AIM: To investigate whether enteroviral infection might trigger acute pancreatitis in patients made susceptible due to high alcohol consumption. METHODS: Patients with alcohol-induced acute pan-creatitis were analyzed...AIM: To investigate whether enteroviral infection might trigger acute pancreatitis in patients made susceptible due to high alcohol consumption. METHODS: Patients with alcohol-induced acute pan-creatitis were analyzed for signs of simultaneous or preceding enteroviral infection. We studied the serum samples of 40 patients hospitalized for alcohol-induced acute pancreatitis and 40 controls recruited from an alcohol detoxification center. Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect enterovirus RNA and diagnose acute viremia. Immuno-globulin G (IgG), immunoglobulin A (IgA) and immuno-globulin M (IgM) enteroviral antibodies were measured using enzyme immunoassay to detect subacute andprevious infections. The samples were considered posi-tive when the antibody titers were≥15 IU. Further-more, using RT-PCR, we studied pancreatic biopsy sam-ples obtained during surgery from nine patients with chronic pancreatitis, one patient with acute pancreatitis and ten control patients with pancreatic carcinoma for evidence of persisting enteroviral RNA in the pancreatic tissue. RESULTS: No enterovirus RNA indicating acute viremia was detected by RT-PCR in the serum samples of any patient or control. A high incidence of positive antibody titers was observed in both study groups: IgM antibod-ies had positive titers in 5/40 (13%) vs 4/40 (10%), P=0.723; IgG in 15/40 (38%) vs 19/40 (48%), P=0.366; and IgA in 25/40 (63%) vs 33/40 (83%), P=0.045, patients and controls, respectively. Ten (25%) patients had severe pancreatitis and two (5%) required treatment in intensive care. The median length of hos-pitalization was 7 d (range: 3-47 d). The severity of acute pancreatitis or the length of hospitalization was not associated with enteroviral IgM, IgG or IgA anti-bodies. Five pancreatic biopsy samples tested positive with RT-PCR, three (8%) in the control group and two (5%) in the patient group (P=0.64). CONCLUSION: The rate of enteroviral infection is not increased in patients with alcohol-induced acute pan-creatitis when compared to alcoholics with similar high alcohol use.展开更多
BACKGROUND Abdominal pain in chronic pancreatitis(CP)may require invasive interventions.Surgical procedures are rare,and little is known about the long-term results.AIM To study the nationwide frequency of pancreatic ...BACKGROUND Abdominal pain in chronic pancreatitis(CP)may require invasive interventions.Surgical procedures are rare,and little is known about the long-term results.AIM To study the nationwide frequency of pancreatic surgery for CP in Finland,and postoperative symptoms and quality of life(QoL).METHODS All patients in Finland with a diagnosis of CP who had undergone pancreatic surgery during 2000-2008 were selected from a national register.Only patients with CP as an indication for pancreatic surgery were included.Medical records were studied and questionnaires QLQ-C30,PAN26 and AUDIT,and symptom questionnaires were sent out.RESULTS During the 9-year period,pancreatic surgery for CP was performed on 30 patients[77%men,median age 45(21-62)years].Eighty-three percent underwent endoscopic procedures before surgery.Surgery was performed a median 2(0-10)years after the original CP diagnosis,and 17%developed postoperative complications.Primary pain relief after surgery was reported in 70%of cases.Need for strong pain medication was lower after surgery.Eight of 21(38%)returned the questionnaires and 88%reported that surgery had reduced their pain and 63%were almost or entirely pain-free at a median 14(10-18)years after surgery.QoL results did not differ from those in our control Finnish CP group.CONCLUSION Surgery for CP is rare in Finland and most patients had prior endoscopic procedures.Patients who returned the questionnaires reported less pain and good QoL during the 14-year follow-up.展开更多
文摘AIM: To investigate whether enteroviral infection might trigger acute pancreatitis in patients made susceptible due to high alcohol consumption. METHODS: Patients with alcohol-induced acute pan-creatitis were analyzed for signs of simultaneous or preceding enteroviral infection. We studied the serum samples of 40 patients hospitalized for alcohol-induced acute pancreatitis and 40 controls recruited from an alcohol detoxification center. Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect enterovirus RNA and diagnose acute viremia. Immuno-globulin G (IgG), immunoglobulin A (IgA) and immuno-globulin M (IgM) enteroviral antibodies were measured using enzyme immunoassay to detect subacute andprevious infections. The samples were considered posi-tive when the antibody titers were≥15 IU. Further-more, using RT-PCR, we studied pancreatic biopsy sam-ples obtained during surgery from nine patients with chronic pancreatitis, one patient with acute pancreatitis and ten control patients with pancreatic carcinoma for evidence of persisting enteroviral RNA in the pancreatic tissue. RESULTS: No enterovirus RNA indicating acute viremia was detected by RT-PCR in the serum samples of any patient or control. A high incidence of positive antibody titers was observed in both study groups: IgM antibod-ies had positive titers in 5/40 (13%) vs 4/40 (10%), P=0.723; IgG in 15/40 (38%) vs 19/40 (48%), P=0.366; and IgA in 25/40 (63%) vs 33/40 (83%), P=0.045, patients and controls, respectively. Ten (25%) patients had severe pancreatitis and two (5%) required treatment in intensive care. The median length of hos-pitalization was 7 d (range: 3-47 d). The severity of acute pancreatitis or the length of hospitalization was not associated with enteroviral IgM, IgG or IgA anti-bodies. Five pancreatic biopsy samples tested positive with RT-PCR, three (8%) in the control group and two (5%) in the patient group (P=0.64). CONCLUSION: The rate of enteroviral infection is not increased in patients with alcohol-induced acute pan-creatitis when compared to alcoholics with similar high alcohol use.
基金Medical Research Fund of Pirkanmaa Hospital District,No.9X024and Sigrid Jusélius Foundation,No.MS424.
文摘BACKGROUND Abdominal pain in chronic pancreatitis(CP)may require invasive interventions.Surgical procedures are rare,and little is known about the long-term results.AIM To study the nationwide frequency of pancreatic surgery for CP in Finland,and postoperative symptoms and quality of life(QoL).METHODS All patients in Finland with a diagnosis of CP who had undergone pancreatic surgery during 2000-2008 were selected from a national register.Only patients with CP as an indication for pancreatic surgery were included.Medical records were studied and questionnaires QLQ-C30,PAN26 and AUDIT,and symptom questionnaires were sent out.RESULTS During the 9-year period,pancreatic surgery for CP was performed on 30 patients[77%men,median age 45(21-62)years].Eighty-three percent underwent endoscopic procedures before surgery.Surgery was performed a median 2(0-10)years after the original CP diagnosis,and 17%developed postoperative complications.Primary pain relief after surgery was reported in 70%of cases.Need for strong pain medication was lower after surgery.Eight of 21(38%)returned the questionnaires and 88%reported that surgery had reduced their pain and 63%were almost or entirely pain-free at a median 14(10-18)years after surgery.QoL results did not differ from those in our control Finnish CP group.CONCLUSION Surgery for CP is rare in Finland and most patients had prior endoscopic procedures.Patients who returned the questionnaires reported less pain and good QoL during the 14-year follow-up.