Дисертації з теми "Pancreatiti"
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Fernandes, Cátia Conceição da Encarnação. "Clínica médica e cirúrgica em animais de companhia: pancreatite em animais de companhia." Master's thesis, Universidade de Évora, 2015. http://hdl.handle.net/10174/18224.
Повний текст джерелаFitzsimmons, Deborah. "Quality of life in pancreatic cancer and chronic pancreatitis." Thesis, University of Southampton, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.326844.
Повний текст джерелаMalluta, Éverson Fernando. "Avaliação do pâncreas através da ecoendoscopia em pacientes portadores de Doença de Crohn." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/5/5147/tde-28012009-151207/.
Повний текст джерелаBACKGROUND: Pancreas injury usually is not mentioned as an extra-intestinal manifestation of Crohns disease, but the few available series suggest pancreatic injury in a significant proportion of these patients, ranging from 1.2% to 58% in this series. Endoscopic ultrasound (EUS) presents the advantage of having a much higher sensitivity than the abdominal ultrasound or computadorized tomography in evaluating pancreas abnormalities. Compared to the endoscopic retrograde cholangiopancreatography, EUS has at least an equal sensitivity, with a lower complication rate. AIMS: To evaluate the incidence of pancreatic alterations by means of the EUS in Crohns disease, correlating them with clinical, endoscopic and biochemical data. METHODS: Fifty one patients with Crohns disease, age between 18 and 60 years-old (mean = 38), without previous history of pancreatic disease, diabetes mellitus or alcoholism, were submitted to EUS. The control-group was formed by 20 patients submitted to EUS with no previous history of pancreatic or Crohns disease. Clinical, endoscopic and biochemical data were collected in order to determine possible predictive factors. Eleven variables were analyzed, both in pancreatic parenchyma and ducts. The patients with 3 or more alterations were submitted to magnetic resonance. Pancreatic function was determined using fecal elastase assay in 39 patients. RESULTS: Of the 51 analyzed patients, 56% were female, with mean diagnosis time of seven years (1-25) and Crohns disease Activity Index (CDAI) of 102 (20-419). Two patients (3.9%) presented 4 alterations in the EUS exam, 3 (5.9%) presented 3 alterations, 11 (21.5%) had 2 alterations and 13 (25.5%) had 1 alteration in the EUS, which were statistically significant when compared to the control-group, in whom only 16% presented 1 exam alteration (p<0.001). The parenchymal abnormalities were more common, totalizing 39 findings when compared to 11 ductal abnormalities. The patients with 3 or more alterations in the exam were submitted to magnetic resonance; however, pancreatic lesions were not detected. Four patients (10%) had low fecal elastase measurement, suggestive of exocrine pancreatic insufficiency. None of these patients had significant pancreatic alterations in EUS. The only predictive factor that correlated with the number of alterations in EUS was isolated ileal disease. CONCLUSIONS: Patients with Crohns disease had a higher incidence of pancreatic abnormalities (10% with 3 or more alterations in endoscopic ultrasound) in comparison to the control-group. These alterations were found most frequently in the pancreatic parenchyma, which might explain the lack of correlation with the magnetic resonance, which is more prone to detect duct abnormalities. The only predictive factor to these alterations on EUS was ileal disease
Sampaio, Cristina Cardoso. "Pancreatite alcoólica." Master's thesis, [s.n.], 2014. http://hdl.handle.net/10284/4842.
Повний текст джерелаA pancreatite alcoólica é uma das principais complicações do consumo excessivo de álcool. O risco de desenvolver a doença aumenta com a ingestão de doses crescentes de álcool, sugerindo que os efeitos tóxicos estão relacionados com a quantidade de álcool ingerida. No entanto, apenas uma minoria dos alcoólicos desenvolve pancreatite, o que indica a necessidade de um fator desencadeador adicional para iniciar a lesão pancreática clinicamente evidente. A pancreatite alcoólica começa como um processo agudo necroinflamatório/ autodigestivo, progredindo com repetidos episódios de necroinflamação. O seu espectro clínico inclui pancreatite aguda (dor abdominal aguda e elevados níveis séricos das enzimas pancreáticas) e pancreatite crónica (dor abdominal, má digestão e diabetes). Têm sido feitos avanços significativos que fornecem uma visão sobre os mecanismos moleculares da lesão pancreática provocada pelo álcool, principalmente no que diz respeito aos seus efeitos tóxicos sobre as células acinares pancreáticas e recentemente, nas células estreladas pancreáticas (PSCs), que desempenham um papel fundamental na fibrose, caraterística da pancreatite crónica alcoólica. Alcoholic pancreatitis is a major complication of alcohol abuse. The risk of developing pancreatitis increases with increasing doses of alcohol, suggesting that alcohol exerts dose-related toxic effects on the pancreas. However, it is also clear that only a minority of alcoholics develop the disease, indicating that an additional trigger may be required to initiate clinically evident pancreatic injury. Alcoholic pancreatitis is thought to begin as an acute necroinflammatory/autodigestive process in a susceptible individual and to progress with repeated episodes. The clinical spectrum of the disease includes acute pancreatitis (acute abdominal pain and raised sérum levels of pancreatic enzymes) and chronic pancreatitis (abdominal pain, maldigestion, diabetes). Significant advances have been made in recent years that provide an insight into the molecular mechanisms of alcohol-related pancreatic injury, particularly with respect to the direct toxic effects of alcohol on pancreatic acinar cells and on the recently characterized PSCs, with may play a key role in the fibrosis of alcoholic chronic pancreatitis.
Шевченко, Володимир Порфирович, Владимир Порфирьевич Шевченко, Volodymyr Porfyrovych Shevchenko, V. O. Bratushka, Y. I. Sobolev, I. A. Myslovsky, O. V. Kravez, et al. "The results of surgical treatment of pancreatic pseudocysts following acute pancreatitis." Thesis, Видавництво СумДУ, 2012. http://essuir.sumdu.edu.ua/handle/123456789/27527.
Повний текст джерелаIkuta, Kozo. "Nardilysin inhibits pancreatitis and suppresses pancreatic ductal adenocarcinoma initiation in mice." Kyoto University, 2019. http://hdl.handle.net/2433/242408.
Повний текст джерелаWilson, Benjamin Gregg. "Feline pancreatic lipase: purification and validation of a clinically significant radioimmunoassay for the diagnosis of feline pancreatitis." Texas A&M University, 2003. http://hdl.handle.net/1969.1/1581.
Повний текст джерелаAbou, Khalil Jad. "Pancreatic fistulas after pancreatico-duodenectomies: are pancreatico-gastrostomies safer than pancreatico-jejunostomies? a quasi-experiment and propensity-score adjusted analysis." Thesis, McGill University, 2014. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=122998.
Повний текст джерелаCONTEXTE les fistules pacreatiques (PF) constituent une cause significative de la morbiditée et mortalité subie par les patients qui recoivent une pancreaticoduodenectomie (PD). La technique ideale pour retablir la continuité pancreatico-enterique est inconnue. Il n'est pas donné que les Pancreatico-Gastrostomies (PG) donne moi de PF et de complications post-operatives que les Pancreatico-Jejunostomies(PJ). BUT: Nous avons comparé le profile de complications post-operatoire chez les patients ayant subi une PG or PJ apres PD au Centre Universitaire de Sante McGill. METHODOLOGIE: Nous avons collecté des données pre-operatoires ainsi que les complications post- operatoires pour les patients ayant subi une PD dans notre base de données entre 1999 et 2011 et ayant subi une reconstruction par PG ou PJ. Nous avons performé une regression logistique ajustée pour un" propensity-score" pour identifier l'effet de la technique chirurgicale sur les PF, les delais de la motilitée gastrique (DGE), et les complications totales. nous avons utilisé les classifications ISGPF et Strasberg et Linehan pour PF et la definition ISGPS pour DGE. La morbidité totale a été evaluée par la classification Clavien-Dindo et l'Index Comprehensif de Morbidité (CCI). RESULTATS 23/103 et 20/103 (p=0.49) des patients ont developpé une PF et 74/103 et 55/103 patients ont eu DGE en periode post operatoire dans les groupes PG et PJ respectivement (p=0.02). Le grade Clavien-Dindo des complications n'etait pas different entre les groupes (p=0.29) mais le CCI l'etait (38.4 vs. 31.4 for PG vs. PG respectivement, p=0.02.) l'analyse multivariable ajustée pour le "Propensity-score" n'a pas montré d'effet de la technique chirurgical sur PF (p=0.89), DGE grades B/C (p=0.9) ou CCI (p=0.41) mais il restait un effet sur le DGE de toutes les grades de severité (p=0.012.) CONCLUSION Les patients ayant recu une PG n'avaient pas moins de PF que ceux ayant recu une PJ aprés PD a notre institution; Les deux groupes ont souffert du meme profile de complications, mais le groupe PG avait plus de DGE de toutes grades.
Camargo, Enilton Aparecido. "Caracterização da pancreatite aguda induzida por fosfolipases 'A IND. 2' secretorias." [s.n.], 2007. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308940.
Повний текст джерелаTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
Made available in DSpace on 2018-08-10T04:13:39Z (GMT). No. of bitstreams: 1 Camargo_EniltonAparecido_D.pdf: 1739135 bytes, checksum: faa68531f796834af8491c48ada0ccc0 (MD5) Previous issue date: 2007
Resumo: A pancreatite aguda e uma doença inflamatória do pâncreas caracterizada por intensa necrose pancreática e efeitos sistêmicos secundários como lesão pulmonar, os quais são a principal causa da mortalidade observada nessa doença. Ha evidencia de que as fosfolipases A2 (PLA2) tem um importante papel na fisiopatologia da pancreatite aguda. O objetivo deste trabalho foi investigar a capacidade de PLA2s de induzir pancreatite em ratos e os mecanismos envolvidos nesse fenômeno. As seguintes PLA2s foram utilizadas: piratoxina-I (homologo Lys-49 de PLA2 desprovido de atividade catalitica), bothropstoxina-II (homologo Asp-49 de PLA2 com baixa atividade catalítica) e a PLA2 proveniente do veneno de Naja moçambique moçambique (que possui alta atividade catalítica). Ratos Wistar machos (200-250 g) provenientes do CEMIB/UNICAMP foram utilizados. As PLA2s foram injetadas no ducto biliopancreatico de animais anestesiados e apos diferentes tempos experimentais foram avaliados o extravasamento de proteínas plasmáticas no pâncreas, infiltrado de neutrofilos no pâncreas e pulmão e amilase serica. A analise histológica do pâncreas e pulmão também foi realizada em alguns grupos experimentais. Piratoxina-I foi capaz de causar extravasamento de proteínas plasmáticas no pâncreas, infiltrado de neutrofilos no pulmão e os níveis sericos de amilase. Alem disso, a piratoxina-I causou alterações histológicas nos tecidos pancreático (infiltrado de neutrofilos, necrose de células acinares e edema intersticial) e pulmonar (edema intersticial e diminuição do espaço alveolar), que foram mais evidentes nos tempos iniciais da pancreatite (4-12h). Bothropstoxina-II e a PLA2 do veneno de Naja moçambique moçambique, a semelhança da Piratoxina-I, também foram capazes de aumentar o extravasamento de proteínas plasmáticas e o influxo de neutrofilos no tecido pancreático por mecanismos nao relacionados a sua atividade catalítica. Entretanto, o influxo de neutrofilos para o pulmão e o aumento dos níveis sericos de amilase causados por essas PLA2s foi dependente de sua atividade catalítica. As PLA2s também causaram secreção deamilase de acinos pancreáticos isolados, que foi dependente da atividade catalítica dessas enzimas. Adicionalmente, com o objetivo de entender o mecanismo envolvido na pancreatite induzida pela PLA2 de Naja mocambique mocambique animais foram tratados com os seguintes agentes farmacológicos: pentoxifilina (inibidor da sintese de TNF-á), SR140333 (antagonista de receptor NK1), icatibant (antagonista de receptor B2), L-NAME (inibidor não seletivo das NOS), aminoguanidina (inibidor preferencial da NOS induzivel), indometacina (inibidor não seletivo de COX), celecoxib (inibidor seletivo de COX-2), PCA4248 (antagonista dos receptores de PAF) e AA861 (inibidor da 5-lipoxigenase). Em conjunto, nossos dados mostraram que os efeitos locais e secundários são multimediados, envolvendo a participação de bradicinina, substancia P, NO, TNF-á, PAF e metabolitos das COXs. Em conclusão, demonstramos que as PLA2s secretorias são capazes de induzir pancreatite aguda em ratos quando injetadas no ducto biliopancreatico, um quadro caracterizado por efeitos inflamatórios locais e secundários cuja mediação farmacológica envolve vários fatores. Alem disso, a pancreatite aguda induzida pelas PLA2s reproduz algumas alterações observadas na pancreatite aguda em humanos, representando uma nova estratégia de estudo da fisiopatologia da pancreatite aguda
Abstract: Acute pancreatitis is an inflammatory disease of the pancreas that is characterized by intense pancreatic necrosis and remote systemic effects such as the lung injury that is the main cause of death during acute pancreatitis. There are evidences that phospholipases A2 (PLA2) have an important role in the acute pancreatitis pathophysiology. The aim of this work was to investigate the ability of PLA2 to induce acute pancreatitis in rats, and the mechanisms underlying this phenomenon. The following PLA2s were used: piratoxin-I (a Lys-49 PLA2 homologue devoid of catalytic activity), bothropstoxin-II (an Asp-49 PLA2 homologue with low catalytic activity) and PLA2 from Naja mocambique mocambique venom (high catalytic activity). Male Wistar rats (200-250g) provided by CEMIBUNICAMP have been used. The PLA2s were injected into the common bile duct of anesthetized rats, after which pancreatic plasma protein extravasation, pancreatic and lung neutrophil infiltration and serum levels of amylase were measured. Histology of the pancreatic and lung tissue has also been carried out in some experimental group. Piratoxin-I was able to increase the pancreatic plasma protein extravasation, lung neutrophil infiltration and serum amylase levels. In addition, Piratoxin-I caused histological changes in the pancreatic (neutrophil infiltration, areas of acinar cell necrosis and interstitial edema) and lung (interstitial edema and diminuition of alveolar space) tissues, which were more evident in the early periods (4-12h) after the injection. Bothropstoxin-II and PLA2 from Naja mocambique mocambique venom were also able to increase the plasma protein extravasation and neutrophil influx in the pancreatic tissue by mechanisms unrelated to their catalytic activity. However, the remote lung neutrophil influx caused by these PLA2s was shown to depend on their catalytic activity. The enhancement of serum amylase levels was also dependent on the catalytic activity of these enzymes. The PLA2s also caused amylase secretion from isolated pancreatic acini, which was dependent on their catalytic activity. Next, in order to further understand the mechanisms involved in pancreatitis induced by PLA2 Naja mocambique mocambique, animals were treated with the following pharmacological agents: pentoxifylline (TNF-á synthesis inhibitior), SR140333 (NK1receptor antagonist), icatibant (B2 receptor antagonist), L-NAME (non-selective NOS inhibitor), aminoguanidine (preferential inducible NOS inhibitor), indomethacin (nonselective COX inhibitor), celecoxib (selective COX-2 inhibitor), PCA4248 (PAF receptor antagonist) and AA861 (5-lipoxygenase inhibitor). Taken together our data showed that local and remote effects are multimediated, involving the participation of bradykinin, substance P, NO, TNF-á, PAF and COXs metabolites. In conclusion, we have shown that secretory PLA2s are able to induce acute pancreatitis in rats when injected into the common bile duct. Therefore, PLA2-induce acute pancreatitis reproduces some aspects of the human disorder representing a new strategy to study the pathophysiology of acute pancreatitis
Doutorado
Farmacologia
Doutor em Farmacologia
Karjula, H. (Heikki). "Diagnosis, treatment and prophylaxis of pancreatic fistulas in severe necrotizing pancreatitis and the long-term outcome of acute pancreatitis." Doctoral thesis, Oulun yliopisto, 2019. http://urn.fi/urn:isbn:9789526224312.
Повний текст джерелаTiivistelmä Akuutti nekrotisoiva haimatulehdus ja erityisesti siihen liittyvä bakteeri-infektio on sairaus, johon liittyy korkea komplikaatio- ja kuolleisuusriski. Tautia usein komplisoi infektion lisäksi nekroosiin liittyvä haimafisteli, joka tekee hoidosta entistä haasteellisemman. Viime aikaisissa tutkimuksissa on käsitelty runsaasti mini-invasiivista nekrosektomiaa, mutta suhteellisen vähän on tutkimuksia nekrotisoivaan haimatulehdukseen liittyvästä fisteliongelmasta. Haimatulehdus-potilaiden pitkäaikaisennuste on myös epäselvä. Tämän väitöskirjatutkimuksen tavoitteena oli selvittää nekrotisoivaan haimatulehdukseen liittyvän haimafistelin yleisyyttä, diagnostiikkaa, ehkäisyä ja hoitoa. Lisäksi tarkasteltiin akuuttiin haimatulehdukseen sairastuneiden potilaiden pitkäaikaisennustetta. Ensimmäisessä osatyössä ilmeni, että kaikille potilaille, joille suoritettiin haiman nekrosektomia kehittyi fisteli ja endoskooppinen transpapillaarinen haimateiden stenttaus (ETPS) osoittautui hyväksi ja turvalliseksi hoidoksi fistelin hoidossa. Toisessa prospektiivisessa randomoidussa kontrolloidussa osatyössä tutkittiin profylaktista haimateiden stenttausta nekrotisoivassa haimatulehduksessa. Tutkimus osoitti, etteivät potilaat hyötyneet stenttauksesta: toimenpiteestä oli enemmän haittaa kuin hyötyä. Tämän tutkimuksen mukaan protetisointia ei suositella tehtäväksi taudin alkuvaiheessa. Kolmannessa osatyössä selvitettiin haiman nekrosektomian jälkeisen haimafistelin diagnosointia. Tutkimustuloksen mukaan haimafistelin osoittamiseksi dreenieritteen amylaasitasoa mittaamalla tarvitaan useita mittauskertoja, koska yksittäisen mittauksen sensitiivisyys on matala. Neljännessä osatyössä analysoitiin Oulun yliopistollisessa sairaalassa 1995–2012 akuutin haimatulehduksen sairastaneiden työikäisten potilaiden pitkäaikaisennustetta ja kuolinsyitä. Noin kymmenen vuoden seurannassa tutkimusryhmän (n = 1 644) kuolleisuus oli yli nelinkertainen verrattuna ikä- ja sukupuolivakioituihin verrokeihin (n = 8 220). Merkittävin kuolleisuutta lisäävä tekijä oli alkoholi. Tutkimuksemme osoitti, että infektoituneen haimanekroosiin liittyvä haimafisteli on huomioitava hoidossa. Varhaisesta profylaktisesta haimateiden protetisoinnista ei tutkimuksessa osoitettu olevan hyötyä. Alkoholin aiheuttaman haimatulehduksen pitkäaikaisennusteen mortaliteetti on korkea johtuen alkoholin käytöstä ja siihen liittyvistä sairauksista
Ross, Natasha Patrice. "Metabolomic profiling of acute pancreatitis and pancreatic cancer : in search of biomarkers." Thesis, University of Aberdeen, 2015. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=228074.
Повний текст джерелаWiddson, Adam Lewis. "An investigation into the pathogenesis and treatment of pancreatic infection in acute pancreatitis." Thesis, University of Oxford, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.291609.
Повний текст джерелаZilio, Mariana Blanck. "Etiologia da pancreatite aguda - revisão sistemática e metanálise." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2018. http://hdl.handle.net/10183/179745.
Повний текст джерелаBackground: Gallstones and alcohol are the most common etiology of acute pancreatitis (AP) and is reported to account for about 40% and 30% of cases respectively. However, in Rio Grande do Sul - BR, we observed a frequency of acute biliary pancreatitis (ABP) around 77% of cases and alcoholic acute pancreatitis (AAP) in only 8%. Besides the possibility of differences of our own population, it is possible that the incidence of PAB is increasing. Objective: estimate the global frequency of ABP, AAP and the cases considered idiopathic pancreatitis (IAP) in published studies from 2006 to October 18 2017. Compare the frequencies for ABP, AAP and AIP among studies that performed review of individual records of patients or collected data prospectively and those using only the hospital discharge diagnostic codes for etiologic diagnosis. Compare the frequency of ABP, AAP and IAP by geographic region. Methods: A systematic review of observational studies in English, Spanish and Portuguese, from 2006 to October 18, 2017 was done. Random-effects metaanalysis was used to assess the frequency of biliary, alcoholic and idiopathic AP worldwide and to perform the analysis of 6 subgroups (hospital discharge coded diagnosis, individual patient chart review, studies from US, Latin America, Europe and studies from Asia). Results: Forty-six studies were included representing 2.341.007 cases of PA in 36 countries. The overall estimate for ABP was 41.6% (95% CI 39.2 to 44.1), followed by AAP with 20.5% (95% CI 16.6 to 24 6) and IAP with 18.3% (95% CI 15.1 - 21.7). In studies with hospital discharge coded diagnosis IAP was the most frequent with 37.9% (95% CI 35.1 to 40.8). In studies with individual patient chart review PAB 5 was more frequent with 46% (95% CI 42.3 to 49.8). In US studies IAP was he most frequent etiology with 34.7% (95% CI 32.3 to 37.2). In Latin America PAB was estimated 68.5% of the cases (95% CI 57.8 to 78.3). In Europe, Asia and one Australian study, the most frequent cause was the ABP in 41.3% (95% CI 37.9 to 44.7), 42% (95% CI 28.8 to 55.8) and 40% (95% CI 36.8 to 43.2) of the cases respectively. One study from South Africa had AAP in 70.2% (95% CI 64.5 to 75.4) of the cases. Conclusion: Gallstones are the main etiology of AP globally, twice as frequent as the second one. Latin America has a frequency for ABP much higher than the rest of the world. Large population studies using coded diagnoses and American studies show high rates IAP. The importance of the etiological diagnosis resides in treating the cause in order to prevent recurrence.
MOCHIMARU, YUKA, SHIHO KONDO, MAKOTO YAMAGUCHI, MARIKO ISHIGURO, LANJUAN YI, MIYUKI NAKAKUKI, AKIKO YAMAMOTO, and HIROSHI ISHIGURO. "PHYSIOLOGY AND PATHOPHYSIOLOGY OF BICARBONATE SECRETION BY PANCREATIC DUCT EPITHELIUM." Nagoya University School of Medicine, 2012. http://hdl.handle.net/2237/16018.
Повний текст джерелаTsuji, Yoshihisa. "Perfusion computerized tomography can predict pancreatic necrosis in early stages of severe acute pancreatitis." Kyoto University, 2010. http://hdl.handle.net/2433/120574.
Повний текст джерелаHenriques, Tiago. "Clínica médica e cirúrgica em animais de companhia: relatório de estágio sobre pancreatite felina." Master's thesis, Universidade de Évora, 2012. http://hdl.handle.net/10174/10420.
Повний текст джерелаAsada, Masanori. "Identification of a novel autoantibody against pancreatic secretory trypsin inhibitor in patients with autoimmune pancreatitis." Kyoto University, 2008. http://hdl.handle.net/2433/135788.
Повний текст джерелаCardoso, Catarina Flaspoehler Barreto Gomes. "Abordagem da pancreatite canina e felina : do diagnóstico clínico ao diagnóstico histopatológico." Master's thesis, Universidade de Lisboa. Faculdade de Medicina Veterinária, 2015. http://hdl.handle.net/10400.5/8787.
Повний текст джерелаPancreatite é a doença pancreática exócrina mais comum, tanto nos cães como nos gatos. Nos últimos anos esta afeção tem sido alvo de investigação e de avanços significativos, mas o seu diagnóstico continua a ser bastante desafiante em Medicina Veterinária. A apresentação clínica dos animais é muito variável e acompanhada de achados clínicopatológicos pouco específicos. A sua etiologia, mecanismos fisiopatológicos, classificação, tratamento e prognóstico são igualmente assuntos em constante evolução. O presente trabalho tem como objetivo a análise geral de 52 casos clínicos, de cães e gatos com suspeita e/ou diagnóstico de pancreatite. Foi, então, realizada uma ampla revisão bibliográfica relacionada com esta afeção, de forma a aprofundar os conhecimentos sobre o assunto, dando especial importância aos vários meios de diagnóstico utilizados na sua deteção. Posteriormente foram analisados os casos clínicos recolhidos, avaliando a utilidade dos meios de diagnóstico mais correntemente utilizados na prática clínica (imunoreatividade à lipase pancreática sérica (PLI) e ecografia abdominal), isoladamente ou combinados com o diagnóstico histopatológico desta doença. Pudemos concluir que a combinação da avaliação do historial do animal com a medição do PLI sérico, acompanhado da realização de uma ecografia abdominal, é a forma mais fiável e prática no diagnóstico de pancreatite. Idealmente estes devem ser acompanhados de uma citologia ou histopatologia pancreática, de maneira a obter um diagnóstico definitivo.
ABSTRACT - CANINE AND FELINE PANCREATITIS APPROACH: FROM CLINICAL TO HISTOPATHOLOGIC DIAGNOSIS - Pancreatitis is the most common exocrine pancreatic disease in both cats and dogs. In recent years the disease has been under investigation and significant advances have been made, but the diagnosis remains quite challenging . The clinical presentation is very variable and accompanied by some nonspecific clinicopathological findings. The etiology, pathophysiology, classification, treatment and prognosis are also subjects in constant evolution. This paper focused on the general analysis of 52 clinical cases of dogs and cats with suspected and/or diagnosis of pancreatitis. A comprehensive literature review was then performed relating to this condition, in order to deepen the knowledge on the subject, paying particular attention to the various diagnostic methods used in its diagnostic. The collected clinical cases, assessing the usefulness of diagnostic tools most commonly used in clinical practice were analyzed (serum pancreatic lipase immunoreactivity (PLI) and abdominal ultrasound), alone or combined with the histopathological diagnosis of this disease. Although, we consider that the evaluation the animal's history with measurement of serum PLI and abdominal ultrasound the safest and most practical way in the diagnosis of pancreatitis, ideally these should be accompanied by a pancreatic cytology or histopathology, in order to obtain a definitive diagnosis as shown in this study.
Quintal, Alexandra da Silva. "A pancreatite canina e os seus fatores de risco : estudo de série de casos." Master's thesis, Universidade de Lisboa, Faculdade de Medicina Veterinária, 2019. http://hdl.handle.net/10400.5/18818.
Повний текст джерелаA pancreatite é a doença do pâncreas exócrino mais comum no cão e estudos histopatológicos têm vindo a apontar que é ainda mais comum do que se pensava inicialmente, tanto no que diz respeito à doença crónica como aguda. É ainda uma doença com elevada taxa de mortalidade, em especial no que diz respeito à pancreatite aguda, e o conhecimento acerca da sua fisiopatologia, fatores de risco, tratamento, diagnóstico e prognóstico exigem ainda esforços de forma a conhecer melhor a doença, tornando-a por tudo isso ainda um desafio para o médico veterinário. No estudo em questão centramo-nos na avaliação dos fatores de risco, pelo que consideramos os estudos já existentes com a realização de uma revisão bibliográfica abrangente, mas com especial atenção na temática central. Posteriormente analisamos 7 casos retrospetivamente, selecionados tendo em conta a existência de sinais clínicos, valor cPLI alterado e imagem ecográfica compatível com a doença. A pancreatite é uma doença comumente considerada como essencialmente idiopática apesar de muitos fatores de risco terem sido descritos, mas com muitos deles a precisarem de estudos mais aprofundados. Tendo em conta a revisão bibliográfica consideramos a idade, raça, hipertrigliceridémia, babesiose, erros alimentares, excesso de peso e algumas doenças endócrinas concomitantes como situações de relevância como fatores de risco. No entanto, é importante considerar que alguns destes fatores podem estar relacionados e que a génese da doença pode ter uma origem multifatorial em muitos dos casos.
ABSTRACT - CANINE PANCREATITIS AND RISK FATORS: CASE SERIES - Pancreatitis is the most common disease of exocrine pancreas in dogs and histopathological studies showed that chronic and acute pancreatitis are most common than originally thought. Pancreatitis has a high mortality, especially in acute pancreatitis, and pathophysiology, risk factors, treatment, diagnosis and prognosis still poorly understood making it a challenging disease for the veterinarian. In our study, we focus on the assessment of risk factors. We performed an extensive bibliographical review with special interest in risk factors and we analyzed 7 cases retrospectively, selected based on the clinical signs, values cPLI above reference and ultrasonographic findings compatible with the disease. Pancreatitis etiology is still considered idiopathic. Nevertheless, several risk factors have been proposed, although they need further studies. Considering the literature review we consider that age, breed, hypertriglyceridemia, babesiosis, dietary indiscretions, overweight and some concomitant endocrine diseases are well documented as risk factors. However, it is important to underline that some of these factors can be related and that the onset of the disease may have a multifactorial origin in many cases.
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Yamamoto, Gen. "Pancreatic Stellate Cells Have Distinct Characteristics from Hepatic Stellate Cells and Are Not the Unique Origin of Collagen-Producing Cells in the Pancreas." Kyoto University, 2018. http://hdl.handle.net/2433/230997.
Повний текст джерелаDarwish, Ammar. "Systemic and mucosal immunity in patients with periampullary cancer, obstructive jaundice and chronic pancreatitis." Thesis, University of Manchester, 2014. https://www.research.manchester.ac.uk/portal/en/theses/systemic-and-mucosal-immunity-in-patients-with-periampullary-cancer-obstructive-jaundice-and-chronic-pancreatitis(b6e3ee83-3e4e-4b34-8c36-8eb75c3961cc).html.
Повний текст джерелаSantana, Danielle Gomes. "Efeito do extrato etanólico de Caesalpinia pyramidalis tul. na pancreatite aguda em ratos." Universidade Federal de Sergipe, 2011. https://ri.ufs.br/handle/riufs/3758.
Повний текст джерелаA pancreatite aguda (PA) é uma doença inflamatória do pâncreas que geralmente se apresenta acompanhada de dor abdominal e possui elevada mortalidade nas suas formas mais graves. Não há terapia específica para tratar esta doença, ou as complicações pulmonares decorrentes dela, o que torna de interesse a busca de novas substâncias para a sua terapêutica. Neste âmbito, o uso de plantas medicinais pode ser uma estratégia viável para tratar esta condição inflamatória, bem como a dor a ela associada. Neste estudo investigou-se, portanto, o efeito do extrato etanólico da entrecasca de Caesalpinia pyramidalis Tul. (Fabaceae) (EECp) na PA induzida pela obstrução do ducto biliopancreático (ODBP). Inicialmente foi realizada a análise cromatográfica do extrato pela técnica de cromatografia líquida de alta eficiência (CLAE). Para efeito de estudo, os grupos de animais foram eutanasiados 6 (protocolo 1) ou 24 h (protocolo 2) após a indução da PA. Ratos machos Wistar (200-250 g, n=6-8 por grupo) foram pré-tratados pela via oral com EECp (100, 200 ou 400 mg/kg, protocolo 1 ou 400 mg/kg, protocolo 2) ou veículo (tween 80 0,2% em salina 0,9%) 1 h antes e 12 h após a indução da PA ou falsa cirurgia (sham). Antes (-1 h) e após 6, 12 ou 24 h, foram realizadas medidas da hiperalgesia abdominal com o von Frey eletrônico. A atividade locomotora dos animais foi avaliada pelo teste do campo aberto. Após eutanásia e coleta dos tecidos, determinou-se a atividade de mieloperoxidase (MPO) e a concentração de malondialdeído (MDA) em pâncreas e pulmão, o índice de edema pancreático, as concentrações séricas de amilase, lipase e nitrato/nitrito e a contagem total e diferencial de leucócitos no sangue. A análise cromatográfica do extrato sugeriu a presença do flavonóide rutina em sua composição. Em ambos os protocolos experimentais (6 ou 24 h), a ODBP aumentou significativamente todos os parâmetros inflamatórios e bioquímicos avaliados, quando comparados ao respectivo grupo sham. Os dados obtidos neste estudo permitem afirmar que os efeitos causados pelo EECp, na pancreatite induzida pela ODBP, incluem (i) a redução da inflamação pancreática, devido a inibição do infiltrado de neutrófilos e do edema pancreáticos; (ii) a atenuação da inflamação sistêmica, através do decréscimo da contagem de leucócitos no sangue periférico, bem como, da redução do infiltrado de neutrófilos pulmonar, em especial, nos estágios iniciais da pancreatite; (iii) a diminuição da peroxidação lipídica pancreática e pulmonar, o que pode contribuir para os efeitos anti-inflamatórios observados nestes tecidos; (iv) a diminuição dos níveis séricos de nitrato/nitrito; (v) a redução parcial dos níveis de amilase e lipase e (vi) a inibição da hiperalgesia abdominal, um efeito que persiste por no mínimo 12 h com a maior dose de EECp utilizada e é confirmado pela ausência de alteração da atividade locomotora dos animais no campo aberto. Os resultados demonstram que o EECp diminui a inflamação e a hiperalgesia durante a PA induzida por OBDP. Estas atividades são de interesse para o desenvolvimento de estudos ou abordagens futuras para o tratamento da PA em humanos.
Coimbra, Daniela Viveiros. "Relação entre a 1,2-o-dilauril-rac-glicero-3-ácido glutárico-(6’metilresorufina) éster (DGGR) Lipase e ecografia pancreática em felinos." Master's thesis, Universidade de Lisboa, Faculdade de Medicina Veterinária, 2020. http://hdl.handle.net/10400.5/20552.
Повний текст джерелаA pancreatite é atualmente considerada a doença mais comum do pâncreas exócrino no gato. Contudo, o diagnóstico ante-mortem continua a ser um desafio pela sua apresentação clínica inespecífica e subtil. O exame ecográfico é uma técnica imagiológica com sensibilidade baixa e variável e com utilidade limitada para o diagnóstico de pancreatite felina (PF). Não obstante os diversos estudos existentes, é necessário continuar a avaliar e atualizar segundo a evolução do conhecimento da doença e da tecnologia disponível incluindo testes laboratoriais recentes e cada vez mais utilizados na prática clínica, tal como a 1,2-o-dilauril-rac-glicero-3-ácido glutárico-(6’metilresorufina) éster (DGGR) Lipase. O principal objetivo é avaliar a relação entre a DGGR-Lipase e a ecografia abdominal em gatos com suspeita clinica de pancreatite e valores de DGGR-Lipase >25 U/L (consistente com diagnóstico de pancreatite), nomeadamente obtenção da sensibilidade da ecografia no diagnóstico da PF, prevalência dos sinais ecográficos e valores médios de DGGR-Lipase para os diferentes sinais ecográficos pancreáticos e extra-pancreáticos. O estudo incluiu 46 gatos com valores de DGGR-Lipase acima dos valores de referência e exame ecográfico realizado com um intervalo máximo de 72h entre os dois exames. Usando o aumento da atividade sérica da DGGR-Lipase como marcador de pancreatite em gatos com suspeita clínica, a sensibilidade da ecografia foi variável (21,7 a 73,9%), dependendo dos critérios ecográficos considerados. Verificou-se que os sinais ecográficos mais prevalentes foram parênquima pancreático hipoecogénico, aumento da espessura do pâncreas e espessamento difuso da parede do intestino delgado sem perda de camadas. Gatos com aumento da espessura do pâncreas, parênquima hipoecogénico, lesões focais pancreáticas e reatividade mesentérica peri-pancreática, isoladamente ou em conjunto, apresentaram valores de DGGR-Lipase significativamente superiores em relação aos animais sem estes sinais ecográficos. Concluiu-se que, devido à natureza da doença nos gatos, não podem ser aplicados critérios ecográficos estritos em prejuízo da sensibilidade do diagnóstico ecográfico de PF. A presença de um ou dois dos três sinais ecográficos (aumento de espessura, parênquima pancreático hipoecogénico e reatividade mesentérica peri-pancreática) poderá ser um bom critério para considerar fortemente a suspeita e/ou presença de PF, para além da presença de outros sinais extra-pancreáticos. Estes três sinais ecográficos tradicionalmente associados a PF apresentam valores superiores de DGGR-Lipase e sugerem uma possível relação com situações de maior grau de inflamação. Assim, a aplicabilidade da ecografia permanece limitada sendo um exame complementar que não deve ser utilizado isoladamente na exclusão ou diagnóstico de PF.
ABSTRACT - Pancreatitis is currently considered the most common disease of the exocrine pancreas in the cat. However, ante-mortem diagnosis remains a challenge due to its nonspecific and subtle clinical presentation. The ultrasound is an imaging technique with low and variable sensitivity and with limited utility for the diagnosis of feline pancreatitis (FP). Despite several published studies, it is necessary to continue to evaluate and update according to the evolution of knowledge of the disease and available technology, including recent laboratory tests and increasingly used in clinical practice, such as the 1,2-O-Dilauryl-Rac-Glycero-3-Glutaric Acid-(6’Methylresorufin) (DGGR) Lipase. The main objective of this study is to evaluate the association between DGGR-Lipase and abdominal ultrasound in cats with clinical suspicion of pancreatitis and DGGR-Lipase values> 25 U / L, consistent with a diagnosis of pancreatitis,, to determine the sensitivity of ultrasound in the diagnosis of FP, as well as the prevalence of echographic signs in cats with pancreatitis. It is also our objective to determine the mean values of DGGR- Lipase for the different pancreatic and extra-pancreatic ultrasound signs. The study included 46 cats with DGGR-Lipase values above the reference values and an ultrasound examination performed within a maximum of 72 hours between both exams. Using the increased serum activity of DGGR-Lipase as a marker of pancreatitis in cats with clinical suspicion, the sensitivity of the ultrasound was variable (21.7 to 73.9%), depending on the ultrasound criteria considered. The results showed the most prevalent ultrasound signs were hypoechogenic pancreatic parenchyma, increased pancreas thickness and diffuse thickening of the small intestine wall without loss of layers. Cats with increased pancreas thickness, hypoechogenic parenchyma, pancreatic focal lesions and peri-pancreatic mesenteric reactivity, alone or together, presented DGGR-Lipase values significantly higher than animals without these echographic signs. We concluded that, due to the nature of the disease in cats, strict ultrasound criteria cannot be applied to the detriment of the sensitivity of the ultrasound diagnosis of PF. The presence of one or two of the three ultrasound signs (thickening, hypoechogenic pancreatic parenchyma and peri-pancreatic mesenteric reactivity) may be a good criterion to strongly consider the suspicion and/or presence of FP, in addition to the presence of other extra-pancreatic signs. These three echographic signs traditionally associated with FP present higher values of DGGR-Lipase and suggest a possible relationship with a higher degree of inflammation. Therefore, the applicability of ultrasound remains limited, being a complementary exam that should not be used alone in the exclusion or diagnosis of FP.
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Costa, Marianges Zadrozny Gouvêa da. "Frequência de tabagismo e das mutações N34S e P55S do gene Serine Protease Inhibitor Kazal-Type 1 (SPINK1) e da mutação R254W do gene Quimotripsina C (CTRC) em pacientes portadores de pancreatite crônica e em controle." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/5/5168/tde-06112015-160722/.
Повний текст джерелаChronic pancreatitis is a complex disorder in which the interaction between environmental and genetic factors results in the disease. This study included 148 patients with chronic pancreatitis, 110 chronic alcoholics and 297 healthy controls in order to investigate the frequency of smoking and N34S and P55S mutation of SPINK1 gene and R254W of CTRC gene in this population. A questionnaire was applied and gene sequencing was done, after having the Informed Consent Statement. Those with chronic pancreatitis had alcoholic etiology in 74% of cases and idiopathic in 26%. Alcoholic pancreatitis presented in a distinct way of idiopathic chronic pancreatitis. The first group is composed of a higher prevalence of males (88.18% versus 34.21%), by higher mean age (55.64 years versus 45.20 years), lower frequency of Caucasians (63.89% versus 84.21%), lower education (23.30% completed secondary or higher education versus 57.89%) and worst impact from the disease such as diarrhea (54.21% versus 24.24%), weight loss (56.07% versus 24.24%), diabetes mellitus (57.94% versus 36.36%) and occurrence of pancreatic pseudocysts (31.78% versus 12 , 12%). These effects were not accompanied by increased frequency of morphological changes, such as pancreatic calcifications or dilation of the main pancreatic duct. The frequency of smoking was significantly higher in patients with alcoholic pancreatitis than in alcoholics without chronic pancreatitis, therefore tabagism may be considered as a cofactor for the development of chronic pancreatitis among alcoholics (p = 0.002); the frequency of N34S mutation of SPINK1 gene in patients with chronic pancreatitis was 3.38%, higher than the rate of 0.49% found in the control groups (p = 0.016); the frequency of 2.03% of the P55S mutation of SPINK1 gene and the frequency of 0.67% of the CTRC gene R254W mutation found in patients with chronic pancreatitis were not statistically different when compared to the frequencies of 0.49% of both mutations, found in the control groups. (p = 0.120 and 0.751) For the investigation of the association of smoking and N34S mutation of SPINK1 gene with the clinical and morphological features of chronic pancreatitis, it was noticed that the N34S mutation did not determine a greatest severity in the presentation of chronic pancreatitis, however smoking was associated with a higher frequency of diabetes mellitus in patients with chronic pancreatitis. It was concluded that smoking and the N34S mutation of SPINK1 gene are positively correlated with chronic pancreatitis
Afonso, Ana Rita Sousa Pereira. "Doença pancreática canina : estudo retrospectivo." Master's thesis, Universidade Técnica de Lisboa. Faculdade de Medicina Veterinária, 2012. http://hdl.handle.net/10400.5/4984.
Повний текст джерелаA doença pancreática tem sido alvo de investigação, principalmente durante a última década, e de avanços significativos na compreensão dos mecanismos fisiopatológicos, diagnóstico, tratamento e prognóstico. Relativamente à doença inflamatória, o diagnóstico baseia-se maioritariamente na medição da concentração de lipase pancreática canina (cPL) e imagem ecográfica compatível. No presente estudo a ecografia, pela sua disponibilidade de resultados, assume uma maior importância no diagnóstico de pancreatite canina. O diagnóstico definitivo só pode ser efectuado por meio de histopatologia, raramente utilizado na prática clínica. O tratamento é essencialmente sintomático e o prognóstico é muito variável, dependendo sobretudo da resposta individual. Não foi possível encontrar nenhum parâmetro rotineiramente avaliado que pudesse ser usado como indicador de prognóstico, no presente estudo. No que respeita à doença neoplásica, a forma exócrina da mesma mimetiza, em muitos aspectos, a inflamação pancreática e o seu diagnóstico e tratamento seguem os mesmos moldes da doença inflamatória. A doença neoplásica endócrina, este estudo abordando apenas insulinomas, apresenta um quadro clínico e diagnóstico completamente diferente do já referido, em que a disponibilidade de resultados necessários à sua confirmação permite um diagnóstico precoce e com elevado grau de confiança, podendo assim melhorar o prognóstico destes pacientes. A ecografia mostrou ser, mais uma vez, o exame de eleição na confirmação, quantificação e localização de lesões. Os resultados do presente estudo estão de acordo com aqueles relatados em estudos anteriores, em que não foi possível encontrar parâmetros indicativos de diagnóstico ou prognóstico. O recurso à ecografia permite não só a exclusão de diagnósticos diferenciais em quadros abdominais agudos, mas também a confirmação precoce de doença pancreática.
ABSTRACT - CANINE PANCREATIC DISEASE – RETROSPECTIVE STUDY - Pancreatic disease has been investigated, essentially during the last decade, and some major improvements have been made regarding the understanding of the pathophysiologic mechanisms, diagnosis, treatment and prognosis. In the inflammatory disease, the diagnosis is largely based in the measurement of the canine pancreatic lipase (cPL) and compatible ultrasound image. The current study shows the ultrasound as the most important diagnostic method because of the availability and quick results. The definitive diagnosis can only be made by histopathology, which is rarely performed in the general practice. The treatment for pancreatitis is essentially symptomatic and the prognosis is highly variable, depending mostly on the individual response. It was not possible, in this study, to identify any clinical finding as a prognostic or diagnostic indicator. Regarding neoplastic disease, in many ways the exocrine form mimics pancreatic inflammation and its diagnosis and treatment follows the same described above. Pancreatic endocrine neoplasia, addressed only by insulinomas in this study, presents clinical features and diagnosis that are completely different from exocrine disease. The availability of the tests needed to confirm it allows an early diagnosis with a high degree of confidence, improving the animals’ prognosis. The ultrasound proved to be, once again, the best method in the confirmation, quantification and localization of the pancreatic lesions. The results of this study are in agreement with those made previously, and it was not possible to find any parameter that can be used as a diagnostic or prognostic indicator. The use of ultrasound enables not only the exclusion of differential diagnoses in an animal with acute abdomen, but also an early confirmation of pancreatic disease.
Domingues, Joana de Sousa Almeida. "Contribuição para a identificação de indicadores de risco no prognóstico da pancreatite em canídeos : estudo retrospetivo de 22 casos." Master's thesis, Universidade de Lisboa, Faculdade de Medicina Veterinária, 2016. http://hdl.handle.net/10400.5/11844.
Повний текст джерелаA pancreatite canina é uma doença bastante comum na prática clínica e pode variar de aguda a crónica e de ligeira a grave. A apresentação clínica desta doença varia muito, dependendo da sua gravidade, o que dificulta não só o diagnóstico mas também a elaboração de um prognóstico. Para além disso, ainda não existem sistemas objetivos de classificação da gravidade validados para a pancreatite canina. No entanto, já estão descritos alguns indicadores de doença grave. No presente estudo avaliaram-se, de forma retrospetiva, vários parâmetros, que incluíram características do animal, sinais clínicos e resultados do exame físico, exames laboratoriais, sinais ecográficos e tempo de internamento, e a relação destes com o desfecho. O estudo incidiu numa amostra de 22 indivíduos e teve como objetivos: determinar a possível influência de fatores fenotípicos na evolução de casos de pancreatite; avaliar o valor prognóstico dos sinais clínicos, exame físico, sinais ecográficos e de determinados exames hematológicos apresentados na consulta inicial em cães com diagnóstico de pancreatite; identificar possíveis fatores de risco para um desfecho fatal; e avaliar e comparar a utilidade dos sistemas de classificação de gravidade já criados para indivíduos com pancreatite na elaboração de um prognóstico. Os resultados obtidos neste estudo sugerem que a presença de letargia, a evidência de um mesentério reativo, a presença de trombocitopenia e de valores mais elevados de Spec® cPL, assim como um maior número de alterações hematológicas se encontraram associados a um mau prognóstico.
ABSTRACT - CONTRIBUTION FOR THE IDENTIFICATION OF RISK FACTORS IN THE PROGNOSIS OF PANCREATITIS IN DOGS: RETROSPECTIVE STUDY OF 22 CASES - Canine pancreatitis is a very common disease, ranging from acute to chronic, and from mild to severe forms. Its clinical presentation varies, depending on the severity of the disease, which can make it difficult to diagnose and give a prognosis. Besides, up to date there are no objective severity classification scales validated for canine pancreatitis. However, there are some known indicators of severe disease. In the present study, various parameters, including animal characteristics, clinical signs and physical examination findings, laboratorial exams, ultrasound findings and hospitalization time, and their association with the outcome, were evaluated. The present study included 22 individuals and had the following aims: evaluation of the influence of physiological factors in the evolution of pancreatitis; evaluation of the prognosis value of clinical signs, physical examination findings, ultrasound findings and laboratorial exams in dogs with pancreatitis; identification of possible risk factors for a fatal outcome; comparison of already existing severity classification sistems for pancreatites and evaluation of their prognosis value The results obtained sugest that the presence of lethargy, the evidence of a reactive mesentery, the presence of thrombocytopenia, higher values of Spec® cPL and a higher number of haematological abnormalities are associated with a negative prognosis.
Mendoza, Beatriz Costa Gago. "The effect of prednisolone therapy on canine serum levels of 1,2-o-dilauryl-rac-glycero glutaric acid-(6'-methylresorufin) ester (DGGR) lipase." Master's thesis, Universidade de Lisboa, Faculdade de Medicina Veterinária, 2020. http://hdl.handle.net/10400.5/20543.
Повний текст джерелаABSTRACT - 1,2-o-dilauryl-rac-glycero glutaric acid-(6'-methylresorufin) ester (DGGR) lipase is a widely available biomarker, increasingly used in the investigation of canine pancreatitis mainly due to its low cost compared to pancreatic lipase immunoreactivity (cPLI). A previous study showed a good agreement between cPLI and DGGR lipase concentration. While the effect of corticotherapy on cPLI quantification has been studied, its influence on DGGR lipase is unknown. This study aims to evaluate the effect of prednisolone therapy in canine DGGR lipase serum levels. A prospective cohort study was conducted, including the measurement of DGGR lipase in two groups: the study group (SG) composed of dogs treated with oral prednisolone for a medical reason, at the initial dosage of 0.5-1.7 mg/kg/day for at least 3 weeks, and the control group (CG) composed of healthy untreated dogs. As an inclusion criterion, animals had basal DGGR lipase within the reference range (<80 U/L). DGGR lipase was measured at three time points (Day 0(T0), Day 7-10(T1), and Day 21-30(T2)) in both groups. The analysis was performed using a previously validated kit (Randox® DGGR lipase). Thirty-four dogs were included (17 dogs for each group, which were age and sex-matched). At T0, there was no significant difference in DGGR lipase concentrations between groups (p=0.868). Mean starting dosage of prednisolone was 0.94 (±0.85) mg/kg/day, decreasing to 0.45 (±0.05) mg/kg/day after T1. The median DGGR lipase concentration in SG at each time point (T0, T1, and T2) was: 24.74 (14.45-31.48) U/L, 36.82 (23.8-80.16) U/L and 29.52 (15.91-48.48) U/L, respectively. There was a statistically significant effect of prednisolone on DGGR lipase values (p=0.007) over T0, T1, and T2. A poor correlation was verified between the variations of DGGR lipase and the correspondent prednisolone dosage of T0-T1 and T1-T2 (rs=0.371 e rs=0.121, respectively). In CG, DGGR lipase did not significantly change over the three time points (p=0.926). This study suggests that DGGR lipase levels are affected by oral prednisolone therapy in dogs treated for a medical reason. However, as values remained below the considered significant upper limit (160 U/L), this variation does not seem to be clinically relevant.
RESUMO - O EFEITO DA PREDNISOLONA NO DOSEAMENTO DA 1,2-O-DILAURYL-RAC- -GLYCERO GLUTARIC ACID-(6′-METHYLRESORUFIN) ESTER (DGGR) LIPASE - 1,2-o-dilauryl-rac-glycero glutaric acid-(6'-methylresorufin) ester (DGGR) lipase é um biomarcador recentemente disponível, que tem vindo a ser cada vez mais utilizado na exploração clínica de pancreatite em cães, sobretudo pelo seu custo acessível face à lipase pancreática específica (cPLI). Foi demonstrada uma boa concordância entre a cPLI e a DGGR lipase. Estudos prévios avaliaram a influência da corticoterapia no doseamento de cPLI. Contudo, a influência na DGGR lipase ainda não é conhecida. Este estudo visa avaliar o efeito da prednisolona nos níveis sérios de DGGR lipase em cães. Foi efetuado um estudo prospetivo de coorte, que incluiu a medição da DGGR lipase em dois grupos: o grupo de estudo (GE) constituído por cães aos quais foi administrada prednisolona por via oral com justificação médica na dose inicial de 0.5-1.7mg/kg/dia durante pelo menos 3 semanas e o grupo controlo (GC) composto por cães saudáveis sem tratamento concomitante. Como critério de inclusão consideraram-se cães com valores de DGGR lipase abaixo do valor de referência (<80 U/L). A DGGR lipase foi quantificada em três pontos temporais (Dia 0 (T0), Dia 7-10 (T1) e Dia 21-30 (T2)). A análise foi efetuada com recurso a um kit previamente validado (Randox® DGGR lipase). Foram incluídos 34 cães (17 cães em cada grupo, emparelhados relativamente ao género e idade). Em T0 não se observou diferença estatisticamente significativa entre grupos (p=0.868). A dose inicial média de prednisolona foi de 0.94 (±0.85) mg/kg/dia, tendo decrescido para 0.45 (±0.05) mg/kg/dia após T1. A concentração mediana de DGGR lipase no GE em cada ponto temporal (T0, T1 e T2) foi: 24.74 (14.45-31.48) U/L, 36.82 (23.8-80.16) U/L e 29.52 (15.91-48.48) U/L, respetivamente. Observou-se um efeito estatisticamente significativo da prednisolona nos valores de DGGR lipase ao longo de T0, T1 e T2 (p=0.007). Foi verificada uma baixa correlação entre as variações de DGGR lipase e a dose de prednisolona correspondente em T0-T1 e T1-T2 (rs=0.371 e rs=0.121, respetivamente). Em relação ao GC não se observaram diferenças estatisticamente significativas ao longo de T0, T1 e T2 (p=0.926). Sugere-se que a DGGR lipase seja afetada pela administração oral de prednisolona por justificação médica. No entanto, como os valores permanecem abaixo do limite máximo considerado (160 U/L), esta variação não aparenta ser clinicamente relevante.
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Neves, Susana Filipa Cabrita. "Clínica e cirurgia de animais de companhia." Master's thesis, Universidade de Évora, 2016. http://hdl.handle.net/10174/19148.
Повний текст джерелаDuarte, Joana Maria de Carvalho Teixeira. "Clínica de animais de companhia." Master's thesis, Universidade de Évora, 2016. http://hdl.handle.net/10174/19807.
Повний текст джерелаTokunaga, Koji. "Optimizing b‐values for accurate depiction of pancreatic cancer with tumor-associated pancreatitis on computed diffusion-weighted imaging." Kyoto University, 2020. http://hdl.handle.net/2433/253187.
Повний текст джерелаGestic, Martinho Antonio. "Tratamento cirúrgico da pancreatite crônica com a técnica de Frey = análise dos resultados." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309057.
Повний текст джерелаDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-16T22:56:32Z (GMT). No. of bitstreams: 1 Gestic_MartinhoAntonio_M.pdf: 3381516 bytes, checksum: 2ac6e6bb2938cf49388dd92cfe4fb63c (MD5) Previous issue date: 2010
Resumo: O tratamento cirúrgico da pancreatite crônica é indicado na falência do tratamento clínico da dor e na presença de complicações da doença. O emprego da melhor técnica ainda é um desafio e, ao longo do último século, várias técnicas foram desenvolvidas determinando três padrões de procedimento: descompressivos, ressecativos e mistos. A técnica de Frey é do tipo mista, recentemente desenvolvida e que apresenta excelentes resultados no alívio da dor secundária à pancreatite crônica. Seu princípio propõe baixas taxas de morbidade e mortalidade pós-operatórias e menor dano às funções pancreáticas comparáveis às cirurgias descompressivas (Partington-Rochelle, Puestow) com a mesma efetividade das cirurgias ressecativas (duodenopancreatectomias) no controle da dor. O objetivo deste trabalho é descrever a casuística e analisar os resultados de uma série consecutiva de pacientes com pancreatite crônica submetidos à técnica de Frey no Hospital de Clínicas da UNICAMP. Foram analisados retrospectivamente 73 pacientes consecutivos de janeiro de 1991 a dezembro de 2007, sem tratamento cirúrgico prévio para pancreatite crônica e com pelo menos um ano de seguimento pós-operatório. Estudou-se o perfil da população, indicação cirúrgica, complicações pós-operatórias e resultados a longo prazo no controle da dor e das complicações. Os pacientes apresentaram idade média de 40,6 anos, sendo a maioria homens (97,3%) e a etiologia alcoólica foi a mais freqüente (95,9%). A dor abdominal acometia todos os pacientes, 98,8% com intensidade moderada ou severa. A taxa de morbidade global foi de 28,7% e as complicações mais freqüentes foram as infecciosas (13,7%), dentre elas as pneumonias; a prevalência de fístulas da anastomose pancreática foi de 6,8%. Não houve mortalidade cirúrgica. Em seguimento médio de 77,0 meses, 91,4% dos pacientes apresentavam remissão dolorosa completa e houve aumento do IMC no pós-operatório (p < 0,001). Insuficiência exócrina nova apareceu em 49% dos pacientes e diabetes de novo em 36,7%. A recidiva de ingestão alcoólica ocorreu em 32,9% dos pacientes, os quais apresentaram menor expectativa de vida em relação àqueles que se mantiveram abstêmios (p = 0,02). As principais causas de mortalidade tardia foram as neoplasias do trato aéreo-digestivo superior e complicações de cirrose hepática. Identificaram-se associações estatisticamente significativas entre abstinência alcoólica pré-operatória com menor taxa de complicações infecciosas e fistulas; a quantidade de ingestão de álcool e o tempo de aparecimento de diabetes nova pós-operatória; o calibre do ducto pancreático com o surgimento de diabetes pós-operatória; e níveis elevados de amilase sérica e no liquido do dreno abdominal no primeiro dia pós-operatório com fístulas. A técnica de Frey mostrou-se uma opção segura e eficaz para o tratamento cirúrgico da pancreatite crônica, proporciononando melhora da sintomatologia dolorosa e reganho de peso e não interrompeu a deterioração das funções exócrina e endócrina do pâncreas. A recidiva do abuso da ingestão de etanol é um problema freqüente nesses pacientes e interfere na sobrevida deles
Abstract: Surgical treatment of chronic pancreatitis is indicated for failure in clinical pain management of the disease. Frey's surgery is one of the techniques available for intervention in this process. Application of the best technique is still a challenge today and, over the last century, several techniques were developed by determining three patterns of treatment: decompression, resection and mixed. Frey's procedure is a mixed technique, which was recently developed and shows excellent results in pain relief. Its principle suggests low rates of morbidity and mortality after surgery and less damage to pancreatic function comparable to surgical decompression (Partington-Rochelle, Puestow) with the same effectiveness of the resection procedures (pancreatoduodenectomy) in pain control. The aim of this paper is to describe and analyze the results of a consecutive series of patients with chronic pancreatitis underwent Frey technique at the Hospital de Clínicas of UNICAMP. Seventy-three consecutive patients were retrospectively analyzed from January 1991 to December 2007, with no previous surgical treatment for chronic pancreatitis and with at least one year of follow-up. We studied the profile of the population, surgical indication, postoperative complications and long-term results in controlling pain and complications. Patients had mean age of 40.6 years, most were men (97.3%) and alcoholic etiology was the most frequent (95.9%). Abdominal pain gripped all patients, 98.8% with moderate or severe intensity. The overall morbidity rate was 28.7% and the most frequent complications were infections (13.7%), among them pneumonia. Fistulas of pancreatic anastomosis were 6.8%. There was no surgical mortality. At mean follow-up of 77.0 months, 91.4% of patients had complete pain remission and there was increased of BMI postoperatively (p < 0.001). New exocrine insufficiency appeared in 49% and new diabetes in 36.7%. Recurrence of alcohol consumption occurred in 32.9% of patients, which showed a lower life expectancy than those who remained abstinent (p = 0.02). The main causes of late death were neoplasm of the upper aero-digestive tract and complications of liver cirrhosis. We identified significant associations between preoperative alcohol abstinence with a lower rate of infectious complications and fistulas; the amount of alcohol intake and time of onset of postoperative diabetes; diameter of the pancreatic duct with the onset of postoperative diabetes; and elevated levels of amylase in blood and abdominal drain fluid on the first postoperative day with fistulas. Frey procedure proved to be a safe and effective option for the surgical treatment of disabling pain caused by chronic pancreatitis provided regained weight but did not stop the deterioration of exocrine and endocrine functions of the pancreas. Recurrence of ethanol abuse is a frequent problem in these patients and interferes with their life expectancy
Mestrado
Fisiopatologia Cirúrgica
Mestre em Ciências da Cirurgia
Coelho, Ana Maria de Mendonça. "Mecanismos de ação da solução salina hipertônica na pancreatite aguda experimental." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5154/tde-07052010-170926/.
Повний текст джерелаINTRODUCTION: Severe acute pancreatitis (AP) is characterized by hemodynamic alterations and systemic inflammatory response leading to a high mortality rate. In AP the inappropriate activation of pancreatic enzymes plays an important role in pancreas autodigestion and in the inflammatory mechanisms responsible for the systemic response of the disease. In a previous study, we have demonstrated that hypertonic saline solution infusion significantly reduced mortality in experimental AP through an improvement in the hemodynamic conditions and by an antiinflammatory response, but its effects on the pancreatic lesions were not evaluated. The aim of the present study was to evaluate if the hypertonic saline solution reduces mortality in AP through a local effect attenuating the pancreatic lesion and/or by reducing the systemic inflammatory response syndrome (SIRS). METHODS: An experimental model of severe AP by injection of 0.5ml of 2.5% sodium taurocholate into the pancreatic duct was utilized. A hundred and forty two male Wistar rats were divided into 4 groups: C (control, without AP), ST (no treated AP), SSF (animals received 34ml/kg of normal saline solution of NaCl 0.9% IV, 1 hour after AP), and SSH (animals received 4ml/Kg of hypertonic saline solution of NaCl 7.5% IV, 1 hour after AP). After 2, 12 and 24 hours of induction of AP volume of ascitic fluid, trypsinogen activation peptides (TAP) levels and amylase activity in ascitic fluid and serum were determined. Pancreatic lipid peroxidation (MDA), myeloperoxidase (MPO) activity, and pancreatic histology were analysed 2 and 24 hours after AP. TNF-, IL-6, and IL-10 levels in ascitic fluid, serum, and pancreatic tissue were also analyzed. RESULTS: There were no significant differences in TAP levels and amylase activity in the ascitic fluid and serum in animals of groups ST, SSF and SSH. No differences in pancreatic MPO, MDA and histological score were observed among these three groups with AP. In the SSH group it was observed a significant decrease in volume of ascitic fluid and inflammatory cytokines levels (TNF-, IL-6, and IL-10) in ascitic fluid, serum, and pancreatic tissue when compared to ST and SSF groups (p<0.05). CONCLUSIONS: These findings suggest that hypertonic saline solution decreases local and systemic inflammatory response in acute pancreatitis without changing the intensity of the pancreatic lesions.
Amaral, Rizia Callou. "Diminuição dos níveis de quimiocinas no tecido cardíaco de ratos idosos submetidos ao modelo de pancreatite aguda grave: um novo mecanismo cardioprotetor durante a inflamação sistêmica." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5164/tde-20092016-155605/.
Повний текст джерелаAcute pancreatitis (AP) is a disease frequently associated with uncontrolled local and systemic inflammation that is responsible for the morbidity and mortality of this disease. Regardless of the initial mechanism, the inflammatory process is triggered by injury to the pancreatic acinar cells, leading to recruitment of inflammatory cell that produce cytokines and chemokines, which play an important role in the pathogenesis of this disease. Pancreatic inflammation induces profound disturbances in homeostasis, leading to tissue injury in other organs such as the intestine and lung. On the other hand, organs such as the brain have structural and cellular mechanisms of protection against inflammation. It has been described that patients with heart failure exhibit cardiac injury, leading to the production of pro-inflammatory cytokines, activation of T cells and activation of the complement system. In addition to inflammatory cascade during all stage of the PA, the cardiovascular system may suffer cardiac and histological changes compatible with inflammatory process triggered by the AP. The intensity of systemic inflammation associated with AP is similar in young and old rats, however, the duration of systemic inflammation is much longer in older animals. Advanced age is considered to be an independent prognostic factor for a poorer prognosis in AP, but the mechanisms involved are not fully understood. We analyzed the gene expression of several cytokines, chemokines and growth factors in young and aged rats hearts in an animal model of AP to investigate the effects of systemic inflammation on the heart, and to determine whether the effects are modified with age. Young and old rats were subjected to AP using taurocholic acid (2.5%) and after 11 hours, the cardiac tissue was collected to histology and RNA extraction. The determination of mRNA of cytokines and chemokines was performed by PCR array. The expression of interleukins IL-6 and IL-10 and the chemokines CCL7 and CCL19 in the aged AP rats was lower than young AP rats. However, CXCL3 and CCL20 levels showed opposite results, with increased levels in the aged AP group. The expression of CCL20 and CCL19 was greater in both young and aged AP rats compared with their respective controls. In aged AP rats there were a reduction in the expression of CXCL1, CCL1, CCL11 and IL-10 compared to their controls, and among healthy groups, the elderly rats expressed more than the young rats. In histological analysis, the neutrophils infiltration was significantly higher in the heart tissue of AP rats, both young and old, compared with their controls. This study indicates that systemic inflammation may show unique features for different organs in the body and decreased gene expression of some chemokines in the heart tissue of older AP may suggest a possible cardioprotective mechanism in older animals
Llimona, Flávia. "Co-ativador de transcrição gênica PGC-1 na pancreatite aguda." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/5/5165/tde-20052011-174649/.
Повний текст джерелаPGC1 is a family of transcriptional coactivators that controls the expression of several genes involved in cell energy homeostasis. PGC1 isoforms and are present in tissues with high oxidative metabolism and are able to enhance mitochondrial biogenesis, -oxidation of fatty acids and gluconeogenesis in response to exposure to cold, fasting and exercise. Initial results showed macrophages in vitro present increased PGC-1 expression after 1h exposure to zymosan. Thus, we hypothesized that PGC-1 could be up-regulated in response to bacterial insult. We tested our hypothesis following PGC-1 expression in an acute pancreatitis (AP) model, characterized initially by a strong sterile inflammatory response, followed, few days later, by bacterial intestinal translocation and disseminated infection. AP was induced by retrograde infusion of sodium taurocholate (2.5%). We also analysed PGC-1 in a model of sepsis by cecal ligation and puncture (CLP), whose intestinal content is deposited in the peritoneum, causing a severe local and disseminated infection. Animals submitted to PA and treated with Imipenem for 48 hours were also analyzed, as well as the interference of PGC-1 ASO in phagocytosis process. PGC-1 and expression were measured by quantitative PCR. AP was confirmed by increased blood amylase and the systemic inflammation was noted by leukocytosis after 48h. PGC1 was increased in spleen and circulating leukocytes 48h after AP and in peritoneal lavage 24h after AP and CLP. On the other hand, PGC1 was decreased in spleen 24h after AP induction. Imipenem treatment decreased PGC-1. The decreased of PGC-1 after ASO transfection led to a reduction of phagocytosis process. Thus, we conclude there is a PGC-1 increase in bacterial presence and this increase is related to phagocytosis
Häberle, Lena Julia [Verfasser], Irene [Akademischer Betreuer] Esposito, Bernhard [Gutachter] Holzmann, and Irene [Gutachter] Esposito. "Characterization of Pancreatic Stellate Cells in Pancreatic Ductal Adenocarcinoma and Cases of Chronic Pancreatitis of Various Etiologies / Lena Julia Häberle ; Gutachter: Bernhard Holzmann, Irene Esposito ; Betreuer: Irene Esposito." München : Universitätsbibliothek der TU München, 2018. http://d-nb.info/1156461782/34.
Повний текст джерелаCOUPRIE, LAURENT. "Apport des ponctions et drainages percutanes dans le traitement des faux kystes et des collections observes au cours des pancreatites aigues ou lors de poussees de pancreatite sur pancreatite chronique." Nantes, 1990. http://www.theses.fr/1990NANT083M.
Повний текст джерелаCieza, Rubio Napoleon Eduardo. "Mechanistic Studies in the Inflammatory Response of Pancreatitis and Pancreatric Cancer - Role of Myeloid Derived Suppressor Cells." Thesis, The University of Arizona, 2015. http://hdl.handle.net/10150/594648.
Повний текст джерелаMeyer, Alberto Luiz Monteiro. "Alterações cardíacas na pancreatite aguda experimental." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/5/5168/tde-01112013-162651/.
Повний текст джерелаBackground: Several mechanisms are involved in the development of the local and systemic response in acute pancreatitis. Cardiovascular system may be affected throughout the clinical course of acute pancreatitis. The aim was to evaluate local myocardial cytokine production, as well as, functional and histological myocardial alterations in severe acute pancreatitis. Methods: The animals were divided into three groups: Group 1: control; Group 2: sham; Group 3: severe acute pancreatitis. Echocardiographic assessment of cardiac function, serum levels of amylase and cytokines (TNF-alfa, IL-6 and IL-10), and mRNA expression of TNF-alfa, IL-6 and TGF-beta were measured. Myocardial tissue alterations were analysed by histological examination. Results: The serum TNF-alfa, and IL-10 levels were significant higher in acute pancreatitis 2h group. The mRNA IL-6 levels from acute pancreatitis 2h group were statistically higher. The mRNA TNF-alfa levels from sham group and acute pancreatitis 2h group were statistically lower. Significant changes in the left ventricular diameter were found in acute pancreatitis 2h and 12h groups. There were statistical changes for vacuolar degeneration, picnosis and loss of nucleus, and lymphocytes. Conclusion: We found cardiac and histological changes compatible with the inflammatory process triggered by severe acute pancreatitis with the promotion of local myocardial cytokine production
Pinho, Andreia V. "Pancreatic Acinar Cell Plasticity. Senescense, epitelial-mesenchymal transition and p53." Doctoral thesis, Universitat Pompeu Fabra, 2011. http://hdl.handle.net/10803/38435.
Повний текст джерелаLas células pancreáticas acinares poseen plasticidad que les permite adquirir distintos programas de diferenciación, estando implicadas en enfermedades como la pancreatitis crónica y el adenocarcinoma ductal pancreático. En este trabajo hemos demostrado que las células acinares cultivadas en suspensión se desdiferencian, adquiriendo un fenotipo de progenitores pancreáticos embrionarios. En estas células se induce un programa de senescencia asociado con la activación de las vías de p53 y Ras. Un fenotipo similar se evidencia en modelos de pancreatitis crónica experimental. Cultivos acinares en los que se ha inactivado p53 sobrepasan el bloqueo de crecimiento y pierden el fenotipo pancreático, presentando una transición epitelio‐mesenquimal y manteniendo la expresión de marcadores de endodermo pre‐pancreático y de células madre. Durante la inducción de una pancreatitis aguda experimental, la ausencia de p53 resulta en un incremento de la proliferación acinar y en un retraso en la regeneración. Nuestros resultados demuestran que la desdiferenciación de las células acinares participa en el desarrollo de enfermedades pancreáticas. El control del crecimiento celular y de la diferenciación pancreática epitelial dependiente de p53 constituye un mecanismo de supresión tumoral que puede limitar el desarrollo del PDAC.
Betzler, Alexander, Soeren Torge Mees, Josefine Pump, Sebastian Schölch, Carolin Zimmermann, Daniela E. Aust, Jürgen Weitz, Thilo Welsch, and Marius Distler. "Clinical impact of duodenal pancreatic heterotopia – Is there a need for surgical treatment?" Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2017. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-227082.
Повний текст джерелаOliveira, Maria Beatriz Sobral de. "Avaliação da frequência de doença osteometabólica entre portadores de pancreatite crônica alcoólica e sua correlação com os hábitos alimentares e a composição corporal." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/5/5168/tde-24022016-090200/.
Повний текст джерелаThe bone tissue is extremely complex, along with cartilage constitutes the skeletal system. Both bones as cartilage are composed of metabolically active tissue with two basic functions for the body, mechanical and biochemistry. The impact of the caloric deficit and weight loss can reduce bone mass and change body composition. In chronic alcoholic pancreatitis patients alcohol intake over a long period, in addition to reference the high consumption of cigarettes and poor nutrition. The objectives were to evaluate the frequency of osteometabolic disease, eating habits, the frequency of vitamin D deficiency and how the body mass found by total body densitometry relate to bone deficiency in individuals with chronic pancreatitis of alcoholic etiology . We evaluated three groups of male patients with chronic pancreatitis alcoholic. They were according to the results of bone densitometry. 5 in osteoporosis group, 26 in the osteopenia group and 8 in the normal group. All patients underwent three-day food record, measurements of weight, height, waist and hip, body mass index (BMI) and laboratory tests. The body composition was evaluated by densitometry by dual energy X-ray absorptiometry (DXA) and electrical bioimpedance. 79% of male patients with alcoholic chronic pancreatitis had compromised bone mineral density. Patients were prescribed vitamin D were excluded however results in the majority of patients had normal levels of the vitamin. Half of all patients smoking. Patients with higher bone involvement were thinner, there was no difference between patients according to BMI. Patients classified as normal by DXA were younger than patients with osteopenia and osteoporosis. In summary, osteoporosis and osteopenia are undervalued sources of morbidity in patients with chronic pancreatitis and necessary health management guidelines bone in this group of patients
Marques, Victor Leonardo Saraiva. "Pancreatite em pacientes com lúpus eritematoso sistêmico juvenil." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/5/5141/tde-14032018-102453/.
Повний текст джерелаIntroduction: Pancreatitis is a rare and a life-threatening systemic lupus erythematosus (SLE) manifestation in childhood-onset SLE (cSLE). Objective: To study the classification of pancreatitis in cSLE according to the International Study Group of Pediatric Pancreatitis and determine the overall prevalence, clinical features, laboratory, and first episode outcomes. Methods: A multicenter cohort study in 10 pediatric rheumatology centers, included 852 patients with cSLE. Results: Pancreatitis was diagnosed in 22 of 852 (2.6%) patients with cSLE. It was classified as acute pancreatitis in 20 (91%), acute recurrent pancreatitis in 2 (9%), and none of them had chronic pancreatitis. None of them had gallstones, traumatic pancreatitis, or reported alcohol/tobacco use. The comparison of patients with pancreatitis (first episode) and without this complication revealed a shorter disease duration [1 (0-10) vs. 4 (0-23) anos, P<0.0001] and higher median of Systemic Lupus Erythematosus Disease Activity Index 2000 [21 (0-41) vs. 2 (0-45), P < 0.0001]. The frequencies of fever (P < 0.0001), weight loss (P < 0.0001), serositis (P < 0.0001), nephritis (P < 0.0001), arterial hypertension (P < 0.0001), acute renal failure (P < 0.0001), macrophage activation syndrome (P < 0.0001), and death (P=0.001) were also higher in patients with pancreatitis. The frequencies of intravenous methylprednisolone use (P < 0.0001) and the median of prednisone dose [55 (15-60) vs. 11 (1-90) mg/dia, P<0.0001] were significantly higher in patients with pancreatitis. Of note, the 2 patients with acute recurrent pancreatitis had 2 episodes, with pain free interval of 1 and 4 years. Conclusions: This was the first study characterizing pancreatitis using the International Study Group of Pediatric Pancreatitis standardized definitions in patients with cSLE showing that the predominant form is acute pancreatitis seen in association with glucocorticoid treatment and active severe disease
Zürcher, Patrick. "Mutations and polymorphisms of the SPINK1, PRSS1 and CFTR gene in patients with alcoholic and idiopathic chronic pancreatits and pancreatic carcinoma /." [S.l.] : [s.n.], 2008. http://opac.nebis.ch/cgi-bin/showAbstract.pl?sys=000277037.
Повний текст джерелаCarvalho, Maria Betânia Trindade. "Alterações funcionais em artéria mesentérica de ratos com pancreatite aguda." Universidade Federal de Sergipe, 2014. https://ri.ufs.br/handle/riufs/3985.
Повний текст джерелаA pancreatite aguda é um processo inflamatório que se desenvolve a partir de lesão dos ácinos pancreáticos e também pode envolver tecidos peripancreáticos e outros órgãos. Alterações na função vascular são propostas como fatores que contribuem sobremaneira para a morbidade dos pacientes com pancreatite, entretanto poucos estudos foram direcionados para entender estas alterações e os mecanismos subjacentes. Com base nessas premissas, o objetivo do presente estudo foi investigar as alterações vasculares provocadas pela pancreatite aguda induzida por obstrução do ducto biliopancreático (ODBP) sobre a reatividade de artéria mesentérica de ratos, com o intuito de gerar conhecimento científico sobre os mecanismos envolvidos nesta condição e permitir abordagens futuras que levem ao melhor tratamento desta doença em humanos. Para tanto, foram utilizados ratos machos adultos Wistar (220-300 g) que foram divididos em grupos falso operado (Sham), no qual somente houve a cirurgia, sem obstrução do ducto, ou ODBP, o qual foi submetido a cirurgia e obstrução do ducto biliopancreático. Em seguida, os animais dos diferentes grupos foram eutanasiados após 24 ou 48 h e a artéria mesentérica superior foi removida, bem como soro foi separado para dosagem de amilase. Desta artéria foram obtidos anéis com endotélio (1-2 mm) que foram utilizados para a realização dos experimentos de reatividade in vitro e mensuração de óxido nítrico (NO) e ânion superóxido (O2 -). Para os experimentos de reatividade, os anéis foram montados em sistema de banho de órgão isolado e foi testada sua resposta relaxante ou contrátil, mediante estimulação com acetilcolina (ACh) ou fenilefrina (Fen) respectivamente. Para avaliar a produção de NO e O2 -nos anéis dos animais dos diferentes grupos, foram utilizadas sondas fluorescentes específicas para estes radicais livres. Nos animais com ODBP foram encontradas concentrações séricas de amilase elevadas após 24 (p<0,05) ou 48 h (p<0,001), quando comparados ao grupo sham, confirmando a indução da pancreatite. Os anéis dos animais com ODBP demonstraram uma diminuição da resposta relaxante à acetilcolina ou contrátil à fenilefrina após 24 ou 48 h da indução da pancreatite, quando comparados aos animais do grupo sham. Também foi observado aumento na produção de NO (p<0,05) e de O2 - (p<0,05) nos anéis coletados após 48 h, mas não 24 h da indução da pancreatite. Estes achados mostraram que a indução da pancreatite aguda por ODBP prejudica tanto a resposta relaxante quanto a contrátil de anéis de artéria mesentérica, por mecanismos que possivelmente são desencadeados pelo aumento na produção de NO e O2 -, provavelmente associado com o processo inflamatório. Entretanto, experimentos adicionais são necessários para identificar os mecanismos pelos quais a pancreatite aguda causa estes efeitos.
Moraes, José Maria Mendes. "Realimentação oral em pacientes com pancreatite aguda: a composição química e calórica da dieta influencia na recorrência da dor abdominal?" Universidade Federal de Juiz de Fora (UFJF), 2009. https://repositorio.ufjf.br/jspui/handle/ufjf/5548.
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Na pancreatite aguda (PA), a necessidade de restringir gordura durante a realimentação ainda não foi estudada. A tese é que iniciar a realimentação oral com dieta sólida completa após PA seria seguro e poderia resultar em um tempo menor de hospitalização. O objetivo deste trabalho foi explorar a segurança e o tempo de internação quando uma dieta sólida completa é utilizada como refeição inicial após quadro de PA leve, comparando com outras duas dietas: líquida e pastosa. Pacientes com PA leve foram randomizados para receber uma entre três dietas: líquida clara, pastosa ou sólida completa como refeição inicial durante realimentação oral. A progressão da dieta e a alta hospitalar foram determinadas por médicos não membros da equipe do ensaio. Os pacientes foram monitorados diariamente para recorrência de dor abdominal (endpoint primário), tolerância à dieta, tempo de internação (endpoint secundário) e durante sete dias após a alta para registrar a frequência da recorrência de dor. Um total de 210 pacientes foi avaliado, 70 em cada tipo de dieta. Baseado no protocolo, não houve diferença na frequência da recorrência de dor durante a realimentação entre os três tipos de dieta: 20% para a dieta líquida, 17% para a pastosa e 21% para a sólida completa (P=0,80). Os pacientes que receberam uma dieta sólida completa sem recorrência de dor abdominal tiveram um tempo menor de internação (mediano de -1,5 dia) quando comparados com os que receberam a dieta pastosa ou líquida (P=0,000). A realimentação com dieta sólida completa após PA leve foi bem tolerada e resultou em um tempo menor de internação em pacientes sem recorrência de dor abdominal.
In acute pancreatitis (AP) the need for fat restriction during refeeding has not been studied. The thesis is that to start oral refeeding with a full solid diet after mild AP would be safe and might result in a shorter length of hospitalization. The objective of this study was to explore the safety and length of hospital stay when a full solid diet is used as the initial meal after a mild AP comparing to two other diets: liquid and pasty. Patients with mild AP were randomized to receive one of three diets: clear liquid, pasty or full solid as the initial meal during oral refeeding. Diet progression and hospital discharge were determined by non-members of the trial team. Patients were monitored daily for abdominal pain recurrence (primary endpoint), diet tolerance, length of hospitalization (secondary endpoint) and during seven days after discharge to record the pain recurrence rates. A total of 210 patients was evaluated, 70 in each type of diet. Based on the protocol, there was no difference in pain recurrence rates during refeeding between the three diet types: 20% for liquid diet, 17% for pasty and 21% for full solid (P=0.80). The patients who received a full solid diet without abdominal pain recurrence had a shorter length of hospitalization (median of -1.5 days) when compared with those who received the liquid or pasty diets (P=0.000). Oral refeeding with a full solid diet after mild AP was well tolerated and resulted in a shorter length of hospitalization in patients without abdominal pain recurrence.
Júnior, Carlos Kiyoshi Furuya. "Fistulotomia papilar versus cateterização convencional para acesso biliar endoscópico: avaliação clínico-laboratorial." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/5/5132/tde-15032018-095757/.
Повний текст джерелаBackground: The success of biliary tract cannulation is important for the diagnosis and treatment of biliopancreatic diseases in endoscopic retrograde cholangiopancreatography (ERCP) procedures. ERCP is associated with severe complications and mortality. The aim of the study was to compare the success, laboratory profile and complications of the direct papillary fistulotomy technique with standard catheter and guidewire access. Methods: In the period from July 2010 to May 2017, two groups were selected and randomized for ERCP: cannulation with catheter and guidewire (Group I) and papillary fistulotomy (Group II). The curves of amylase, lipase and C-reactive protein (T0, 12 and 24 hours) and complications (pancreatitis, bleeding and perforation) were evaluated after ERCP. Results: A total of 102 patients (66 females and 36 males, mean age 59.11 ± 18.7 years) were divided into 51 patients for Group I and 51 for Group II. The success of cannulation was 76.47% and 100%, in Groups I and II, respectively (p = 0.0002). Twelve patients (23.53%) of Group I were considered to have difficult cannulation and were submitted to fistulotomy with successful biliary access. There were 13.73% (2 perforations and 5 mild pancreatitis) and 2% (1 patient with perforation and pancreatitis) complications in Groups I and II, respectively (p=0,062). Conclusion: Papillary fistulotomy demonstrated greater efficacy in the bile duct cannulation and presented lower serum amylase and lipase compared with standard catheter and guidewire cannulation. Complications were similar in the two techniques
Dias, Cláudia Maria da Costa. "Incidência e valor do cálcio ionizado no prognóstico em gatos com pancreatite." Master's thesis, Universidade Técnica de Lisboa. Faculdade de Medicina Veterinária, 2013. http://hdl.handle.net/10400.5/5502.
Повний текст джерелаA pancreatite é uma doença catabólica grave, alvo de diversas investigações que visam a melhor compreensão dos mecanismos histológicos, etiológicos e fisiopatológicos associados à doença, e de avanços significativos no diagnóstico, tratamento e prognóstico, no Homem e em animais de companhia. No presente estudo avaliou-se a concentração de cálcio sérico ionizado em indivíduos com diagnóstico de pancreatite, enfatizando-se o valor que este parâmetro pode ter como indicador do prognóstico, se for rotineiramente avaliado. O estudo incidiu numa amostra de 12 felinos (felis silvestris catus) (n=12), e teve como objetivos: 1) verificar a possível influência de determinados fatores fisiológicos (género, idade, peso vivo e raça) na evolução da pancreatite; 2) comparar as variações séricas do cálcio ionizado na pancreatite, no dia do diagnóstico da doença e no dia da alta médica/morte ou eutanásia do doente; 3) determinar a incidência dos baixos valores séricos de cálcio ionizado na doença; e 4) avaliar o valor no prognóstico da baixa concentração de cálcio sérico ionizado na pancreatite em gatos com sinais clínicos e diagnóstico presuntivo de pancreatite. Os resultados obtidos sugerem que a hipocalcémia é uma alteração eletrolítica comum em indivíduos com pancreatite, e que a concentração sérica de cálcio ionizado baixa corresponde a um prognóstico reservado, sendo prudente iniciar uma terapêutica médica agressiva, principalmente em doentes cuja concentração sérica de cálcio ionizado seja ≤ 1 mmol/L.
ABSTRACT - INCIDENCE AND VALUE OF IONIZED CALCIUM ON PROGNOSTIC OF CATS WITH PANCREATITIS - Pancreatitis is a severe metabolic disease, which has been target of several investigations regarding the understanding of histological, etiological and pathophysiological mechanisms of the disease, and significant advances in the diagnosis, treatment and prognosis, in human and small animals patients. The present study evaluated the plasma ionized calcium concentration during pancreatitis, emphasizing the value that this parameter can take as an indicator of prognosis, if it is routinely evaluated. The study was developed in a sample of 12 cats (felis silvestris catus) (n=12), and had the following aims: 1) to verify the possible influence of the physiologic factors sex, age, weight and breed in the evolution of pancreatitis; 2) to study the plasma ionized calcium variations in pancreatitis, on the day of diagnosis and on the day of discharge/death or euthanasia; 3) to determine the incidence of low serum ionized calcium concentration; and 4) to evaluate the prognostic significance of low plasma ionized calcium concentration in cats with clinical signs and presumptive diagnosis of pancreatitis. The results obtained suggest that the low plasma ionized calcium concentration is a common electrolyte abnormality in patients with pancreatitis. In addition, when plasma ionized calcium concentration is low the cats have a poorer outcome, being prudent to assign a more aggressive medical therapy, particularly in cats with pancreatitis that have a plasma ionized calcium concentration ≤ 1 mmol/L.
Rios, Ester Correia Sarmento. "Efeito da solução hipertônica (NaCI 7,5%) no estresse oxidativo e nos processos de morte celular e remodelamento tecidual hepático em pancreatite aguda experimental." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5167/tde-10092010-174041/.
Повний текст джерелаIt has been shown an hepatic injury following pancreatitis and a positive correlation with severity of the disease. Hypertonic Solution (HS) reduced morbidity and mortality in experimental pancreatitis. We hypothesize that hypertonic solution resuscitation of acute pancreatitis (AP) may exert antiinflammatory effects by modulating hepatic oxidative stress, apoptosis and matrix extracellular remodeling in liver. Wistar rats were divided in four groups: C- control animals not subjected to insult or treatment; NT- subjected to pancreatitis induction and receiving no treatment; NS- subjected to pancreatitis induction and receiving normal saline (0.9% NaCl); HSsubjected to pancreatitis induction and receiving hypertonic saline (7.5% NaCl). AP was induced by retrograde infusion of 2,5% sodium taurocholate into the pancreatic duct transduodenally. At 4, 12 and 24 h following pancreatitis induction, liver tissue samples were assayed in order to analyse expression of metalloproteinases (MMPs) -2 and -9, iNOS, collagens (type I and III), Heat Shock Proteins (HSPs) 47, 60, 70 and 90, caspases -2 and -7, APAF-1 and AIF, production of the cytokines TNF-, IL-1, IL-6 and IL-10, Nitrite/nitrate and ALT, Lipid peroxidation and formation of Nytrotirosine. Hypertonic solution resuscitation significantly modulates the oxidative stress in liver by reduction of iNOS gene expression (p<0,01 vs. NS), nitrite and nitrate levels (p<0,01 vs. NS), lipid peroxidation (p<0,05 vs. NT), ALT release (p<0,01 vs. NS) and peroxinitrite inhibition after 12 hours of pancreatitis induction. Consequently, the HSP70 production has not been activated due to the hypertonic solution effect in hepatic protection. At 4 h and 12 h, MMP-9 expression and activity increased in the NS and NT groups, although remaining at basal levels in the HS group (p<0.05 vs. past, pas). At 12 h, MMP-2 expression increased in the NS group (p<0.05 vs. c) but not in the HS group. At 4 h after pancreatitis induction, HSP47 expression increased in the NS and NT groups. Greater extracellular matrix remodelling occurred in the NS and NT groups than in the HS group, probably as a result of the hepatic wound-healing response to repeated injury. However, the collagen content in hepatic tissue remained at basal levels in the HS group. The proteins involved in apoptosis remained unchanged in all groups. Hypertonic saline is hepatoprotective, since it decreases oxidative stress in the critical time resulting in diminished liver damage, reducing hepatic remodelling, maintaining the integrity of the hepatic extracellular matrix during pancreatitis. Hypertonic saline-mediated regulation of MMP expression might have clinical relevance in pancreatitis-associated liver injury
Pirolla, Eduardo Henrique. "\"Incidência de pancreatite aguda em pacientes com traumatismo raquimedular agudo\"." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/5/5140/tde-14092006-133959/.
Повний текст джерелаAcute pancreatitis is a result of corrosive activity of pancreatic digestive enzymes, and many etiologic agents trigger acute pancreatitis by a variety of different mechanisms, but the ultimate result is a tissue destruction. The incidence in spinal cord injury patients is higher than the normal population. The clinical diagnosis of acute pancreatitis in spinal cord injury patients is hampered by a lower or lost visceral sensitivity, as a result in a necessity of laboratory investigations to confirm diagnosis. A prospective study with 78 acute spinal cord injury patients of The Clinical Hospital of the College of Medicine of University of São Paulo is performed. The incidence of pancreatitis is larger in patients of spinal cord injury ASIA A and with ileus paralytic
Pereira, Miguel Simões dos Reis Silva. "Importância dos fatores de insulino-resistência em gatos com diabetes mellitus." Master's thesis, Universidade de Lisboa. Faculdade de Medicina Veterinária, 2014. http://hdl.handle.net/10400.5/6509.
Повний текст джерелаA diabetes mellitus tipo 2 é uma endocrinopatia complexa com uma prevalência elevada nos gatos domésticos. Essencialmente esta doença caracteriza-se por uma incapacidade dos tecidos periféricos responderem adequadamente à insulina (insulino-resistência) e por uma incapacidade relativa ou absoluta por parte das células-β do pâncreas em produzir insulina, alterações estas que culminam num estado de hiperglicemia crónico. A administração de insulina exógena, o maneio alimentar e o exercício físico (para controlo de obesidade) devem ser instituídos correta e precocemente estando, nestas condições, associados a taxas de remissão até aos 80%. Infelizmente, embora sujeitos a uma terapêutica adequada, nem todos os gatos conseguem atingir um bom controlo da doença, nem tão pouco a sua remissão. Em cerca de 20% da população felídea diabética este facto deve-se à chamada “diabetes mellitus secundária”, que surge como sequela de outras doenças nomeadamente a acromegalia, a pancreatite e o hiperadrenocorticismo. Estas doenças concomitantes induzem e exacerbam estados de insulino-resistência e de diminuição da produção de insulina pelas células-β pancreáticas. Deste modo, o conhecimento, o diagnóstico e o tratamento destas doenças concomitantes à diabetes mellitus têm um papel ímpar no controlo e estabilização da doença e eventual remissão da mesma. Na sequência da carência de estudos nesta área em Portugal, o presente trabalho teve como objetivo primordial perceber a importância, dos diferentes fatores de insulino-resistência, nomeadamente a obesidade, a pancreatite e a acromegalia em gatos com diagnóstico de diabetes mellitus, no Hospital Escolar da Faculdade de Medicina Veterinária (HEFMV). Assim, os resultados obtidos sugerem: 1) que mais de 50% dos gatos desta região que desenvolveram diabetes tinham história de excesso de peso ou obesidade; 2) que a pancreatite felina é um fator destabilizador da diabetes comum nos gatos desta região (38,5% a 47,8%) que requer doses mais elevada de insulina exógena (p <0.05); 3) que a acromegalia deve ser, cada vez mais, considerada pelo médico veterinário em gatos diabéticos mal controlados, mesmo com doses muito altas de insulina (> 6 UI/kg), e que surjam com ganho de peso.
ABSTRACT - Type II diabetes mellitus is a complex endocrinopathy quite prevalent in domestic cats. This disease is essentially characterized by an inability of the peripheral tissues to answer appropriately to insulin (insulin-resistance) and by a relative or absolute inability of the pancreatic β cells to produce insulin, events which will result in a chronic state of hyperglycemia. The administration of exogenous insulin, the feeding management and physical exercise (to control obesity) should be established correctly and early on, being associated in these cases to remission rates up to 80%. Unfortunately not all the cats that are being correctly treated can reach a good control of the disease, let alone its remission. In about 20% of the diabetic feline population this is due to “secondary diabetes mellitus”, which arises as a sequel of other diseases such as acromegaly, pancreatitis and feline hyperadrenocorticism. These concomitant diseases induce and exacerbate insulin-resistant states and diminish the production of insulin by the pancreatic β cells. Thus, the knowledge, the diagnostic and the treatment of these concomitant diseases plays a key role in controlling, stabilizing and even in a potential remission of the mellitus diabetes. Following the lack of studies in this field in Portugal, the main goal of this work was to understand the importance of the different insulin-resistance factors, especially obesity, pancreatitis and acromegaly in cats that were diagnosed with diabetes mellitus, in the Hospital of the Faculty of Veterinary Medicine of Lisbon. Therefore the results of this study show that: 1) more than 50% of the cats that developed diabetes had a history of excess weight or obesity; 2) pancreatitis is a destabilizing factor of diabetes mellitus in cats in this area (38,5% to 47,8%) and requires higher dosage of exogenous insulin; 3) acromegaly should be, increasingly, taken into consideration by the veterinarian when evaluating diabetic cats poorly managed, even with extreme doses of insulin (>6 UI/kg), which exhibit a weight gain.