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Your search keyword '"Robert, Hawes"' showing total 4 results
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4 results on '"Robert, Hawes"'

1. Effect of endoscopic ultrasound guided celiac plexus block on the palliation of pain in chronic pancreatitis (EPOCH Trial): study protocol for a randomized multicenter sham-controlled trial {1}

Author

C. Mel Wilcox, Ji Young Bang, James Buxbaum, Timothy B. Gardner, Robert Hawes, Prashant Kedia, Samuel H. Mardini, Thiruvengadam Muniraj, Udayakumar Navaneethan, Veeral M. Oza, Paul Tarnasky, Shyam Thakkar, Irving Waxman, Shyam Varadarajulu, and on behalf of the US Pancreatic Disease Study Group

Subjects
Chronic pancreatitis, Celiac plexus block, Abdominal pain, Endoscopic ultrasonography, Medicine (General), R5-920
Abstract

Abstract Background Celiac plexus block has been commonly utilized for the treatment of chronic pancreatitis-associated abdominal pain. Prospective studies suggest efficacy in 30 to 50% of patients, although no randomized sham-controlled trials have been performed. The objective of this study is to assess the effect of endoscopic ultrasound (EUS)-guided celiac plexus block on abdominal pain in patients with documented chronic pancreatitis. Methods This is a two-arm randomized sham-controlled trial with blinded evaluators. The study will be conducted at multiple academic sites in the United States who are members of the United States Pancreatic Disease Study Group (USPG). Patients referred for EUS to exclude chronic pancreatitis as a cause of abdominal pain as well as those with established painful chronic pancreatitis undergoing EUS for another indication will be eligible. At the time of EUS with confirmation of chronic pancreatitis by standard EUS diagnostic criteria, patients will be randomized to either celiac plexus block or sham whereby an anesthetic and steroid combination will be injected into the celiac plexus or saline will be injected into the gastric lumen with the same type of needle as used for celiac plexus block, respectively. The main outcome measure will be a 50% reduction in abdominal pain using the Brief Pain Inventory Short Form (BPI-SF) at 1 month post-intervention. A number of secondary outcomes will be measured including visual analog scale (VAS), Comprehensive Pain Assessment Tool Short Form (COMPAT-SF) pain scores, and quality of life using a pancreas-specific validated measure (PANQOLI). Discussion In this study, the effect of celiac plexus block on abdominal pain in patients with chronic pancreatitis will be compared to a sham intervention. This randomized trial will offer a definitive assessment of the role of celiac plexus block for the treatment of abdominal pain in this setting. Trial registration {2} ClinicalTrials.gov NCT 06178315. Registered on December 21, 2023

Published
2024
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3. Acute pancreatitis precedes chronic pancreatitis in the majority of patients: Results from the NAPS2 consortium

Author

Vikesh K. Singh, David C. Whitcomb, Peter A. Banks, Samer AlKaade, Michelle A. Anderson, Stephen T. Amann, Randall E. Brand, Darwin L. Conwell, Gregory A. Cote, Timothy B. Gardner, Andres Gelrud, Nalini Guda, Christopher E. Forsmark, Michele Lewis, Stuart Sherman, Thiruvengadam Muniraj, Joseph Romagnuolo, Xiaoqing Tan, Gong Tang, Bimaljit S. Sandhu, Adam Slivka, C. Mel Wilcox, Dhiraj Yadav, Peter Banks, Darwin Conwell, Simon K. Lo, Timothy Gardner, John Baillie, Robert Hawes, Christopher Lawrence, Babak Etemad, Mark DeMeo, Michael Kochman, Judah N. Abberbock, M. Michael Barmada, Emil Bauer, Elizabeth Kennard, Jessica LaRusch, Michael O'Connell, Kimberly Stello, Jyothsna Talluri, Stephen R. Wisniewski, Frank Burton, James DiSario, Mary Money, and William Steinberg

Subjects
Hepatology, Endocrinology, Diabetes and Metabolism, Pancreatitis, Chronic, Acute Disease, Gastroenterology, Humans, Pancreatic Diseases, Article, Abdominal Pain
Abstract

INTRODUCTION: The mechanistic definition of chronic pancreatitis (CP) identifies acute pancreatitis (AP) as a precursor stage. We hypothesized that clinical AP frequently precedes the diagnosis of CP and is associated with patient- and disease-related factors. We describe the prevalence, temporal relationship and associations of AP in a well-defined North American cohort. METHODS: We evaluated data from 883 patients with CP prospectively enrolled in the North American Pancreatitis Studies across 27 US centers between 2000 and 2014. We determined how often patients had one or more episodes of AP and its occurrence in relationship to the diagnosis of CP. We used multivariable logistic regression to determine associations for prior AP. RESULTS: There were 624/883 (70.7%) patients with prior AP, among whom 161 (25.8%) had AP within 2 years, 115 (18.4%) within 3–5 years, and 348 (55.8%) >5 years prior to CP diagnosis. Among 504 AP patients with available information, 436 (86.5%) had >1 episode. On multivariable analyses, factors associated with increased odds of having prior AP were a younger age at CP diagnosis, white race, abdominal pain, pseudocyst(s) and pancreatic duct dilatation/stricture, while factors associated with a lower odds of having prior AP were exocrine insufficiency and pancreatic atrophy. When compared with patients with 1 episode, those with >1 AP episode were diagnosed with CP an average of 5 years earlier. CONCLUSIONS: Nearly three-quarters of patients were diagnosed with AP prior to CP diagnosis. Identifying which AP patients are at-risk for future progression to CP may provide opportunities for primary and secondary prevention.

Published
2022

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