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1. Length of Variable Numbers of Tandem Repeats in the Carboxyl Ester Lipase (CEL) Gene May Confer Susceptibility to Alcoholic Liver Cirrhosis but Not Alcoholic Chronic Pancreatitis.

Author

Karianne Fjeld, Sebastian Beer, Marianne Johnstone, Constantin Zimmer, Joachim Mössner, Claudia Ruffert, Mario Krehan, Christian Zapf, Pål Rasmus Njølstad, Stefan Johansson, Peter Bugert, Fabio Miyajima, Triantafillos Liloglou, Laura J Brown, Simon A Winn, Kelly Davies, Diane Latawiec, Bridget K Gunson, David N Criddle, Munir Pirmohamed, Robert Grützmann, Patrick Michl, William Greenhalf, Anders Molven, Robert Sutton, and Jonas Rosendahl

Subjects
Medicine, Science
Abstract

Carboxyl-ester lipase (CEL) contributes to fatty acid ethyl ester metabolism, which is implicated in alcoholic pancreatitis. The CEL gene harbours a variable number of tandem repeats (VNTR) region in exon 11. Variation in this VNTR has been linked to monogenic pancreatic disease, while conflicting results were reported for chronic pancreatitis (CP). Here, we aimed to investigate a potential association of CEL VNTR lengths with alcoholic CP.Overall, 395 alcoholic CP patients, 218 patients with alcoholic liver cirrhosis (ALC) serving as controls with a comparable amount of alcohol consumed, and 327 healthy controls from Germany and the United Kingdom (UK) were analysed by determination of fragment lengths by capillary electrophoresis. Allele frequencies and genotypes of different VNTR categories were compared between the groups.Twelve repeats were overrepresented in UK ACP patients (P = 0.04) compared to controls, whereas twelve repeats were enriched in German ALC compared to alcoholic CP patients (P = 0.03). Frequencies of CEL VNTR lengths of 14 and 15 repeats differed between German ALC patients and healthy controls (P = 0.03 and 0.008, respectively). However, in the genotype and pooled analysis of VNTR lengths no statistical significant association was depicted. Additionally, the 16-16 genotype as well as 16 repeats were more frequent in UK ALC than in alcoholic CP patients (P = 0.034 and 0.02, respectively). In all other calculations, including pooled German and UK data, allele frequencies and genotype distributions did not differ significantly between patients and controls or between alcoholic CP and ALC.We did not obtain evidence that CEL VNTR lengths are associated with alcoholic CP. However, our results suggest that CEL VNTR lengths might associate with ALC, a finding that needs to be clarified in larger cohorts.

Published
2016
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2. My COVID Experience: 'I Wish It Was Different'

Author

Marianne Johnstone-Petty

Subjects
Medical education, Anesthesiology and Pain Medicine, business.industry, SARS-CoV-2, Wish, Medicine, COVID-19, Humans, General Medicine, business, General Nursing
Published
2021

4. A scoping review of nurse-led advance care planning

Author

Marianne Johnstone-Petty, Jeannette Kates, Erica Frechman, Kristen DeSanto, Regina M. Fink, Djin L Tay, and Phyllis B. Whitehead

Subjects
Advance care planning, animal structures, Special populations, Nurse leaders, Communication, Teaching, American nurse association, Medical care, Nurse's Role, humanities, Call to action, Nurse led, Advance Care Planning, stomatognathic system, Nursing, bacteria, Humans, lipids (amino acids, peptides, and proteins), Psychology, General Nursing
Abstract

Background Advance care planning (ACP) supports persons at any age or health status to determine their values, goals, and preferences regarding future medical care. The American Nurses Association endorses nurses to facilitate ACP to promote patient- and family-centered care. Purpose This project reviewed and synthesized literature on nurse-led ACP training models. Methods A scoping review used the Arksey and O'Malley Framework to identify: (a) ACP training model type, (b) nurse-led ACP recipients, (c) ACP in special populations, (d) ACP outcomes. Findings Of 33 articles reviewed, 19 included 11 established models; however, the primary finding was lack of a clearly identified evidence-based nurse-led ACP training model. Discussion Nurses are integral team members, well positioned to be a bridge of communication between patients and care providers. This is a call to action for nurse leaders, researchers, educators to collaborate to identify and implement an evidence-based, effective nurse-led ACP training model.

Published
2021

5. Diagnosis and treatment in chronic pancreatitis: an international survey and case vignette study

Author

Yama Issa, Hjalmar C. van Santvoort, Paul Fockens, Marc G. Besselink, Thomas L. Bollen, Marco J. Bruno, Marja A. Boermeester, Frank G. Moody, Claude Bertrand, Colin Johnson, Aude van Lander, Ross Carter, John B. Conneely, Frederik Berrevoet, Donzília Sousa Silva, Zong-Fang Li, Philippe Lévy, Kofi Oppong, Timothy B. Gardner, C. Mel Wilcox, Jeremy French, Michael Steer, Edward L. Bradley, Peter Layer, Bertrand Napoleon, Jorge Antonio Mosquera, D.J. Gouma, Roland Andersson, Antonio Manzelli, J.M. Klaase, Massimo Falconi, Enrique de-Madaria, Riccardo Casadei, Giuseppe Malleo, Raffaele Pezzilli, Ewa Malecka-Panas, Matthias Lohr, Julia Mayerle, Erik A.J. Rauws, Martin L. Freeman, Affirul Chairil Ariffin, Bhavin Vasavada, Paul Bo-San Lai, Jose Luis Beristain-Hernandez, Álvarez Juan, Haralds Plaudis, Dionisios Vrochides, Vincenzo Neri, Vimalraj Velayutham, Aleksey Andrianov, Joan Figueras, Kjetil Soreide, Aliaksei Shcherba, Mahir Gachabayov, Roger G. Keith, Georgios Tsoulfas, Michael Anthony Fink, Stefano Crippa, Mehrdad Nikfarjam, Dibyajyoti Bora, Rajendra Desai, Marcello Donati, Jan Jin Bong, Emma Martínez Moneo, Gareth Morris-Stiff, Ahmet Coker, Alexandre Prado de Resende, Suryabhan Sakhahari Bhalerao, Sadiq S. Sikora, Dezső Kelemen, László Czakó, Hariharan Ramesh, Oleg Rummo, Aliaksei Fedaruk, Alexey Hlinnik, Madhusudhan Chinthakindi, Traian Dumitrascu, Vyacheslav Egorov, Vincent Bettschart, Michele Molinari, E. Aldana D. Guillermo, Susan L. Orloff, Daniel Vasilev Kostov, Laurent Sulpice, Brett Knowles, Yasutoshi Kimura, Gabriele Marangoni, Rajeev Joshi, Tibor Gyökeres, null Bedin, V. Vladimir, Arpad Ivanecz, Adelmo Antonucci, Jones A.O. Omoshoro-Jones, Richard Nakache, Marco Del Chiaro, Marianne Johnstone, Tomoaki Saito, Gianpaolo Balzano, Serge Chooklin, Piero Boraschi, Walter Park, Pedro Nuno Valente Reis Pereira, Nico Pagano, Pavlos Lykoudis, Lars Ivo Partecke, Aliaksandr Siatkouski, Rosa Jorba Martín, Yasunari Kawabata, Luís Carvalho Lourenço, Carlos Marra-Lopez, Jun Kyu Lee, Nils Habbe, Robert C. Verdonk, Yliya Rabotyagova, Rupjyoti Talukdar, Luca Frulloni, Shamil Galeev, Zoltán Berger, Takeo Yasuda, Thilo Hackert, Ziyovuddin Saatov, Dimitri Aristotle Raptis, Jaume Boadas, Francesco Vitali, Livia Archibugi, Miroslav Ryska, Balazs Tihanyi, Vikesh K. Singh, Atsushi Masamune, Paul Yeaton, Kerrington D. Smith, Shrey Modi, Laura Cosen-Binker, Savio George Barreto, Eugenio Morandi, Sergio Valeri, Cintia Yoko Morioka, Luis F. Lara, Yoshifumi Takeyama, Frank G. Gress, Young-Dong Yu, Ezio Gaia, Sorin Traian Barbu, Ali Tüzün İnce, Akkraporn Deeprasertvit, Yu-Ting Chang, Stephen Olusola Abiola, Sabite Kacar, Peter Muscarella, Henri Braat, Samuel Han, Ali A. Aghdassi, Jean-Louis Frossard, Jill P. Smith, M.P. Schwartz, H.M. van Dullemen, N.G. Venneman, B.W.M. Spanier, Sjoerd Kuiken, Erwin van Geenen, Greg Beilman, Georgios Papachristou, Oscar Chapa Azuela, P. van der Schaar, Nevin Oruc, Marie-Paule Anten, William H. Nealon, Jesús García-Cano, Manol Jovani, Ziad Melki, Mustafa Mohammed Ahmed Ibrahim, M.U. Awajdarip, Mohammad Azam, K.G. Sabu, Igor Ermolaev, Shiran Shetty, Belei Oana, Juris Pokrotnieks, Malgorzata Lazuchiewicz-Kot, Riadh Bouali, Marek Winiarski, Marcus Schmitt, Mihai Rimbas, Alexander Meining, Bories Erwan, Peter N. Meier, Rainer Schoefl, Ahmed Youssef Altonbary, Igor Marsteller, Ingo Wallstabe, Skerdi Prifti, Arnaud Lemmers, M. Horvath, Ajay Kumar, Joseph J. Palermo, Issa, Y., van Santvoort, H. C., Fockens, P., Besselink, M. G., Bollen, T. L., Bruno, M. J., Boermeester, M. A., Moody, F. G., Bertrand, C., Johnson, C., van Lander, A., Carter, R., Conneely, J. B., Berrevoet, F., Sousa Silva, D., Li, Z. -F., Levy, P., Oppong, K., Gardner, T. B., Wilcox, C. M., French, J., Steer, M., Bradley, E. L., Layer, P., Napoleon, B., Mosquera, J. A., Gouma, D. J., Andersson, R., Manzelli, A., Klaase, J. M., Falconi, M., de-Madaria, E., Casadei, R., Malleo, G., Pezzilli, R., Malecka-Panas, E., Lohr, M., Mayerle, J., Rauws, E. A. J., Freeman, M. L., Ariffin, A. C., Vasavada, B., Lai, P. B. -S., Beristain-Hernandez, J. L., Juan, A., Plaudis, H., Vrochides, D., Neri, V., Velayutham, V., Andrianov, A., Figueras, J., Soreide, K., Shcherba, A., Gachabayov, M., Keith, R. G., Tsoulfas, G., Fink, M. A., Crippa, S., Nikfarjam, M., Bora, D., Desai, R., Donati, M., Bong, J. J., Martinez Moneo, E., Morris-Stiff, G., Coker, A., de Resende, A. P., Bhalerao, S. S., Sikora, S. S., Kelemen, D., Czako, L., Ramesh, H., Rummo, O., Fedaruk, A., Hlinnik, A., Chinthakindi, M., Dumitrascu, T., Egorov, V., Bettschart, V., Molinari, M., Guillermo, E. A. D., Orloff, S. L., Kostov, D. V., Sulpice, L., Knowles, B., Kimura, Y., Marangoni, G., Joshi, R., Gyokeres, T., Bedin, Vladimir, V., Ivanecz, A., Antonucci, A., Omoshoro-Jones, J. A. O., Nakache, R., Del Chiaro, M., Johnstone, M., Saito, T., Balzano, G., Chooklin, S., Boraschi, P., Park, W., Pereira, P. N. V. R., Pagano, N., Lykoudis, P., Partecke, L. I., Siatkouski, A., Martin, R. J., Kawabata, Y., Lourenco, L. C., Marra-Lopez, C., Lee, J. K., Habbe, N., Verdonk, R. C., Rabotyagova, Y., Talukdar, R., Frulloni, L., Galeev, S., Berger, Z., Yasuda, T., Hackert, T., Saatov, Z., Raptis, D. A., Boadas, J., Vitali, F., Archibugi, L., Ryska, M., Tihanyi, B., Singh, V. K., Masamune, A., Yeaton, P., Smith, K. D., Modi, S., Cosen-Binker, L., Barreto, S. G., Morandi, E., Valeri, S., Morioka, C. Y., Lara, L. F., Takeyama, Y., Gress, F. G., Yu, Y. -D., Gaia, E., Barbu, S. T., Ince, A. T., Deeprasertvit, A., Chang, Y. -T., Abiola, S. O., Kacar, S., Muscarella, P., Braat, H., Han, S., Aghdassi, A. A., Frossard, J. -L., Smith, J. P., Schwartz, M. P., van Dullemen, H. M., Venneman, N. G., Spanier, B. W. M., Kuiken, S., van Geenen, E., Beilman, G., Papachristou, G., Chapa Azuela, O., van der Schaar, P., Oruc, N., Anten, M. -P., Nealon, W. H., Garcia-Cano, J., Jovani, M., Melki, Z., Ibrahim, M. M. A., Awajdarip, M. U., Azam, M., Sabu, K. G., Ermolaev, I., Shetty, S., Oana, B., Pokrotnieks, J., Lazuchiewicz-Kot, M., Bouali, R., Winiarski, M., Schmitt, M., Rimbas, M., Meining, A., Erwan, B., Meier, P. N., Schoefl, R., Altonbary, A. Y., Marsteller, I., Wallstabe, I., Prifti, S., Lemmers, A., Horvath, M., Kumar, A., Palermo, J. J., Surgery, Amsterdam institute for Infection and Immunity, Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, CCA - Cancer Treatment and Quality of Life, CCA - Imaging and biomarkers, AGEM - Digestive immunity, AGEM - Re-generation and cancer of the digestive system, Cancer Center Amsterdam, APH - Methodology, AII - Infectious diseases, Issa, Yama, van Santvoort, Hjalmar C., Fockens, Paul, Besselink, Marc G., Bollen, Thomas L., Bruno, Marco J., Boermeester, Marja A., Moody, Frank G., Bertrand, Claude, Johnson, Colin, van Lander, Aude, Carter, Ro, Conneely, John B., Berrevoet, Frederik, Sousa Silva, Donzã­lia, Zong-Fang, Li, Lã©vy, Philippe, Oppong, Kofi, Gardner, Timothy B., Wilcox, C. Mel, French, Jeremy, Steer, Michael, Bradley, Edward L., Layer, Peter, Napoleon, Bertrand, Mosquera, Jorge Antonio, Andersson, Roland, Manzelli, Antonio, Falconi, Massimo, de-Madaria, Enrique, Casadei, Riccardo, Malleo, Giuseppe, Pezzilli, Raffaele, Malecka-Panas, Ewa, Lohr, Matthia, Mayerle, Julia, Rauws, Erik A. J., Freeman, Martin L., Ariffin, Affirul Chairil, Vasavada, Bhavin, Lai, Paul Bo-San, Beristain-Hernandez, Jose Lui, Juan, à lvarez, Plaudis, Harald, Vrochides, Dionisio, Neri, Vincenzo, Velayutham, Vimalraj, Andrianov, Aleksey, Figueras, Joan, Soreide, Kjetil, Shcherba, Aliaksei, Gachabayov, Mahir, Keith, Roger G., Tsoulfas, Georgio, Fink, Michael Anthony, Crippa, Stefano, Nikfarjam, Mehrdad, Bora, Dibyajyoti, Desai, Rajendra, Donati, Marcello, Bong, Jan Jin, Martínez Moneo, Emma, Morris-Stiff, Gareth, Coker, Ahmet, de Resende, Alexandre Prado, Bhalerao, Suryabhan Sakhahari, Sikora, Sadiq S., Kelemen, Dezså, Czakã³, Lã¡szlã³, Ramesh, Hariharan, Rummo, Oleg, Fedaruk, Aliaksei, Hlinnik, Alexey, Chinthakindi, Madhusudhan, Dumitrascu, Traian, Egorov, Vyacheslav, Bettschart, Vincent, Molinari, Michele, Guillermo, E. Aldana D., Orloff, Susan L., Kostov, Daniel Vasilev, Sulpice, Laurent, Knowles, Brett, Kimura, Yasutoshi, Marangoni, Gabriele, Joshi, Rajeev, Gyã¶keres, Tibor, Bedin, Null, Ivanecz, Arpad, Antonucci, Adelmo, Omoshoro-Jones, Jones A. O., Nakache, Richard, Del Chiaro, Marco, Johnstone, Marianne, Saito, Tomoaki, Balzano, Gianpaolo, Chooklin, Serge, Boraschi, Piero, Park, Walter, Pereira, Pedro Nuno Valente Rei, Pagano, Nico, Lykoudis, Pavlo, Partecke, Lars Ivo, Siatkouski, Aliaksandr, Martã­n, Rosa Jorba, Kawabata, Yasunari, Lourenã§o, Luís Carvalho, Marra-Lopez, Carlo, Lee, Jun Kyu, Habbe, Nil, Verdonk, Robert C., Rabotyagova, Yliya, Talukdar, Rupjyoti, Frulloni, Luca, Galeev, Shamil, Berger, Zoltã¡n, Yasuda, Takeo, Hackert, Thilo, Saatov, Ziyovuddin, Raptis, Dimitri Aristotle, Boadas, Jaume, Vitali, Francesco, Archibugi, Livia, Ryska, Miroslav, Tihanyi, Balaz, Singh, Vikesh K., Masamune, Atsushi, Yeaton, Paul, Smith, Kerrington D., Modi, Shrey, Cosen-Binker, Laura, Barreto, Savio George, Morandi, Eugenio, Valeri, Sergio, Morioka, Cintia Yoko, Lara, Luis F., Takeyama, Yoshifumi, Gress, Frank G., Young-Dong, Yu, Gaia, Ezio, Barbu, Sorin Traian, Ä°nce, Ali Tüzün, Deeprasertvit, Akkraporn, Chang, Yu-Ting, Abiola, Stephen Olusola, Kacar, Sabite, Muscarella, Peter, Braat, Henri, Han, Samuel, Aghdassi, Ali A., Frossard, Jean-Loui, Smith, Jill P., Kuiken, Sjoerd, van Geenen, Erwin, Beilman, Greg, Papachristou, Georgio, Chapa Azuela, Oscar, Oruc, Nevin, Anten, Marie-Paule, Nealon, William H., García-Cano, Jesãº, Jovani, Manol, Melki, Ziad, Ibrahim, Mustafa Mohammed Ahmed, Azam, Mohammad, Ermolaev, Igor, Shetty, Shiran, Oana, Belei, Pokrotnieks, Juri, Lazuchiewicz-Kot, Malgorzata, Bouali, Riadh, Winiarski, Marek, Schmitt, Marcu, Rimbas, Mihai, Meining, Alexander, Erwan, Borie, Meier, Peter N., Schoefl, Rainer, Altonbary, Ahmed Youssef, Marsteller, Igor, Wallstabe, Ingo, Prifti, Skerdi, Lemmers, Arnaud, Kumar, Ajay, Palermo, Joseph J., and Gastroenterology & Hepatology

Subjects
Endoscopic ultrasound, medicine.medical_treatment, Islets of Langerhans Transplantation, Practice Patterns, Diagnosis, treatment, chronic pancreatitis, survey, Bioinformatics, 0302 clinical medicine, Risk Factors, Lithotripsy, Diagnosis, 03.02. Klinikai orvostan, Endoscopy, Digestive System, Chronic, Practice Patterns, Physicians', Tomography, Digestive System Surgical Procedures, treatment, medicine.diagnostic_test, Gastroenterology, Magnetic Resonance Imaging, X-Ray Computed, Treatment Outcome, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Predictive value of tests, Pancreatectomy, 030211 gastroenterology & hepatology, Autologous, medicine.medical_specialty, Clinical Decision-Making, Transplantation, Autologous, Decision Support Techniques, chronic pancreatitis, 03 medical and health sciences, Predictive Value of Tests, Pancreatitis, Chronic, medicine, Humans, survey, Pancreatic duct, Transplantation, Physicians', Hepatology, business.industry, General surgery, Gastroenterologists, Endoscopy, Magnetic resonance imaging, medicine.disease, Pancreatitis, Health Care Surveys, Tomography, X-Ray Computed, business, Digestive System
Abstract

Background The aim of the study was to evaluate the current opinion and clinical decision-making process of international pancreatologists, and to systematically identify key study questions regarding the diagnosis and treatment of chronic pancreatitis (CP) for future research. Methods An online survey, including questions regarding the diagnosis and treatment of CP and several controversial clinical case vignettes, was send by e-mail to members of various international pancreatic associations: IHPBA, APA, EPC, ESGE and DPSG. Results A total of 288 pancreatologists, 56% surgeons and 44% gastroenterologists, from at least 47 countries, participated in the survey. About half (48%) of the specialists used a classification tool for the diagnosis of CP, including the Mayo Clinic (28%), Mannheim (25%), or Buchler (25%) tools. Overall, CT was the preferred imaging modality for evaluation of an enlarged pancreatic head (59%), pseudocyst (55%), calcifications (75%), and peripancreatic fat infiltration (68%). MRI was preferred for assessment of main pancreatic duct (MPD) abnormalities (60%). Total pancreatectomy with auto-islet transplantation was the preferred treatment in patients with parenchymal calcifications without MPD abnormalities and in patients with refractory pain despite maximal medical, endoscopic, and surgical treatment. In patients with an enlarged pancreatic head, 58% preferred initial surgery (PPPD) versus 42% initial endoscopy. In patients with a dilated MPD and intraductal stones 56% preferred initial endoscopic ± ESWL treatment and 29% preferred initial surgical treatment. Conclusion Worldwide, clinical decision-making in CP is largely based on local expertise, beliefs and disbeliefs. Further development of evidence-based guidelines based on well designed (randomized) studies is strongly encouraged.

Published
2017
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6. Ketamine Use for Complex Pain in the Palliative Care Population

Author

Marianne Johnstone-Petty

Subjects
medicine.medical_specialty, Palliative care, Population, MEDLINE, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Pain Management, Ketamine, Intensive care medicine, education, Pain Measurement, Advanced and Specialized Nursing, Community and Home Care, education.field_of_study, Analgesics, business.industry, Palliative Care, Retrospective cohort study, Guideline, Pain management, 030220 oncology & carcinogenesis, Neuropathic pain, business, 030217 neurology & neurosurgery, medicine.drug
Abstract

Palliative care patients are predisposed to complex pain, including refractory pain, neuropathic pain, opioid-induced hyperalgesia, and opioid-induced neurotoxicity. Palliative care complex pain management can include use of subanesthetic parenteral ketamine. Support for subanesthetic ketamine exists from anecdotal experiences and nonrandomized studies, but there is a lack of statistically significant evidence to support or dismiss its use. Ketamine is sought for illegal, nonmedical purposes, so the lack of evidence coupled with potential for exploitation makes judicious and knowledgeable use critical. Palliative care nurse practitioners, as experts in symptom management, should evaluate and consider all potentially beneficial treatment strategies for complex pain, including novel strategies such as subanesthetic ketamine treatment. Several databases and clinical guideline repositories, along with inspection of germane articles' reference lists, were utilized to collect original research, retrospective studies, literature reviews, and case reports pertinent to the management of palliative care complex pain with parenteral ketamine. In conclusion, the evidence-based clinical decision-making process is engaged to outline a method to weigh the risks versus benefits of subanesthetic ketamine for this population of patients.

Published
2018

7. Incidence of Post-ERCP Pancreatitis From Direct Pancreatic Juice Collection in Hereditary Pancreatitis and Familial Pancreatic Cancer Before and After the Introduction of Prophylactic Pancreatic Stents and Rectal Diclofenac

Author

J. Butler, James Nicholson, Guruprasad P. Aithal, Marianne Johnstone, Michael Raraty, Robert Sutton, Howard Smart, William Greenhalf, Richard J. Jackson, Jonathan Evans, Sara Harrison, Trevor Cox, Martin Lombard, Nathan Howes, John P. Neoptolemos, Christopher Halloran, Sanchoy Sarkar, Thomas Hanna, C. Grocock, and Paula Ghaneh

Subjects
Adult, Male, medicine.medical_specialty, Diclofenac, Endocrinology, Diabetes and Metabolism, Risk Assessment, Gastroenterology, Endocrinology, Pancreatic Juice, Administration, Rectal, Predictive Value of Tests, Risk Factors, Pancreatitis, Chronic, Internal medicine, Pancreatic cancer, Biomarkers, Tumor, Odds Ratio, Internal Medicine, medicine, Humans, Genetic Testing, Prospective Studies, Registries, Prospective cohort study, Cholangiopancreatography, Endoscopic Retrograde, Hereditary pancreatitis, Endoscopic retrograde cholangiopancreatography, Hepatology, medicine.diagnostic_test, business.industry, Incidence, Incidence (epidemiology), Anti-Inflammatory Agents, Non-Steroidal, Odds ratio, Middle Aged, medicine.disease, United Kingdom, Pancreatic Neoplasms, Logistic Models, Treatment Outcome, Pancreatitis, Multivariate Analysis, Pancreatic juice, Female, Stents, business
Abstract

Individuals from hereditary pancreatitis (HP) and familial pancreatic cancer (FPC) kindreds are at increased risk of developing pancreatic cancer. Premalignant molecular changes may be detected in pancreatic juice collected by endoscopic retrograde cholangiopancreatography (ERCP). The objective was to determine the risk of post-ERCP pancreatitis (PEP).A prospective study (1999-2013) was undertaken of 80 ERCPs (24 in HP and 56 in FPC) from 60 individuals and the impact of PEP prophylaxis using a self-expelling pancreatic stent and 50 mg diclofenac per rectum from 2008.There was no PEP in the HP cohort and 13 (23.2%) PEP from 56 procedures in the FPC cohort (P = 0.0077). Up to 2008 PEP had occurred in 7 (43.8%) of 16 procedures in FPC individuals versus none of 18 procedures in HP individuals (P = 0.0021). After the introduction of prophylaxis, the incidence of PEP fell to 6 (15.0%) of 40 procedures in FPC individuals (P = 0.0347).The odds ratio (95% confidence interval) was 0.23 (0.06-0.84) in favor of prophylaxis (0.035).Individuals with HP are at minimal risk for PEP. Although the risk of PEP in individuals with FPC can be reduced by using prophylactic self-expelling stents and diclofenac, it remains too high for routine screening.

Published
2015
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8. The impact of timing of cholecystectomy following gallstone pancreatitis

Author

Caroline E. Richardson, Abhilasha Patel, Thomas Pinkney, Aneel Bhangu, A. Torrance, Elizabeth Hepburn, T. James Royle, Marianne Johnstone, David C. Bartlett, and Paul Marriott

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Operative Time, Pilot Projects, Gallstones, Recurrent pancreatitis, Recurrence, medicine, Humans, Cholecystectomy, Aged, Retrospective Studies, Aged, 80 and over, Cholangiopancreatography, Endoscopic Retrograde, First episode, business.industry, General surgery, Retrospective cohort study, Guideline, Middle Aged, medicine.disease, Surgery, Pancreatitis, Female, Guideline Adherence, business, Complication, Follow-Up Studies
Abstract

Introduction Current guidelines for the management of acute gallstone pancreatitis recommend cholecystectomy as definitive treatment during primary admission or within 2 weeks of discharge, with the aim of preventing recurrent pancreatitis. However, cholecystectomy during the inflammatory phase may increase surgical complication rates. This study aimed to determine whether adherence to the guidelines prevents recurrent pancreatitis while minimising surgical complications. Methods Multi-centre review of seven UK hospitals, indentifying patients presenting with their first episode of gallstone pancreatitis between 2006 and 2008. Results A total of 523 patients with gallstone pancreatitis were identified, of which 363 (69%) underwent cholecystectomy (72 during the primary admission or within 2 weeks of discharge; 291 following this). Overall, 7% of patients had a complication related to cholecystectomy of which a greater proportion occurred when cholecystectomy was performed within guideline parameters (13% vs 6%; p = 0.07). 11% of patients were readmitted with recurrent pancreatitis prior to surgery, with those undergoing cholecystectomy outside guideline parameters being most at risk ( p = 0.006). Conclusion This study suggests cholecystectomy within guideline parameters significantly reduces recurrence of pancreatitis but may increase the risk of surgical complications. A prospective randomised study to assess the associated morbidity is required to inform future guidelines.

Published
2014
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9. Short-Term Continuous High-Volume Hemofiltration on Clinical Outcomes of Severe Acute Pancreatitis

Author

Robert Sutton, Jia Guo, Muhammad A. Javed, Zong-Wen Huang, Ping Xue, Marianne Johnstone, Qing Xia, Kiran Altaf, Tao Jin, Xiao-Nan Yang, Wei Huang, and Ziqi Lin

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Endocrinology, Internal medicine, Hemofiltration, Internal Medicine, medicine, High volume hemofiltration, Humans, In patient, Prospective Studies, Renal Insufficiency, Prospective cohort study, APACHE, Aged, Hepatology, Interleukin-6, business.industry, Incidence (epidemiology), Middle Aged, medicine.disease, Surgery, Clinical trial, C-Reactive Protein, Treatment Outcome, Pancreatitis, Health evaluation, Acute Disease, Acute pancreatitis, Female, business, Biomarkers
Abstract

This study aimed to conduct a single-center prospective trial of short-term continuous high-volume hemofiltration (HVHF) in patients with predicted severe acute pancreatitis (SAP).Patients with acute pancreatitis with Acute Physiology and Chronic Health Evaluation II scores of greater than 15 on admission between January 2008 and December 2010 were allocated to receive either optimal standard therapy or 72 hours of continuous HVHF on an alternate basis, beginning as soon as possible after admission. Biomarkers and clinical outcomes were compared between the 2 groups.A total of 61 patients received either conventional therapy (n = 29) or HVHF (n = 32). High-volume hemofiltration treatment was associated with a significant reduction in the incidence of renal failure (P = 0.013), infected pancreatic necrosis (P = 0.048), length of hospitalization (P = 0.005), mortality (P = 0.033), as well as duration of renal (P0.001), respiratory (P = 0.002), and hepatic failure (P = 0.001). Acute Physiology and Chronic Health Evaluation II score and C-reactive protein and interleukin 6 levels were significantly reduced after the start of HVHF on days 1, 3, and 7 (all, P0.05).This study suggests that short-term HVHF may reduce local and systemic complications and mortality in patients with SAP with Acute Physiology and Chronic Health Evaluation score of greater than 15.

Published
2014
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11. How does chronic pancreatitis affect the quality of life in patients?

Author

Marianne Johnstone, Robert Sutton, and Matthew Wilcox

Subjects
medicine.medical_specialty, ComputingMethodologies_SIMULATIONANDMODELING, business.industry, ComputingMethodologies_IMAGEPROCESSINGANDCOMPUTERVISION, General Medicine, medicine.disease, Affect (psychology), ComputingMilieux_COMPUTERSANDEDUCATION, Medicine, Pancreatitis, Surgery, In patient, business, Intensive care medicine, ComputingMilieux_MISCELLANEOUS, ComputingMethodologies_COMPUTERGRAPHICS
Published
2016
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12. Preoperative risk factors for conversion from laparoscopic to open cholecystectomy: a validated risk score derived from a prospective U.K. database of 8820 patients

Author

Robert P. Sutcliffe, Marianne Hollyman, James Hodson, Glenn Bonney, Ravi S. Vohra, Ewen A. Griffiths, Stephen Fenwick, Mohamed Elmasry, Quentin Nunes, David Kennedy, Raja B. Khan, Muhammad A.S. Khan, Conor J. Magee, Steven M. Jones, Denise Mason, Ciny P. Parappally, Pawan Mathur, Michael Saunders, Sara Jamel, Samer U.l. Haque, Sara Zafar, Muhammad H. Shiwani, Nehemiah Samuel, Farooq Dar, Andrew Jackson, Bryony Lovett, Shiva Dindyal, Hannah Winter, Saquib Rahman, Kevin Wheatley, Tom Nieto, Soofiyah Ayaani, Haney Youssef, Rajwinder S. Nijjar, Helen Watkin, David Naumann, Sophie Emeshi, Piyush B. Sarmah, Kathryn Lee, Nikita Joji, Jonathan Heath, Rebecca L. Teasdale, Chamindri Weerasinghe, Paul J. Needham, Hannah Welbourn, Luke Forster, David Finch, Jane M. Blazeby, William Robb, Angus G.K. McNair, Alex Hrycaiczuk, Alexandros Charalabopoulos, Sritharan Kadirkamanathan, Cheuk-Bong Tang, Naga V.G. Jayanthi, Nigel Noor, Brian Dobbins, Andrew J. Cockbain, April Nilsen-Nunn, Jonathan de Siqueira, Mike Pellen, Jonathan B. Cowley, Wei-Min Ho, Victor Miu, Timothy J. White, Kathryn A. Hodgkins, Alison Kinghorn, Matthew G. Tutton, Yahya A. Al-Abed, Donald Menzies, Anwar Ahmad, Joanna Reed, Shabuddin Khan, David Monk, Louis J. Vitone, Ghulam Murtaza, Abraham Joel, Stephen Brennan, David Shier, Catherine Zhang, Thusidaran Yoganathan, Steven J. Robinson, Iain J.D. McCallum, Michael J. Jones, Mohammed Elsayed, Liz Tuck, John Wayman, Kate Carney, Somaiah Aroori, Kenneth B. Hosie, Adam Kimble, David M. Bunting, Adeshina S. Fawole, Mohammed Basheer, Rajiv V. Dave, Janahan Sarveswaran, Elinor Jones, Chris Kendal, Michael P. Tilston, Martin Gough, Tom Wallace, Shailendra Singh, Justine Downing, Katherine A. Mockford, Eyad Issa, Nayab Shah, Neal Chauhan, Timothy R. Wilson, Amir Forouzanfar, Jonathan R.L. Wild, Emma Nofal, Catherine Bunnell, Khaliel Madbak, Sudhindra T.V. Rao, Laurence Devoto, Najaf Siddiqi, Zechan Khawaja, James C. Hewes, Laura Gould, Alice Chambers, Daniel U. Rodriguez, Gourab Sen, Stuart Robinson, Francis Bartlett, David M. Rae, Thomas E.J. Stevenson, Kas Sarvananthan, Simon J. Dwerryhouse, Simon M. Higgs, Oliver J. Old, Thomas J. Hardy, Reena Shah, Steve T. Hornby, Ken Keogh, Lucinda Frank, Musallam Al-Akash, Emma A. Upchurch, Richard J. Frame, Michael Hughes, Clare Jelley, Simon Weaver, Sudipta Roy, Toritseju O. Sillo, Giorgios Galanopoulos, Tamzin Cuming, Pedro Cunha, Salim Tayeh, Sarantos Kaptanis, Mohamed Heshaishi, Abdalla Eisawi, Michael Abayomi, Wee S. Ngu, Katie Fleming, Dalvir S. Bajwa, Vivek Chitre, Kamal Aryal, Paul Ferris, Michael Silva, Simon Lammy, Sarah Mohamed, Amir Khawaja, Adnan Hussain, Mudassar A. Ghazanfar, Maria I. Bellini, Hamdi Ebdewi, Mohamed Elshaer, Gianpiero Gravante, Benjamin Drake, Arikoge Ogedegbe, Dipankar Mukherjee, Chanpreet Arhi, Lola Giwa, Nusrat Iqbal, Nicholas F. Watson, Smeer K. Aggarwal, Philippa Orchard, Eduardo Villatoro, Peter D. Willson, Kam W.J. Mok, Thomas Woodman, Jean Deguara, Giuseppe Garcea, Benoy I. Babu, Alistair R. Dennison, Deep Malde, David Lloyd, John P. Slavin, Robert P. Jones, Laura Ballance, Stratos Gerakopoulos, Periyathambi Jambulingam, Sami Mansour, Naomi Sakai, Vikas Acharya, Mohammed M. Sadat, Lawen Karim, David Larkin, Khalid Amin, Amarah Khan, Jennifer Law, Saurabh Jamdar, Stella R. Smith, Keerthika Sampat, Kathryn M. O'shea, Mangta Manu, Fotini M. Asprou, Nabeela S. Malik, Jessica Chang, Marianne Johnstone, Michael Lewis, Geoffrey P. Roberts, Babu Karavadra, Evangelos Photi, James Hewes, Dan Rodriguez, Derek A. O'Reilly, Anthony J. Rate, Hema Sekhar, Lucy T. Henderson, Benjamin Z. Starmer, Peter O. Coe, Sotonye Tolofari, Jenifer Barrie, Gareth Bashir, Jake Sloane, Suroosh Madanipour, Constantine Halkias, Alexander E.J. Trevatt, David W. Borowski, Jane Hornsby, Michael J. Courtney, Suvi Virupaksha, Keith Seymour, Sarah Robinson, Helen Hawkins, Sadiq Bawa, Paul V. Gallagher, Alistair Reid, Peter Wood, Jonathan G. Finch, J.Guy Finch, Jitesh Parmar, Euan Stirland, James Gardner-Thorpe, Ahmed Al-Muhktar, Mark Peterson, Ali Majeed, Farrukh M. Bajwa, Jack Martin, Alfred Choy, Andrew Tsang, Naresh Pore, David R. Andrew, Waleed Al-Khyatt, Christopher Taylor Santosh Bhandari, Adam Chambers, Dhivya Subramanium, Simon K.C. Toh, Nicholas C. Carter, Stuart J. Mercer, Benjamin Knight, Vardhini Vijay, Swethan Alagaratnam, Sidhartha Sinha, Shahab Khan, Shamsi S. El-Hasani, Abdulzahra A. Hussain, Vish Bhattacharya, Nisheeth Kansal, Tani Fasih, Claire Jackson, Midhat N. Siddiqui, Imran A. Chishti, Imogen J. Fordham, Zohaib Siddiqui, Harald Bausbacher, Ileana Geogloma, Kabita Gurung, George Tsavellas, Pradeep Basynat, Ashish K. Shrestha, Sanjoy Basu, Alok Chhabra, Mohan Harilingam, Mohamed Rabie, Mansoor Akhtar, Pradeep Kumar, Sadaf F. Jafferbhoy, Najam Hussain, Soulat Raza, Manzarul Haque, Imran Alam, Rabiya Aseem, Shakira Patel, Mehek Asad, Michael I. Booth, William R. Ball, Christopher P.J. Wood, Ana C. Pinho-Gomes, Ambareen Kausar, Mohammed Obeidallah, Joseph Varghase, Joshil Lodhia, Donal Bradley, Carla Rengifo, David Lindsay, Sivakumar Gopalswamy, Ian Finlay, Stacy Wardle, Naomi Bullen, Syed Y. Iftikhar, Altaf Awan, Javed Ahmed, Paul Leeder, Guiseppe Fusai, Giles Bond-Smith, Alicja Psica, Yogesh Puri, David Hou, Fergus Noble, Karoly Szentpali, Jack Broadhurst, Ravindra Date, Martin R. Hossack, Yan L. Goh, Paul Turner, Vinutha Shetty, Manel Riera, Christina A.W. Macano, Anisha Sukha, Shaun R. Preston, Jennifer R. Hoban, Daniel J. Puntis, Sophie V. Williams, Richard Krysztopik, James Kynaston, Jeremy Batt, Matthew Doe, Andrzej Goscimski, Gareth H. Jones, Claire Hall, Nick Carty, Jamil Ahmed, Sofoklis Panteleimonitis, Rohan T. Gunasekera, Andrea R.G. Sheel, Hannah Lennon, Caroline Hindley, Marcus Reddy, Ross Kenny, Natalie Elkheir, Emma R. McGlone, Rajasundaram Rajaganeshan, Kate Hancorn, Anita Hargreaves, Raj Prasad, David A. Longbotham, Dhakshinamoorthy Vijayanand, Imeshi Wijetunga, Paul Ziprin, Christopher R. Nicolay, Geoffrey Yeldham, Edward Read, James A. Gossage, Rachel C. Rolph, Husam Ebied, Manraj Phull, Mohammad A. Khan, Matthew Popplewell, Dimitrios Kyriakidis, Anwar Hussain, Natasha Henley, Jessica R. Packer, Laura Derbyshire, Jonathan Porter, Shaun Appleton, Marwan Farouk, Melvinder Basra, Neil A. Jennings, Shahda Ali, Venkatesh Kanakala, Haythem Ali, Risha Lane, Richard Dickson-Lowe, Prizzi Zarsadias, Darius Mirza, Sonia Puig, Khalid Al Amari, Deepak Vijayan, Robert Sutcliffe, Ravi Marudanayagam, Zayed Hamady, Abheesh R. Prasad, Abhilasha Patel, Damien Durkin, Parminder Kaur, Laura Bowen, James P. Byrne, Katherine L. Pearson, Theo G. Delisle, James Davies, Mark A. Tomlinson, Michelle A. Johnpulle, Corinna Slawinski, Andrew Macdonald, James Nicholson, Katy Newton, James Mbuvi, Ansar Farooq, Bhavani S. Mothe, Zakhi Zafrani, Daniel Brett, James Francombe, Philip Spreadborough, James Barnes, Melanie Cheung, Ahmed Z. Al-Bahrani, Giuseppe Preziosi, Tomas Urbonas, Justin Alberts, Mekhlola Mallik, Krashna Patel, Ashvina Segaran, Triantafyllos Doulias, Pratik A. Sufi, Caroline Yao, Sarah Pollock, Antonio Manzelli, Saj Wajed, Michail Kourkulos, Roberto Pezzuto, Martin Wadley, Emma Hamilton, Shameen Jaunoo, Robert Padwick, Mazin Sayegh, Richard C. Newton, Madhusoodhana Hebbar, Sameh F. Farag, Madhu Hebbar, John Spearman, Mohammed F. Hamdan, Conrad D'Costa, Christine Blane, Mathew Giles, Mark B. Peter, Natalie A. Hirst, Tanvir Hossain, Arslan Pannu, Yesar El-Dhuwaib, Tamsin E.M. Morrison, Greg W. Taylor, Ronald L.E. Thompson, Ken McCune, Paula Loughlin, Roger Lawther, Colman K. Byrnes, Duncan J. Simpson, Abi Mawhinney, Conor Warren, Damian McKay, Colin McIlmunn, Serena Martin, Matthew MacArtney, Tom Diamond, Phil Davey, Claire Jones, Joshua M. Clements, Ruairi Digney, Wei M. Chan, Stephen McCain, Sadaf Gull, Adam Janeczko, Emmet Dorrian, Andrew Harris, Suzanne Dawson, Dorothy Johnston, Barry McAree, Essam Ghareeb, George Thomas, Martin Connelly, Stephen McKenzie, Krzysztos Cieplucha, Gary Spence, William Campbell, Gareth Hooks, Neil Bradley, Arnold D.K. Hill, John T. Cassidy, Michael Boland, Paul Burke, Deirdre M. Nally, Elmoataz Khogali, Wael Shabo, Edrin Iskandar, Gerry P. McEntee, Maeve A. O'Neill, Colin Peirce, Emma M. Lyons, Adrian W. O'Sullivan, Rohan Thakkar, Paul Carroll, Ivan Ivanovski, Paul Balfe, Matthew Lee, Des C. Winter, Michael E. Kelly, Emir Hoti, Donal Maguire, Priyadarssini Karunakaran, Justin G. Geoghegan, Sean T. Martin, Keith S. Cross, Fiachra Cooke, Saquib Zeeshan, James O. Murphy, Ken Mealy, Helen M. Mohan, Yuwaraja Nedujchelyn, Muhammad F. Ullah, Irfan Ahmed, Francesco Giovinazzo, James Milburn, Sarah Prince, Eleanor Brooke, Joanna Buchan, Ahmed M. Khalil, Elizabeth M. Vaughan, Michael I. Ramage, Roland C. Aldridge, Simon Gibson, Gary A. Nicholson, David G. Vass, Alan J. Grant, David J. Holroyd, Angharad Jones, Cherith M.L.R. Sutton, Patrick O'Dwyer, Frida Nilsson, Beatrix Weber, Tracey K. Williamson, Kushik Lalla, Alice Bryant, Ross Carter, Craig R. Forrest, David I. Hunter, Ahmad H. Nassar, Mavis N. Orizu, Katrina Knight, Haitham Qandeel, Stuart Suttie, Rowena Belding, Andrew McClarey, Alan T. Boyd, Graeme J.K. Guthrie, Pei J. Lim, Andreas Luhmann, Angus J.M. Watson, Colin H. Richards, Laura Nicol, Marta Madurska, Ewen Harrison, Kathryn M. Boyce, Amanda Roebuck, Graeme Ferguson, Pradeep Pati, Michael S.J. Wilson, Faith Dalgaty, Laura Fothergill, Peter J. Driscoll, Kirsty L. Mozolowski, Victoria Banwell, Stephen P. Bennett, Paul N. Rogers, Brendan L. Skelly, Claire L. Rutherford, Ahmed K. Mirza, Taha Lazim, Henry C.C. Lim, Diana Duke, Talat Ahmed, William D. Beasley, Marc D. Wilkinson, Geta Maharaj, Cathy Malcolm, Timothy H. Brown, Guy M. Shingler, Nicholas Mowbray, Rami Radwan, Paul Morcous, Simon Wood, Abbas Kadhim, Duncan J. Stewart, Andrew L. Baker, Nicola Tanner, and Hrishikesh Shenoy

Subjects
Male, Databases, Factual, medicine.medical_treatment, 0302 clinical medicine, Risk Factors, Odds Ratio, Prospective Studies, Prospective cohort study, Framingham Risk Score, Gastroenterology, Age Factors, Gallbladder, Middle Aged, Conversion to Open Surgery, Treatment Outcome, Cholecystectomy, Laparoscopic, 030220 oncology & carcinogenesis, Predictive value of tests, 030211 gastroenterology & hepatology, Female, Original Article, Risk assessment, Dilatation, Pathologic, Adult, medicine.medical_specialty, Digestive System Diseases, MEDLINE, Risk Assessment, 03 medical and health sciences, Sex Factors, Predictive Value of Tests, medicine, Humans, Aged, Common Bile Duct, Chi-Square Distribution, Hepatology, Laparoscopyc cholecystectomy, business.industry, General surgery, Reproducibility of Results, Odds ratio, United Kingdom, Surgery, preoperative assessment, Logistic Models, Multivariate Analysis, Cholecystectomy, business, Chi-squared distribution, risk factors
Abstract

Laparoscopic cholecystectomy is commonly performed, and several factors increase the risk of open conversion, prolonging operating time and hospital stay. Preoperative stratification would improve consent, scheduling and identify appropriate training cases. The aim of this study was to develop a validated risk score for conversion for use in clinical practice.Preoperative patient and disease-related variables were identified from a prospective cholecystectomy database (CholeS) of 8820 patients, divided into main and validation sets. Preoperative predictors of conversion were identified by multivariable binary logistic regression. A risk score was developed and validated using a forward stepwise approach.Some 297 procedures (3.4%) were converted. The risk score was derived from six significant predictors: age (p = 0.005), sex (p 0.001), indication for surgery (p 0.001), ASA (p 0.001), thick-walled gallbladder (p = 0.040) and CBD diameter (p = 0.004). Testing the score on the validation set yielded an AUROC = 0.766 (p 0.001), and a score6 identified patients at high risk of conversion (7.1% vs. 1.2%).This validated risk score allows preoperative identification of patients at six-fold increased risk of conversion to open cholecystectomy.

Published
2016

13. Common genetic variants in the CLDN2 and PRSS1-PRSS2 loci alter risk for alcohol-related and sporadic pancreatitis

Author

Marla Gearing, David G. Clark, Steven L. Carroll, Marianne Johnstone, Darwin L. Conwell, Gregory A. Cote, Sandra Weintraub, Matthew P. Frosch, Stuart Sherman, Badri N. Vardarajan, Joshua A. Sonnen, Lindy E. Harrell, Peter B. Cotton, Lisa L. Barnes, Lawrence S. Honig, Carol A. Miller, Adam Slivka, Michelle A. Anderson, Nadine M. Melhem, David A. Bennett, Joel H. Kramer, Jill P. Smith, Michele D. Lewis, Mary Ganguli, Jean Paul Vonsatte, Thomas J. Montine, Lee-Way Jin, Kenneth B. Fallon, Marilyn S. Albert, Eliezer Masliah, John H. Growdon, Barry Reisberg, Chuanhai Cao, Patricia L. Kramer, Douglas J. Hartman, Allan I. Levey, Jennifer Williamson, Vivianna M. Van Deerlin, Wayne W. Poon, Alison Goate, Vijay P. Singh, Bernie Devlin, Christiane Reitz, Ann C. McKee, Amanda Smith, Neill R. Graff-Radford, Walter A. Kukul, John Baillie, Andres Gelrud, Ranjan Duara, Thomas D. Bird, Clinton B. Wright, Deborah Blacker, Chiao-Feng Lin, Ge Li, Ronald C. Kim, Deborah C. Mash, Debby W. Tsuang, John P. Neoptolemos, Timothy B. Gardner, Kathryn L. Lunetta, Steven G. Younkin, Kara L. Hamilton-Nelson, Ronald L. Hamilton, F. Yesim Demirci, Eric M. Reiman, Charles DeCarli, John M Olichney, Richard Mayeux, Gregory A. Jicha, Michael R. O'Connell, Matt Tector, Eileen H. Bigio, Jonathan D. Glass, M. Ilyas Kamboh, Randall E. Brand, Christopher Lawrence, Steven E. Arnold, Jessica LaRusch, Elaine R. Peskind, David H. Cribbs, M.-Marsel Mesulam, Constantine G. Lyketsos, Michelle L. Kienholz, Frank M. LaFerla, Duane Beekly, Kelley Faber, Salvatore Spina, Gyungah Jun, Thiruvengadam Muniraj, Erik D. Roberson, Anna Karydas, Steven H. Ferris, Bruce L. Miller, Randall L. Woltjer, Li-San Wang, Lon S. Schneider, John C. Morris, John Q. Trojanowski, Jeffrey Kaye, Joseph E. Parisi, Nilufer Ertekin-Taner, Harry V. Vinters, Lidiya Orlichenko, Robert Barber, Chris E. Forsmark, Mary Sano, Bimaljit S. Sandhu, Peter A. Banks, Martin R. Farlow, Bradley T. Hyman, Joseph F. Quinn, Gary W. Beecham, James A. DiSario, Hakon Hakonarson, Daniel C. Marson, Adam C. Naj, Frank Martiniuk, Oscar L. Lopez, Mary E. Money, Julia Mayerle, William Greenhalf, Kathryn Roeder, Adam L. Boxer, Christine M. Hulette, Gerard D. Schellenberg, Georgios I. Papachristou, Douglas Galasko, James R. Burke, Donna B. Stolz, Murray A. Raskind, Peter Simon, Linda J. Van Eldik, Robert A. Hawes, Chang En Yu, Tatiana Foroud, Jonathan L. Haines, Stephen R. Wisniewski, William W. Seeley, Dhiraj Yadav, James J. Lah, C. Mel Wilcox, Sid Gilman, Liana G. Apostolova, Howard J. Rosen, Clinton T. Baldwin, Robert S. Stern, Narcis O. Zarnescu, Dennis W. Dickson, Margaret A. Pericak-Vance, Ashok Raj, Stephen T. Amann, Joseph D. Buxbaum, Ronald C. Petersen, Robert C. Green, David C. Whitcomb, Rudolph E. Tanzi, Lindsay A. Farrer, Helena C. Chui, Laura B. Cantwell, Wendy J. Mack, Samer Alkaade, Nigel J. Cairns, Thomas G. Beach, Frank Ulrich Weiss, Alyssa M. Krasinskas, Elizabeth Head, Nalini M. Guda, Julie A. Schneider, Malcolm B. Dick, Roger N. Rosenberg, Jill R. Murrel, Otto Valladares, Andrew J. Saykin, Huntington Potter, John R. Gilbert, Neil W. Kowall, Joseph Romagnuolo, Markus M. Lerch, Aimee Pierce, Roger L. Albin, John M. Ringman, James B. Leverenz, Carlos Cruchaga, Joshua W. Miller, Lei Yu, M. Michael Barmada, Lambertus Klei, Andrew P. Lieberman, Bernardino Ghetti, Robert Sutton, Kathleen A. Welsh-Bohmer, Juan C. Troncoso, Edward H. Koo, Elizabeth Crocco, Eden R. Martin, Daniel H. Geschwind, and Regina M. Carney

Subjects
Male, Pancreatic disease, Pancreatitis, Alcoholic, Genome-wide association study, Biology, Article, 03 medical and health sciences, 0302 clinical medicine, Sex Factors, Gene Frequency, Genotype, Genetics, medicine, PRSS2, Humans, Genetic Predisposition to Disease, Trypsin, Allele, Allele frequency, Homozygote, Genetic Variation, medicine.disease, 3. Good health, Hemizygote, 030220 oncology & carcinogenesis, Immunology, Claudins, Mutation, Trypsinogen, Pancreatitis, 030211 gastroenterology & hepatology, Female, Genome-Wide Association Study
Abstract

Pancreatitis is a complex, progressively destructive inflammatory disorder. Alcohol was long thought to be the primary causative agent, but genetic contributions have been of interest since the discovery that rare PRSS1, CFTR and SPINK1 variants were associated with pancreatitis risk. We now report two associations at genome-wide significance identified and replicated at PRSS1-PRSS2 (P < 1 × 10(-12)) and X-linked CLDN2 (P < 1 × 10(-21)) through a two-stage genome-wide study (stage 1: 676 cases and 4,507 controls; stage 2: 910 cases and 4,170 controls). The PRSS1 variant likely affects disease susceptibility by altering expression of the primary trypsinogen gene. The CLDN2 risk allele is associated with atypical localization of claudin-2 in pancreatic acinar cells. The homozygous (or hemizygous in males) CLDN2 genotype confers the greatest risk, and its alleles interact with alcohol consumption to amplify risk. These results could partially explain the high frequency of alcohol-related pancreatitis in men (male hemizygote frequency is 0.26, whereas female homozygote frequency is 0.07).

Published
2012

14. Thyroglobulin monitoring after treatment of well-differentiated thyroid cancer

Author

C Drefty, Jaafar Bennouna, E Mirallié, J Visset, Marianne Johnstone, A Hamy, and I Resche

Subjects
Adult, Male, medicine.medical_specialty, Pathology, Adolescent, medicine.medical_treatment, Thyroglobulin, Gastroenterology, Thyroid carcinoma, Internal medicine, Adenocarcinoma, Follicular, Biomarkers, Tumor, medicine, Humans, Thyroid Neoplasms, Thyroid cancer, Aged, Retrospective Studies, Not evaluated, business.industry, Thyroid, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Adenocarcinoma, Papillary, medicine.anatomical_structure, Oncology, Disease Progression, Thyroidectomy, Lymph Node Excision, Adenocarcinoma, Female, Surgery, Lymphadenectomy, Neoplasm Recurrence, Local, business, Neck
Abstract

Aims. The prognosis for well-differentiated thyroid carcinomas is favourable after treatment, but the rate of recurrence is around 20%. Cervical ultrasonography, radio-iodine scans, and monitoring of serum thyroglobulin ( T g ) levels allow these recurrences to be diagnosed. The management of patients with isolated elevated T g levels is controversial in the presence of negative radio-iodine scans. Methods. The records of 57 patients diagnosed with recurrence of well-differentiated thyroid cancer were reviewed. Serum T g was not evaluated in 31 of these patients (group 1) and measured in the other 26 cases (group 2). Results. Forty-three recurrence sites were found; four deposits in the thyroid bed and 39 cervical metastatic nodes, with an average of five nodes per patient. The radio-iodine scan was accurate in detecting 10/24 of cases, radiology in 9/17, and elevated T g levels in 20/25. Thirteen patients with recurrences diagnosed on the basis of T g levels had negative radio-iodine scans. After surgery, T g levels were normal in 10 patients from group 1 and 16 patients from group 2 ( p =0.0078). Conclusions. Elevated T g levels are indicative of disease progression or recurrence in patients who have previously been operated on for well-differentiated thyroid cancer. Even when the radiological study or radio-iodine scan is normal, surgical re-exploration of the neck, with total thyroidectomy and lymphadenectomy, is advisable.

Published
2004
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15. The effect of two hydrophilic monomers on the water uptake of a heterocyclic methacrylate system

Author

Francis J. Hughes, Marianne Johnstone, Michael Braden, and Mangala P. Patel

Subjects
Absorption of water, Materials science, Kinetics, Biophysics, Serum albumin, Biocompatible Materials, Bioengineering, (Hydroxyethyl)methacrylate, Methacrylate, Absorption, Diffusion, Biomaterials, chemistry.chemical_compound, Polymer chemistry, Animals, Methylmethacrylates, Serum Albumin, biology, Water, Biomaterial, Monomer, Polymerization, chemistry, Mechanics of Materials, Ceramics and Composites, biology.protein, Methacrylates, Thermodynamics, Chickens
Abstract

The room temperature polymerising system poly(ethyl methacrylate) (PEM)/tetrahydrofurfuryl methcrylate (THFM) has been modified by replacing some of the THFM by hydroxyethyl methacrylate (HEMA) and hydroxypropyl methacrylate (HPM), respectively. In both cases, the equilibrium uptake of the parent system is reduced substantially, in spite of the hydrophilic nature of these monomers. The effect is less with HPM. Corresponding to these decreases in uptake are substantial increases in the diffusion coefficients. This points to changes from a cluster-dominated process, to a more continuum-based process in the dual monomer systems. Addition of chicken serum albumin to these systems increases water uptake. At higher levels of HEMA addition, there is a substantial increase in polymerisation exotherm.

Published
2000
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16. Carcinoma showing thymus-like elements of the thyroid gland: report of three cases including one case with breast cancer history

Author

Xi Liu, Hongyan Wang, Guanjun Zhang, Yili Wang, Wei Huang, Xiaofeng Li, Yuan Deng, Xuebin Zhang, Quentin M. Nunes, Marianne Johnstone, and Yongqiang Ke

Subjects
Adult, Male, Cancer Research, Pathology, medicine.medical_specialty, Squamous Differentiation, Thyroid Gland, Breast Neoplasms, Thymus Gland, Histogenesis, Pathology and Forensic Medicine, Cytokeratin, Carcinoembryonic antigen, medicine, Carcinoma, Humans, Neoplasms, Glandular and Epithelial, Thyroid Neoplasms, biology, CD117, Thyroid, Neoplasms, Second Primary, General Medicine, Thymus Neoplasms, medicine.disease, medicine.anatomical_structure, Oncology, biology.protein, Female, Differential diagnosis
Abstract

Carcinoma showing thymus-like elements (CASTLE) is a rare malignant tumor of the thyroid or adjacent neck soft tissues, whose histogenesis is still debated. It may resemble other primary or metastatic poorly differentiated tumors histologically and the differential diagnosis is crucial for CASTLE has a better prognosis. However, CASTLE as a second primary tumor has not been reported in the literature. We report three cases of thyroid CASTLE, including a unique tumor following breast-conserving surgery for early-stage breast invasive carcinoma. There were two female and one male. All three tumors were located in the right lobe of the thyroid, and one tumor showed extension into the surrounding soft tissue. Histologically, all tumors showed expansive growth and consisted of cords, nests or sheets of epithelial cells divided into irregularly shaped lobules by fibrous connective tissue with lymphoplasmacytic infiltration. Focal squamous differentiation resembling Hassall's corpuscles were observed. All cases stained positively for CD5, CD117, high molecular weight cytokeratin, cytokeratin, P63, carcinoembryonic antigen and epithelial membrane antigen. Positive staining for Bcl-2 in two cases and chromogranin A in one case was noted. Ki-67 expression ranged from 15 to 25%. Thyroid transcription factor and CD3 were negative. There was no evidence of recurrent or metastatic disease at following surgery. These features demonstrated CASTLE may arise from branchial pouch remnants, the thyroid solid cell nests. CASTLE is a rare entity, awareness of its occurrence as a second primary tumor is important to avoid overtreatment because it is associated with a favorable prognosis.

Published
2013

17. Length of Variable Numbers of Tandem Repeats in the Carboxyl Ester Lipase (CEL) Gene May Confer Susceptibility to Alcoholic Liver Cirrhosis but Not Alcoholic Chronic Pancreatitis

Author

Constantin Zimmer, Kelly Davies, Diane Latawiec, William Greenhalf, Jonas Rosendahl, Fabio Miyajima, Karianne Fjeld, Pål R. Njølstad, Robert Grützmann, Christian Zapf, Anders Molven, Sebastian Beer, S Winn, Peter Bugert, Marianne Johnstone, Laura J. Brown, Triantafillos Liloglou, Munir Pirmohamed, Claudia Ruffert, David N. Criddle, Patrick Michl, Bridget Gunson, Stefan Johansson, Joachim Mössner, Robert Sutton, and Mario Krehan

Subjects
Male, 0301 basic medicine, Heredity, Cirrhosis, Pancreatic disease, Pancreatitis, Alcoholic, German People, Social Sciences, lcsh:Medicine, Minisatellite Repeats, Chi Square Tests, Exon, Mathematical and Statistical Techniques, Liver Cirrhosis, Alcoholic, Medizinische Fakultät, Germany, Genotype, Medicine and Health Sciences, Psychology, Ethnicities, Public and Occupational Health, lcsh:Science, Aged, 80 and over, Genetics, Alcohol Consumption, Multidisciplinary, Liver Diseases, Exons, Middle Aged, Addicts, Genetic Mapping, Alcoholism, Variable number tandem repeat, Physical Sciences, Female, Statistics (Mathematics), Research Article, Adult, medicine.medical_specialty, Substance-Related Disorders, Addiction, Variant Genotypes, Gastroenterology and Hepatology, Biology, Research and Analysis Methods, 03 medical and health sciences, Tandem repeat, Internal medicine, Mental Health and Psychiatry, medicine, Humans, Genetic Predisposition to Disease, ddc:610, Alcoholics, Statistical Methods, Statistical Hypothesis Testing, Allele frequency, Aged, Nutrition, lcsh:R, Biology and Life Sciences, Lipase, medicine.disease, United Kingdom, Diet, 030104 developmental biology, Endocrinology, Pancreatitis, Chronic Disease, People and Places, Population Groupings, lcsh:Q, Mathematics
Abstract

Background Carboxyl-ester lipase (CEL) contributes to fatty acid ethyl ester metabolism, which is implicated in alcoholic pancreatitis. The CEL gene harbours a variable number of tandem repeats (VNTR) region in exon 11. Variation in this VNTR has been linked to monogenic pancreatic disease, while conflicting results were reported for chronic pancreatitis (CP). Here, we aimed to investigate a potential association of CEL VNTR lengths with alcoholic CP. Methods Overall, 395 alcoholic CP patients, 218 patients with alcoholic liver cirrhosis (ALC) serving as controls with a comparable amount of alcohol consumed, and 327 healthy controls from Germany and the United Kingdom (UK) were analysed by determination of fragment lengths by capillary electrophoresis. Allele frequencies and genotypes of different VNTR categories were compared between the groups. Results Twelve repeats were overrepresented in UK ACP patients (P = 0.04) compared to controls, whereas twelve repeats were enriched in German ALC compared to alcoholic CP patients (P = 0.03). Frequencies of CEL VNTR lengths of 14 and 15 repeats differed between German ALC patients and healthy controls (P = 0.03 and 0.008, respectively). However, in the genotype and pooled analysis of VNTR lengths no statistical significant association was depicted. Additionally, the 16–16 genotype as well as 16 repeats were more frequent in UK ALC than in alcoholic CP patients (P = 0.034 and 0.02, respectively). In all other calculations, including pooled German and UK data, allele frequencies and genotype distributions did not differ significantly between patients and controls or between alcoholic CP and ALC. Conclusions We did not obtain evidence that CEL VNTR lengths are associated with alcoholic CP. However, our results suggest that CEL VNTR lengths might associate with ALC, a finding that needs to be clarified in larger cohorts.

Published
2016
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18. Endoscopic ultrasound-guided choledoco-duodenostomy as an alternative to percutaneous trans-hepatic cholangiography

Author

Marianne Johnstone, Jonathan C. Evans, James Nicholson, and Michael Raraty

Subjects
Endoscopic ultrasound, Male, medicine.medical_specialty, Percutaneous, radiological imaging/intervention < pancreatic neoplasia, Time Factors, Decompression, Duodenostomy, medicine.medical_treatment, interventional radiology < chronic pancreatitis, Percutaneous transhepatic cholangiography, Choledochostomy, Endosonography, Cholangiography, Technical Report, medicine, Humans, outcomes < pancreatic neoplasia, interventional endoscopy < chronic pancreatitis, Ultrasonography, Interventional, Aged, Cholangiopancreatography, Endoscopic Retrograde, Cholestasis, medicine.diagnostic_test, Hepatology, business.industry, Gastroenterology, Stent, Bilirubin, Middle Aged, Decompression, Surgical, digestive system diseases, endoscopic palliation < pancreatic neoplasia, Treatment Outcome, England, Female, Stents, Radiology, business, Biomarkers
Abstract

Background Endoscopic ultrasonography (EUS)-guided choledochoduodenostomy (CDS) is an alternative to percutaneous transhepatic cholangiography (PTC) drainage in patients with an obstructed biliary system where conventional endoscopic retrograde biliary drainage (ERBD) has been unsuccessful. Methods Five EUS-CDS procedures were reviewed to assess whether successful decompression was achieved and maintained. Results There was technical success in each instance with no immediate complications. There was a significant fall in the median bilirubin of 164 mmol/l. The median follow-up was 44 days. In one patient the stent migrated with no adverse outcome. Conclusion EUS-CDS is a viable alternative to PTC with fewer complications and comparable success rates. EUS-CDS may offer a future route for novel therapeutic advances.

Published
2012

19. Mirtazapine: a solution for postoperative gastroparesis?

Author

Michael Peter, Pranai Buddhdev, Robert T Diggory, and Marianne Johnstone

Subjects
medicine.medical_specialty, Metoclopramide, business.industry, medicine.medical_treatment, Mirtazapine, Erythromycin, General Medicine, medicine.disease, Article, Domperidone, Surgery, Gastropexy, Ondansetron, medicine, Hernia, Gastroparesis, business, medicine.drug
Abstract

This report describes the case of a 52-year-old man with an obstructed para-oesophageal hiatus hernia who required a gastropexy, who postoperatively developed gastroparesis which inadequately responded to conventional prokinetics including erythromycin, metoclopramide, ondansetron, and domperidone. The patient’s symptoms were relieved rapidly with a trial of mirtazapine. A review of related literature is presented.

Published
2011

20. The diagnosis of chronic pancreatitis: A systematic review

Author

Marianne Johnstone, William Greenhalf, James Nicholson, John P. Neoptolemos, Richard J. Jackson, Thomas Hanna, and Robert Sutton

Subjects
medicine.medical_specialty, Hepatology, business.industry, Endocrinology, Diabetes and Metabolism, Gastroenterology, medicine, Pancreatitis, Intensive care medicine, business, medicine.disease
Published
2014
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21. Genetic variants associated with PDAC also contribute to chronic pancreatitis susceptibility

Author

Heiko Witt, Debra T. Silverman, Marta Rava, Núria Malats, Nathalia A. Giese, Josefina Mora, Daniele Camp, Tomàs López, Cosmeri Rizzato, Mahmud M. Barmada, Frank Ulrich Weiss, Stephen J. Chanock, Julia Mayerle, William Greenhalf, Marta Flández, Federico Canzian, Markus M. Lerch, Xavier Molero, Roger L. Milne, Francisco X. Real, Miquel Porta, Jonas Rosendahl, Manolis Kogevinas, Nathaniel Rothman, David C. Whitcomb, Marianne Johnstone, Antoni Farré, and Laufey T. Amundadottir

Subjects
Mutation, Hepatology, business.industry, Endocrinology, Diabetes and Metabolism, Haplotype, Gastroenterology, Mutagenesis (molecular biology technique), Promoter, Transfection, medicine.disease_cause, Molecular biology, Plasmid, Acinar cell, Medicine, Luciferase, business
Abstract

s / Pancreatology 15 (2015) S1eS141 S16 Materials & methods: SPINK1 promoter variants were constructed by site-directed mutagenesis and cloned into a luciferase reporter vector. Cells were transfected with the reporter plasmids and luciferase expression was then measured from the cell lysates. Results: We found that most variants caused relatively small changes in promoteractivity. Surprisingly, however,weobserved significantvariations in theeffectsof thepromotervariants inthedifferentcell lines.Only fourvariants exhibited consistently reduced promoter activity in all acinar cell lines, confirming previous reports that variants c.-108G>T, c.-142T>C, and c.-147A>G are risk factors for chronicpancreatitis and identifying c.-52G>Tas anovel risk variant. In contrast, variant c.-215G>A, which is linked with the diseaseassociated splice-site mutation c.194þ2T>C, caused increased promoter activity, which may mitigate the overall effect of the pathogenic haplotype. Conclusion: Our study lends further support to the notion that sequence evaluation of the SPINK1 promoter region in patients with chronic pancreatitis is justified as part of the etiological investigation.

Published
2015
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22. Molecular analysis of duodenal pancreatic juice in the detection of pancreatic cancer: A comparison of supernatant and sediment

Author

Sanchoy Sarkar, J.A. Nicholson, Marianne Johnstone, Robert Sutton, Hollie Pufal, Jonathon Evans, Thomas Hanna, William Greenhalf, John P. Neoptolemos, Martin Lombard, H Smart, and Li Yan

Subjects
medicine.medical_specialty, Hepatology, business.industry, Endocrinology, Diabetes and Metabolism, Gastroenterology, Sediment (wine), medicine.disease, Molecular analysis, Internal medicine, Pancreatic cancer, Pancreatic juice, medicine, business
Published
2015
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23. The pancreatic cancer risk estimation and stratification (pancreas) model for familial pancreatic cancer

Author

William Greenhalf, J.A. Nicholson, Pascal Hammell, Marianne Johnstone, Thomas Hanna, Antonio Taktak, C. Grocock, Sara Harrison, John P. Neoptolemos, Louis Vitone, Eithne Costello, Andrea Sheel, MM Lerch, J. Butler, and Detlef K. Bartsch

Subjects
Oncology, medicine.medical_specialty, Hepatology, business.industry, Endocrinology, Diabetes and Metabolism, Gastroenterology, medicine.disease, Stratification (mathematics), medicine.anatomical_structure, Pancreatic cancer, Internal medicine, Familial Pancreatic Cancer, Medicine, CA19-9, business, Pancreas
Published
2015
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24. Is the association of the p.N34S SPINK1 variant explicable by a high risk halpotype rather than the polymorphism?

Author

Stephen P. Pereira, Michael Raraty, Roger Mountford, Robert Sutton, Roy Chaudhuri, James Nicholson, Martin Lombard, Richard Gibbons, Stephen B. Murphy, William Greenhalf, Werner Van Steenbergen, Ross Carter, John P. Neoptolemos, Christopher Halloran, Vincaine Rebours, Eva Holmberg, Alistair J Makin, Sara Harrison, Paul Brennan, Peter Adlard, Marianne Johnstone, Jonathan Grant, and Paula Ghaneh

Subjects
Genetics, Hepatology, Polymorphism (materials science), business.industry, Endocrinology, Diabetes and Metabolism, Gastroenterology, Medicine, business
Published
2013
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25. Divisum May be Preserving Pancreatic Function in CFTR Patients—But at a Cost

Author

James Nicholson, William Greenhalf, and Marianne Johnstone

Subjects
Male, medicine.medical_specialty, Pathology, Cystic Fibrosis Transmembrane Conductance Regulator, Gastroenterology, Internal medicine, Pancreatic function, medicine, Humans, Trypsin, Pancreas, Hepatology, biology, business.industry, medicine.disease, Cystic fibrosis transmembrane conductance regulator, medicine.anatomical_structure, Pancreatitis, Carrier protein, biology.protein, Female, Carrier Proteins, business, medicine.drug
Published
2012
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27. Association of carboxyl-ester lipase variable nucleotide tandem repeat with alcoholic chronic pancreatitis and alcoholic liver disease

Author

Diane Latawiec, John P. Neoptolemos, S Winn, Kelly Davies, Munir Pirmohamed, Triantafillos Liloglou, David N. Criddle, Laura J. Brown, Marianne Johnstone, Robert Sutton, Fabio Miyajima, and William Greenhalf

Subjects
medicine.medical_specialty, Alcoholic liver disease, Necrosis, Hepatology, business.industry, Endocrinology, Diabetes and Metabolism, Autophagy, Gastroenterology, Mitochondrion, medicine.disease, Cell morphology, Endocrinology, Apoptosis, Internal medicine, Organelle, medicine, Pancreatitis, medicine.symptom, business
Abstract

s / Pancreatology 14 (2014) S1eS129 S57 pancreatitis was induced by four hourly injections of caerulein [50 mg/kg/ dose] and in the high dose group by8 injections. Further, one groupof animals that received 4 injections was given a longer duration of injury by sacrificing this group at the 9th hour after the induction of pancreatitis by caerulein. The pancreatic tissue was processed for transmission electron microscopy. Results: The acinar cells of the pancreatitis groups revealed autophagosomes that contained cellular organelles, including mitochondria. The animals that received a higher dose had numerous cells showing a necrotic morphology, whereas the animals in the low dose group showed a predominantly apoptotic cell morphology. Conclusion: Dysfunctional organelles in the injured pancreatic acinar cells are degraded by macroautophagy that includes mitochondriae. The consequent energy deficit in the cells may lead to necrosis.

Published
2014
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28. Risk of other cancers in familial pancreatic cancer

Author

Paula Ghaneh, Pascal Hammal, Tom Hanna, Robert Sutton, William Greenhalf, Markus M. Lerch, Marianne Johnstone, John P. Neoptolemos, J.A. Nicholson, Sara Harrison, and Detlef K. Bartsch

Subjects
Oncology, Liver surgery, medicine.medical_specialty, Hepatology, business.industry, Endocrinology, Diabetes and Metabolism, fungi, Gastroenterology, Cancer, medicine.disease, Pancreatic surgery, medicine.anatomical_structure, Internal medicine, Familial Pancreatic Cancer, medicine, Postoperative outcome, In patient, Major complication, Pancreas, business
Abstract

s / Pancreatology 14 (2014) S1eS129 S7 only preoperative variables were included. The CRA was collected prospectively in patients undergoing pancreatic or liver surgery. Consultants prospectively predicted the postoperative major complications on scale of 0-100%. The diagnostic accuracy of PSM’s were assessed by the discriminative ability of the model and compared against that of the CRA. Results: Eight PSM’s for HPB surgery were identified. A total of 126 (56 pancreas, 70 liver) patients were included. Major complication rate was 8.5% in the liver group, 23.2% in the pancreas group. The performance of the PSM’s was poor (AUC’s ranging from 0.40-0.55). The performance of the CRA in pancreatic and liver surgery was 0.51 (95%-CI 0.30-0.72) and 0.76 (95%-CI 0.51-1.0) respectively. Conclusion: The performance of the PSM’s for pancreatic and liver surgerywas poor in our dataset. The CRAwas superior compared to the PSM’s in the liver group, however not in the pancreas group. These results suggest the complexity of assessing the risk of postoperative outcome in pancreatic surgery and emphasize the need formore accurate PSM’s for pancreatic surgery.

Published
2014
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29. Early short-term continuous high-volume haemofiltration improves clinical outcomes of severe acute pancreatitis

Author

K. Altaf, Jia Guo, Ping Xue, Muhammad A. Javed, Robert Sutton, Xiao Yang, Zi Lin, Marianne Johnstone, Wei Huang, Tao Jin, Qing Xia, and Zong Huang

Subjects
medicine.medical_specialty, Hepatology, business.industry, Endocrinology, Diabetes and Metabolism, Internal medicine, Gastroenterology, Cardiology, Medicine, Acute pancreatitis, business, medicine.disease, Volume (compression), Term (time)
Published
2013
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30. Detection of mutations in pancreatic juice collected from the duodenum by post secretin-aspiration is not reliable

Author

Marianne Johnstone, William Greenhalf, Martin Lombard, Paula Ghaneh, Sanchoy Sarkar, Michael Raraty, John P. Neoptolemos, Christopher Halloran, J.A. Nicholson, H Smart, R. Sutton, Li Yan, J. Evans, and J. Butler

Subjects
medicine.medical_specialty, Hepatology, business.industry, Endocrinology, Diabetes and Metabolism, General surgery, Gastroenterology, Secretin, medicine.anatomical_structure, Academic unit, Pancreatic juice, Duodenum, Medicine, business, Royal infirmary
Abstract

Nigel B. Jamieson , Nigel I.J. Chan , Alan K. Foulis , Euan J. Dickson , Colin J. McKay , C. Ross Carter . West of Scotland Pancreatic Unit, College of Medical, Veterinary and Life of Sciences, University of Glasgow, UK University Department of Surgery, Academic Unit of Surgery, College of Medical, Veterinary and Life of Sciences, University of Glasgow, UK Department of Pathology, Glasgow Royal Infirmary, Alexandra Parade, Glasgow, G31 2ER, UK

Published
2013
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31. Prediction of the severity of acute pancreatitis on admission by urinary trypsinogen activation peptide: A meta-analysis

Author

Tao Jin, Muhammad A. Javed, Christopher Halloran, Li Wen, Qing Xia, Marianne Johnstone, Kiran Altaf, Wei Huang, Ping Xue, and Junjie Xiong

Subjects
Adult, Male, medicine.medical_specialty, Pathology, Trypsinogen, Urinary system, macromolecular substances, Severity of Illness Index, digestive system, Gastroenterology, chemistry.chemical_compound, Patient Admission, Predictive Value of Tests, Internal medicine, Severity of illness, Odds Ratio, medicine, Humans, Aged, Aged, 80 and over, biology, business.industry, musculoskeletal, neural, and ocular physiology, C-reactive protein, General Medicine, Odds ratio, Middle Aged, Prognosis, medicine.disease, digestive system diseases, Pancreatitis, nervous system, chemistry, Predictive value of tests, Acute Disease, biology.protein, Acute pancreatitis, Female, business, Oligopeptides, Biomarkers, Meta-Analysis
Abstract

To undertake a meta-analysis on the value of urinary trypsinogen activation peptide (uTAP) in predicting severity of acute pancreatitis on admission.Major databases including Medline, Embase, Science Citation Index Expanded and the Cochrane Central Register of Controlled Trials in the Cochrane Library were searched to identify all relevant studies from January 1990 to January 2013. Pooled sensitivity, specificity and the diagnostic odds ratios (DORs) with 95%CI were calculated for each study and were compared to other systems/biomarkers if mentioned within the same study. Summary receiver-operating curves were conducted and the area under the curve (AUC) was evaluated.In total, six studies of uTAP with a cut-off value of 35 nmol/L were included in this meta-analysis. Overall, the pooled sensitivity and specificity of uTAP for predicting severity of acute pancreatitis, at time of admission, was 71% and 75%, respectively (AUC = 0.83, DOR = 8.67, 95%CI: 3.70-20.33). When uTAP was compared with plasma C-reactive protein, the pooled sensitivity, specificity, AUC and DOR were 0.64 vs 0.67, 0.77 vs 0.75, 0.82 vs 0.79 and 6.27 vs 6.32, respectively. Similarly, the pooled sensitivity, specificity, AUC and DOR of uTAP vs Acute Physiology and Chronic Health Evaluation II within the first 48 h of admission were found to be 0.64 vs 0.69, 0.77 vs 0.61, 0.82 vs 0.73 and 6.27 vs 4.61, respectively.uTAP has the potential to act as a stratification marker on admission for differentiating disease severity of acute pancreatitis.

Published
2013
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32. Impact of service centralisation on outcomes for patients with pancreatic cancer

Author

Paula Ghaneh, Michael Raraty, Robert Sutton, John P. Neoptolemos, Christopher Halloran, and Marianne Johnstone

Subjects
Oncology, Centralisation, Service (business), medicine.medical_specialty, Hepatology, business.industry, Endocrinology, Diabetes and Metabolism, Gastroenterology, medicine.disease, Internal medicine, Pancreatic cancer, medicine, Intensive care medicine, business
Published
2012
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33. PMO-107 Role of ERCP in the management of acute gallstone pancreatitis—a review of current practice

Author

T.D. Pinkney, A Patel, J Royle, D Bartlett, E. Hepburn, C.E. Richardson, Marianne Johnstone, P. Marriott, and A. Torrance

Subjects
First episode, medicine.medical_specialty, Common bile duct, business.industry, General surgery, medicine.medical_treatment, Gastroenterology, Gallstones, Bleed, medicine.disease, digestive system, digestive system diseases, Surgery, Clostridium Difficile Colitis, surgical procedures, operative, Recurrent pancreatitis, medicine.anatomical_structure, Medicine, Pancreatitis, Cholecystectomy, business
Abstract

Introduction Cholecystectomy is the preferred definitive treatment to prevent further episodes of gallstone pancreatitis, if patients have clear bile ducts and are suitable for surgery. Endoscopic retrograde cholangio-pancreatography (ERCP) is utilised to either clear the biliary tree of gallstones prior to operation or as definitive treatment in those deemed unsuitable for surgery. We aimed to determine how ERCP is being utilised, its effect on recurrent pancreatitis and readmission rates. Methods A multi-centre retrospective review was performed of patients presenting with their first episode of gallstone pancreatitis between 2006 and 2008. All patients with confirmed biochemical diagnosis of pancreatitis plus a radiological diagnosis of gallstones were included. Data were collected on demographics, ERCP, operative management and readmissions. Groups were compared using χ 2 and medians using Mann–Whitney U. Results 523 patients were identified (36% male, median age 63) in seven acute hospital trusts. 166 (32%) underwent ERCP with 20 (13%) having a failed procedure. 127 (77%) underwent sphincterotomy with the common bile duct being clear in 80% (133). 28 (17%) were performed within 72 h of admission and 105 (63%) were performed during the index admission. There was no effect on the timing of ERCP in the likelihood of the procedure failing to be completed (median time 10 vs 10.5 days). 364 patients underwent cholecystectomy with 29% undergoing ERCP prior to surgery. ERCP was performed as the definitive procedure in 58 patients; median age 80 years compared to 58 years in those undergoing cholecystectomy (p two patients died following successful ERCPs; one 87 year old of Clostridium difficile colitis and one 81 year old of pancreatitis. There was one episode of post ERCP pancreatitis, and one bleed that resolved spontaneously. An additional 5 patients developed a second episode of pancreatitis subsequent to their ERCP. Sphincterotomy had not been performed in three of these cases (p=0.08). ERCP with the index admission was the only significant factor to reduce recurrent pancreatitis rates (OR 0.092 (0.013–0.673); p Conclusion ERCP is currently being used as definitive treatment for gallstone pancreatitis in selected elderly patients. In our series ERCP had an acceptable rate of morbidity associated with the procedure, and was shown to significantly reduce the rate of recurrent pancreatitis. However, overall readmission rates were not improved by ERCP, with this only being achieved by cholecystectomy during the index admission. Competing interests None declared.

Published
2012
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35. Ketamine Use for Complex Pain in the Palliative Care Population.

Author

Johnstone-Petty M

Subjects
Analgesics standards, Analgesics therapeutic use, Humans, Ketamine therapeutic use, Pain Management methods, Pain Measurement methods, Palliative Care methods, Palliative Care standards, Ketamine standards, Pain Management standards
Abstract

Palliative care patients are predisposed to complex pain, including refractory pain, neuropathic pain, opioid-induced hyperalgesia, and opioid-induced neurotoxicity. Palliative care complex pain management can include use of subanesthetic parenteral ketamine. Support for subanesthetic ketamine exists from anecdotal experiences and nonrandomized studies, but there is a lack of statistically significant evidence to support or dismiss its use. Ketamine is sought for illegal, nonmedical purposes, so the lack of evidence coupled with potential for exploitation makes judicious and knowledgeable use critical. Palliative care nurse practitioners, as experts in symptom management, should evaluate and consider all potentially beneficial treatment strategies for complex pain, including novel strategies such as subanesthetic ketamine treatment. Several databases and clinical guideline repositories, along with inspection of germane articles' reference lists, were utilized to collect original research, retrospective studies, literature reviews, and case reports pertinent to the management of palliative care complex pain with parenteral ketamine. In conclusion, the evidence-based clinical decision-making process is engaged to outline a method to weigh the risks versus benefits of subanesthetic ketamine for this population of patients.

Published
2018
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