ABSTRACT
Insuficiência exócrina do pâncreas tem sido revisitada em vários compêndios médicos internacionais e suas novas etiologias avaliadas e reconfirmadas. Neste artigo abordamos as causas mais comuns e tradicionais, pancreatite crônica e fibrose cística, bem como as recentemente mais enfatizadas como doença celíaca e diabetes mellitus. Comentamos a clínica e o diagnóstico precoce e o tratamento com reposição enzimática
Pancreatic exocrine insufficiency has been broadly discussed in international medical literature. New aetiologies have been studied and reaffirmed. In this paper we describe common and traditional causes such as chronic pancreatitis and cystic fibrosis as well as the most recently emphasised celiac disease and diabetes. We also review clinical features, early diagnosis and pancreatic enzyme replacement therapy
Subject(s)
Humans , Male , Female , Cystic Fibrosis/complications , Exocrine Pancreatic Insufficiency/etiology , Pancreatitis, Chronic/complications , Celiac Disease , Diabetes Mellitus , Pancreatic Ducts/physiology , Early Diagnosis , Secretin , Enzyme Replacement Therapy , Pancreatic Function Tests/methodsABSTRACT
La pancreatitis aguda es una entidad frecuente en nuestro medio. La enfermedad biliar es la causa principal en el desencadenamiento de ella. La evolución de la pancreatitis aguda puede adquirir diferentes formas clínicas que se relacionan con el pronóstico. Se proponen factores pronósticos de la enfermedad tanto desde el punto de vista clínico, de laboratorio y de imagenología. Se analizan los tratamientos actuales y conductas terapéuticas
Subject(s)
Humans , Pancreatitis/diagnosis , Amylases/blood , Diagnosis, Differential , Diagnosis-Related Groups , Pancreatic Diseases/microbiology , Physical Examination/methods , Cross Infection/diagnosis , Lipase/blood , Pancreatitis/classification , Pancreatitis/complications , Pancreatitis/therapy , Pancreatic Pseudocyst/diagnosis , Pancreatic Function Tests/methodsABSTRACT
Alcoólatras assintomáticos (ingestäo média de 109 gramas de etanol por dia) assim como näo alcoólatras (grupo controle) foram submetidos ao teste de estímulo com infusäo de arginina I.V. e ao estímulo com glicose administrada por via oral. O teste de estímulo com glicose näo discriminou o grupo alcoólatra enquanto o teste com arginina mostrou: a) hiperglicemia no grupo alcoólatra durante o período de pós-infusäo; e b) hipoinsulinemia no grupo alcoólatra durante o período de infusäo do aminoácido. A resposta das células alfa (secreçäo de glucagon) a este estímulo foi semelhante nos dois grupos estudados. Sugerimos que alcoólatras assintomáticos e com resposta insulinêmica normal ao estímulo com glicose per os devam ser submetidos ao teste de infusäo de arginina antes que sua funçäo pancreática endócrina possa ser considerada normal
Subject(s)
Adult , Middle Aged , Humans , Alcoholism/physiopathology , Arginine , Glucose , Pancreas/physiopathology , Pancreatic Function Tests/methods , Alcoholism/metabolism , Arginine/administration & dosage , Glucose/administration & dosage , Insulin/bloodABSTRACT
Twenty healthy subjects have been selected for the present study. There was significant parallelism between trypsin and lipase secretion but frequent dissociation between trypsin and amylase. Lower values of pancreatic volume, bicarbonate and enzymes secretion as compared to the Western reports are explained by the lower weight of Indians in comparison to Western people. Prostigmine an inexpensive and reliable alternative to pancreozmin is recommended for routine clinical studies of pancreatic enzymes.