Home India • Download Chronic pancreatitis and pancreatic diabetes in India by V. Balakrishnan (M.D.), Harish Kumar (DNB), Indian PDF

Download Chronic pancreatitis and pancreatic diabetes in India by V. Balakrishnan (M.D.), Harish Kumar (DNB), Indian PDF

By V. Balakrishnan (M.D.), Harish Kumar (DNB), Indian Pancreatitis Study Group, S. Sudhindran, A. G. Unnikrishnan

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Knowing both the genetic and environmental risk 9 in the future will be important because the environmental risks are the easiest to change! Taken together, it appears that the similarities between idiopathic chronic pancreatitis and TCP or FCPD are that the initial injury to the pancreas is trypsin-related. The difference is that the response to repeated injury differs between these groups. This hypothesis can be illustrated by considering Figure 2. In this case the third domain, the response to RAP that leads to fibrosis, could be replaced by other modifying factors that predispose to Btype pain, calcifications or diabetes (Table 1).

The problem of complex genetic traits compounds the difficulty in using power calculations to answer a question. In the United States, as in Asia, it is becoming increasing clear that diseases of the pancreas result in a broad spectrum of clinical signs and symptoms. The variables include age of onset, presence or absence of acute attacks of inflammation, severity of attacks, degree of fibrosis, degree, nature and severity of pain, degree and location of calcifications, diabetes with or without insulin and/ or glucagon deficiency, and risk of pancreatic cancers.

Bradley EL, 3rd. A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Arch Surg 1993;128(5):586-90. 10. Etemad B, Whitcomb DC. Chronic pancreatitis: Diagnosis, classification, and new genetic developments. Gastroenterology 2001;120:682-707. 11. Mack DR, Forstner GG, Wilschanski M, Freedman MH, Durie PR. Shwachman syndrome: exocrine pancreatic dysfunction and variable phenotypic expression.

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