Contribution of pancreatic enzyme replacement therapy to survival and quality of life in patients with pancreatic exocrine insufficiency.

The objective of this study was to analyze the current evidence for the use of pancreatic enzyme replacement therapy (PERT) in affecting survival and quality of life in patients with pancreatic exocrine insufficiency (PEI). Systematic searches of the literature were performed using the PubMed database. Articles were selected for inclusion if they reported findings from trials assessing the effects of PERT on quality of life, survival, malabsorption, growth parameters (such as height, body weight and body mass index), or gastrointestinal symptoms (such as abdominal pain, stool consistency and flatulence). PERT improved PEI-related malabsorption and weight maintenance in patients with cystic fibrosis, chronic pancreatitis, pancreatic cancer, and post-surgical states. In patients with chronic pancreatitis, PERT improved PEI-related symptoms and quality of life measures. Several small retrospective studies have also suggested that PERT may have a positive impact on survival, but long-term studies assessing this effect were not identified. PERT is effective for treating malnutrition and supporting weight maintenance, and it is associated with improved quality of life and possibly with enhanced survival in patients with PEI. However, there is evidence that not all patients with PEI receive adequate PERT. Future work should aim to assess the long-term effects of PERT on the survival of patients with PEI. PMID: 31171887 [PubMed - in process]
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research

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ConclusionOverall, these guidelines provide consistent recommendations on who should receive breast reconstruction education, who is a candidate for postmastectomy breast reconstruction, and the appropriate timing of reconstruction and extent of mastectomy. Future updates from all should focus on expanding to include alloplastic and autologous forms of reconstruction and should include a broad scope of relevant questions.
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research
I tried searching but couldn't find a relevant thread. I was wondering if anyone has experience with a hospital employed job that compensates in "collections minus expenses." How exactly does this work in a hospital setting? The hospital is still getting the facility fee for each clinic visit (hospital clinic)/procedure - so I'm not really clear on what "expenses" are typically attributed to the physician. Can anyone share their pay structure with this kind of system?
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
This study, therefore, aims to investigate the effects of generalised trust and happiness on all-cause and cause-specific mortality. The distinction between different causes of death (i.e. cardiovascular vs. cancer-related mortality) allowed us to assess if psychosocial mechanisms could account for associations between generalised trust, happiness and mortality. The study sample was derived from US General Social Survey data from 1978 to 2010 (response rates ranged from 70 to 82 per cent), and combined with death records from the National Death Index. The analytical sample comprised 23,933 individuals with 5382 validated d...
Source: Social Science and Medicine - Category: Psychiatry & Psychology Source Type: research
Authors: Feng X, Zhang M, Meng J, Wang Y, Liu Y, Liang C, Fan S Abstract We aimed to investigate the potential mechanisms of progression and identify novelprognosis-related biomarkers for papillary renal cell carcinoma (PRCC) patients. The relateddata were derived from The Cancer Genome Atlas (TCGA), and then, analyzed by Weightedgene co-expression network analysis (WGCNA). The correlation between each module andthe clinical traits were analyzed by Pearson's correlation analysis. Pathway analysis wasconducted to reveal potential mechanisms. Hub genes within each module were screenedby intra-module analysis, and vis...
Source: Oncology Research - Category: Cancer & Oncology Tags: Oncol Res Source Type: research
ConclusionsUnplanned admissions are more frequently related to general anaesthesia, lengthy surgeries and procedures such as arthroscopy, hallux valgus corrections or removal of osteosynthesis material. The major reasons for unplanned admissions were inadequate postoperative pain management for overnight admissions and wound infection for admissions after discharge.ResumenObjetivoLos procedimientos de Cirugía Ortopédica y Traumatología (COT) realizados en Unidades de Cirugía Mayor Ambulatoria (CMA) ofrecen importantes ventajas que desaparecen cuando la recuperación postoperatoria no es la...
Source: Revista Espanola de Cirugia Ortopedica y Traumatologia - Category: Orthopaedics Source Type: research
Publication date: January–February 2020Source: Revista Española de Cirugía Ortopédica y Traumatología (English Edition), Volume 64, Issue 1Author(s): A. Abarquero-Diezhandino, G. Luengo-Alonso, D. Alonso-Tejero, E.J. Sánchez-Morata, C. Olaya-Gonzalez, J. Vilá y RicoAbstractBackground and aimsAt least 10% of ankle fractures involve the posterior malleolus of the tibia, which has been related to poorer long-term prognosis. Our aim was to analyse the clinical and functional outcomes of ankle fractures involving the posterior edge, treated surgically without direct reduction of t...
Source: Revista Espanola de Cirugia Ortopedica y Traumatologia - Category: Orthopaedics Source Type: research
ConclusionIn the presence of an osteolytic lesion with perilesional oedema in the greater tuberosity, the intraosseous expansion of a calcifying tendinopathy should be included in the differential diagnosis. In our cases the arthroscopic treatment was successful.ResumenAntecedentes y ObjetivoLa tendinitis calcificante del manguito de los rotadores es una de las causas frecuentes de dolor en el hombro. El objetivo fue dar a conocer una presentación poco habitual de la tendinitis calcificante de hombro, la expansión intraósea, que en muchos casos puede ser confundida con una lesión tumoral o infec...
Source: Revista Espanola de Cirugia Ortopedica y Traumatologia - Category: Orthopaedics Source Type: research
ConclusionsThe use of cement in OVF with relative indication led to the same clinical benefit in our sample as those with standard indication. A higher number of leakages occurred in the relative indication group with no clinical consequences or adjacent fractures.ResumenIntroducciónLa cementación vertebral ha demostrado eficacia en mejorar la calidad de vida y el dolor en fracturas vertebrales osteoporóticas (OVF) sin déficit neurológico no susceptibles de tratamiento conservador. Se aconseja emplearla en fracturas recientes, con aplastamiento 50% y>12 meses de evolución de la ...
Source: Revista Espanola de Cirugia Ortopedica y Traumatologia - Category: Orthopaedics Source Type: research
We report a unique case of a 60-year-old woman developing endometrial cancer in a uterine deposit 18 years after she had undergone laparoscopic subtotal hysterectomy with morcellation for benign pathology. She had used unopposed estrogen as menopausal hormone therapy. She presented with a pelvic mass that was causing pressure symptoms. On imaging, the mass had an enhancing vascular nodular component and appeared to abut normal ovaries and the residual cervix. She proceeded to laparotomy, where a 12 cm pelvic mass was found morbidly adherent to the bladder anteriorly and to the cervical stump. The pelvic mass was excise...
Source: Case Reports in Womens Health - Category: OBGYN Source Type: research
Pancreatic exocrine insufficiency occurs when there is insufficient production or delivery of pancreatic enzymes required for the digestion and absorption of food. It is associated with relatively poor outcomes, including reduced quality of life and survival.1 Common causes are cancer of the head/body of the pancreas, chronic pancreatitis, pancreatic resection and cystic fibrosis. It can occur following duodenectomy, gastrectomy or untreated coeliac disease via a reduction in cholecystokinin and thereby post-prandial pancreatic stimulation.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
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