Pancreatitis, alcohol

Once the presence of fasting lipemia has been established, di-ffereyitiation between primary and secondary hyperlipemias can usually be made on the basis of presence or absence of clinical and laboratory findings characteristic of an underlying disease. Plasma lipid and lipoprotein patterns as determined by lipid analyses, ultracentrifugation and electrophoresis are not necessarily diagnostic since similar findings are present in EHL and hyperlipemia of diabetic ketoacidosis, acute pancreatitis, alcoholism, etc. (Schettler 1955, Lees and Fredrickson 1964, Jahnke 1965). 

Pancreatic lipase pancreas fats and other organic esters organic acid and alcohol (often gly ceroi) 7-0... 

LY311727 is an indole acetic acid based selective inhibitor of human non-pancreatic secretory phospholipase A2 (hnpsPLA2) under development by Lilly as a potential treatment for sepsis. The synthesis of LY311727 involved a Nenitzescu indolization reaction as a key step. The Nenitzescu condensation of quinone 4 with the p-aminoacrylate 39 was carried out in CH3NO2 to provide the desired 5-hydroxylindole 40 in 83% yield. Protection of the 5-hydroxyl moiety in indole 40 was accomplished in H2O under phase transfer conditions in 80% yield. Lithium aluminum hydride mediated reduction of the ester functional group in 41 provided the alcohol 42 in 78% yield. 

The patient s history will identify risk factors for acute pancreatitis, such as age greater than 70 years or history of alcohol abuse. Finally, computed tomography (CT) scan or ultrasound of the abdomen can help to identify pancreatic fluid collections.12... 

Supplementation with pancreatic enzymes may reduce the pain and fatty diarrhea associated with chronic pancreatitis (Table 20-3). Best results are achieved in patients who have mild non-alcoholic pancreatic disease. Common pancreatic enzyme supplements contain lipase, amylase, and protease in varying proportions. Thus, the dose can be tailored to the patient s requirement for exogenous enzyme supplementation and response to therapy. 

Causes of hypocalcemia include hypoparathyroidism, hypomagnesemia, alcoholism, hyperphosphatemia, blood product infusion (due to chelation by the citrate buffers), chronic renal failure, vitamin D deficiency, acute pancreatitis, alkalosis, and hypoalbuminemia. Medications that cause hypocalcemia include phosphate replacement products, loop diuretics, phenytoin (Dilantin, available as generic), pheno-barbital (available as generic), corticosteroids, aminoglycoside antibiotics, and acetazolamide (available as generic).34,39,42... 

O Primary peritonitis develops in up to 25% of patients with alcoholic cirrhosis.3 Patients undergoing continuous ambulatory peritoneal dialysis (CAPD) average one episode of peritonitis every 2 years.4 Secondary peritonitis may be caused by perforation of a peptic ulcer traumatic perforation of the stomach, small or large bowel, uterus, or urinary bladder appendicitis pancreatitis diverticulitis bowel infarction inflammatory bowel disease cholecystitis operative contamination of the peritoneum or diseases of the female genital tract such as septic abortion, postoperative uterine infection, endometritis, or salpingitis. Appendicitis is one of the most common causes of intraabdominal infection. In 1998, 278,000 appendectomies were performed in the United States for suspected appendicitis.5... 

Although earlier work had showed a positive association between coffee consumption and pancreatic cancer rates across countries,2 it was the much-publicized case-control study of MacMahon et al.3 in 1981 that attracted widespread attention to the question of a possible link. In that study, which was designed primarily to investigate the role of smoking and alcohol in pancreatic cancer, 369 pancreatic cancer patients prior to diagnosis and 644 hospital controls reported their typical daily coffee and tea consumption. Unexpectedly, the authors found a significantly increased risk of pancreatic cancer associated with coffee consumption (overall rela-... 

Many other organs are also sensitive to alcohol abuse. The stomach may develop chronic or acute gastritis, and ulcers are prevented from healing. Pancreatitis... 

Stark MJ, Burke YD, McKinzie JH, Ayoubi AS and Crowell PL. 1995. Chemotherapy of pancreatic cancer with the monoterpene perillyl alcohol. Cancer Lett 96 15-21. 

The answer is d. (Hardman, p 935.) Pancrelipase is an alcoholic extract of hog pancreas that contains lipase, trypsin, and amylase. It is effective in reducing the steatorrhea of pancreatic insufficiency None of the other drugs mentioned have significant action in the digestion of fats... 

Gallstones and alcohol abuse account for most cases in the United States. A cause cannot be identified in some patients (idiopathic pancreatitis). 

C. Multiple, partial, and other /3 barrels Acid proteases domains 1 and 2 Alcohol dehydrogenase domain 1 Pancreatic ribonuclease... 

Unfortunately, the size of the crystallographic problem presented by elastase coupled with the relatively short lifedme of the acyl-enzyme indicated that higher resolution X-ray data would be difficult to obtain without use of much lower temperatures or multidetector techniques to increase the rate of data acquisition. However, it was observed that the acyl-enzyme stability was a consequence of the known kinetic parameters for elastase action on ester substrates. Hydrolysis of esters by the enzyme involves both the formation and breakdown of the covalent intermediate, and even in alcohol-water mixtures at subzero temperatures the rate-limidng step is deacylation. It is this step which is most seriously affected by temperature, allowing the acyl-enzyme to accumulate relatively rapidly at — 55°C but to break down very slowly. Amide substrates display different kinetic behavior the slow step is acylation itself. It was predicted that use of a />-nitrophenyl amid substrate would give the structure of the pre-acyl-enzyme Michaelis complex or even the putadve tetrahedral intermediate (Alber et ai, 1976), but this experiment has not yet been carried out. Instead, over the following 7 years, attention shifted to the smaller enzyme bovine pancreatic ribonuclease A. 

Risk factors for deficiency Pregnancy (neural tube defects in fetus may result) Alcoholism Severe malnutrition Risk fiictors for deficiency Pernicious anemia Gastric resection Chronic pancreatitis Severe malnutrition Vegan Infection with D. latum... 

Zinc is a microelement essential for proper functioning of the human body. The level of daily demand for zinc was established as 13 to 16 mg (Ziemlahski, 2001). Zinc plays a role in protein and carbohydrate metabolism and is a component of over 60 metaloenzymes, including alkaline phosphatase, pancreatic carboxypeptidases A and B, alcoholic and lactic dehydrogenases, carbonate anhydrase, and proteases. It also forms bonds with nucleic acids -which is very important for their functioning (Prasad, 1983 Valee and Falchuk, 1993). 

Savary, P. (1971). The action of pure pig pancreatic lipase upon esters of long-chain fatty acids and short-chain primary alcohols. Biochim. Biophys. Acta 248,149-155. 

Olsen GW, et al. A case-control study of pancreatic cancer and cigarettes, alcohol, coffee and diet. Am J Public Health 1989 79(8) 1016-1019. 

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