground: During the pandemic of COVID-19, the overwhelm of infected patients created an exponential surge for ICU and ward beds. As a result, a major proportion of elective surgeries was postponed. However, various emergency and urgent procedures were allowed. Due to the mortality complications of hepatopancreatobiliary issues, we decided to afford urgent procedures under intensive protective arrangements. Method and results: In our ward (liver transplant), 4 ICU beds and 16 ward beds were allocated to non-COVID-19 patients. A total of 36 hepatopancreatobiliary procedures were managed for one month. All the surgeries were afforded under personal protective equipment and other intensive protective arrangements for personnel and patients. During 6 weeks following the surgery, all patients were followed up through telemedicine and no new case of COVID-19 was detected. Conclusion: In general, it appears that intensive protections could significantly reduce the number of COVID-19 incidence among patients with co-morbidities who undergo invasive procedures.


Assuntos
Doenças Biliares/cirurgia , Infecções por Coronavirus/complicações , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Serviço Hospitalar de Emergência/normas , Hepatopatias/cirurgia , Pancreatopatias/cirurgia , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/complicações , Betacoronavirus , Doenças Biliares/complicações , Infecções por Coronavirus/epidemiologia , Transmissão de Doença Infecciosa/prevenção & controle , Feminino , Humanos , Hepatopatias/complicações , Masculino , Pessoa de Meia-Idade , Pancreatopatias/complicações , Pandemias , Pneumonia Viral/epidemiologia
2.
Rev Gastroenterol Mex ; 85(3): 312-320, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32620315

RESUMO

The coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) virus. COVID-19 affected more than 6million persons worldwide in fewer than 4 months, after the report of the first cases in China in December 2019. The relation of the disease caused by SARS-Cov-2 to immunosuppressive treatment used in different gastrointestinal disorders is uncertain, resulting in debate with regard to suspending immunosuppressive therapy to improve infection outcome. Said suspension implies the inherent risk for graft rejection or autoimmune disease exacerbation that can potentially worsen the course of the infection. Based on the presently available evidence, a treatment stance has been established for patients with gastrointestinal diseases that require immunosuppressive therapy.


Assuntos
Infecções por Coronavirus/complicações , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Hepatopatias/tratamento farmacológico , Pancreatopatias/tratamento farmacológico , Pandemias , Pneumonia Viral/complicações , Humanos , Hepatopatias/complicações , Transplante de Fígado , Transplante de Pâncreas , Pancreatopatias/complicações
6.
Zhonghua Wai Ke Za Zhi ; 58(5): 326-330, 2020 May 01.
Artigo em Chinês | MEDLINE | ID: mdl-32107909

RESUMO

Objective: To explore the proper protective measures for pancreatic diseases treatment during the outbreak of 2019 coronavirus disease(COVID-19). Methods: Clinical data of four cases of patients that suffered COVID-19 from February 2(nd) to February 9(th), 2020 at Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were reviewed induding 4 males and 1 female, aging of 50, 51, 46, 87 years old, respectively. After the first patients cuffed nosocomial infection of COVID-19, the general protective measures were updated.Only one patient was admitted to each room alone, with no more than one caregiver. The body temperature of care givers was measured twice a day.Primary protections were applied to all staff.The floor was sterilized using disinfectant with an effective chlorine concentration of 1 000 mg/L. The protective measures for interventional procedures were as follow. Primary protection was applied to the operators of central venipuncture catheter, percutaneous abdominal/pleural drainage, percutaneous retroperitoneal drainage, percutaneous transhepatic cholangial drainage and other surgical procedures with local anesthesia and epidural anesthesia. Secondary protection was applied to the operators of endoscopic retrograde cholangiopancreatography and surgical procedures with general anesthesia. Results: There were four patients who were diagnosed as COVID-19, of which one died of COVID-19, two were cured, and one was still in hospital for COVID-19. After the update of protective measures, no more nosocomial infection of COVID-19 occurred. Two central venipuncture catheter, three percutaneous abdominal or pleural drainage, one percutaneous retroperitoneal drainage, one percuteneous transhepatic cholecyst drainage and one open surgery with general anesthesia were performed with no infection of operators. Conclusions: The caregivers of patients are potential infection source of COVID-19. Enhanced protective measures including the management measures of caregivers can decrease the risk of nosocomial infection of COVID-19.


Assuntos
Infecções por Coronavirus , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pancreatopatias , Pandemias , Pneumonia Viral , Idoso de 80 Anos ou mais , Betacoronavirus , Cateterismo , Colangiopancreatografia Retrógrada Endoscópica , Coronavirus , Infecções por Coronavirus/complicações , Surtos de Doenças , Drenagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatopatias/complicações , Pancreatopatias/terapia , Flebotomia , Pneumonia Viral/complicações
7.
Eur J Radiol ; 124: 108827, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31951892

RESUMO

PURPOSE: The aim of this study was to noninvasively explore pancreatic morphological and mechanical changes in diabetic patients with or without microangiopathy and to investigate the clinical correlations of pancreatic stiffness or size with diabetic microangiopathy. METHODS: A total of 213 type 2 diabetic patients with / without microangiopathy (91/122) were prospectively enrolled. Microangiopathy included diabetic retinopathy, diabetic nephropathy and diabetic peripheral neuropathy. Each subject underwent pancreatic ultrasonography and elastography. The shear wave velocity (SWV) and thickness of the head, body and tail were measured and compared. Receiver operating characteristic (ROC) curves was performed in the diagnosis of microangiopathy. Risk factors of the occurrence of more microvascular complications were explored. RESULTS: The SWV in pancreas increased significantly in patients with microangiopathy (P < 0.01) while the thickness was similar in all patients. The area under ROC curve for the SWV in pancreatic body was greatest (0.747) and the sensitivity, specificity were 73.0, 70.9 %. There was a significant shift towards the occurrence of more microvascular complications for patients with increasing of the SWV in pancreatic body (OR 39.25), long duration of diabetes (OR 1.077), aging (OR 1.039) and elevation of microalbuminuria (OR 1.004). CONCLUSIONS: The SWV in pancreatic body was significantly high in diabetic patients with microangiopathy and was prominently correlated with the number of microvascular complications. The SWV in pancreatic body may be considered as a potential marker for diabetic microangiopathy and its occurrence.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/diagnóstico por imagem , Angiopatias Diabéticas/complicações , Angiopatias Diabéticas/diagnóstico por imagem , Técnicas de Imagem por Elasticidade/métodos , Pancreatopatias/complicações , Pancreatopatias/diagnóstico por imagem , Adulto , Idoso , China , Diabetes Mellitus Tipo 2/patologia , Angiopatias Diabéticas/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pâncreas/irrigação sanguínea , Pâncreas/diagnóstico por imagem , Pâncreas/patologia , Pancreatopatias/patologia , Estudos Prospectivos , Curva ROC , Sensibilidade e Especificidade
10.
Pediatr Ann ; 48(11): e441-e447, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31710363

RESUMO

Exocrine pancreatic insufficiency in children can lead to lifelong complications related to malnutrition and poor growth. The clinical presentation can be subtle in the early stages of insufficiency as the large functional capacity of the pancreas is gradually lost. The pediatrician plays a crucial role in the early identification of these children to ensure a timely referral so that a diagnosis can be made and therapy initiated. Early nutritional therapy allows for prevention and correction of deficiencies, which leads to improved outcomes and survival. When insufficiency is suspected, the workup should start with an indirect test of exocrine pancreatic function, such as fecal elastase, to establish the diagnosis. Once a diagnosis is established, further testing to delineate the etiology should be pursued, with cystic fibrosis being high on the differential list and assessed for with a sweat test. Assessment of anthropometry at every visit is key, as is monitoring of laboratory parameters and physical examination findings that are suggestive of malabsorption and malnutrition. The mainstay of management is administration of exogenous pancreatic enzymes to facilitate digestion and absorption. [Pediatr Ann. 2019;48(11):e441-e447.].


Assuntos
Transtornos da Nutrição Infantil/etiologia , Insuficiência Pancreática Exócrina/diagnóstico , Acil-CoA Desidrogenase de Cadeia Longa/deficiência , Anus Imperfurado/complicações , Criança , Transtornos da Nutrição Infantil/diagnóstico , Transtornos da Nutrição Infantil/terapia , Quimotripsina/metabolismo , Síndrome Congênita de Insuficiência da Medula Óssea/complicações , Fibrose Cística/complicações , Gorduras na Dieta/metabolismo , Displasia Ectodérmica/complicações , Terapia de Reposição de Enzimas , Insuficiência Pancreática Exócrina/etiologia , Insuficiência Pancreática Exócrina/terapia , Fezes/enzimologia , Transtornos do Crescimento/complicações , Perda Auditiva Neurossensorial/complicações , Humanos , Hipotireoidismo/complicações , Deficiência Intelectual/complicações , Erros Inatos do Metabolismo Lipídico/complicações , Doenças Mitocondriais/complicações , Doenças Musculares/complicações , Nariz/anormalidades , Avaliação Nutricional , Pâncreas/diagnóstico por imagem , Pâncreas/fisiologia , Pancreatopatias/complicações , Elastase Pancreática/metabolismo , Testes de Função Pancreática , Pancreatite Crônica/complicações , Pancreatite Crônica/etiologia , Síndrome de Shwachman-Diamond/complicações , Esteatorreia/etiologia , Tripsinogênio/sangue
11.
Clinics (Sao Paulo) ; 74: e1337, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31664423

RESUMO

OBJECTIVES: Nonalcoholic fatty pancreas disease (NAFPD) is characterized by excessive fat deposition in the pancreas in the absence of alcohol consumption. In this study, we aimed to detect a possible relationship between adipose tissue accumulation, prediabetes and diabetes. METHODS: This cross-sectional and retrospective study included 110 patients. Three groups were classified as controls, patients with prediabetes and patients with type 2 diabetes. The abdominal computed tomography (CT) attenuation measurement results of the pancreas were evaluated independently by two experienced radiologists. CT measurements and biochemical parameters were compared between study groups. The relationship between continuous variables was assessed by using one-way ANOVA. To determine the changes in the dependent variable for the effects on study groups, the independent variable was adjusted using ANCOVA. A p-value less than 0.05 was considered statistically significant. RESULTS: The presence of prediabetes and type 2 diabetes was correlated with a decrease in the mean Hounsfield Unit (HU) value of the pancreas (p=0.002). Age was determined to be an independent risk factor and was correlated with NAFPD (p=0.0001). When compared to the controls (p=0.041), 71% of patients with prediabetes and 67% of patients with type 2 diabetes were observed to have an increased incidence of NAFPD. Decreased serum amylase was found to be correlated with the mean HU value of the pancreas (p=0.043). CONCLUSION: NAFPD was independently correlated with both prediabetes and type 2 diabetes adjusted for age (p=0.0001) in this study. Additionally, age was determined to be an independent risk factor and was correlated with NAFPD.


Assuntos
Diabetes Mellitus Tipo 2/diagnóstico por imagem , Pancreatopatias/diagnóstico por imagem , Adulto , Idoso , Estudos de Casos e Controles , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatopatias/complicações , Estado Pré-Diabético/complicações , Estado Pré-Diabético/diagnóstico por imagem , Estudos Retrospectivos , Fatores de Risco , Tomografia Computadorizada por Raios X
12.
Rev Esp Enferm Dig ; 111(11): 896, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31663362

RESUMO

The term 'hemosuccus pancreaticus' was first coined in 1970 by Sandblom (1). It refers to bleeding that occurs through the pancreatic duct and is a rare cause of gastrointestinal hemorrhage.


Assuntos
Hemorragia Gastrointestinal/etiologia , Hemorragia/complicações , Pancreatopatias/complicações , Ductos Pancreáticos , Humanos , Masculino , Pessoa de Meia-Idade
13.
Rev Med Inst Mex Seguro Soc ; 57(2): 118-123, 2019 Jul 31.
Artigo em Espanhol | MEDLINE | ID: mdl-31618567

RESUMO

Background: Annular pancreas is a congenital abnormality which causes duodenal obstruction in neonates. It befalls upon 1 patient amongst every 12 000-15 000 newborns. It often appears in adulthood. Clinical traits include abdominal pain, intestinal obstruction, vomiting, and pancreatitis. The diagnosis requires image studies and surgical exploration. Clinical case: Female patient, 11 years of age, presenting intermittent chronic abdominal pain, underweight for her age. Treated by a private physician with ranitidine (4 mg/kg/day) and ibuprofen (5 mg/kg/dose) orally, for one month, due to acid-peptic disease. On December 31, 2017, she was attended at Pediatric Emergency presenting epigastric pain, and nausea. She vomited bile contents 4 times over a 24 hour span. Other symptoms included painful reaction to epigastric palpation, positive pancreatic points, negative Murphy's sign, no hepatomegaly or splenomegaly, decreased peristaltic noises. Reported: amylase 2163 U/L, lipase 821 U/L, lactic dehydrogenase 461 U/L. Pancreatic ultrasound: 19.3 mm head, 23.2 mm body and 10 mm tail. She was admitted to pediatrics, where the annular pancreas condition was confirmed through ultrasound and computed tomography scan. She then underwent conservative treatment. Conclusion: The patient displayed typical annular pancreas symptoms. Image studies were key to the diagnosis.


Assuntos
Dor Abdominal/etiologia , Pâncreas/anormalidades , Pancreatopatias/complicações , Pancreatopatias/diagnóstico por imagem , Criança , Feminino , Humanos , Pâncreas/diagnóstico por imagem , Radiografia Abdominal , Estômago/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ultrassonografia
15.
ANZ J Surg ; 89(12): 1587-1592, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31533199

RESUMO

BACKGROUND: Several indices of sarcopenia (SARC) exist in the literature, however, there is no consensus as to the best SARC index to predict post-operative morbidity following pancreatic surgery. METHODS: A prospectively collected database was reviewed in a single institution including a total of 89 consecutive patients who had undergone pancreatic resection between 2015 and 2018. RESULTS: A total of 89 patients comprised the cohort. Seventy-one percent (63/89) underwent pancreaticoduodenectomy. SARC was identified in 49 patients (55%) using psoas muscle index, 44 patients (49%) using the skeletal muscle index and 25 patients (28%) using the skeletal muscle attenuation. Post-operative morbidity did not differ between SARC and non-SARC (NSARC) patients using all three preoperative computed tomography measures (skeletal muscle index SARC 64%, 28/44, NSARC 64%, 29/45, P = 1.000; psoas muscle index SARC 63%, 31/49, NSARC 65%, 26/40, P = 0.810; skeletal muscle attenuation SARC 17/25, NSARC 40/64, P = 0.247). However, sarcopenic obesity was a significant independent risk factor for overall post-operative morbidity on multivariate analysis (odds ratio 1.241 (SE 0.608), P = 0.041) with the highest specificity (81%). CONCLUSION: Preoperative sarcopenic obesity can be an important independent predictor of post-operative morbidity following pancreatic resection. There remains a need for standardization of SARC indices.


Assuntos
Obesidade/complicações , Pancreatopatias/complicações , Pancreatopatias/cirurgia , Pancreaticoduodenectomia/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Sarcopenia/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Pancreatopatias/patologia , Músculos Psoas , Fatores de Risco
16.
Nutr Clin Pract ; 34 Suppl 1: S49-S56, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31535735

RESUMO

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.


Assuntos
Transtornos do Metabolismo dos Lipídeos/fisiopatologia , Pancreatopatias/fisiopatologia , Humanos , Resistência à Insulina , Transtornos do Metabolismo dos Lipídeos/complicações , Desnutrição/complicações , Síndrome Metabólica/complicações , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Obesidade/complicações , Pâncreas/metabolismo , Pancreatopatias/complicações , Fatores de Risco
17.
Zhonghua Wai Ke Za Zhi ; 57(9): 654-659, 2019 Sep 01.
Artigo em Chinês | MEDLINE | ID: mdl-31474056

RESUMO

Objective: To analyze the risk factors for biochemical leak progressing to grade B pancreatic fistula after pancreaticoduodenectomy(PD) early. Methods: Retrospective analysis was conducted in the whole clinical data of 190 patients who had incurred biochemical leak from November 2014 to April 2017 at the First Hospital of China Medical University.There were 112 males and 78 females, aging of (73±6) years(range:22 to 77 years).And all the potential factors for progressing from biochemical leak to grade B were analyzed with univariate and logistic regression multivariate model. These statistically significant preoperative indicators which enabled the plotting of the receiver operation characteristic(ROC) curves were selected for plotting the ROC curves, calculating the area under the curve(AUC) and evaluating the forecast values. With pertinence to indicators with the forecast values above the medium level, the maximum predictive performance of the critical value was determined by using the different cut-off values to calculate the Youden index and other indicators. Results: Among the 190 cases of PD patients, there were 81 cases had incurred biochemical leak including 36 cases with no progression, 41 cases progressing to grade B and 4 cases progressing from grade B to grade C.Univariate analysis showed CT value of pancreatic body, acute pancreatitis preoperatively, and the platelet(PLT), prealbumin, ALT on postoperative 3-4 days were risk factors for progressing from biochemical leak to grade B. Multivariate analysis showed CT value, acute pancreatitis preoperatively, and the PLT on postoperative 3-4 days were independent risk factors. Postoperatively patients with biochemical leak got acute pancreatitis before surgery were more likely to progress to grade B as well as those with the lower CT value before surgery or the lower PLT at 3-4 days after surgery. The AUC of CT value was 0.734. Using 39.8 HU as CT value, the sensitivity, specificity and Youden index were 73.2%, 75.0% and 0.482, with the highest performance prediction. Conclusion: The analysis of CT value of pancreatic body for standardized judgment of pancreas texture, the rational treatments of acute pancreatitis preoperatively and appropriate administration of patients with platelet-related drugs during perioperative period can respectively forecast and prevent progressing from biochemical leak to grade B.


Assuntos
Fístula Anastomótica/etiologia , Pancreatopatias/cirurgia , Fístula Pancreática/etiologia , Pancreaticoduodenectomia/efeitos adversos , Doença Aguda , Adulto , Idoso , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatopatias/complicações , Pancreatite/complicações , Pancreatite/cirurgia , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
19.
Am J Nephrol ; 50(3): 177-186, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31394536

RESUMO

BACKGROUND: Cardiovascular (CV) disease is the leading cause of death in kidney and simultaneous pancreas-kidney (SPK) transplant recipients. Assessing abdominal aortic calcification (AAC), using lateral spine x-rays and the Kaupilla 24-point AAC (0-24) score, may identify transplant recipients at higher CV risk. METHODS: Between the years 2000 and 2015, 413 kidney and 213 SPK first transplant recipients were scored for AAC at time of transplant and then followed for CV events (coronary heart, cerebrovascular, or peripheral vascular disease), graft-loss, and all-cause mortality. RESULTS: The mean age was 44 ± 12 years (SD) with 275 (44%) having AAC (26% moderate: 1-7 and 18% high: ≥8). After a median of 65 months (IQR 29-107 months), 46 recipients experienced CV events, 59 died, and 80 suffered graft loss. For each point increase in AAC, the unadjusted hazard ratios (HR) for CV events and mortality were 1.11 (95% CI 1.07-1.15) and 1.11 (1.08-1.15). These were similar after adjusting for age, gender, smoking, transplant type, dialysis vintage, and diabetes: aHR 1.07 (95% CI 1.02-1.12) and 1.09 (1.04-1.13). For recipients with high versus no AAC, the unadjusted and fully-adjusted HRs for CV events were 5.90 (2.90-12.02) and 3.51 (1.54-8.00), for deaths 5.39 (3.00-9.68) and 3.38 (1.71-6.70), and for graft loss 1.30 (0.75-2.28) and 1.94 (1.04-3.27) in age and smoking history-adjusted analyses. CONCLUSION: Kidney and SPK transplant recipients with high AAC have 3-fold higher CV and mortality risk and poorer graft outcomes than recipients without AAC. AAC scoring may be useful in assessing and targeted risk-lowering strategies.


Assuntos
Aorta Abdominal/patologia , Falência Renal Crônica/cirurgia , Transplante de Rim/mortalidade , Transplante de Pâncreas/mortalidade , Pancreatopatias/cirurgia , Calcificação Vascular/mortalidade , Adulto , Doenças Cardiovasculares/complicações , Feminino , Humanos , Estimativa de Kaplan-Meier , Falência Renal Crônica/complicações , Falência Renal Crônica/mortalidade , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Pancreatopatias/complicações , Pancreatopatias/mortalidade , Modelos de Riscos Proporcionais , Diálise Renal/efeitos adversos , Risco , Fumar , Transplantados , Resultado do Tratamento , Calcificação Vascular/complicações
20.
Pediatr Diabetes ; 20(7): 955-963, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31314155

RESUMO

BACKGROUND: Only few studies have been conducted on pancreatic diabetes and data from large epidemiological studies are missing. Our main objective was to study the most important differences and similarities between pediatric individuals with pancreatic diabetes and type 1 diabetes (T1D). METHODS: Patients <20 years of age were identified from the diabetes patient follow-up registry (DPV). Data of the most recent treatment year between January 2000 and March 2018 were aggregated. Propensity score was used to match individuals with pancreatic diabetes to individuals with T1D. Matching was conducted one-to-one by sex, age, diabetes duration, body mass index SD score (BMI-SDS), and migration background. RESULTS: We studied 731 individuals with pancreatic diabetes and 74 460 with T1D. In the matched cohort of 631 pairs, HbA1c was significantly lower in pancreatic diabetes (7.4% [95% confidence interval: 7.2; 7.5%]) compared to T1D patients (8.7% [8.5; 8.8%]). Daily insulin dose (0.80 IU/kg [0.77; 0.84] vs 0.86 IU/kg [0.82; 0.90]) and insulin pump use (13.3% [10.7; 16.4] vs 22.1% [19.0; 25.6%]) were lower in patients with pancreatic diabetes. However, event rates of severe hypoglycemia were similar between pancreatic and T1D patients (8.8 [5.4; 14.2] vs 9.6 [5.9; 15.6] events per 100 patient years). CONCLUSIONS: With the use of robust epidemiological data, our study improves the knowledge on clinical characteristics in pediatric individuals with pancreatic diabetes. Moreover, our results serve as a basis to reconsider treatment options and for discussing clinical practice guidelines for patients with this rare medical condition.


Assuntos
Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/etiologia , Pancreatopatias/complicações , Pancreatopatias/epidemiologia , Adolescente , Adulto , Idade de Início , Glicemia/análise , Glicemia/metabolismo , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos de Coortes , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/tratamento farmacológico , Insuficiência Pancreática Exócrina/complicações , Insuficiência Pancreática Exócrina/diagnóstico , Insuficiência Pancreática Exócrina/epidemiologia , Insuficiência Pancreática Exócrina/cirurgia , Feminino , Seguimentos , Hemoglobina A Glicada/análise , Hemoglobina A Glicada/metabolismo , Humanos , Insulina/administração & dosagem , Sistemas de Infusão de Insulina , Masculino , Pancreatopatias/diagnóstico , Pancreatopatias/cirurgia , Sistema de Registros , Adulto Jovem
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