pancreatopathy

  • 文章类型: Journal Article
    胰腺炎的组织学证据通常在猫的尸检研究中发现。由于非特异性临床体征,胰腺炎的临床诊断具有挑战性。缺乏诊断脂肪酶切断,和常见的多种疾病。尚不清楚在病猫中发现单独的胰腺炎的频率,以及在病猫中发现胰腺炎的临床病理证据的频率不能导致胰腺炎的临床诊断。我们的目的是评估疑似胰腺炎的猫的合并症程度,评估患有高脂血症的患病猫仅被诊断为非胰腺疾病的频率,并比较他们的临床发现。563只客户拥有的住院猫的医疗记录,可用的脂肪酶活性测量(LIPCRoche)>30U/L(RI,6-26)进行搜索,并按器官系统记录和分组医疗诊断。临床病理结果在单独患有胰腺炎(PA)的猫之间进行了比较,胰腺炎并发疾病(PD),无可疑胰腺炎(NP)。我们发现PA存在于33只(6%)猫中,PD组中有159只猫(28%),371只猫(66%)没有可疑的胰腺炎(NP)。临床,实验室,PA和PD猫的超声检查结果没有差异。三组之间的脂肪酶活性没有差异。PD和NP猫中最常见的疾病类别是胃肠道疾病,肝胆,肾/尿,和内分泌,和肾/尿,胃肠,心脏,和骨骼肌肉,分别。我们得出的结论是,猫很少因为怀疑胰腺炎而住院,PA猫在临床上与PD猫没有差异。未诊断为胰腺炎的病猫高脂血症可能是由于反应性胰腺炎或先前存在的慢性胰腺炎。
    Histological evidence of pancreatitis is commonly found in necropsy studies in cats. A clinical diagnosis of pancreatitis is challenging due to nonspecific clinical signs, a lack of diagnostic lipase cutoffs, and frequent presence of multiple diseases. It is still unknown how often pancreatitis alone is found in sick cats and how often clinicopathological evidence of pancreatitis in sick cats does not lead to a clinical diagnosis of pancreatitis. Our aims were to evaluate the extent of comorbidities in cats with suspected pancreatitis, evaluate how often sick cats with hyperlipasemia are diagnosed only with non-pancreatic diseases, and compare their clinical findings. Medical records of 563 client-owned hospitalized cats with available lipase activity measurement (LIPC Roche) > 30 U/L (RI, 6-26) were searched and medical diagnoses recorded and grouped by organ system. Clinicopathological findings were compared between cats with pancreatitis alone (PA), pancreatitis with concurrent disease (PD), and no suspected pancreatitis (NP). We found that PA was present in 33 (6%) cats, 159 cats (28%) were in the PD group, and 371 cats (66%) had no suspected pancreatitis (NP). Clinical, laboratory, and ultrasonographic findings did not differ between PA and PD cats. Lipase activities did not differ between the three groups. The most common disease categories in PD and NP cats were gastrointestinal, hepatobiliary, renal/urinary, and endocrine, and renal/urinary, gastrointestinal, cardiac, and musculoskeletal, respectively. We conclude that cats are rarely hospitalized because of suspected pancreatitis alone, and PA cats did not differ clinically from PD cats. Hyperlipasemia in sick cats without a diagnosis of pancreatitis may be due to a reactive pancreatopathy or preexisting chronic pancreatitis.
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  • 文章类型: Journal Article
    Type 1 diabetes (T1D) is one of the most frequent chronic autoimmune diseases in humans, characterized by the lack of insulin production resulting in high blood glucose levels and lifelong requirement of exogenous insulin administration for survival. It is now recognized that the autoimmune process begins years before the clinical onset, in a stage called pre-symptomatic T1D, in which the presence of β-cell-specific autoantibodies is detectable. Our aim is to review evidence for T1D as a \"whole-pancreas disease,\" featured by both endocrine and exocrine pancreas alterations already at early disease stages.
    In this review, we discuss a series of recent observations indicating that in genetically predisposed individuals, structural and functional abnormalities as well as immune cell infiltration of the exocrine pancreas are already present in the pre-symptomatic stages of the disease. Despite T1D being considered a β-cell-specific disease, numerous reports point to the presence of exocrine pancreas subclinical abnormalities occurring during disease development. These observations challenge the long-standing idea that T1D exocrine damage exists as a mere consequence of disease progression and provide further explanation of mechanisms underlying T1D pathogenesis.
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  • 文章类型: Journal Article
    BACKGROUND: Limited data exists concerning the coincidence of chronic pancreatitis (CP) and liver cirrhosis with respect to the patient outcome after liver transplantation (LT). The aim of the study was to identify risk factors for graft loss after liver transplantation and to evaluate the impact of CP on graft survival.
    METHODS: We analyzed the data of 421 cirrhotic patients who underwent evaluation for primary liver transplantation from January 2007 to January 2014. Diagnosis of CP based on morphologic findings which were graded according to the Cambridge and Manchester classification. (Graft) survival after LT was analyzed by Cox regression analysis. Recipient- and donor-related risk factors for graft loss were evaluated using univariate and multivariate analysis.
    RESULTS: 40/421 cirrhotic patients suffered from CP (9.5%). 250/421 (59.4%) patients underwent LT between January 2007 and January 2014. In total, 89 patients died or were in need of a re-transplantation during follow-up until August 2017. Patients with CP (N = 26) were at increased risk for graft loss after LT (hazard ratio = 2.183; 95% confidence interval = 1.232-3.868). CP (P = 0.001), a MELD score ≥24 (P = 0.021), absence of esophageal or gastrical varices (P = 0.018), the age of the donor (P = 0.008) and infections after transplantation (P = 0.030) were independent risk factors for organ loss after transplantation in the multivariate Cox regression analysis.
    CONCLUSIONS: Patients with chronic pancreatitis are at increased risk for graft loss after LT. A high MELD score, the absence of esophageal or gastrical varices, an advanced donor age and post-transplant infections negatively affect graft survival, too.
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