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Prediction of severe acute pancreatitis:Current knowledge and novel insights

World Journal of Gastroenterology 2008年第41期14卷 6273-6275页

作者： georgios i papachristou Department of Medicine Division of Gastroenterology Hepatology and Nutrition University of Pittsburgh Medical Center

Acute pancreatitis (AP) is a common and potentially lethal acute inflammatory process with a highly variable clinical course. it is still unclear why some patients progress to organ failure and others do not. Physicians, ability to predict which patients will develop severe disease is limited. Routine clinical and laboratory data and multi-factorial clinical scores measured on admission and during the first 48 h of hospitalization are currently the standards of care used to estimate the magnitude of the inflammatory response to injury. Current literature highlights several common environmental, metabolic and genetic factors that increase the risk of AP development and subsequent adverse sequelae. Several cytokines have been found to play a critical role in the pathogenesis of AP by driving the subsequent inflammatory response, to include tumor necrosis factor-α (TNF-α), interleukin-1 (iL-1), iL-6 and monocyte chemotactic protein-1 (MCP-1). Large, prospective studies are still needed to address these questions by identifying AP risk factors and serum biomarkers of severe disease.

关键词： Acute pancreatitis Prediction Severity Monocyte chemotactic protein-1

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Clinical outcomes of isolated renal failure compared to other forms of organ failure in patients with severe acute pancreatitis

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World Journal of Gastroenterology 2017年第29期23卷 5431-5437页

作者： Amir Gougol Mohannad Dugum Anwar Dudekula Phil Greer Adam Slivka David C Whitcomb Dhiraj Yadav georgios i papachristou Division of Gastroenterology Hepatology and Nutrition Department of Medicine University of Pittsburgh

To assess differences in clinical outcomes of isolated renal failure (RF) compared to other forms of organ failure (OF) in patients with severe acute pancreatitis (SAP). METHODSUsing a prospectively maintained database of patients with acute pancreatitis admitted to a tertiary medical center between 2003 and 2016, those with evidence of persistent OF were classified to renal, respiratory, cardiovascular, or multi-organ (2 or more organs). Data regarding demographics, comorbidities, etiology of acute pancreatitis, and clinical outcomes were prospectively recorded. Differences in clinical outcomes after development of isolated RF in comparison to other forms of OF were determined using independent t and Mann-Whitney U tests for continues variables, and χ2 test for discrete variables. RESULTSAmong 500 patients with acute pancreatitis, 111 patients developed persistent OF: mean age was 54 years, and 75 (67.6%) were male. Forty-three patients had isolated OF: 17 (15.3%) renal, 25 (21.6%) respiratory, and 1 (0.9%) patient with cardiovascular failure. No differences in demographics, etiology of acute pancreatitis, systemic inflammatory response syndrome scores, or development of pancreatic necrosis were seen between patients with isolated RF vs isolated respiratory failure. Patients with isolated RF were less likely to require nutritional support (76.5% vs 96%, P = 0.001), iCU admission (58.8% vs 100%, P = 0.001), and had shorter mean iCU stay (2.4 d vs 15.7 d, P isolated respiratory failure. None of the patients with isolated RF or isolated respiratory failure died. CONCLUSiONAmong patients with SAP per the Revised Atlanta Classification, approximately 15% develop isolated RF. This subgroup seems to have a less protracted clinical course compared to other forms of OF. isolated RF might be weighed less than isolated respiratory failure in risk predictive modeling of acute pancreatitis.

关键词： Renal failure Respiratory failure Organ failure Acute pancreatitis Clinical outcomes

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Colorectal cancer screening: Modalities and adherence

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World Journal of Gastroenterology 2024年第24期30卷 3048-3051页

作者： georgios Metaxas Athena papachristou Martha Stathaki Department of Surgery Elena Venizelou HospitalAthens 11521Greece

in the last decade,several studies have explored various modalities and strategies for colorectal cancer(CRC)screening,taking into account epidemiological data,individual characteristics,and socioeconomic *** this editorial,we comment further on a retrospective study by Agatsuma et al published in the recent issue of the World Journal of *** focus is on screening trends,particularly in relation to efforts to improve the currently suboptimal uptake among the general population worldwide,aiming to enhance early diagnosis rates of *** is a need to raise awareness through health edu-cation programs and to consider the use of readily available,non-invasive screening *** strategies are crucial for attracting screen-eligible populations to participate in first-line screening,especially those in high-or average-risk groups and in regions with limited *** biopsies and biomarkers represent rapidly evolving trends in screening and diagnosis;however,their clinical relevance has yet to be standardized.

关键词： Colorectal cancer Screening test High-risk group Strategies Biomarker Liquid biopsy Screening adherence

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Effect of pancreatic endotherapy on quality of life in chronic pancreatitis patients:A systematic review

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World Journal of Gastrointestinal Endoscopy 2021年第8期13卷 336-344页

作者： Samuel Y Han georgios i papachristou Raj J Shah Darwin L Conwell Division of Gastroenterology Hepatology and NutritionThe Ohio State University Wexner Medical CenterColumbusOH 43210United States Division of Gastroenterology and Hepatology University of Colorado Anschutz Medical CampusAuroraCO 80045United States

BACKGROUND Pancreatic endotherapy provides treatment options for the management of chronic pancreatitis-related structural complications such as pancreatic duct stones,strictures,and pancreatic fluid *** studies detailing endotherapy,however,have focused on technical success outcomes such as stone clearance or stricture *** To review the effect of pancreatic endotherapy on patient-centered *** Systematic review of studies examining pancreatic *** A total of 13 studies including 3 randomized clinical trials were *** majority of studies found an improvement in quality of life with pancreatic *** While pancreatic endotherapy does appear to improve quality of life,there are clear gaps in knowledge regarding many pancreatic endotherapy ***,qualitative analysis is lacking in these studies and further work is needed to elucidate the patient experience with pancreatic endotherapy.

关键词： Chronic pancreatitis Pancreatic endotherapy Endoscopic retrograde cholangiopancreatography Quality of life

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