Role of bedside pancreatic scores and C-reactive protein in predicting pancreatic fluid collections and necrosis

Vinish, Doraiswami Babu; Abishek, V; Sujatha, K.; Sarangapani, Arulprakash; Solomon, Rajkumar; Ganesh, P

doi:10.1007/s12664-017-0728-6

Cited by 14 publications

(11 citation statements)

References 32 publications

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“…An important point with CRP is that although it is one of the earliest acute-phase reactants that increase in level, CRP level higher than 170 mg/dl at 48 hours has been reported to be more valuable for predicting severe acute pancreatitis and pancreatic necrosis than CRP level measurements at any time before 48 hours. 6 Further, the importance of CRP lies in its value for predicting the healing of acute pancreatic inflammation as follow-up CRP levels will correctly reveal which patients will develop complications or which will heal uneventfully. 7 Combining serum CRP level measurements taken at 48 hours later will improve the Ranson scoring system for having a higher accuracy for the differentiation of the mild and severe forms of AP.…”

Section: Discussionmentioning

confidence: 99%

C-reactive protein levels in acute pancreatitis and its clinical significance

2019

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Background: Acute pancreatitis is one of the most common problems faced by surgeon in their practice. Alcohol being one of the most important etiology in country like India. The most common line of management has always been conservative until and unless surgery is indicated for its complications. Till date amylase and lipase have been used as diagnostic tool for it however certain prognostic tools like CRP are still under evaluation. Thus we have made an attempt to evaluate its significance as a prognostic tool in this study.Methods: A hospital based observational comparative prospective study was done with 100 patients to measure C-reactive protein (CRP) levels in patients of acute pancreatitis and evaluate if CRP levels predict the severity of pancreatitis.Results: The mean serum CRP level of patients with Ranson’s score <3 was significantly higher as compared to mean serum CRP level of patients with Ranson’s score ≥3 (10.54±5.00 mg/l vs 7.29±3.94 mg/l). There was significant association of serum CRP and Ranson’s score of patients.Conclusions: The rapid response of CRP to changes in the intensity of the inflammatory stimulus suggests that it might be valuable in the assessment and monitoring of acute pancreatitis. It was observed in our study that measurement of CRP level is a simple method to assess the severity of disease.

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Section: Discussionmentioning

confidence: 99%

C-reactive protein levels in acute pancreatitis and its clinical significance

2019

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“…Although the mortality rate in mild and moderate AP is low, this value is still unacceptably high (30%) in its severe form (Parniczky et al, 2016 ). Since no specific therapy is available, only prompt and accurate interventions, such as aggressive fluid therapy can be beneficial (Vinish et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Bidirectional Relationship Between Reduced Blood pH and Acute Pancreatitis: A Translational Study of Their Noxious Combination

et al. 2018

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Acute pancreatitis (AP) is often accompanied by alterations in the acid-base balance, but how blood pH influences the outcome of AP is largely unknown. We studied the association between blood pH and the outcome of AP with meta-analysis of clinical trials, and aimed to discover the causative relationship between blood pH and AP in animal models. PubMed, EMBASE, and Cochrane Controlled Trials Registry databases were searched from inception to January 2017. Human studies reporting systemic pH status and outcomes (mortality rate, severity scores, and length of hospital stay) of patient groups with AP were included in the analyses. We developed a new mouse model of chronic metabolic acidosis (MA) and induced mild or severe AP in the mice. Besides laboratory blood testing, the extent of pancreatic edema, necrosis, and leukocyte infiltration were assessed in tissue sections of the mice. Thirteen studies reported sufficient data in patient groups with AP (n = 2,311). Meta-analysis revealed markedly higher mortality, elevated severity scores, and longer hospital stay in AP patients with lower blood pH or base excess (P < 0.001 for all studied outcomes). Meta-regression analysis showed significant negative correlation between blood pH and mortality in severe AP. In our mouse model, pre-existing MA deteriorated the pancreatic damage in mild and severe AP and, vice versa, severe AP further decreased the blood pH of mice with MA. In conclusion, MA worsens the outcome of AP, while severe AP augments the decrease of blood pH. The discovery of this vicious metabolic cycle opens up new therapeutic possibilities in AP.

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“…There are multiple forms of tumor cell death such as necroptosis [1] [2] [3], pyroptosis [4] or inflammatory necrosis [5], autophagy [6] [7] [8], oncosis [9], entosis [10] [11], paraptosis [12], ferroptosis [13] [14] [15] and so on, with necrosis and apoptosis being the most commonly seen ones [16]. Each of these forms occurs with a different mechanism and holds various impacts on their biological effects, with that of autophagy being a very special one.…”

Section: Introductionmentioning

confidence: 99%

Autophagy-Inducing Effect of Compound Berberine on CNE2 NPC Cells via Interference with the Targets in P13K/AKT/mTOR Signaling Pathway

Liu¹,

Yu²,

Lin³

et al. 2020

IJCM

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Objective: To investigate the autophagy-inducing effect of Compound Berberine (CBBR) on CNE2 nasopharyngeal carcinoma (NPC) cells and its possible targets in P13K/AKT/mTOR signaling pathway. Methods: CNE2 cells at exponential growth phase were taken as the target cells in this study. Firstly, IC50 concentration for CBBR was determined by MTT assay. Then, 3 different concentrations of CBBR, 0.25 mg•mL −1 , 0.50 mg•mL −1 and 1.00 mg•mL −1 , around the concentration of IC50, were taken for followed intervention experiments respectively. Fluorescein labeling method was utilized to assay the inducing effect of CBBR on the autophagic activity of CNE2 cells, followed by Western blot procedure to explore the changes of key messenger molecules in the autophagy-related signaling pathway of P13K/AKT/mTOR, both combined with 3-MA block test in a comparative way and carried out by detecting the expressive levels of Beclin 1, LC3-II and LC3-I as well as the ratio of LC3-II:LC3-I. Results: IC50 of CBBR was determined at the level of 0.5 mg•mL −1. The inducing effect of CBBR on autophagy of CNE2 cells was shown occurring in various modes, not a simple concentration-dependent tendency, with its effect minimal at the concentration of 0.25 mg•mL −1 and maximal at the concentration of 0.50 mg•mL −1 , while only slightly higher at the concentration of 1.00 mg•mL −1 than that of 0.5 mg•mL −1. Although its inducing effect was weakened a little following the pretreatment by 3-MA

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Role of bedside pancreatic scores and C-reactive protein in predicting pancreatic fluid collections and necrosis

Abstract: BISAP, HAPS, and SIRS scores and CRP of 150 mg/L all correlated significantly with the occurrence of fluid collections and pancreatic necrosis on CT at 72 h. None of the scores was superior to the other in this respect.

Cited by 14 publications

References 32 publications

C-reactive protein levels in acute pancreatitis and its clinical significance

C-reactive protein levels in acute pancreatitis and its clinical significance

Bidirectional Relationship Between Reduced Blood pH and Acute Pancreatitis: A Translational Study of Their Noxious Combination

Autophagy-Inducing Effect of Compound Berberine on CNE2 NPC Cells via Interference with the Targets in P13K/AKT/mTOR Signaling Pathway

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