Pancreas最新文献

{"title":"Rectal Nonsteroidal Anti-Inflammatory Drugs, Aggressive Hydration With Lactated Ringer's Solution, Somatostatin or Combinations for Prophylaxis Post-ERCP Acute Pancreatitis: A Network Meta-Analysis.","authors":"Yunzhi Shen, Yu Bai","doi":"10.1097/MPA.0000000000002648","DOIUrl":"10.1097/MPA.0000000000002648","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the clinical efficacy of Rectal nonsteroidal anti-inflammatory drugs (NSAIDs), Aggressive hydration with Lactated Ringer's solution (ALRS), somatostatin, or combinations in preventing pancreatitis and hyperamylasemia after endoscopic retrograde cholangiopancreatography (ERCP).</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA guidelines, searching all studies from the PubMed, Embase, Ovid, Cochrane library and Google Scholar. Stata software 14.0 and RevMan 5.4 were used for statistical analysis. Outcomes assessed included the incidence of post-ERCP pancreatitis (PEP), post-ERCP hyperamylasemia (PEHA), bleeding, and perforation.</p><p><strong>Results: </strong>Forty-one trials were identified and included in the network meta-analysis, involving 15,627 patients. Somatostatin (OR=0.49, 95% CI= 0.34-0.71), rectal indomethacin (OR=0.63, 95% CI= 0.44-0.9), and rectal indomethacin + somatostatin (OR=0.31, 95% CI= 0.14-0.69) were all more efficacious than placebo in preventing PEP. The combination of rectal indomethacin and somatostatin was the best preventive strategy for PEP, with a surface under the cumulative ranking curves (SUCRA) probability of 80.9%. In terms of PEHA, somatostatin (OR=0.18, 95% CI= 0.1-0.33), rectal indomethacin (OR=0.68, 95% CI= 0.55-0.84), and rectal indomethacin + somatostatin (OR=0.45, 95% CI= 0.28-0.73) were all more efficacious than placebo in preventing PEHA. On the basis of the SUCRA, rectal indomethacin + somatostatin (100%) was found to be the most efficacious modality for the prevention of PEHA. In addition, rectal indomethacin + somatostatin showed the lowest risk of bleeding (77.5%) and perforation (93.8%).</p><p><strong>Conclusions: </strong>The combination of rectal indomethacin and somatostatin was most effective for preventing PEP and PEHA, which has the lowest risk of bleeding and perforation. Given the limited number of studies directly assessing this combination, SUCRA rankings do not always imply clinically meaningful superiority, more large-scale clinical RCTs need to be included in the future to confirm this conclusion.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e736-e746"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13348838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The IL-33/ST2 Signaling Axis Alleviates Splenic Injury in Severe Acute Pancreatitis by Inhibiting T-Cell Ferroptosis.","authors":"Lijian Cui, Ning Xu, Jianhong Chen, Chuxuan Bin, Yue Feng, Baona Guo, Enjie Zhang, Yingyi Luan, Chenghong Yin","doi":"10.1097/MPA.0000000000002654","DOIUrl":"10.1097/MPA.0000000000002654","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate whether the IL-33/ST2 signaling axis alleviates SAP-induced splenic injury by regulating ferroptosis in T lymphocytes.</p><p><strong>Methods: </strong>A murine SAP model was established through intraperitoneal injection of cerulein and lipopolysaccharide (LPS). Recombinant IL-33 was administered intraperitoneally. Histopathologic changes, inflammatory cytokines, ferroptosis-related indicators (MDA, Fe 2+ , GSH, GPX4, ACSL4, FTH1), mitochondrial function [mtDNA, ATP, mitochondrial ROS (mito-SOX), and membrane potential], and ultrastructural alterations were assessed. In vitro, Concanavalin A-stimulated splenic T cells were treated with IL-33, the ferroptosis inhibitor Ferrostatin-1 (Fer-1), or the ST2 antagonist soluble ST2 (sST2) to validate the pathway.</p><p><strong>Results: </strong>IL-33 treatment significantly alleviated pancreatic and splenic histopathologic damage, reduced systemic inflammation, and inhibited ferroptosis in the spleen, as evidenced by attenuated lipid peroxidation, attenuated glutathione depletion, and normalized expression of key ferroptosis regulators (GPX4, ACSL4, FTH1). Concurrently, IL-33 improved mitochondrial function and attenuated oxidative stress. In vitro, IL-33 directly inhibited ConA-induced T-cell ferroptosis, an effect mimicked by Fer-1. Crucially, all protective effects of IL-33 were abolished by sST2, confirming that its action is specifically dependent on the ST2 receptor.</p><p><strong>Conclusions: </strong>The IL-33/ST2 axis exerts a protective effect in SAP by inhibiting T-cell ferroptosis, improving mitochondrial function, and maintaining redox homeostasis, highlighting its potential as a therapeutic target.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e767-e779"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13348841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Sarcopenia in Children Undergoing Total Pancreatectomy With Islet Autotransplantation (TPIAT) and Implications for Short-Term Surgical Outcomes.","authors":"Morgan N McLuckey, Pradipta Debnath, Elanchezhian Somasundaram, Bin Zhang, Neha R Santucci, Juan P Gurria, Maisam Abu-El-Haija, Andrew T Trout","doi":"10.1097/MPA.0000000000002651","DOIUrl":"10.1097/MPA.0000000000002651","url":null,"abstract":"<p><strong>Introduction: </strong>Sarcopenia, the loss of muscle mass and function, is a measure of frailty that is correlated with perioperative morbidity in patients with chronic illness and transplant. We sought to understand the prevalence of sarcopenia in our pediatric population undergoing total pancreatectomy with islet cell autotransplantation (TPIAT) and how sarcopenia impacts short-term postsurgical outcomes.</p><p><strong>Methods: </strong>This was a single-center, IRB-approved study of children (1-18.99 y) who underwent TPIAT at our institution. Patients were identified from a prospective registry where clinical data (pain assessments, 30-d postoperative outcomes) were available near the time of surgery. Sarcopenia was assessed through retrospective analysis of cross-sectional imaging using segmentations of the psoas muscle and total abdominal skeletal muscle. Z-scores (<-1.6) calculated using established normal values defined sarcopenia. Change in muscle mass over time was also determined.</p><p><strong>Results: </strong>In our cohort, 32.4% (22/68) of patients were sarcopenic at the time of TPIAT by psoas muscle but only 7.4% (6/81) were sarcopenic by total abdominal skeletal muscle. There was no significant difference in primary outcomes (30-d readmissions, reoperations, and complications; and the number of days spent inpatient after surgery) based on sarcopenia or decreasing muscle mass. There was a statistically significant association between psoas-determined sarcopenia and higher frequency of pain before TPIAT ( P =0.016).</p><p><strong>Conclusions: </strong>Sarcopenia was 32.4% prevalent by psoas muscle measurement but was less prevalent by total abdominal skeletal muscle measurement in children undergoing TPIAT. There was no relationship between the presence of sarcopenia or decreasing muscle mass and 30-day postoperative outcomes but there was a positive association between higher frequency of preoperative pain and sarcopenia.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e758-e766"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13464152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147609611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-onset Pancreatic Cancer is Associated With Better Survival: A SEER Population-Based Analysis.","authors":"Kaewkwan Liengswangwong, Stephen J Pandol","doi":"10.1097/MPA.0000000000002702","DOIUrl":"10.1097/MPA.0000000000002702","url":null,"abstract":"<p><strong>Objectives: </strong>The incidence of early-onset pancreatic cancer is increasing worldwide. This study aimed to evaluate whether survival differences between early and late-onset pancreatic cancer persist after adjustment for tumor characteristics, stage at diagnosis, and treatment, including within stage and treatment-specific subgroups.</p><p><strong>Methods: </strong>This retrospective SEER cohort study included patients with pancreatic adenocarcinoma diagnosed between 2004 and 2020, with survival follow-up through 2022. Multivariable Cox regression analyses were performed to evaluate overall survival (OS) and cancer-specific survival (CSS) according to age group.</p><p><strong>Results: </strong>Among 131,839 patients, 6,366 (4.8%) had early-onset pancreatic cancer and 125,473 (95.2%) had late-onset pancreatic cancer. The median OS was 9 months for EOPC and 6 months for LOPC, while the median CSS was 10 months for EOPC and 6 months for LOPC. Adjusted OS and CSS remained worse in patients with LOPC, with consistent findings across all stages. Among patients who underwent surgery or received chemotherapy, LOPC was associated with poorer outcomes. There was no survival difference in patients with early-onset and late-onset pancreatic cancer among those who received radiation therapy.</p><p><strong>Conclusions: </strong>This study demonstrated better overall survival and cancer-specific survival among EOPC after adjustment for clinical covariates including stage at diagnosis and treatment receipt, and histologic variables. The findings suggest that other factors beyond the available variables may contribute to better survival observed in younger patients. However, because information on chemotherapy regimens, treatment completion, and performance status was unavailable in the SEER database, residual confounding affecting survival outcomes cannot be excluded, and the findings should therefore be interpreted with caution.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Remimazolam versus Midazolam for Sedation during Endoscopic Ultrasound-Guided Tissue Acquisition in Patients with Solid Pancreatic Lesions.","authors":"Yuki Tanisaka, Shomei Ryozawa, Masafumi Mizuide, Akashi Fujita, Suguru Ito, Ryuichi Watanabe, Ryosuke Hamamura, Yoshiki Matsuno","doi":"10.1097/MPA.0000000000002700","DOIUrl":"10.1097/MPA.0000000000002700","url":null,"abstract":"<p><strong>Objectives: </strong>Remimazolam is an ultra-short-acting benzodiazepine with a shorter pharmacokinetic half-life than midazolam. This study compared the efficacy and safety of remimazolam and midazolam for sedation during endoscopic ultrasound-guided tissue acquisition (EUS-TA) in patients with solid pancreatic lesions.</p><p><strong>Methods and patients: </strong>We retrospectively reviewed patients who underwent EUS-TA under remimazolam (August 2025-February 2026) or midazolam (January 2025-July 2025). The primary outcome was the time from procedure completion to patient awakening. Secondary outcomes included sedation success rate, time to sedation onset, total dose and number of doses, agitation requiring procedure interruption, flumazenil use, and sedation-related adverse events.</p><p><strong>Results: </strong>A total of 101 patients received remimazolam and 105 received midazolam. Median time from procedure completion to patient awakening was significantly shorter with remimazolam (2 min; interquartile range [IQR] 2-3) than with midazolam (4 min; IQR 3-5; P<0.01). The median total number of doses was higher with remimazolam (P<0.01), while flumazenil administration was significantly lower (P<0.01). Sedation success rate, time to sedation onset, agitation requiring procedure interruption, and adverse event rates did not differ significantly.</p><p><strong>Conclusion: </strong>Remimazolam was associated with faster recovery and reduced flumazenil use, suggesting improved efficiency and safety in post-procedural monitoring, along with decreased staff workload after EUS-TA.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ITGB4 Activates the Pentose Phosphate Pathway to Reduce the Sensitivity of Pancreatic Adenocarcinoma to Gemcitabine.","authors":"Xianfei Zhou, Fan Yang, Luoshun Huang, Yisheng Ling, Xianwu Xia","doi":"10.1097/MPA.0000000000002690","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002690","url":null,"abstract":"<p><strong>Background: </strong>Integrinβ4 (ITGB4), a transmembrane adhesion molecule, is closely associated with chemotherapy resistance in tumor cells. The pentose phosphate pathway (PPP) is a critical metabolic pathway that enables tumor cells to cope with chemotherapeutic stress and maintain survival. However, the specific mechanisms of ITGB4 regulating the PPP to influence the sensitivity of pancreatic adenocarcinoma (PAAD) to gemcitabine (GEM) remain unclear.</p><p><strong>Methods: </strong>Data from the TCGA-PAAD dataset were utilized to assess ITGB4 expression level and its correlation with patient prognosis. The correlation between ITGB4 and the expression of key PPP genes was assessed. RT-qPCR and Western blot were employed to measure levels of ITGB4 and G6PD. The half-maximal inhibitory concentration (IC50) of GEM in cells and cell vitality were determined using the CCK-8 assay. Cell proliferation capacity was examined via the EdU assay. Glucose consumption, lactate production, and intracellular levels of NADP⁺ and NADPH were measured using specific kits to evaluate PPP metabolic activity. Intracellular reactive oxygen species (ROS) levels were detected by flow cytometry to analyze changes in the redox state.</p><p><strong>Results: </strong>The high expression status of ITGB4 in PAAD was significantly linked with poor prognosis in patients, and its expression level was also positively correlated with the expression of PPP key genes. Based on functional experiment, knocking down the expression of ITGB4 significantly enhanced the sensitivity of PAAD cells to GEM. At the same time, knocking down ITGB4 resulted in significantly elevated intracellular NADPH levels and ROS levels, suggesting that the PPP pathway may be suppressed. In addition, upon 6-AN treatment, the increase in IC50 value and cell proliferation enhancement caused by overexpression of ITGB4 in GEM were reversed.</p><p><strong>Conclusion: </strong>ITGB4 reduces the sensitivity of PAAD cells to GEM by activating the PPP. This finding not only elucidates the mechanism of ITGB4 in PAAD chemo-resistance but also offers a theoretical basis for improving the efficacy of GEM treatment and developing targeted therapeutic strategies.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determination of Psychological Comorbidities in Children With Acute Recurrent or Chronic Pancreatitis Referred for Total Pancreatectomy With Islet Autotransplantation Evaluation: A Single-Center Study.","authors":"Hailey Kramer, Neha R Santucci, Olivia Lee, Juan P Gurria, Todd Jenkins, Kristin Rich, Cheryl Hartzell, Maisam Abu-El-Haija","doi":"10.1097/MPA.0000000000002649","DOIUrl":"10.1097/MPA.0000000000002649","url":null,"abstract":"<p><strong>Background: </strong>Multiple psychological factors and related comorbidities affect children with chronic pancreatitis (CP) or acute recurrent pancreatitis (ARP). We aimed to describe the frequency of psychological symptoms/diagnoses in children with CP/ARP and predict the severity of the disease burden based on these factors.</p><p><strong>Methods: </strong>We retrospectively identified patients aged 5 years or younger with a prior history of CP/ARP who were evaluated by a pediatric psychologist as part of their evaluation for total pancreatectomy with islet autotransplantation (TPIAT) at a single center. Symptoms of psychological disorders and prior psychological diagnoses were identified. Patients and their families completed pain questionnaires as part of clinical care. Demographic and pancreatic disease data were collected from electronic medical records.</p><p><strong>Key results: </strong>Of 105 children (mean age 12.1 ± 3.5 y, 54.3% females, 84.4% white), 37.1% had a psychological diagnosis [20.0% anxiety, 13.3% depression, 23.8% attention-deficit hyperactivity disorder (ADHD), 4.8% post-traumatic stress disorder (PTSD)] while 86.7% displayed symptoms based on DSM-5 criteria (75.7% anxiety, 32.3% depression, 21.1% suicidal ideation, and 40.2% panic). Regarding pain, 38.8% of patients reported daily abdominal pain, 24.3% weekly, 14.6% monthly, and 22.3% less than once per month. In the 6 months prepsychology appointment, 70.9% used opioids in the inpatient setting, 25.7% used opioids in the outpatient setting, and 45.2% were on a neuromodulator to control their pain. The median pain severity did not statistically differ by psychological diagnosis or symptoms ( P =0.16).</p><p><strong>Conclusion: </strong>There was a high prevalence of psychological diagnoses/symptoms in patients with ARP/CP, including suicidal ideation. This highlights the need for future prospective studies to explore the role of mental health in disease outcomes in children with CP or ARP.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e647-e652"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147593500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Assessment of Direct and Passive Smoking Across the Pancreatitis Spectrum.","authors":"Samuel Han, Dhiraj Yadav, Jun Xu, Melena D Bellin, William E Fisher, Evan L Fogel, Chris Forsmark, Phil A Hart, Liang Li, Stephen J Pandol, Walter G Park, Guru Trikudanathan, Stephen K Van Den Eeden, Santhi Swaroop Vege, Darwin L Conwell, Christie Y Jeon","doi":"10.1097/MPA.0000000000002621","DOIUrl":"10.1097/MPA.0000000000002621","url":null,"abstract":"<p><strong>Objectives: </strong>Smoking is a key risk factor for pancreatitis, contributing to pathogenesis and disease progression. Data regarding second-hand smoking, or passive smoking (PS) exposure, are lacking. We therefore aimed to assess the impact of PS exposure across the pancreatitis spectrum.</p><p><strong>Methods: </strong>We analyzed baseline data from the PROCEED study, a multicenter study in the United States including patients with acute (AP), recurrent acute (RAP), and chronic (CP) pancreatitis. Participants detailed their individual smoking history and PS exposure, which was compared between AP, RAP, and CP subgroups. Participant factors and clinical characteristics were compared by level of individual and PS exposure.</p><p><strong>Results: </strong>Among 1369 participants (190 AP, 498 RAP, 681 CP), 346 (25.3%) were current and 409 (29.9%) were former smokers. The CP subgroup had the highest proportion of current smokers (36.7% CP vs 15.1% RAP, 11.1% AP, P < 0.001). PS exposure was also significantly higher in the CP subgroup (68.6% CP vs 58.2% RAP, 55.3% AP, P < 0.001). A minority (16.3%) with CP reported no smoking exposure (by self or passive) while nearly half smoked ≥20 pack-years. The mean PS duration was significantly higher in CP participants (21.8 y) compared with those with AP (17.8 y) or RAP (18.9 y) ( P < 0.0166).</p><p><strong>Conclusions: </strong>In this multicenter study, we affirmed an association with smoking use and intensity with CP-related complications. For the first time, we report a high prevalence of prior exposure to passive smoking in all pancreatitis subtypes, which requires further study to understand the impact on disease outcomes.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e653-e660"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13222071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145990365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Pain With Healthcare Use and Indirect Burden in Pediatric Acute, Recurrent, and Chronic Pancreatitis.","authors":"Rui Li, Caitlin B Murray, Homer Aalfs, Mark Lowe, Aliye Uc, Tonya M Palermo","doi":"10.1097/MPA.0000000000002626","DOIUrl":"10.1097/MPA.0000000000002626","url":null,"abstract":"<p><strong>Objectives: </strong>Abdominal pain affects nearly 80% of youth with acute recurrent or chronic pancreatitis (ARP/CP), yet its broader burden is poorly understood. We characterized direct (healthcare utilization) and indirect (school absenteeism, parental work loss) burden in youth with painful ARP/CP and examined associations with pain characteristics and health-related quality of life (HRQOL).</p><p><strong>Methods: </strong>Youth with painful ARP/CP and caregivers were recruited from INSPPIRE sites and the community. Caregivers reported healthcare use and indirect burden using the Client Service Receipt Inventory. Youth completed validated measures of pain severity, pain interference, and HRQOL. Negative binomial and logistic regression assessed associations between pain, HRQOL, and disease burden.</p><p><strong>Results: </strong>Ninety youth (mean age=14.9) were included. Over 9 months, youth had a median of 1 hospital admission (3 -nights stay), 1.5 ED visits, 4 outpatient visits, 1 non-physician service type, 18.5 missed school days, and 6.0 parental workdays lost; 1 in 6 parents provided additional weekly childcare. Higher pain severity was associated with higher ED (+33%) and outpatient visits (+20%), more medication use (+35%), complementary and alternative medicine (CAM) use (+136%), and more school days missed (+48%). Higher pain interference was linked to more hospital admissions (+38%) and longer stays (+103%), greater outpatient (+21%), non-physician (+20%), CAM (+120%), medication use (+41%; opioids +138%), and more school (+100%) and parental workday loss (+133%). Higher HRQOL was associated with lower burden.</p><p><strong>Conclusions: </strong>Pediatric painful ARP/CP imposes a substantial direct and indirect burden. Interventions targeting pain and disability may reduce healthcare use and improve functioning and family well-being.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e595-e601"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic Ductal Adenocarcinoma (PDAC) Arising from Mixed Duct Intraductal Papillary Mucinous Neoplasm (IPMN) can Mimic Multifocal Pseudocyst.","authors":"Yeshika Thapa, Carson Cornell Creamer, Jyoti Yadav, Yaseen Perbtani, Tony S Brar","doi":"10.1097/MPA.0000000000002698","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002698","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148332019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}