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Could the burden of pancreatic cancer originate in childhood?

World Journal of Gastroenterology 2021年第32期27卷 5322-5340页

作者： smaranda diaconescu Georgiana Emmanuela Gîlcă-Blanariu Silvia Poamaneagra Otilia Marginean Gabriela Paduraru Gabriela Stefanescu Department of Pediatrics “Grigore T.Popa”University of Medicine and PharmacyIasi 700115Romania Department of Pediatric Gastroenterology St Mary Emergency Children's HospitalIasi 700309Romania Department of Gastroenterology and Hepatology "Grigore T.Popa"University of Medicine and PharmacyIasi 700115Romania Department of Gastroenterology and Hepatology “St.Spiridon”Emergency HospitalIasi 700111Romania Doctoral School George Emil Palade University of MedicinePharmacyScience and TechnologyTargu Mures 540142Romania Department of Pediatrics Research Center of Disturbance of Growth and Development on Children-BeliveUniversity of Medicine and Pharmacy“Victor Babes”TimisoaraTimisoara 300041Romania First Clinic of Pediatrics "Louis Turcanu"Emergency Childen's HospitalTimisoara 300011Romania

The presence of pancreatic cancer during childhood is extremely rare,and physicians may be tempted to overlook this diagnosis based on age ***,there are primary malignant pancreatic tumors encountered in pediatric patients,such as pancreatoblastoma,and tumors considered benign in general but may present a malignant potential,such as the solid pseudo-papillary tumor,insulinoma,gastrinoma,and vasoactive intestinal peptide secreting *** early diagnosis and management are of paramount importance since the survival rates tend to differ for various types of these *** pediatric cancers may present pancreatic metastases,such as renal cell carcinoma,which may evolve with pancreatic metastatic disease even after two or more *** childhood diseases may create a predisposition for the development of pancreatic cancer during adulthood;hence,there is a need for extensive screening strategies and complex programs to facilitate the transition from pediatric to adult ***,genetic studies highlight the fact the specific gene mutations and family aggregations may be correlated with a special predisposition towards pancreatic *** review aims to report the main pancreatic cancers diagnosed during childhood,the most important childhood diseases predisposing to the development of pancreatic malignancies,and the gene mutations associates with pancreatic malignant tumors.

关键词： Pancreatic cancer Pancreatic metastasis Childhood Adult Screening Transition

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Split-dose or hybrid nonsteroidal anti-inflammatory drugs and Nacetylcysteine therapy for prevention of post-retrograde cholangiopancreatography pancreatitis

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World Journal of Clinical Cases 2019年第3期7卷 300-310页

作者： Laura Pavel Gheorghe Gh Balan Alexandra Nicorescu Georgiana Emmanuela Gilca-Blanariu Catalin Sfarti Stefan Chiriac smaranda diaconescu Vasile Liviu Drug Gheorghe Balan Gabriela Stefanescu Gastroenterology "Grigore T.Popa" University of Medicine and Pharmacy Endocrinology "Grigore T. Popa" University of Medicine and Pharmacy Department of Mother and Child Medicine "Grigore T. Popa" University of Medicine and Pharmacy

BACKGROUND Despite significant technical and training improvements, the incidence of postendoscopic retrograde cholangiopancreatography(ERCP) pancreatitis(PEP) has not significantly dropped. Although many studies have evaluated the efficacy of various agents, e.g. nonsteroidal anti-inflammatory drugs, octreotide,antioxidants, administered via various dosages, routes(oral, intrarectal or parenteral), and schedules(before or after the procedure), the results have been *** To evaluate efficacy of three pharmacologic prophylactic methods for prevention of *** In this prospective, single-center randomized trial, patients who underwent firsttime ERCP for choledocholithiasis were randomly assigned to three groups. The first group received 600 mg N-acetylcysteine 15 min prior to ERCP, and perrectum administration of 50 mg indomethacin both prior to and after completion of the ERCP. The second group was administered only the 50 mg indomethacin per-rectum both prior to and after the ERCP. The third group was administeredper-rectum 100 mg indomethacin only after the ERCP, representing the control group given the guideline-recommended regimen. The primary end-point was PEP *** Among the total 211 patients evaluated during the study, 186 fulfilled the inclusion criteria and completed the protocol. The percentages of patients who developed PEP in each of the three groups were not significantly different(χ2 =2.793, P = 0.247). Among the acute PEP cases, for all groups, 14 patients developed mild pancreatitis(77.77%) and 4 moderate. No severe cases of PEP occurred, and in all PEP cases the resolution was favorable. No adverse events related to the medications(digestive hemorrhage, rectal irritation, or allergies)*** The efficacies of split-dose indomethacin and combined administration(Nacetylcysteine with indomethacin) for preventing PEP were similar to that of the standard regimen.

关键词： Endoscopic retrograde cholangiopancreatography Prophylaxis Postendoscopic retrograde cholangiopancreatography pancreatitis Nonsteroidal antiinflammatory drugs N-acetylcysteine

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