Malnutrition is a frequent complication in patients with chronic pancreatitis. Maldigestion as a ... more Malnutrition is a frequent complication in patients with chronic pancreatitis. Maldigestion as a consequence of pancreatic exocrine insufficiency is the major cause of malnutrition in these patients. Together with that, toxic habits and alterations of the gastroduodenal transit may play a relevant role. Malnutrition in chronic pancreatitis is associated with osteoporosis, sarcopenia, poor quality of life, and increased mortality. An adequate nutritional evaluation including anthropometric, biochemical, and morphologic parameters is recommended in these patients. Nutritional advice and support together with an adequate pancreatic enzyme replacement therapy are indicated.
Page 1. 236 Introduction Chronic pancreatitis is defined as a chronic inflamma-tory disease that ... more Page 1. 236 Introduction Chronic pancreatitis is defined as a chronic inflamma-tory disease that results in irreversible morphologic and functional changes within the pancreas. In the context of this inflammatory process, there ...
This database was generated and used in the study "Influence of polymorphisms in genes invol... more This database was generated and used in the study "Influence of polymorphisms in genes involved in platelet activation and inflammatory response on aspirin-related upper gastrointestinal bleeding: A Case-Control Study" <br>
Objectives Exocrine pancreatic insufficiency is a frequent and clinically relevant complication o... more Objectives Exocrine pancreatic insufficiency is a frequent and clinically relevant complication of pancreatic cancer probably secondary to pancreatic duct obstruction. We aimed at evaluating the impact of endoscopic pancreatic drainage on pancreatic function in patients with unresectable pancreatic cancer. Methods A double-blind, prospective, randomized, single-center, interventional study was designed. Patients undergoing endoscopic retrograde cholangiopancreatography for jaundice secondary to unresectable pancreatic cancer were randomized to biliary drainage (group A) or biliopancreatic drainage (group B). Pancreatic function was evaluated by 13C-mixed triglyceride breath test before and 2 weeks after endoscopic retrograde cholangiopancreatography. Breath test result is expressed as 13C-cumulative recovery rate. Abdominal symptoms and nutritional markers were evaluated as secondary outcomes. Results Twenty patients were included. Sixteen patients had exocrine pancreatic insufficiency, and 13 completed the study (7 in group A and 6 in group B). The median absolute improvement of 13C-cumulative recovery rate was of 23.75% (interquartile range, 9.62–31.74) after biliopancreatic drainage compared with −1.92% (interquartile range, −4.17 to 13.92) after biliary drainage (P = 0.015). Nutritional markers improved after biliopancreatic drainage, but not after biliary drainage. Conclusions Biliopancreatic and not biliary endoscopic drainage is associated with a significant improvement of exocrine pancreatic function in patients with unresectable pancreatic cancer.
Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva, Jan 24, 2018
the incidence of cystic pancreatic lesions (CPL) in the asymptomatic population is increasing. Ac... more the incidence of cystic pancreatic lesions (CPL) in the asymptomatic population is increasing. Achieving a preoperative diagnosis of CPL still remains a challenge. to evaluate the diagnostic accuracy of the cytological diagnosis of CPL from samples obtained by cytology brush versus standard endoscopic ultrasound fine needle aspiration (EUS-FNA). a multicenter, randomized, open-label trial was performed of EUS-cytology brush (EUS-EB) versus EUS-FNA for the cytological diagnosis of CPL. Patients that underwent EUS-FNA with a CPL > 15 mm were included and randomized into two groups: group I, EUS-EB; group II, EUS-FNA. The final diagnosis was based on the histological evaluation of surgical specimens and clinical parameters, imaging and a five year follow-up in non-operated patients. The main outcome was the diagnostic accuracy of both methods. Secondary outcomes were the diagnostic adequacy of specimens and the rate of adverse events. Data were compared using the Chi-squared test. A...
JED-M Elastography is a method used to evaluate the hardness of different tissues and is based on... more JED-M Elastography is a method used to evaluate the hardness of different tissues and is based on the principle that softer parts of tissues are easier to deform under compression than stiffer sections of tissues. Elastography translates the elastic properties of tissues into a map of different colors, which reads like a virtual biopsy; the stiffness of tissues is related to their histologic features. An elastographic blue predominant pattern, which is associated with a high strain ratio value, indicates the malignant nature of a pancreatic lesion or lymph node with a high accuracy. However, a green predominant pattern, which is associated with a low strain ratio value, indicates the benign nature of an explored lesion. The accuracy of endoscopic ultrasound (EUS) elastography for the diagnosis of malignancy is higher than 90%.
Malnutrition is a frequent complication in patients with chronic pancreatitis. Maldigestion as a ... more Malnutrition is a frequent complication in patients with chronic pancreatitis. Maldigestion as a consequence of pancreatic exocrine insufficiency is the major cause of malnutrition in these patients. Together with that, toxic habits and alterations of the gastroduodenal transit may play a relevant role. Malnutrition in chronic pancreatitis is associated with osteoporosis, sarcopenia, poor quality of life, and increased mortality. An adequate nutritional evaluation including anthropometric, biochemical, and morphologic parameters is recommended in these patients. Nutritional advice and support together with an adequate pancreatic enzyme replacement therapy are indicated.
Page 1. 236 Introduction Chronic pancreatitis is defined as a chronic inflamma-tory disease that ... more Page 1. 236 Introduction Chronic pancreatitis is defined as a chronic inflamma-tory disease that results in irreversible morphologic and functional changes within the pancreas. In the context of this inflammatory process, there ...
This database was generated and used in the study "Influence of polymorphisms in genes invol... more This database was generated and used in the study "Influence of polymorphisms in genes involved in platelet activation and inflammatory response on aspirin-related upper gastrointestinal bleeding: A Case-Control Study" <br>
Objectives Exocrine pancreatic insufficiency is a frequent and clinically relevant complication o... more Objectives Exocrine pancreatic insufficiency is a frequent and clinically relevant complication of pancreatic cancer probably secondary to pancreatic duct obstruction. We aimed at evaluating the impact of endoscopic pancreatic drainage on pancreatic function in patients with unresectable pancreatic cancer. Methods A double-blind, prospective, randomized, single-center, interventional study was designed. Patients undergoing endoscopic retrograde cholangiopancreatography for jaundice secondary to unresectable pancreatic cancer were randomized to biliary drainage (group A) or biliopancreatic drainage (group B). Pancreatic function was evaluated by 13C-mixed triglyceride breath test before and 2 weeks after endoscopic retrograde cholangiopancreatography. Breath test result is expressed as 13C-cumulative recovery rate. Abdominal symptoms and nutritional markers were evaluated as secondary outcomes. Results Twenty patients were included. Sixteen patients had exocrine pancreatic insufficiency, and 13 completed the study (7 in group A and 6 in group B). The median absolute improvement of 13C-cumulative recovery rate was of 23.75% (interquartile range, 9.62–31.74) after biliopancreatic drainage compared with −1.92% (interquartile range, −4.17 to 13.92) after biliary drainage (P = 0.015). Nutritional markers improved after biliopancreatic drainage, but not after biliary drainage. Conclusions Biliopancreatic and not biliary endoscopic drainage is associated with a significant improvement of exocrine pancreatic function in patients with unresectable pancreatic cancer.
Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva, Jan 24, 2018
the incidence of cystic pancreatic lesions (CPL) in the asymptomatic population is increasing. Ac... more the incidence of cystic pancreatic lesions (CPL) in the asymptomatic population is increasing. Achieving a preoperative diagnosis of CPL still remains a challenge. to evaluate the diagnostic accuracy of the cytological diagnosis of CPL from samples obtained by cytology brush versus standard endoscopic ultrasound fine needle aspiration (EUS-FNA). a multicenter, randomized, open-label trial was performed of EUS-cytology brush (EUS-EB) versus EUS-FNA for the cytological diagnosis of CPL. Patients that underwent EUS-FNA with a CPL > 15 mm were included and randomized into two groups: group I, EUS-EB; group II, EUS-FNA. The final diagnosis was based on the histological evaluation of surgical specimens and clinical parameters, imaging and a five year follow-up in non-operated patients. The main outcome was the diagnostic accuracy of both methods. Secondary outcomes were the diagnostic adequacy of specimens and the rate of adverse events. Data were compared using the Chi-squared test. A...
JED-M Elastography is a method used to evaluate the hardness of different tissues and is based on... more JED-M Elastography is a method used to evaluate the hardness of different tissues and is based on the principle that softer parts of tissues are easier to deform under compression than stiffer sections of tissues. Elastography translates the elastic properties of tissues into a map of different colors, which reads like a virtual biopsy; the stiffness of tissues is related to their histologic features. An elastographic blue predominant pattern, which is associated with a high strain ratio value, indicates the malignant nature of a pancreatic lesion or lymph node with a high accuracy. However, a green predominant pattern, which is associated with a low strain ratio value, indicates the benign nature of an explored lesion. The accuracy of endoscopic ultrasound (EUS) elastography for the diagnosis of malignancy is higher than 90%.
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Papers by J.enrique Domínguez-muñoz