(Press-News.org) These findings validate the significance of the previously described first threshold - the point when the damage to the acinar cells of the pancreas is sufficient to trigger the infamous inflammatory cascade (Barreto and Saccone, 2010) - while highlighting the importance of a second threshold, namely the point when a person develops clinical symptoms of the disease sufficient to warrant going to hospital.
"This transcontinental collaboration of pancreatologists drew on their vast clinical and research experience spanning decades investigating the pathophysiology and treatments for AP - one of the most common causes for emergency presentations all over the world," says corresponding author Dr Stephen Pandol MD, from the Cedars Sinai Medical Center in California.
"This study presents the most updated and comprehensive pathogenesis of AP along with various promising avenues for further research," adds first author Dr Savio Barreto, from Flinders University's College of Medicine and Public Health.
The new Gut paper, 'Critical thresholds: key to unlocking the door to the prevention and specific treatments for acute pancreatitis' (2021) by SG Barreto, A Habtezion, A Gukovskaya, A Lugea, C Jeon, D Yadav, P Hegyi, V Venglovecz, R Sutton and SJ Pandol has been published in Gut (BMJ) DOI: 10.1136/gutjnl-2020-322163
Article co-authors include experts from Cedars Sinai Medical Center (Stephen.Pandol@cshs.org), Stanford University School of Medicine, UCLA, West Los Angeles VA Healthcare Center, University of Pittsburgh Medical Center (US), University of Szeged, University of Pécs (Hungary) and University of Liverpool (UK).
In another international collaborative study, experts have compared costs related to the complex pancreatic operation called the Whipple's operation (or pancreatoduodenectomy) performed on 1406 patients from three hospitals in three continents (US, Italy and India) to demonstrate that it is possible to identify the drivers of costs of surgery.
"The information generated from understanding these drivers can be used to forecast the costs associated with any surgery," says Dr Barreto, a surgeon and researcher based at Flinders University in South Australia.
"The study not only achieved its goal of identifying cost drivers in surgery, but more importantly identified variations in these drivers (for the same procedure) across the three cohorts," he says.
"In this study, the authors developed a cost forecasting tool (an 'APP') to provide patients, at the time of informed financial consent, as well as funding agencies, with a more realistic cost estimate for a given operation. The APP warrants future validation."
The incidence of pancreatic cancer is increasing around the world. Surgery is an important contributor to health care expenditure around the world.
The term 'catastrophic expenditure' has been introduced to reflect the financial hardship of care afflicting nearly 25% of patients and their families faced the prospect of surgery. This has prompted the World Bank and the Lancet Commission on Global Surgery to set the ambitious goal of eliminating impoverishment due to the cost of surgery.
The problem of excessive billing needs to be tackled by introducing cost transparency, preoperative informed financial consent, price regulation and negotiated rates between health care providers and insurer.
Each year pancreatic cancer is diagnosed in 250,000 patients worldwide (more than 40,000 in the US), and because only a limited number of patients are diagnosed early enough for successful surgical intervention, 225,000 die. To date, chemotherapy and radiotherapy are only partially and transiently effective.
INFORMATION:
See 'Forecasting surgical costs: Towards informed financial consent and financial risk reduction' (2020) by SG Barreto, N Bulamu, A Chaudhary, G Chen, K Kawakami, L Maggino, G Malleo, S Pendharkar, MT Trudeau, R Salvia, CM Vollmer Jr and JA Windsor published in Pancreatology (Elsevier) DOI 10.1016/j.pan.2020.12.014
Deep in the Brazilian Amazon River basin, scientists led by the Smithsonian's National Museum of Natural History fish research associate C. David de Santana discovered a small, river-fed lake filled with more than 100 adult electric eels, many of which were upwards of 4 feet long. On its own, this was an intriguing discovery, electric eels--a type of knifefish rather than true eels--were thought to be solitary creatures.
But in this lake along the banks of the Iriri River in Brazil's state of Pará, the researchers witnessed the eels working together to herd small fish called tetras into tightly packed balls. Then groups of up to ...
Underwater seagrass meadows may trap, extract and carry marine plastic debris to shore, thereby helping to remove plastic litter from the sea, according to a study published in Scientific Reports.
Previous research suggested that most plastics end up in the seafloor and that some are washed back to shore; however, how this occurs was unclear.
Seagrass meadows are widespread in shallow coastal waters and are involved in trapping and binding sediment particles that form the seabed. To assess the role that seagrass may have in trapping and removing marine plastic, Anna Sanchez-Vidal and colleagues measured the amount of plastic debris collected from seagrass litter ...
Advancements in energy technologies, healthcare, semiconductors and food production all have one thing in common: they rely on developing new materials--new combinations of atoms--that have specific properties enabling them to perform a needed function. In the not-too-distant past, the only way to know what properties a material had was by performing experimental measurements or using very expensive computations.
More recently, scientists have been using machine learning algorithms to rapidly predict the properties that certain arrangements of atoms would have. The challenge with this approach is it requires a lot of highly accurate data to train the model, which often does not exist.
By combining large ...
Retinal cells derived from adult human eye stem cells survived when transplanted into the eyes of monkeys, an important early step in the validation of this approach for treating blindness, according to a study by Liu, et al recently published in Stem Cell Reports. The retinal pigment epithelium (RPE), a layer of pigmented cells in the retina, is essential for sustaining normal vision. Blindness due to RPE dysfunction, such as macular degeneration, affects about 200 million people worldwide.
To restore this population of cells, researchers extracted retinal stem cells from donated cadaver adult eyes, grew them into RPE cells and transplanted them into the eyes of monkeys. ...
Retinal cells derived from a cadaver human eye survived when transplanted into the eyes of primate models, an important advance in the development of cell therapy to treat blindness, according to a study published on January 14 in Stem Cell Reports.
The retinal pigment epithelium (RPE), a layer of pigmented cells in the retina, functions as a barrier and regulator in the eye to maintain normal vision. RPE dysfunction can lead to eye disorders including macular degeneration and can cause blindness, which affects about 200 million people worldwide.
To restore this population of cells, ...
A major roadblock to computational design of high-entropy alloys has been removed, according to scientists at Iowa State University and Lehigh University. Engineers from the Ames Lab and Lehigh University's Department of Mechanical Engineering and Mechanics have developed a process that reduces search time used for predictive design 13,000-fold.
According to Ganesh Balasubramanian, an associate professor at Lehigh, the goal of the team's research was to accelerate the computational modeling of complex alloys. The tools available for creating random distribution of atoms in materials simulation models, he says, have been used for many, many years now and are limited in ...
What The Study Did: The number of patients undergoing cancer screening tests and of subsequent cancer diagnoses during the COVID-19 pandemic in the largest health care system in the northeastern United States was assessed in this study.
Authors: Toni K. Choueiri, M.D., of the Dana-Farber Cancer Institute and Quoc-Dien Trinh, M.D., of Brigham and Women's Hospital in Boston, are the corresponding authors.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamaoncol.2020.7600)
Editor's Note: The article includes conflict ...
What The Study Did: Which demographic and socioeconomic factors were associated with patient participation in telehealth during the COVID-19 pandemic surge was examined in this observational study.
Authors: Ilaaf Darrat, M.D., M.B.A., of the Henry Ford Hospital in Detroit, is the corresponding author.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamaoto.2020.5161)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, ...
What The Study Did: Researchers investigated the association of home confinement during the COVID-19 outbreak with myopia (nearsightedness) development in school-age children in China.
Authors: Xuehan Qian, M.D., Ph.D., of Tianjin Medical University Eye Hospital in Tianjin, China, is the corresponding author. This is an open access article distributed under the terms of the CC-BY License. © 2021 Wang J et al. JAMA Ophthalmology.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamaophthalmol.2020.6239)
Editor's Note: The ...
Cardiac rehabilitation is a therapy that combines guided exercise along with heart-healthy lifestyle education that can be life-saving for the majority of people who have had a major cardiac event, such as a heart attack. However, it is underutilized in the United States, with many hospitals referring just 20 percent or fewer of their eligible patients, largely because the referral process can be cumbersome. But new research shows that implementing a simple, easy to use "opt-out" pathway in the electronic health record drastically increased the rate of referrals, which could lead to fewer rehospitalizations and even lowered mortality. Led by researchers at the Perelman School of Medicine ...
