Amylase Content Research Articles

Diagnostic accuracy of computed tomography in chronic pancreatitis

It is widely accepted that postoperative pancreatic fistula (POPF) accompanied by bacterial infection results in a worse outcome than POPF alone. However, few studies evaluating predictive indicators of POPF have focused on bacterial infection.A consecutive 100 patients who underwent pancreaticoduodenectomy at our institute for periampullary disease were enrolled. POPF was assessed according to the International Study Group of Pancreatic Fistula consensus guidelines; grades B and C were defined as clinically relevant POPF (CR-POPF). The patients’ characteristics, perioperative surgical factors, and laboratory data including the results of culture and smear testing performed using drainage fluid on postoperative days (PODs) 1 and 3 were analyzed.The overall incidence of CR-POPF was 25%. Univariate analyses revealed that the factors associated with CR-POPF were male sex, soft pancreas, MPD diameter, higher serum C-reactive protein concentration and white blood cell count on POD 3, higher amylase concentration in drainage fluid, and culture and/or smear positivity of drainage fluid. Multivariate analysis newly revealed that the smear positivity of drainage fluid on POD 3 was the independent risk factors for CR-POPF (p = 0.027).Smear positivity of drainage fluid on POD 3 after pancreaticoduodenectomy may be a new predictor of CR-POPF.

Survival Length after Pancreaticoduodenectomy for Adenocarcinoma in Correlation with Preoperative CT Characteristics and Tumour Resections Margin Assesment

It is widely accepted that postoperative pancreatic fistula (POPF) accompanied by bacterial infection results in a worse outcome than POPF alone. However, few studies evaluating predictive indicators of POPF have focused on bacterial infection.A consecutive 100 patients who underwent pancreaticoduodenectomy at our institute for periampullary disease were enrolled. POPF was assessed according to the International Study Group of Pancreatic Fistula consensus guidelines; grades B and C were defined as clinically relevant POPF (CR-POPF). The patients’ characteristics, perioperative surgical factors, and laboratory data including the results of culture and smear testing performed using drainage fluid on postoperative days (PODs) 1 and 3 were analyzed.The overall incidence of CR-POPF was 25%. Univariate analyses revealed that the factors associated with CR-POPF were male sex, soft pancreas, MPD diameter, higher serum C-reactive protein concentration and white blood cell count on POD 3, higher amylase concentration in drainage fluid, and culture and/or smear positivity of drainage fluid. Multivariate analysis newly revealed that the smear positivity of drainage fluid on POD 3 was the independent risk factors for CR-POPF (p = 0.027).Smear positivity of drainage fluid on POD 3 after pancreaticoduodenectomy may be a new predictor of CR-POPF.

Alterations of pancreatic functions and lipid profiles in dairy cows with left displacement of the abomasum

The objectives of this study were to determine the serum activities of the pancreatic enzymes amylase, lipase, trypsinogen 1 and trypsinogen 2, serum concentrations of total cholesterol, high density lipoprotein, low-density lipoprotein and triglycerides and serum inflammatory indicators, namely C-reactive protein and procalcitonin, in Holstein-Friesian dairy cows with left displacement of the abomasum (LDA). A total of 60 cows (30 LDA-affected and 30 healthy) were included in the study. Laboratory analyses were performed using commercially available ELISA kits and chemical reagents according to the manufacturers’ recommendations. There was a significant increase (P ≤ 0.05) in the activities of lipase, trypsinogen 1 and trypsinogen 2 in LDA-affected cows compared to healthy cows. Amylase concentrations, however, remained unchanged. The serum concentrations of total cholesterol and high-density lipoprotein were significantly (P ≤ 0.05) increased in LDA-affected cows while the concentrations of low-density lipoprotein and triglycerides were significantly (P ≤ 0.05) decreased compared to healthy cows. Procalcitonin and C-reactive protein concentrations were significantly (P ≤ 0.05) increased in LDA-affected cows compared to healthy cows. This study indicates that displacement of the abomasum may be associated with significant pathological effects in the pancreas that may affect cows in the post-operative period.

The Results of Duodenum-Preserving Resections of the Pancreas in Chronic Pancreatitis Using the Technology of Sealing the Pancreatic-Intestinal Anastomosis

Background. The problem of chronic pancreatitis in recent years is acute, primarily due to the occurrence of complications and pain that forces you to turn to a surgeon. The main cause of deaths is the failure of the pancreatic anastomosis and the occurrence of bleeding into the cavity of the pancreatic intestinal anastomosis (40 %).Aims: to improve the results of duodenum-preserving resections by introducing the technology of sealing the pancreaticintestinal anastomosis.Materials and methods. The clinic operated 225 patients with chronic pancreatitis. All patients before the operation and in the postoperative period were carried out clinical and biochemical studies, the Frey operation was performed. Patients were divided into two groups. The first group, the group of comparison, included 184 (81.8 %) patients with pancreatoenteroanastomosis formed without additional sealing methods. The second group – the main one – consisted of 41 (18.2 %)patients in which the suture of the pancreatic anastomosis was strengthened with an adhesive composite or with the loop of the small intestine.Results. After the surgery, complications in the control group were recorded in 19 (8.4 %) patients: failure – in 6 (3 %), bleeding into the lumen of pancreatoenteroanastomosis – in 9 (4 %), mortality was 1.8 % (4 persons). There were no complications in the main group. The analysis of the amylase content in the drainage fluid revealed high values in the control group on the 3rd day – 916 ± 15 U/l, in comparison with the main group – 437 ± 16 U/l (p < 0.05). The data obtained indicate that the cause of insolvency of the pancreatic-intestinal anastomosis is the penetration of enzymes through the pancreatic-cervical anastomosis zone into the abdominal cavity. When analyzing the results, it turned out that the failure of the pancreatic-intestinal anastomosis was not detected in any case in patients with sealing.Conclusion. The escape of enzymes destroys the tightness of the superimposed fistula and is characterized by an increase in the level of amylase in the drainage fluid. The proposed sealing technologies decrease the number of postoperative complications and improve the results of treatment.

Haematology, blood biochemistry, parasites and pathology of common eider (Somateria mollisima) males during a mortality event in the Baltic

A mortality event at the Christiansø colony in the Baltic proper killed 115 common eiders (Somateria mollissima) in mid-May 2016. To complement previous studies of incubating females, 39 males were necropsied and from a subsample of these a biochemical and haematological profile was obtained. The birds were emaciated and cachexic having a 50% reduction in body mass. Twenty-nine eiders were diagnosed with hydropericardium, 15 had hunger edema, three birds had enteritis and a single air sac infection. All birds were infested with intestinal Polymorphus minutus and 32 of these with the intestinal Trematoda spp. Microscopic parasitic investigations identified endoparasitic trematodes of the families Bucephhalidae, Echinostomidae, Notocotyluridae and Levinsiniella. White blood cell count showed slight heterophilia and lymphopenia while the albumin:globulin ratio (0.28) indicated stress, immune supression and inflammatory reactions supported by a high heterophil:lymphocyte index (13). Declined plasma concentration of glucose, fructosamine, amylase, albumin and protein likewise indicated long-term starvation prior to mortality indicating phase III starvation (catabolism of protein). The dramatic increase in aspartate transaminase, glutamate-dehydrogenase, lactate-dehydrogenase and bile acids indicate liver disorders while dehydration, renal, heart and bone disorders was reflected in the increased uric acid, urea, phosphor and potassium values. These findings show that male eiders undergo long-term starvation and multi organ failure similar to that of incubating females previously reported from the same colony. It increases our knowledge of the physiology of starving eiders and add to our understanding of the recurrent mortality events in the colony that seems to be linked to changes in food availability being an important factor together with a warmer climate in a declining Baltic eider population. We recommend future studies to focus on food composition, migration patterns and environmental changes including parasitic infections and global warming.

A cluster analysis of the relationship between sucking habits, consistency of food ingested, and taste sensitivity in children.

As sucking habits and eating behavior may be interrelated and also associated with taste, body composition, and sociodemographic factors, the objective was to perform an exploratory analysis to identify groups of children with a high degree of association between intragroup subjects, providing explanation and interpretation of the data. The study initially included 352 prepubertal children (197 girls; 7- to 11-year-old), from whom information about sociodemographic characteristics, duration of breastfeeding, past bottle-feeding and non-nutritive sucking habits, taste sensitivity, body mass index (BMI), and consistency of food ingested were collected. Salivary concentrations of amylase and total protein were also determined. Data were submitted to cluster analysis (hierarchical analysis, K-means, and silhouette plot), one-way ANOVA and correlation tests. Cluster analysis included 159 children, generating three reliable and meaningful clusters: Cluster 1 (labeled "good tasters"), was characterized by older children and higher taste sensitivity; Cluster 2 ("softer food consistency") by longer bottle-feeding duration and children who eat food with lower consistency, and Cluster 3 ("breastfed") by longer breastfeeding duration (silhouette coefficient = 0.61). Cluster 3 also showed the higher percentage of normal-weight children, normal delivery, maternal schooling, and lower rate of past non-nutritional sucking habit. No correlation was found between salivary amylase and total protein concentrations, taste sensitivity and BMI, although taste sensitivity showed to be higher among girls (p = 0.002; power = 88%). The study identified three clusters, highlighting the relationship between nutritional sucking habits, consistency of food ingested, and sociodemographic characteristics. Most importantly, a close relation between bottle-feeding and consumption of soft food consistency was observed.

Feasibility of robotic radical gastrectomy using a monopolar device for gastric cancer.

Laparoscopic gastrectomy using ultrasonic devices occasionally causes postoperative pancreatic fistula. Robotic gastrectomy using monopolar scissors may reduce intraoperative injury to the pancreas. We evaluated the safety and feasibility of robotic gastrectomy. A multicenter prospective study was conducted to evaluate the surgical outcomes of robotic gastrectomy. The primary endpoints were the incidence of intraoperative and postoperative complications and operative mortality. A total of 115 patients were enrolled. The clinical T stages were T1 in 68 patients and T2 or higher in 47 patients. The types of surgery included distal gastrectomy (n = 72), total gastrectomy (n = 39), and proximal gastrectomy (n = 4). Two patients developed intraoperative complications (1.7%), but no cases required conversion to open surgery. The amylase concentration in drainage fluid was higher in cases with pancreatic compression, especially in those with compression for longer than 20min. Postoperative complications of Clavien-Dindo grade ≥ II occurred in 11 patients (9.6%). There was no mortality. A multivariate analysis indicated that a high body mass index and pancreatic compression by an assistant for longer than 20min were independent risk factors for postoperative complications (P = 0.029 and P = 0.010). Robotic gastrectomy using monopolar scissors is safe and feasible. Robotic dissection without compression of the pancreas may reduce postoperative complications.

Intraoperative Body Fluid Amylase as a Novel Indicator of Postgastrectomy Pancreatic Fistula.

Although many methods to prevent the development of postoperative pancreatic fistula (POPF) after gastrectomy have been reported, POPF can only be identified after it has occurred. Various therapeutic measures could be taken if signs of POPF could be detected intraoperatively. We conducted a prospective study in which we attempted to predict POPF by measuring the intraoperative amylase concentration in the peripancreatic body fluid. To collect the body fluid, three sponges were placed around the pancreas at lymph node station Nos. 6, 8, and 11 during lymphadenectomy. The amylase concentration was measured in the body fluid squeezed from the sponges. We investigated whether the intraoperative body fluid amylase concentration (IBAC) was associated with POPF formation. In total, 109 patients were enrolled from February 2016 to March 2018, and we analyzed 81 eligible patients. Clavien-Dindo grade ≥ II POPF occurred in eight patients (9%). The IBAC was significantly higher in sponges No. 6 (P = 0.044) and No. 8 (P = 0.007). The incidence of POPF was predicted by using an IBAC cutoff value for No. 6 (1047IU/L; sensitivity 87.5%; specificity 65.0%; positive likelihood ratio 2.5) and No. 8 (400IU/L; sensitivity 87.5%; specificity 68.5%; positive likelihood value 2.8), respectively. The IBAC in sponge No. 11 tended to be higher (P = 0.054). By measuring the IBAC, surgeons might predict POPF easily and noninvasively during surgery. This method is one of the most effective ways to predict POPF intraoperatively.

Evaluation of preoperative risk factors and postoperative indicators for anastomotic leak of minimally invasive McKeown esophagectomy: a single-center retrospective analysis

BackgroundMinimally invasive McKeown esophagectomy is an important surgical approach for esophageal cancer. Anastomotic leak is one of its common and serious complications. We assumed that the preoperative risk factors and postoperative indicators would predict or detect anastomotic leak.MethodsBetween December 2016 and July 2017, patients underwent minimally invasive McKeown esophagectomy were identified and their preoperative variables and postoperative test indicators were recorded. Fisher’s exact test, 2-tailed unpaired t test, nonparametric test and logistic regression were used to compare these datum between patients with or without anastomotic leak (AL). Receiver Operator Characteristic (ROC) curve was used to identify the best cut-off value of drainage amylase concentration for distinguishing anastomotic leak.ResultsIn all the 96 patients included, 12 patients were diagnosed as anastomotic leak by the esophagram. No differences in preoperative variables were observed between patients with and without AL. Patients in AL group appeared to have a lower prealbumin concentration in AL group on POD (postoperative day) 4(P = 0.05), POD 5(P = 0.04), POD 6 (P = 0.06). Prealbumin concentration cutoff value of 128 g/L on postoperative day 5 is 100.00% sensitive and 50.00% specific for predicting esophageal leaks. Drain amylases levels were higher in patients with anastomotic leak than those without anastomotic leak on POD 3(P = 0.03), POD 4(P = 0.01), POD 5(P < 0.001), POD 6(P < 0.001). The drain amylase cutoff value of 85 IU/L on postoperative day 4 was 75.00% sensitive and 84.00% specific for detecting esophageal leaks; the cutoff value of 65 IU/L on postoperative day 5 was 91.67% sensitive and 80.77% specific. The cutoff of 55/L on POD 6 is 100% sensitive and 86.96% specific.ConclusionDrainage amylase concentration on postoperative days may help to discover anastomotic leak in early stage after minimally invasive McKeown esophagectomy. Prealbumin concentration below 128 g/L on POD 5 might be potential risk factor for anastomotic leak.

B and NK Cells Closely Correlate with the Condition of Patients with Acute Pancreatitis.

Purpose Pancreatitis can lead to systemic inflammatory response, but the relationship between lymphocyte changes and patients with pancreatitis remains unclear. In this study, we evaluated the feedback function of changes in peripheral lymphocyte subsets on the condition of patients with pancreatitis. Materials and Methods 131 acute pancreatitis (AP) patients and 11 chronic pancreatitis (CP) patients constituted the patients' group; 20 healthy individuals were enrolled as healthy controls (HC). Serum concentration of C-reactive protein (CRP), amylase, and lipase and the frequency and absolute number of many types of peripheral lymphocytes (including T, B, NK, CD16+/CD56+ T, CD4+ T, CD8+ T, CD4+CD8+ T, and CD4−CD8− T cells) were detected on admission and the seventh day of standard treatment. Besides, the length of hospital stay was recorded. Results The absolute number of all lymphocytes we studied decreased in patients with CP and in patients with almost all types of AP. The frequency change of lymphocytes varies among the different types of AP. During disease onset, B cell frequency correlated positively with CRP concentration and NK cell frequency correlated positively with amylase and lipase concentration. B cell frequency and CD4+ T cell absolute number were recovering towards normal after short-term treatment. The frequency of B cells and NK cells correlated positively with the length of hospital stay. Conclusions B cells and NK cells closely correlate with patients' condition and may help to diagnose AP more accurately and reflect treatment effect of AP in time, affecting the recovery speed of patients with M-AP, which may help physicians to better understand the pathophysiology of pancreatitis.

Significance of drain fluid amylase check on day 3 after pancreatectomy

The occurrence of pancreatic fistulae (PF) after pancreatectomy is the main cause of prolonged hospital stay, delayed chemotherapy, poor quality of life and post-operative death. The surgical drainage after pancreatectomy can induce ascending infection, early removal is recommended if the possibility of PF is low. The present study analysed the risk factors and predictors of PF, and confirmed the significance of drain fluid amylase concentration (DFA, U/L) among various factors identified. On the basis of these results, we tried to evaluate the practical clinical applicability of DFA and obtain appropriate baseline values. From January 2014 to December 2017, 117 patients underwent major pancreatectomy with pylorus-preserving pancreatoduodenectomy, Whipple procedure, subtotal pancreatectomy or distal pancreatectomy. This study retrospectively collected and analysed demographics, pathological results and prognoses of these patients. Multivariate analysis indicated that the DFA obtained on day 3 after surgery (DFA 3) was the only predictor of PF with statistical significance (P < 0.001). Of all the factors tested, area under the curve was highest for DFA 3 (0.89). In addition, of all the factors tested, DFA 3 with a cut-off value of 1004 U/L had the best sensitivity (92%) and specificity (82%). DFA 3 of a cut-off value of 1004 U/L might be determined to be the best predictor of PF, and early removal of the surgical drain could be considered if DFA (1004 U/L) is lower than the cut-off value at 3 days after surgery.

Bacterial smear test of drainage fluid after pancreaticoduodenectomy can predict postoperative pancreatic fistula

ObjectivesIt is widely accepted that postoperative pancreatic fistula (POPF) accompanied by bacterial infection results in a worse outcome than POPF alone. However, few studies evaluating predictive indicators of POPF have focused on bacterial infection. MethodsA consecutive 100 patients who underwent pancreaticoduodenectomy at our institute for periampullary disease were enrolled. POPF was assessed according to the International Study Group of Pancreatic Fistula consensus guidelines; grades B and C were defined as clinically relevant POPF (CR-POPF). The patients’ characteristics, perioperative surgical factors, and laboratory data including the results of culture and smear testing performed using drainage fluid on postoperative days (PODs) 1 and 3 were analyzed. ResultsThe overall incidence of CR-POPF was 25%. Univariate analyses revealed that the factors associated with CR-POPF were male sex, soft pancreas, MPD diameter, higher serum C-reactive protein concentration and white blood cell count on POD 3, higher amylase concentration in drainage fluid, and culture and/or smear positivity of drainage fluid. Multivariate analysis newly revealed that the smear positivity of drainage fluid on POD 3 was the independent risk factors for CR-POPF (p = 0.027). ConclusionsSmear positivity of drainage fluid on POD 3 after pancreaticoduodenectomy may be a new predictor of CR-POPF.

Study on the expression of MMP-9 in SAP-induced lung injury in rats exposed to high altitude hypoxia

Objective To investigate whether the expression of metal matrix protease-9 (MMP-9) changes with altitude in severe acute pancreatitis (SAP) lung injury by establishing SAP model in rats. The related indexes of pancreas and lung injury and MMP-9 were measured. Methods 280 SPF male Wistar rats were randomly assigned to different altitude groups to establish SAP model , then the serum amylase (AMY) content of each group were detected. The degree of pancreatic injury and pancreatic pathological score were observed under light microscope. The expression level of MMP-9 in lung tissues was measured and analyzed by statistical methods. Results ⑴ At the same altitude, the expression of MMP-9 in each time group increased with time, with statistically significant difference (P<0.05). ⑵ AMY value, pathological score of pancreas and expression of MMP-9 in lung tissue increased with the altitude in the same time group at different altitudes, with statistically significant difference (P<0.05). Conclusions The higher the altitude, the more severe the damage of SAP and lung, and the higher the expression level of MMP-9. Key words: Altitude; Pancreatitis, acute necrotizing; Lung injury, acute; Matrix metalloproteinase 9; Rats

PHYSIOLOGICAL AND IMMUNOLOGICAL RESPONSES OF JAPANESE QUAILS TO OLEOBIOTIC

This study was conducted to investigate the effect of the administration of oleobiotic to the drinking water of Japanese quails. Three different concentrations ofoleobiotic (0, 30 or 50 ml/1000L) were administrated in the drinking water and provided to the birds for 5 weeks. Throughout the five weeks experimental period, there was no significant effect of oelobiotic on the performance parameters including (feed intake, body weight, weight gain and FCR) of Japanese quail. The liver was heavier and there was a tendency of spleen to be heavier by rising levels of oleobiotic. Among the measured biochemical parameters of serum, the concentration of albumin increased in the birds that received the medium level of oleobiotic. The concentration of thyroid stimulating hormone in the serum decreased by rising level of oleobiotic in the drinking water of Japanese quails. Furthermore, the concentration of amylase in the serum decreased at the highest administration level of oleobiotic to the drinking water. As an essential oil, offering of oleobioticwas not promising regarding to the performance and physiology of Japanese quails when birds were raised in a relatively hygienic environment.Further researches are required to examine the efficacy of oleobiotic for poultry. Oleobiotic may expresses its beneficial effects during the bird exposure to highly pathogenic conditions.

Enzyme hydrolysis of cassava peels: treatment by amylolytic and cellulolytic enzymes

Cassava peels provide a cheap non-food biomass waste that can be hydrolyzed to simple sugars as a useful feedstock. Unlike most crop wastes, they have high starch content as well as lignocellulose. In this study, an enzymatic treatment of cassava peels by various concentrations of amylase and glucoamylase is considered. Steam explosion pre-treatments reduced rate and yield of hydrolysis. Milled peels suspended at 10% w/v yielded a maximum reducing sugar of 0.41 g (as glucose) per gram of peels. HPLC analysis showed that levels of soluble oligosaccharides remained low throughout. A pretreatment with amylase at 95 °C slightly increased rates although final yield was the same. Additional treatment with cellulolytic enzymes increases the total hydrolysis yield to 0.61 g (as glucose) per gram of peels representing 91% of the carbohydrate in cassava peels.

Mediastinal pancreatic cysts: review and own clinical observations

To present the results of surgical treatment of patients with mediastinalpancreatogeniccysts (MPC). There were 5 patients with MPC. Laboratory tests revealed increased blood amylase level by 1.5-2 times in 3 cases, urine diastase by 4-5 times - in 2 cases. Pleural effusion with amylase concentration in the fluid from 5680 to 48 640 units was diagnosed in 4 cases. CT data of preudocysts of pancreatic body and tail were obtained in 3 cases, head and body - in 2 patients. These cysts extended to posterior mediastinum through the hiatal orifice for about 3.5-40 cm. Three patients underwent VATS removal of pleural fragments, one - thoracotomy, lung decortication and MPC drainage through pleural cavity. Three patients underwent pancreatic drainage procedures (cystogastrostomy, pancreaticojejunostomy and external drainage of the cyst). A small pseudocyst has been successfully treated by conservative treatment with octreotide. MPC is a rare complication of pancreatitis and often associated with pleural effusion. CT and fluid amylase analysis are the main diagnostic measures. Surgical treatment includes VATS, destruction of pleural fragments and pleural drainage, cystogastrostomy, pancreaticojejunostomy or external drainage of pancreatic pseudocyst.

Interactive Effect of Melatonin and Sodium Nitroprusside on Seed Germination and Seedling Growth of Catharanthus roseus under Cadmium Stress

In this study, impact of seed presoaking with melatonin and sodium nitroprusside (SNP) (as a NO donor) was evaluated on seed germination and seedling growth of Catharanthus roseus (L.) G. Don under both normal and Cd stress conditions. Results showed that 200 µM Cd reduced the relative seed germination, root elongation tolerance and seed germination tolerance index. The melatonin and SNP improved the seed germination, germination rate, seedling length, and vigor index under Cd stress in a dose-dependent manner and the maximum biological responses obtained by 100 μM melatonin and 200 μM SNP. However, 200–400 μM melatonin and 400 μM SNP negatively influenced the seed germination indices and seedling establishment. The cadmium suppressed the amylase activity and contents of soluble and reducing sugars in germinating seeds; thereby it reduced seed germination. Cd stress also decreased subsequent growth of seedlings and increased electrolyte leakage in them. These Cd-induced inhibitory effects were ameliorated by applying both melatonin and SNP. Importantly, melatonin as well as SNP was able to markedly boost the NO content in seeds. The addition of the specific scavenger of NO (cPTIO) reversed the protective effects conferred by melatonin, but inhibition of melatonin biosynthesis by p-CPA could not alleviate effects elicited by SNP completely, suggesting that NO plays role a downstream signal in melatonin-mediated germination responses especially under cadmium stress.

A comparative analysis of urine trypsinogen-2 test strip with serum lipase in diagnosis of acute pancreatitis in emergency set-up

Background: Acute pancreatitis possess difficulty in diagnosis in its emergency presentation. Hence to segregate this disease is important from other specific or non-specific causes of acute abdomen. Hence in suspected cases in majority of patients the urinary trypsinogen-2 test strip (Actim pancreatitis) can be used to detect this disease, especially in emergency set-up. The result of the strip test is then corroborated with findings of serum lipase in the blood.Methods: Author prospectively compared 205 consecutive patients with acute abdominal pain admitted to the casualty, SCB Medical College and Hospital. The patients were tested on admission with the Actim pancreatitis test strip. Serum amylase, serum lipase, and urine trypsinogen-2 concentrations were also determined quantitatively.Results: The Actim pancreatitis test strip was sensitive in 93% cases and specific in 92% cases. This was superior to that of serum lipase (sensitivity 77% and specificity 87%). With a cut-off &gt;3x the upper reference limit, the sensitivity of serum lipase was only 52% while the specificity was 98%. The high sensitivity for the Actim pancreatitis test strip resulted in every high negative predictive value of 99%.Conclusions: In patients with acute abdominal pain seen in emergency department, a negative dipstick for urinary trypsinogen-2 rules out acute pancreatitis with high degree of probability and therefore appears to be more suitable for screening of acute pancreatitis. With its high specificity with a cut-off &gt;3x the upper reference limit, serum lipase is suitable as a confirmatory test for pancreatitis when a positive dipstick result is obtained.

Bladder-Drained Pancreas Transplantation: Urothelial Innate Defenses and Urinary Track Infection Susceptibility

BackgroundPancreas transplantation restores insulin secretion in type 1 diabetes mellitus. The graft also produces exocrine secretions that can be drained enterically (enteric drainage [ED]) or via the bladder (bladder drainage [BD]). We suggest that in BD transplants, such secretions destroy bladder innate immunity, specifically host defense peptides/proteins (HDPs), which increases patient susceptibility to recurrent urinary tract infections (rUTIs). Materials and methodsBD and ED patient records were reviewed retrospectively for UTIs. Urine samples from ED and BD transplant recipients were analyzed for pH, the HDPs β-defensin 2 (HBD2) and lipocalin-2, and amylase concentrations. In vitro, bacterial growth curves and antimicrobial assays were used to evaluate the effects of pH, HBD2, and HBD2 + pancreatic digestive enzymes (pancreatin) on uropathogenic Escherichia coli (UPEC) survival and growth. ResultsUrinalysis revealed a significant difference in pH between the BD and ED cohorts (7.2 ± 0.8 versus 6.7 ± 0.8; P = 0.012). Urinary HDPs were measured and BD, but not ED, lipocalin-2 concentrations were significantly decreased compared with those of diabetics awaiting transplant (P < 0.05). In vitro, an alkaline environment, pH 8.0, concomitant with the urine of the patient who underwent BD transplantation, significantly reduced UPEC growth (P < 0.05); addition of pancreatin to the growth medium was associated with a significant increase (P < 0.001) in growth rate. Antimicrobial data suggested significant UPEC killing in the presence of HBD2 (P < 0.01), but not in the presence of HBD2 + pancreatin (>12,500 amylase units). ConclusionsThese in vivo and in vitro data suggest that BD pancreatic exocrine secretions inactivate the bladder innate defenses, which facilitate UPEC growth and underpins the increased susceptibility of patients who underwent BD pancreas transplantation to rUTIs.

An online mindfulness-based program is effective in improving affect, over-commitment, optimism and mucosal immunity

Previous studies have demonstrated mindfulness-based programs are effective in reducing workplace stress; however, few have investigated the effectiveness of online mindfulness-based programs. Physiological measures are also underutilised when examining the efficacy of these programs. Therefore, we assessed the efficacy of an online mindfulness-based program on both short-term and more enduring aspects of psychological and physiological measures of stress and ill-health. Participants (N = 22) completed an 8-week online mindfulness-based program. Immediately before and after a mindfulness session, participants completed questionnaires to assess the short-term effects on mood and state anxiety and provided saliva samples to assess salivary alpha amylase (sAA) concentrations. Additionally, pre and post the 8-week intervention, participants completed questionnaires assessing workplace stress, over-commitment, work engagement, dispositional mindfulness and personal resources. Saliva samples were collected to measure the cortisol awakening response, sAA awakening response and secretory immunoglobulin A (sIgA). Our findings demonstrate that online mindfulness-based programs induce short-term improvements in fatigue and anxiety in employees. Additionally, we also report a decrease in over-commitment and increases in optimism and mucosal immunity (sIgA) following the program.