| 3 | Natural history,clinical characteristics,outcomes,and long-term follow-up of pain-free chronic pancreatitis显示文摘Background:Chronic pancreatitis(CP)is characterized by chronic abdominal pain and functional insufficiency.However,a small subset of patients with prior acute pancreatitis(AP)and/or underlying risk factors for developing CP may be pain-free at diagnosis and may have a different clinical course.We aimed to compare the clinical characteristics,outcomes,and healthcare utilization between CP patients with and without pain.Methods:Reviewed patients with established CP were followed in our Pancreas Center between January 2016 and April 2021.Patients without risk factors for developing CP and/or without AP prior to their diagnosis and only with incidental radiologic features of CP were excluded,so as tominimize confounding factors of pancreatopathy unrelated to CP.Patients were divided into painful and pain-free groups to analyze differences in demographics,outcomes,and healthcare utilization.Results:Of 368 CP patients,49(13.3%)were pain-free at diagnosis and had remained so for>9 years.There were no significant differences in body mass index,race,sex,or co-morbidities between the two groups.Pain-free patients were older at diagnosis(53.9 vs 45.7,P=0.004)and had less recurrent AP(RAP)(43.8%vs 72.5%,P<0.001)and less exocrine pancreatic insufficiency(EPI)(34.7%vs 65.7%,P<0.001).Pain-free patients had less disability(2.2%vs 22.0%,P=0.003),mental illness(20.4%vs 61.0%,P<0.001),surgery(0.0%vs 15.0%,P=0.059),and therapeutic interventions(0.0%vs 16.4%,P=0.005)for pain.Conclusions:We described a unique subset of patients with underlying risk factors for CP and/or prior AP who were painfree at diagnosis.They were older at diagnosis,had less EPI and RAP,and overall favorable outcomes with minimal resource utilization. | Awais Ahmed Ishani Shah Rachel Bocchino Steven D.Freedman Darshan J.Kothari Sunil G.Sheth | 2023 | Gastroenterology Report2023，11，1： | 0 |
| 4 | Tackling clinical complexity: how inpatient subspecialty gastroenterology services enhance patient care显示文摘Introduction Over the past three decades,the field of gastroenterology(GI)has undergone tremendous transformation.Advances in research have led to a substantial growth in clinical knowledge across many GI conditions.Additionally,over this time,the prevalence of patient complexity,including the number of co-morbidities,mental illness burden,socioeconomic factors,and multidisciplinary needs,have continued to increase.Thus,subspecialization within GI has been an adaptive response to keep pace with the rapid expansion of medical knowledge and evolving patient needs. | Cinthana Kandasamy Darshan J.Kothari Sunil G.Sheth | 2021 | Gastroenterology Report2021，9，6： | 0 |
您所在的机构暂未开通此部分的功能，请联系管理员