When in doubt, take it out? Cholestasis and obstructive gastric outlet syndrome in a patient with suspected chronic pancreatitis.

In some patients with tumors located in the pancreas or in the periampullary region, the decision to perform a surgical resection can be difficult. In patients with concomitant chronic pancreatitis this decision can be even more challenging, since a definitive preoperative differentiation between non-malignant and malignant tumors in many cases is not possible. Clinical symptoms or complications from the tumor often direct a rational treatment strategy.

Efficacy of hypnosis in adults undergoing surgery or medical procedures: a meta-analysis of randomized controlled trials.

This meta-analysis investigates the efficacy of hypnosis in adults undergoing surgical or medical procedures compared to standard care alone or an attention control. Through a comprehensive literature search N=34 eligible randomized controlled trials (RCTs) were included, comprising a total of 2597 patients. Random effects meta-analyses revealed positive treatment effects on emotional distress (g=0.

Genetic and biochemical evidence for a functional role of BACE1 in the regulation of insulin mRNA expression.

Objective: Beta-site amyloid precursor protein cleaving enzyme (BACE1) is highly expressed in pancreatic β-cells. The BACE1 gene is located in a region associated with a high diabetes risk in PIMA Indians.

Design And Methods: INS-1E cells were used to study the impact of siRNA-mediated BACE1 knockdown and glucose metabolism was characterized in Bace1(-/-) mice.

[Psychological interventions in surgical care: a narrative review of current meta-analytic evidence].

Studies investigating the effects of adjunctive psychological interventions to surgical routine care are summarized as a narrative review of existing meta-analyses. Primary studies evaluate the effects of the provision of information, supportive approaches, coping skills training, behavioural instructions, cognitive-behavioural strategies, relaxation, and hypnosis. The meta-analyses include studies of different methodological quality, also considering non-randomized trials, and indicate small to large effects depending on the type of intervention and outcome measure.

[Psychosocial interventions in somatic diseases].

The literature dealing with the topic of this paper seems almost unmanageable. Accordingly, a schema to sort research results is proposed discriminating goal population, service model, indication as well as the treatment model and setting of psychosocial interventions. The state of the art is exemplarily described by testing the integration of psychosocial research results into current guidelines for the treatment of somatic diseases.

Pre-study protocol MagPEP: a multicentre randomized controlled trial of magnesium sulphate in the prevention of post-ERCP pancreatitis.

Background: Acute pancreatitis is the most common complication of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP). In spite of continuing research, no pharmacologic agent capable of effectively reducing the incidence of ERCP-induced pancreatitis has found its way into clinical practise. A number of experimental studies suggest that intrapancreatic calcium concentrations play an important role in the initiation of intracellular protease activation, an initiating step in the course of acute pancreatitis.

Physical and mental health in patients and spouses after intensive care of severe sepsis: a dyadic perspective on long-term sequelae testing the Actor-Partner Interdependence Model.

Objective: To examine the physical and mental long-term consequences of intensive care treatment for severe sepsis in patients and their spouses under consideration of a dyadic perspective using the Actor-Partner Interdependence Model.

Design: Prospective study.

Setting: Patients and spouses who had requested advice from the German Sepsis Aid's National Helpline were invited to participate.

Bypass surgery with psychological and spiritual support (the BY.PASS Study): results of a pragmatic trial based on patients' preference.

Background: Some general hospitals within the German health system provide supportive interventions, psychological as well as spiritual, to their patients. It remains to be proven if these interventions are effective when used in routine clinical practice.

Aim: To evaluate the effectiveness of psychological and spiritual interventions on improving recovery following bypass surgery.

Genetic analyses of heme oxygenase 1 (HMOX1) in different forms of pancreatitis.

Background: Heme oxygenase 1 (HMOX1) is the rate limiting enzyme in heme degradation and a key regulator of inflammatory processes. In animal models the course of pancreatitis was ameliorated by up-regulation of HMOX1 expression. Additionally, carbon monoxide released during heme breakdown inhibited proliferation of pancreatic stellate cells and might thereby prevent the development of chronic pancreatitis (CP).

[Physical and mental long-term sequelae following intensive care of severe sepsis in patients and relatives].

This study aimed at investigating the physical and mental long-term sequelae in survivors of severe sepsis and in their relatives. Furthermore, the role of resilience as protective factor was examined. We contacted all persons who had requested free of charge advice from the German Sepsis Aid's National Helpline and asked them to answer a questionnaire.

CFTR, SPINK1, CTRC and PRSS1 variants in chronic pancreatitis: is the role of mutated CFTR overestimated?

Objective: In chronic pancreatitis (CP), alterations in several genes have so far been described, but only small cohorts have been extensively investigated for all predisposing genes.

Design: 660 patients with idiopathic or hereditary CP and up to 1758 controls were enrolled. PRSS1, SPINK1 and CTRC were analysed by DNA sequencing, and cystic fibrosis transmembrane conductance regulator (CFTR) by melting curve analysis.

[Genetically determined pancreatic diseases].

Overall, genetically determined diseases of the pancreas are rare. Recently, it was demonstrated that in chronic pancreatitis many patients carry genetic changes in associated genes. Aside from chronic pancreatitis, cystic fibrosis is also characterized by exocrine insufficiency in many patients.

A common variant of PNPLA3 (p.I148M) is not associated with alcoholic chronic pancreatitis.

Background: Chronic pancreatitis (CP) is an inflammatory disease that in some patients leads to exocrine and endocrine dysfunction. In industrialized countries the most common aetiology is chronic alcohol abuse. Descriptions of associated genetic alterations in alcoholic CP are rare.

Common CFTR haplotypes and susceptibility to chronic pancreatitis and congenital bilateral absence of the vas deferens.

CFTR mutations enhance susceptibility for idiopathic chronic pancreatitis (ICP) and congenital bilateral absence of the vas deferens (CBAVD); however, it is unknown why CFTR heterozygotes are at increased disease risk. We recently showed that common CFTR variants are associated with aberrantly spliced transcripts. Here, we genotyped for common CFTR variants and tested for associations in two ICP (ICP-A: 126 patients, 319 controls; ICP-B: 666 patients, 1,181 controls) and a CBAVD population (305 patients, 319 controls).

Acoustic radiation force impulse (ARFI) elastography in acute liver failure: necrosis mimics cirrhosis.

Acoustic radiation force Impulse (ARFI) technology correlates shear-wave velocity with fibrosis. It can differentiate between advanced fibrosis and normal tissue in chronic liver disease. However, specificity is impaired by cholestasis, inflammation or oedema in acute hepatitis.

Complete analysis of the human mesotrypsinogen gene (PRSS3) in patients with chronic pancreatitis.

Background/aims: A sustained imbalance of pancreatic proteases and their inhibitors seems to be important for the development of chronic pancreatitis (CP). Mesotrypsin (PRSS3) can degrade intrapancreatic trypsin inhibitors that protect against CP. Genetic variants that cause higher mesotrypsin activity might increase the risk for CP.

Sequence analysis of the human tyrosylprotein sulfotransferase-2 gene in subjects with chronic pancreatitis.

Background/aims: Human trypsinogens are post-translationally sulfated on Tyr154 by the Golgi resident enzyme tyrosylprotein sulfotransferase-2 (TPST2). Tyrosine sulfation stimulates the autoactivation of human cationic trypsinogen. Because increased trypsinogen autoactivation has been implicated as a pathogenic mechanism in chronic pancreatitis, we hypothesized that genetic variants of TPST2 might alter the risk for the disease.

Mutational analysis of the gene encoding the zymogen granule membrane glycoprotein 2 (GP2) in patients with chronic pancreatitis.

Objectives: Premature activation of pancreatic digestive enzymes is considered as a major factor in the pathogenesis of pancreatitis. Genetic alterations of different pancreatic zymogens or their inhibitors have been associated with chronic pancreatitis (CP).

Methods: We sequenced all 12 GP2 exons in 380 German CP patients and in 182 German control subjects.

A variant of the SLC10A2 gene encoding the apical sodium-dependent bile acid transporter is a risk factor for gallstone disease.

Background: Cholelithiasis is a multifactorial process and several mechanisms of gallstone formation have been postulated. As one of these mechanisms, a decreased expression of the ileal apical sodium-dependent bile acid transporter gene SLC10A2 in gallstone carriers was described previously. In this study the SLC10A2 gene was investigated to identify novel genetic variants and their association with gallstone formation.

Bypass surgery with psychological and spiritual support (the By.pass study): study design and research methods.

Effects of psychological as well as spiritual interventions on outcome in cardiac surgery have mostly been studied with a focus on presurgical interventions. Systematically controlled analyses of the effects of psychological and spiritual interventions depending on the patients' preference have not been performed so far, although these studies would help to assign patients to an adequate support. The By.

Angiotensin-converting enzyme insertion/deletion polymorphism in patients with acute and chronic pancreatitis.

Background: Reduction in angiotensin-converting enzyme (ACE) activity has been shown to attenuate pancreatic stellate cell activation and pancreatic fibrosis and suggested as a potential treatment for chronic pancreatitis. The ACE gene insertion/deletion (I/D) polymorphism in intron 16 accounts for nearly half the variation in serum ACE levels. This study determined the frequency of the I/D polymorphism in patients with acute and chronic pancreatitis.

The role of epoxide hydrolase Y113H gene variant in pancreatic diseases.

Objectives: Chronic pancreatitis (CP) and pancreatic adenocarcinoma (pCA) are associated with risk factors such as alcohol intake and tobacco smoking. Microsomal epoxide hydrolase (EPHX1) is a phase II detoxifying enzyme capable of tobacco-borne toxicant inactivation. We studied the role of the EPHX1 c.

The inverse starving test is not a suitable provocation test for Gilbert's syndrome.

Introduction: The aim of this study was to evaluate a simple diagnostic test for Gilbert's syndrome (GS), which avoids hospitalization and exposure to toxic test substrates. GS is the most frequent cause of isolated unconjugated hyperbilirubinemia. The nicotinic acid test and the starving test are established approaches to diagnose GS.

Dieting and disordered eating in German high school athletes and non-athletes.

The purpose of this study was to examine weight concerns, dieting, body dissatisfaction as well as eating behavior of German high school athletes and to compare disordered eating behavior of these athletes with regular high school students. Five hundred and seventy-six young athletes of Elite Sports Schools in the German state of Thuringia and a reference group consisting of 291 non-athletes from regular high schools completed a questionnaire regarding eating behavior and attitudes, dietary history, body image and demographics. The Eating Attitude Test was used to measure disordered eating.