Sex-Related Differences of Acute and Chronic Pancreatitis in Adults

Drake, Madeline; Dodwad, Shah-Jahan M; Davis, Julia; Kao, Lillian S.; Cao, Yanna; Ko, Tien C.

doi:10.3390/jcm10020300

Cited by 35 publications

(28 citation statements)

References 83 publications

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“…24 It is reported in literature that men have a higher risk of death in the course of AP than women. 25 However, our study compared 2 final groups of patients (R0 and R1) that did not differ statistically in sex, age, etiology of AP or disease severity distribution, which is why our research supports the hypothesis that it was rifaximin, not any other epidemiological factor, that could have altered the outcome of the disease in the group that underwent rifaximin treatment.…”

Section: Discussionsupporting

confidence: 58%

Rifaximin in gut microbiota modification in acute pancreatitis: 15 years of retrospective clinical study

Tatur¹,

Lipinski²,

Sznurkowska³

et al. 2022

Adv Clin Exp Med

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Background. Gut decontamination could have some benefits in preventing infectious complications in acute pancreatitis (AP).Objectives. To investigate whether the administration of rifaximin could have an impact on the outcomes of AP. Materials and methods.We conducted a retrospective study on 373 patients with a median age of 50 years that were admitted to our Department of Gastroenterology in the years 2001-2016 with a diagnosis of AP. Patients were subclassified according to the revised Atlanta criteria: mild acute pancreatitis (MAP), moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP). Thereafter, all the patients were divided into 2 groups: in the 1 st group (R0) with MSAP and SAP, patients did not receive rifaximin, and in the 2 nd group (R1), in the cases of MSAP and SAP, rifaximin was administered to patients at a dose of 3 × 400 mg (for at least 5 days and up to 7 days). There was no other difference in the treatment between the groups. The median duration of hospital stay, the number of infectious complications and the mortality rate were recorded for both groups.Results. A significant difference was observed between median durations of hospitalization between the groups with (R1) and without (R0) rifaximin treatment (14 days compared to 24 days, p = 0.001) and in the number of patients infected with pancreatic necrosis (7 compared to 1, p = 0.0487). However, there was no statistically significant difference between the R1 and R0 group in terms of mortality rate. Conclusions.The results indicate that rifaximin seems to be a promising novel therapeutic option in MSAP and SAP.

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Section: Discussionsupporting

confidence: 58%

Rifaximin in gut microbiota modification in acute pancreatitis: 15 years of retrospective clinical study

Tatur¹,

Lipinski²,

Sznurkowska³

et al. 2022

Adv Clin Exp Med

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“…Possible explanations of the high pain relief rates in our study are experience of the endoscopists, possibility to directly treat MPD stenoses and the high technical success rate of DSOP. In addition, our cohort showed a difference in the population, having a higher proportion of female patients and lower proportion of alcohol induced CP compared to former trials [21,22]. Treatment of stones in CP with ESWL has clearly limitations.…”

Section: Discussionmentioning

confidence: 61%

Digital single-operator pancreatoscopy for the treatment of symptomatic pancreatic duct stones: a prospective multicenter cohort trial

et al. 2022

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Background and aims: Digital single operator pancreatoscopy(DSOP) guided lithotripsy is a novel treatment modality for pancreatic endotherapy, with demonstrated technical success in retrospective series between 88% and 100%. The aim of this prospective multicenter trial was to systematically evaluate DSOP in patients with chronic pancreatitis(CP) and symptomatic pancreatic duct stones. Patients and methods: Patients with symptomatic CP and 3 stones >5mm in the main pancreatic duct(MPD) of the pancreatic head or body were included. Primary endpoint was complete stone clearance(CSC) in 3 treatment sessions with DSOP. Current guidelines recommend ESWL for MPD stones >5mm. A performance goal was developed to show that the CSC rate of MPD stones using DSOP was above what has been reported in literature for ESWL. Secondary endpoints were pain relief measured with the Izbicki pain score(IPS), number of interventions and serious adverse events(SAEs). Results Forty CP patients were included. CSC was achieved in 90%(36/40) of patients in intention-to-treat analysis, after a mean of 1.36±0.64 interventions (53 procedures in total). Mean baseline IPS decreased from 55.3 ± 46.2 to 10.9 ±18.3. Overall pain relief was achieved in 82.4%(28/34) with complete pain relief in 61.8%(21/34) and partial pain relief in 20.6%(7/34) after 6-months follow-up. SAEs occurred in 12.5%(5/40) of patients, all treated conservatively. Conclusion: DSOP guided endotherapy is effective and safe for treatment of symptomatic MPD stones in highly selected patients with CP. It significantly reduces pain and could be considered as an alternative to standard ERCP techniques for MPD stone treatment in these patients.

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“…The proposed metabolites were identified by using the reported databases, and confirmation of their identity against biological standards would have strengthened the study. A further potential limitation is the lesser representation of females in the study population, attributable to the lower prevalence of CP among females and in part explained by their less frequent exposure to etiological factors [ 33 ]. In-depth studies are currently under way to test the capacity of this six-metabolite panel to discriminate between CP patients with and without EPI in wider samples containing higher percentages of patients with early stage EPI.…”

Section: Discussionmentioning

confidence: 99%

Untargeted Metabolomics for the Diagnosis of Exocrine Pancreatic Insufficiency in Chronic Pancreatitis

et al. 2021

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Background and Objectives: The clinical manifestations and course of chronic pancreatitis (CP) are often nonspecific and variable, hampering diagnosis of the risk of exocrine pancreatic insufficiency (EPI). Development of new, reproducible, and non-invasive methods to diagnose EPI is therefore a major priority. The objective of this metabolomic study was to identify novel biomarkers associated with EPI. Materials and Methods: We analyzed 53 samples from patients with CP, 32 with and 21 without EPI, using an untargeted metabolomics workflow based on hydrophilic interaction chromatography coupled to high-resolution mass spectrometry. Principal component and partial least squares-discriminant analyses showed significant between-group differentiation, and univariate and multivariate analyses identified potential candidate metabolites that significantly differed between samples from CP patients with EPI and those without EPI. Results: Excellent results were obtained using a six-metabolic panel to diagnose the presence of EPI in CP patients (area under the ROC curve = 0.785). Conclusions: This study confirms the usefulness of metabolomics in this disease setting, allowing the identification of novel biomarkers to differentiate between the presence and absence of EPI in CP patients.

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Sex-Related Differences of Acute and Chronic Pancreatitis in Adults

Cited by 35 publications

References 83 publications

Rifaximin in gut microbiota modification in acute pancreatitis: 15 years of retrospective clinical study

Rifaximin in gut microbiota modification in acute pancreatitis: 15 years of retrospective clinical study

Digital single-operator pancreatoscopy for the treatment of symptomatic pancreatic duct stones: a prospective multicenter cohort trial

Untargeted Metabolomics for the Diagnosis of Exocrine Pancreatic Insufficiency in Chronic Pancreatitis

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