15 results on '"Lohr, J.-Matthias"'
Search Results
2. Autoimmune Pancreatitis Type 1 with Biliary, Nasal, Testicular, and Pulmonary Involvement: A Case Report and a Systematic Review
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Kourie, Mourad, Bogdanovic, Darko, Mahmutyazicioglu, Kamran, Ghazi, Sam, Panic, Nikola, Fjellgren, Eva, Hellkvist, Laila, Thiel, Tomas, Kjellman, Anders, Kartalis, Nikolaos, Danielsson, Olof, Dani, Lara, Lohr, J. -Matthias, Vujasinovic, Miroslav, Kourie, Mourad, Bogdanovic, Darko, Mahmutyazicioglu, Kamran, Ghazi, Sam, Panic, Nikola, Fjellgren, Eva, Hellkvist, Laila, Thiel, Tomas, Kjellman, Anders, Kartalis, Nikolaos, Danielsson, Olof, Dani, Lara, Lohr, J. -Matthias, and Vujasinovic, Miroslav
- Abstract
Introduction: Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated condition associated with fibroinflammatory lesions that can occur at almost any anatomical site. It often presents as a multiorgan disease that may mimic malignancy, infection, or other immune-mediated conditions. Autoimmune pancreatitis (AIP) type 1 is the most prominent manifestation of IgG4-RD in the digestive tract, with common extra-pancreatic inflammation. We present the first patient with AIP and involvement of the testicles and nasal cavity. Patient and methods: A case of a patient with AIP type 1 and other organ involvement (bile ducts, testicles, nasal polyps, and lungs) is described. Additionally, a systematic review of AIP type 1 with testicular and nasal involvement was conducted. Results: The systematic review found two cases of AIP type 1 with testicular involvement and 143 cases with AIP type 1 with nasal cavity involvement. None of them had both testicular and nasal involvement. Conclusions: This is the first case of AIP type 1 with other organ involvement, including testicular and nasal involvement, to be described. The number of patients with nasal and testicular involvement described in the literature is low. Creating awareness of this rare clinical condition is necessary, especially due to the very effective available treatment with corticosteroids and rituximab., Funding Agencies|We thank the Swedish Society for Development of Pancreatology (SveSuP) for their continuing support, promotion, and raising awareness of pancreatic diseases in Swedish society.
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- 2023
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3. Cellular heterogeneity in pancreatic cancer : the different faces of gremlin action
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Moustakas, Aristidis, Lohr, J. Matthias, Heuchel, Rainer L., Moustakas, Aristidis, Lohr, J. Matthias, and Heuchel, Rainer L.
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- 2022
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4. Paraduodenal pancreatitis - problem in the groove
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Vujasinovic, Miroslav, Mucelli, Raffaella Pozzi, Grigoriadis, Aristeidis, Palmer, Isabella, Asplund, Ebba, Rutkowski, Wiktor, Baldaque-Silva, Francisco, Waldthaler, Alexander, Ghorbani, Poya, Verbeke, Caroline S., Lohr, J. Matthias, Vujasinovic, Miroslav, Mucelli, Raffaella Pozzi, Grigoriadis, Aristeidis, Palmer, Isabella, Asplund, Ebba, Rutkowski, Wiktor, Baldaque-Silva, Francisco, Waldthaler, Alexander, Ghorbani, Poya, Verbeke, Caroline S., and Lohr, J. Matthias
- Abstract
Background Paraduodenal pancreatitis (PDP) is a particular form of chronic pancreatitis (CP) occurring in and around the duodenal wall. Despite its low prevalence, this rare condition presents a significant challenge in clinical practice. Methods We retrospectively analysed the electronic medical charts of all patients with a diagnosis of chronic pancreatitis and identified those with PDP, between January 1999 and December 2020. Results There were 35 patients diagnosed with PDP (86% males and 14% females); median age of 56 +/- 11 (range 38-80). Alcohol overconsumption was reported in 81% and smoking in 90% of patients. Abdominal pain was the leading symptom (71%), followed by weight loss, nausea and vomiting, jaundice, and diarrhoea. In 23 patients (66%), recurrent acute pancreatitis attacks were noted. Focal duodenal wall thickening was present in 34 patients (97%), cystic lesions in 80%, pancreatic duct dilatation in 54% and common bile duct dilatation in 46%. Endoscopic treatment was performed on nine patients (26%) and five patients (14%) underwent surgery. Complete symptom relief was reported in 12 patients (34%), partial symptom relief in three (9%), there was no improvement in five (14%), data were not available in three (9%) and 12 (34%) patients died before data analysis. Conclusions PDP is a rare form of pancreatitis, most commonly occurring in the 5th or 6th decade of life, with a predominance in males and patients with a history of smoking and high alcohol consumption. Focal thickening and cystic lesions of the duodenal wall are the most common imaging findings, followed by pancreatic duct and common bile duct dilatation. A minority of patients requires surgery.
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- 2022
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5. Stabilization of the classical phenotype upon integration of pancreatic cancer cells into the duodenal epithelium
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Bozoky, Benedek, Moro, Carlos Fernandez, Strell, Carina, Geyer, Natalie, Heuchel, Rainer L., Lohr, J. Matthias, Ernberg, Ingemar, Szekely, Laszlo, Gerling, Marco, Bozoky, Bela, Bozoky, Benedek, Moro, Carlos Fernandez, Strell, Carina, Geyer, Natalie, Heuchel, Rainer L., Lohr, J. Matthias, Ernberg, Ingemar, Szekely, Laszlo, Gerling, Marco, and Bozoky, Bela
- Abstract
Introduction: Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive solid tumors. Based on transcriptomic classifiers, basal-like and classical PDAC subtypes have been defined that differ in prognosis. Cells of both subtypes can coexist in individual tumors; however, the contribution of either clonal heterogeneity or microenvironmental cues to subtype heterogeneity is unclear. Here, we report the spatial tumor phenotype dynamics in a cohort of patients in whom PDAC infiltrated the duodenal wall, and identify the duodenal epithelium as a distinct PDAC microniche. Materials and methods: We used serial multiplex quantitative immunohistochemistry (smq-IHC) for 24 proteins to phenotypically chart PDAC tumor cells in patients whose tumors infiltrated the duodenal epithelium. Additionally, we used a genetically engineered mouse model to study the PDAC cell phenotype in the small intestinal epithelium in a controlled genetic background. Result: We show that pancreatic cancer cells revert to non-destructive growth upon integration into the duodenal epithelium, where they adopt traits of intestinal cell differentiation, associated with phenotypical stabilization of the classical subtype. The integrated tumor cells replace epithelial cells in an adenoma-like manner, as opposed to invasive growth in the submucosa. Finally, we show that this phenomenon is shared between species, by confirming duodenal integration and phenotypic switching in a genetic PDAC mouse model. Discussion: Our results identify the duodenal epithelium as a distinct PDAC microniche and tightly link microenvironmental cue to cancer transcriptional subtypes. The phenomenon of "intestinal mimicry" provides a unique opportunity for the systematic investigation of microenvironmental influences on pancreatic cancer plasticity.
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- 2021
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6. Comparison of two arylsulfatases for targeted mass spectrometric analysis of microbiota-derived metabolites
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Jain, Abhishek, Correia, Mario S. P., Meistermann, Hannes, Vujasinovic, Miroslav, Lohr, J-Matthias, Globisch, Daniel, Jain, Abhishek, Correia, Mario S. P., Meistermann, Hannes, Vujasinovic, Miroslav, Lohr, J-Matthias, and Globisch, Daniel
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Sulfation of metabolites is the second highest phase II modification in humans, which plays a critical role in the xenobiotics clearance process and gut microbiota-host co-metabolism. Besides the main function to remove xenobiotics from the body, sulfated metabolites have also been linked to inflammation, bacterial pathogenesis and metabolic disorders. A better understanding of how these metabolites impact the human body has turned into an important research area. Analytical methods for selective identification of this metabolite class are scarce. We have recently developed an assay utilizing the arylsulfatase from Helix pomatia due to a high substrate promiscuity combined with state-of-the-art metabolomics bioinformatic analysis for the selective identification of O-sulfated metabolites in human samples. This enzyme requires a multistep purification process as highest purity is needed for the developed mass spectrometric assay. In this study, we have utilized a new and recombinant overexpressed arylsulfatase (ASPC) for the selective identification of organic sulfate esters in human urine samples. We have compared the substrate conversion in urine samples and substrate specificity of this enzyme with purified arylsulfatase from Helix pomatia. Our analysis of urine samples revealed that both enzymes can be utilized for the selective analysis and discovery of sulfated metabolites with high promiscuity as demonstrated by equal hydrolysis of 108 substrates including sulfated conjugates of 27 metabolites of microbial origin. Importantly, we also identified 21 substrates in human urine samples that are exclusively hydrolyzed by ASPC and application of this enzyme increases the discovery of unknown sulfated metabolites with a higher scaffold diversity.
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- 2021
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7. Sensitive mass spectrometric analysis of carbonyl metabolites in human urine and fecal samples using chemoselective modification
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Lin, Weifeng, Conway, Louis P., Block, Annika, Sommi, Greta, Vujasinovic, Miroslav, Lohr, J-Matthias, and Globisch, Daniel
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Biochemistry and Molecular Biology ,Biokemi och molekylärbiologi - Abstract
Metabolites with ketone or aldehyde functionalities comprise a large proportion of the human metabolome, most notably in the form of sugars. However, these reactive molecules are also generated through oxidative stress or gut microbiota metabolism and have been linked to disease development. The discovery and structural validation of this class of metabolites over the large concentration range found in human samples is crucial to identify their links to pathogenesis. Herein, we have utilized an advanced chemoselective probe methodology alongside bioinformatic analysis to identify carbonyl-metabolites in urine and fecal samples. In total, 99 metabolites were identified in urine samples and the chemical structure for 40 metabolites were unambiguously validated using a co-injection procedure. We also describe the preparation of a metabolite-conjugate library of 94 compounds utilized to efficiently validate these ketones and aldehydes. This method was used to validate 33 metabolites in a pooled fecal sample extract to demonstrate the potential for rapid and efficient metabolite detection over a wide metabolite concentration range. This analysis revealed the presence of six metabolites that have not previously been detected in either sample type. The constructed library can be utilized for straightforward, large-scale, and expeditious analysis of carbonyls in any sample type.
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- 2020
8. Detection of cytomegalovirus nucleic acid sequences in pancreas in type 2 diabetes
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Lohr, J. Matthias and Oldstone, Michael B.A.
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Cytomegaloviruses -- Health aspects ,Virus diseases -- Health aspects ,Type 2 diabetes -- Causes of ,Pancreas -- Physiological aspects ,Diabetes -- Causes of - Published
- 1990
9. A tug-of-war in IPMN management: a comparison between 2017 International and 2018 European guidelines
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Fogliati, Alessandro, primary, Crippa, Stefano, additional, Valente, Roberto, additional, Arnelo, Urban, additional, Halimi, Asif, additional, Ateeb, Zeeshan, additional, Longo, Enrico, additional, Aleotti, Francesca, additional, Arcidiacono, Paolo Giorgio, additional, Lohr, J.-Matthias, additional, Falconi, Massimo, additional, and Del Chiaro, Marco, additional
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- 2019
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10. Chemoselective Probe Containing a Unique Bioorthogonal Cleavage Site for Investigation of Gut Microbiota Metabolism
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Garg, Neeraj, Conway, Louis P., Ballet, Caroline, Correia, Mario S. P., Olsson, Frida K. S., Vujasinovic, Miroslav, Lohr, J. -Matthias, Globisch, Daniel, Garg, Neeraj, Conway, Louis P., Ballet, Caroline, Correia, Mario S. P., Olsson, Frida K. S., Vujasinovic, Miroslav, Lohr, J. -Matthias, and Globisch, Daniel
- Abstract
While metabolites derived from gut microbiota metabolism have been linked to disease development in the human host, the chemical tools required for their detailed analysis and the discovery of biomarkers are limited. A unique and multifunctional chemical probe for mass spectrometric analysis, which contains p-nitrocinnamyloxycarbonyl as a new bioorthogonal cleavage site has been designed and synthesized. Coupled to magnetic beads, this chemical probe allows for straightforward extraction of metabolites from human samples and release under mild conditions. This isolation from the sample matrix results in significantly reduced ion suppression, an increased mass spectrometric sensitivity, and facilitates the detection of metabolites in femtomole quantities. The chemoselective probe was applied to the analysis of human fecal samples, resulting in the discovery of four metabolites previously unreported in this sample type and confirmation of the presence of medically relevant gut microbiota-derived metabolites.
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- 2018
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11. New enzymatic and mass spectrometric methodology for the selective investigation of gut microbiota-derived metabolites
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Ballet, Caroline, Correia, Mario S. P., Conway, Louis P., Locher, Theresa L., Lehmann, Laura C., Garg, Neeraj, Vujasinovic, Miroslav, Deindl, Sebastian, Lohr, J. -Matthias, Globisch, Daniel, Ballet, Caroline, Correia, Mario S. P., Conway, Louis P., Locher, Theresa L., Lehmann, Laura C., Garg, Neeraj, Vujasinovic, Miroslav, Deindl, Sebastian, Lohr, J. -Matthias, and Globisch, Daniel
- Abstract
Gut microbiota significantly impact human physiology through metabolic interaction. Selective investigation of the co-metabolism of bacteria and their human host is a challenging task and methods for their analysis are limited. One class of metabolites associated with this co-metabolism are O-sulfated compounds. Herein, we describe the development of a new enzymatic assay for the selective mass spectrometric investigation of this phase II modification class. Analysis of human urine and fecal samples resulted in the detection of 206 sulfated metabolites, which is three times more than reported in the Human Metabolome Database. We confirmed the chemical structure of 36 sulfated metabolites including unknown and commonly reported microbiota-derived sulfated metabolites using synthesized internal standards and mass spectrometric fragmentation experiments. Our findings demonstrate that enzymatic sample pre-treatment combined with state-of-the-art metabolomics analysis represents a new and efficient strategy for the discovery of unknown microbiota-derived metabolites in human samples. Our described approach can be adapted for the targeted investigation of other metabolite classes as well as the discovery of biomarkers for diseases affected by microbiota.
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- 2018
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12. Endoscopic papillectomy and KRAS expression in the treatment of adenoma in the major duodenal papilla
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Haraldsson, Erik, Swahn, Fredrik, Verbeke, Caroline, Mattsson, Johanna S. M., Enochsson, Lars, Ung, Kjell-Arne, Lundell, Lars, Heuchel, Rainer, Lohr, J. -Matthias, Arnelo, Urban, Haraldsson, Erik, Swahn, Fredrik, Verbeke, Caroline, Mattsson, Johanna S. M., Enochsson, Lars, Ung, Kjell-Arne, Lundell, Lars, Heuchel, Rainer, Lohr, J. -Matthias, and Arnelo, Urban
- Abstract
Objective. The use of endoscopic papillectomy for resecting adenomas in the major duodenal papilla is increasing. This study focuses on the following three issues: Can endoscopic papillectomy be performed as a safe diagnostic and/or therapeutic procedure in biopsy-verified or suspected ampullary adenoma? Does expression of mutated KRAS in resected adenomatous tissue predict long-term outcome? What other factors may affect long-term outcome and should, therefore, be considered in decision making prior to endoscopic papillectomy? Material and methods. Thirty-six prospectively collected patients who underwent endoscopic papillectomy at Karolinska University Hospital between 2005 and 2014 were analyzed. Results. The rate of exact agreement between the histomorphological grading of the endoscopic biopsies and the papillectomy specimens was low (48%). Obstructive jaundice at presentation increased the risk of undetected adenocarcinoma (RR = 3.98; 95% CI = 1.46-10.85, p = 0.007). Lesions with malignancies were significantly larger (mean 30.6 mm) than those where only adenomas were found (mean 14.4 mm, p = 0.001). Mutated KRAS was detected in 9 of the 36 post-papillectomy specimens, including 4 of the 5 cases of ampullary adenocarcinoma. Eighteen cases were endoscopically cured after a mean follow-up period of 47 months (range 16-92 months). Conclusions. Endoscopic papillectomy is a valuable staging tool because of the limitations of endoscopic biopsy. Endoscopic papillectomy concomitantly offers a curative treatment for most patients with adenoma in the major duodenal papilla. Jaundice at presentation and large adenomas may indicate the presence of more advanced disease. Determination of mutated KRAS seems to be of limited value in predicting long-term outcome.
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- 2015
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13. Current Concepts in the Diagnosis and Treatment of Type 1 and Type 2 Autoimmune Pancreatitis
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Detlefsen, Sonke, primary, Lohr, J.-Matthias, additional, M. Drewes, Asbjorn, additional, B. Frokjaer, Jens, additional, and Kloppel, Gunter, additional
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- 2011
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14. European Guideline on IgG4-related digestive disease - UEG and SGF evidence-based recommendations
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Lohr, J. -M., Beuers, U., Vujasinovic, M., Alvaro, D., Frokjaer, J. B., Buttgereit, F., Capurso, G., Culver, E. L., De-Madaria, E., Della-Torre, E., Detlefsen, S., Dominguez-Mu~noz, E., Czubkowski, P., Ewald, N., Frulloni, L., Gubergrits, N., Duman, D. G., Hackert, T., Iglesias-Garcia, J., Kartalis, N., Laghi, A., Lammert, F., Lindgren, F., Okhlobystin, A., Oracz, G., Parniczky, A., Mucelli, R. M. P., Rebours, V., Rosendahl, J., Schleinitz, N., Schneider, A., van Bommel, E. F. H., Verbeke, C. S., Vullierme, M. P., Witt, H., Besselink, M. G., Bruno, M. J., Czako, L., Chiaro, M., Filippova, O., Fukuda, A., Gaujoux, S., Hart, P. A., Hegyi, P., Jonas, E., Kahraman, A., Kleger, A., Kuryata, O., Laukkarinen, J., Lerch, M. M., Marchegiani, G., Marschall, H. -U., Matos, C., Molad, Y., Oguz, D., Pukitis, A., Satoi, S., Stone, J. H., Verheij, J., Vries, N., Lohr, J-Matthias, Beuers, Ulrich, Vujasinovic, Miroslav, Alvaro, Domenico, Frokjaer, Jens Brondum, Buttgereit, Frank, Capurso, Gabriele, Culver, Emma L., De-Madaria, Enrique, Della-Torre, Emanuel, Detlefsen, Sonke, Dominguez-Munoz, Enrique, Czubkowski, Piotr, Ewald, Nils, Frulloni, Luca, Gubergrits, Natalya, Duman, Deniz Guney, Hackert, Thilo, Iglesias-Garcia, Julio, Kartalis, Nikolaos, Laghi, Andrea, Lammert, Frank, Lindgren, Fredrik, Okhlobystin, Alexey, Oracz, Grzegorz, Parniczky, Andrea, Mucelli, Raffaella Maria Pozzi, Rebours, Vinciane, Rosendahl, Jonas, Schleinitz, Nicolas, Schneider, Alexander, van Bommel, Eric F. H., Verbeke, Caroline Sophie, Vullierme, Marie Pierre, Witt, Heiko, Besselink, Marc G., Bruno, Marco J., Czako, Laszlo, del Chiaro, Marco, Filippova, Oleksandra, Fukuda, Akihisa, Gaujoux, Sebastien, Hart, Phil A., Hegyi, Peter, Jonas, Eduard, Kahraman, Alisan, Kleger, Alexander, Kuryata, Olexander, Laukkarinen, Johanna, Lerch, Markus M., Marchegiani, Giovanni, Marschal, Hanns-Ulrich, Matos, Celso, Molad, Yair, Oguz, Dilek, Pukitis, Aldis, Satoi, Sohei, Stone, John H., Verheij, Joanne, de Vries, Niek, KKÜ, Gastroenterology and Hepatology, Tytgat Institute for Liver and Intestinal Research, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Löhr, Jm, Beuers, U, Vujasinovic, M, Alvaro, D, Frøkjær, Jb, Buttgereit, F, Capurso, G, Culver, El, de-Madaria, E, DELLA TORRE, E, Detlefsen, S, Dominguez-Muñoz, E, Czubkowski, P, Ewald, N, Frulloni, L, Gubergrits, N, Duman, Dg, Hackert, T, Iglesias-Garcia, J, Kartalis, N, Laghi, A, Lammert, F, Lindgren, F, Okhlobystin, A, Oracz, G, Parniczky, A, Mucelli, Rmp, Rebours, V, Rosendahl, J, Schleinitz, N, Schneider, A, van Bommel, Ef, Verbeke, C, Vullierme, Mp, Witt, H, and UEG guideline working, Group.
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Abdominal pain ,IMMUNOGLOBULIN G4-RELATED DISEASE ,SERUM IGG4 LEVELS ,Medizin ,Disease ,RC799-869 ,Severity of Illness Index ,immune-related cholangitis ,Serology ,0302 clinical medicine ,LONG-TERM OUTCOMES ,Prednisone ,Drug Dosage Calculations ,Child ,other organ involvement ,STEROID-THERAPY ,INTERNATIONAL-CONSENSUS ,Evidence-Based Medicine ,glucocorticoids ,Gastroenterology ,Induction Chemotherapy ,IgG4-related ,Diseases of the digestive system. Gastroenterology ,PRIMARY SCLEROSING CHOLANGITIS ,TYPE-1 AUTOIMMUNE PANCREATITIS ,CONSENSUS DIAGNOSTIC-CRITERIA ,Europe ,Treatment Outcome ,Oncology ,030220 oncology & carcinogenesis ,diabetes mellitus ,030211 gastroenterology & hepatology ,medicine.symptom ,digestive ,autoimmune pancreatitis type 1 ,Glucocorticoid ,Immunosuppressive Agents ,medicine.drug ,Adult ,medicine.medical_specialty ,Digestive System Diseases ,biomarkers ,cancer ,disease ,Maintenance Chemotherapy ,03 medical and health sciences ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,FINE-NEEDLE-ASPIRATION ,Dose-Response Relationship, Drug ,business.industry ,EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY ,Body Weight ,Editorials ,Cancer ,Guideline ,medicine.disease ,business - Abstract
Frulloni, Luca/0000-0001-7417-2655; Hart, Phil/0000-0003-4346-6196; Capurso, Gabriele/0000-0002-0019-8753; de-Madaria, Enrique/0000-0002-2412-9541; Lohr, Matthias/0000-0002-7647-198X; Frokjaer, Jens Brondum/0000-0001-8722-0070 WOS:000542363500001 PubMed: 32552502 The overall objective of these guidelines is to provide evidence-based recommendations for the diagnosis and management of immunoglobulin G4 (IgG4)-related digestive disease in adults and children. IgG4-related digestive disease can be diagnosed only with a comprehensive work-up that includes histology, organ morphology at imaging, serology, search for other organ involvement, and response to glucocorticoid treatment. Indications for treatment are symptomatic patients with obstructive jaundice, abdominal pain, posterior pancreatic pain, and involvement of extra-pancreatic digestive organs, including IgG4-related cholangitis. Treatment with glucocorticoids should be weight-based and initiated at a dose of 0.6-0.8 mg/kg body weight/day orally (typical starting dose 30-40 mg/day prednisone equivalent) for 1 month to induce remission and then be tapered within two additional months. Response to initial treatment should be assessed at week 2-4 with clinical, biochemical and morphological markers. Maintenance treatment with glucocorticoids should be considered in multi-organ disease or history of relapse. If there is no change in disease activity and burden within 3 months, the diagnosis should be reconsidered. If the disease relapsed during the 3 months of treatment, immunosuppressive drugs should be added. National Societies Committee of the United European Gastroenterology (UEG) We gratefully acknowledge the support from the National Societies Committee of the United European Gastroenterology (UEG) for the conduct of these guidelines independent from other sources. No other funding was received.
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- 2020
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15. Prospective study on warfarin and regional chemotherapy in patients with pancreatic carcinoma.
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Nakchbandi W, Müller H, Singer MV, Lohr JM, and Nakchbandi IA
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- Aged, Chemotherapy, Cancer, Regional Perfusion, Deoxycytidine administration & dosage, Deoxycytidine analogs & derivatives, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Mitomycin administration & dosage, Pancreatic Neoplasms mortality, Prospective Studies, Gemcitabine, Anticoagulants administration & dosage, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Pancreatic Neoplasms drug therapy, Warfarin administration & dosage
- Abstract
Aims: The aim is to prospectively examine the effect of regional gemcitabine and mitomycin-C with systemic gemcitabine together with warfarin in patients with inoperable pancreatic carcinoma, and compare the effect to systemic gemcitabine alone., Methods: Seventeen patients received 1.25 mg of warfarin daily, gemcitabine 800 mg/m2 on day 1 and mitomycin-C 8 mg/m2 on day 2 regionally and gemcitabine 800 mg/m2 on day 14 peripherally. The cycle was repeated every 4 weeks., Results: Median survival since presentation was 6.8 months, while median total survival was 9.6 months. Excluding the 3 patients who died before receiving any therapy, the median survival since presentation resulted in 10.7 months and the median total survival, 12.7 months. One patient developed bleeding that required transfusion and 2 patients developed anemia (Grades III/IV). Comparing these data to historical controls of large cohorts supports the notion that this regimen offers a viable alternative to systemic gemcitabine alone., Conclusion: A regimen consisting of regional gemcitabine and mitomycin-C with systemic gemcitabine and low-dose warfarin compares favorably to the gold standard of systemic gemcitabine. These data suggest the feasibility of a large prospective study on the use of warfarin and combined regional and systemic chemotherapy in patients with pancreatic carcinoma.
- Published
- 2008
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