Pancreatitis definition

Lippi et. al (87) and Dirstine (88) circumvented titration by converting the liberated fatty acids into copper salts, which after extraction in chloroform are reacted with diethyldithio-carbamate to form a colored complex which is measured photometrically. While the end point appears to be more sensitive than the pH end point determination, the advantages are outweighed by the additional steps of solvent extraction, centrifugation and incomplete extraction when low concentrations of copper salts are present. Other substrates used for the measurement of lipase activity have been tributyrin ( ), phenyl laurate (90), p-nit ro-pheny1-stearate and 3-naphthyl laurate (91). It has been shown that these substrates are hydrolyzed by esterases and thus lack specificity for lipase. Studies on patients with pancreatitis indicate olive oil emulsion is definitely superior to water soluble esters as substrates for measuring serum lipase activity. 

A complete history and physical examination should assess (1) presence or absence of cardiovascular risk factors or definite cardiovascular disease in the individual (2) family history of premature cardiovascular disease or lipid disorders (3) presence or absence of secondary causes of hyperlipidemia, including concurrent medications and (4) presence or absence of xanthomas, abdominal pain, or history of pancreatitis, renal or liver disease, peripheral vascular disease, abdominal aortic aneurysm, or cerebral vascular disease (carotid bruits, stroke, or transient ischemic attack). 

Many dietary and environmental factors have been implicated as possible etiologic factors in the development of pancreatic cancer, but no definite causal relationships have been established. The strongest evidence points to cigarette smoking as a risk factor associated with pancreatic cancer (20-24). Occupational exposure to certain chemicals has also been linked to pancreatic carcinoma (25). Others in the high-risk group include stone miners, cement workers, gardeners, textile workers, and leather tanners (17,26). 

New data on the sulfonylurea receptor as part of the ATP-dependent potassium channel (SUR-1 in the beta pancreatic cells, involved in insulin secretion, and SUR-2 in the myocardium, involved in cardiac adaptation during ischemia) has still not yielded a definitive answer. The available experimental and clinical data have been systematically reviewed (29). The conclusion was that experimentally the effects of sulfonylureas on heart muscle are both deleterious and protective for glibenclamide while tolbutamide, glimepiride, and gliclazide have no effects. There seem to be no adverse cardiac consequences of chronic treatment with sulfonylureas. 

Insulin is a complex protein molecule produced by the pancreas in all vertebrates. This hormone regulates carbohydrate metabolism. Inability to produce insulin results in diabetes mellitus. Diabetes is treated by injections of insulin. Given the law of definite proportion, would you expect any differences in chemical activity between human insulin extracted from pancreatic tissue and human insulin produced by genetically engineered bacteria Why or why not ... 

Pancreatic lipase can be considered a model for all other lipases. Most if not all of these enzymes seem to be nonspecific carboxyl ester hydrolases of the serine histidine type. Their specificity consists, by definition, in their ability to hydrolyze insoluble substrates, but apart... 

In a review of definite or probable drug-associated pancreatitis spontaneously reported to the Dutch adverse drug reactions system during 1977-98, azathioprine was the suspected drug in four of 34 patients, two of whom had positive rechallenge (37). Although most of the carefully described reports of azathioprine-induced pancreatitis were found in patients with inflammatory bowel disease, transplant recipients can also suffer this complication. 

A definite case of pancreatitis proven by positive rechallenge was also briefly cited in a review of drug-associated pancreatitis spontaneously reported to the Dutch adverse drug reactions system (261). 

The association between propofol and pancreatitis has been listed as probable in 25 reports of pancreatitis associated with propofol to the FDA registry. However, the features of this case, which included resolution of pancreatitis on drug withdrawal and recurrence on rechallenge, suggested that the association should be upgraded to definitely causal. ... 

Ion exchange resins (colestipol,colestyramine), which complex with the brie salts and can interfere with the absorption of the oil-soluble vitamins Aluminum antacids can complex with some of the vitamins and, when used chronically, most definitely can cause hypophosphatemia Cystic fibrosis, which can cause fat malabsorption (steatorrhea) attributed to inadequate production of pancreatic lipases... 

Some authors faced with experimental data from functional studies that did not fulfilled the criteria of definition of Ii- or l2-receptors this was particularly the case in investigations concerning the possible role of pancreatic imidazoline receptors but it was also evoked with regard to sympathetic presynaptic imidazohne receptors. Such sites were provisionally named non-Il, non-l2 receptors [24,25]. 

The definitive diagnosis of AP is surgical examination of the pancreas or pancreatic histology. In the absence of these procedures, the... 

Some clinicians believe that antibiotic prophylaxis is necessary in patients with severe AP in order to prevent pancreatic infection, while others believe that this practice is unnecessary. Antibiotic use in AP remains controversial in patients without definite proof of an infection. Patients with severe AP complicated by necrosis should receive prophylactic treatment with a broad-spectrum antibiotic. 

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