Gábor Olgyai | PubMed Health

PubMed2005

[Combination of early nasojejunal feeding with modern synbiotic therapy in the treatment of severe acute pancreatitis (prospective, randomized, double-blind study)].

BACKGROUND: We showed previously that probiotics containing lactobacilli significantly improve the outcome of acute pancreatitis. "Synbiotic 2000", a new synbiotic composition with high colony forming unit (CFU) comprises four different types of pre- and probiotics. In this prospective, randomized, double-blind study we evaluated the role of "Synbiotic 2000" in the treatment of severe acute pancreatitis. METHODS: Patients with severe acute pancreatitis were randomized into two groups. Nasojejunal feeding was commenced within 24 hours after admission in both groups and continued for at least seven days. The first group of patients received four different lactobacilli preparations with 10(10) CFU, respectively, and prebiotics containing four bioactive fibres (inulin, beta-glucan, resistant starch and pectin) in addition. Patients in the second (control) group received only prebiotics. RESULTS: 62 patients with severe acute pancreatitis completed the study. Altogether 8 patients died. We detected lower incidence of multiorgan failure (MOF), septic complications and mortality in the first group compared to the control, but the differences were statistically not significant. The total incidence of systemic inflammatory response syndrome (SIRS) and MOF were significantly different between the two groups (8 vs. 14; p < 0.05). Furthermore, the number patients recovering with complications were significantly less in the first group receiving modern synbiotic therapy compared to the control (p < 0.05). Finally, we found lower rate of late (over 48 hours) organ failure in the first versus the control group (3.0% vs. 17.2%). CONCLUSION: Our results suggest that early nasojejunal feeding with synbiotic may prevent organ dysfunctions in the late phase of severe acute pancreatitis. In addition, our data also indicate that the infection of pancreatic necrosis may be associated with early phase organ failure.

Adult↗

PubMed2004

[Double resection for synchronous pancreatic and renal cell cancer--case report].

Reports of synchronous or metachronous double kidney-pancreas cancers are very rare. Authors present the history of a 72-year-old woman who had a 10 kg loss of weight and epigastric pain. A complete gastroenterological check-up was carried out: kidney and synchronous pancreatic body cancer were found. The patient underwent distal pancreatectomy, splenectomy and nephrectomy with a worthwhile outcome. After an uneventful postoperative period the patient was discharged in good condition. Histology verified primary pancreatic ductal adenocarcinoma with synchronous primary renal clear cell carcinoma. The patient received oncotherapy and was well at 6 months' follow up. The appearance of different primaries in an individual may indicate a genetic predisposition to different neoplasms. In the literature there are some studies of double primary cancers, they are important because it might provide understanding of a shared genetic basis of different solid tumors. The association between these two cancers demands more detailed epidemiological and molecular investigation.

Aged↗

PubMed2003

[Extraskeletal osteosarcoma in the gallbladder].

Extraskeletal osteosarcoma is a rare malignant soft tissue tumor. Authors present the history of a 61-year-old woman who had bone like tissue in her gallbladder at cholecystectomy. Histology proved, it was extraskeletal osteosarcoma of the gallbladder. Such disease has not been previously reported in the literature. She developed metastatic disease five months after the operation: multiplex cystic-calcified metastases appeared in the abdominal wall and in the peritoneal cavity. We present pathology findings, including ultrastructural features.

Abdominal Wall↗