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Article ; Online: Editorial: Introduction to the issue: state of the art for managing pancreatic diseases.

Yadav, Dhiraj / Olesen, Soren S / Drewes, Asbjørn M

2022 Volume 38, Issue 5, Page(s) 481

MeSH term(s)	Humans ; Pancreatic Diseases/therapy
Language	English
Publishing date	2022-08-17
Publishing country	United States
Document type	Editorial
ZDB-ID	632571-3
ISSN	1531-7056 ; 0267-1379
ISSN (online)	1531-7056
ISSN	0267-1379
DOI	10.1097/MOG.0000000000000871
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Article ; Online: Bias towards surgery for pain in chronic pancreatitis.

Olesen, Søren S / Drewes, Asbjørn M

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.

2020 Volume 20, Issue 3, Page(s) 305–306

MeSH term(s)	Abdominal Pain/surgery ; Humans ; Pancreatitis, Chronic/physiopathology ; Pancreatitis, Chronic/surgery ; Treatment Outcome
Language	English
Publishing date	2020-03-10
Publishing country	Switzerland
Document type	Letter
ZDB-ID	2056680-3
ISSN	1424-3911 ; 1424-3903
ISSN (online)	1424-3911
ISSN	1424-3903
DOI	10.1016/j.pan.2020.03.003
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Zs.A 5553: Show issues

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Article ; Online: Reply.

Kuhlmann, Louise / Olesen, Søren S / Windsor, John A / Drewes, Asbjørn M

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

2022 Volume 20, Issue 12, Page(s) 2922

Language	English
Publishing date	2022-02-04
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2119789-1
ISSN	1542-7714 ; 1542-3565
ISSN (online)	1542-7714
ISSN	1542-3565
DOI	10.1016/j.cgh.2022.01.048
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Zs.A 5836: Show issues

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Article ; Online: Psychiatric Disease Susceptibility and Pain in Chronic Pancreatitis: Association or Causation?

Faghih, Mahya / Drewes, Asbjørn M / Singh, Vikesh K

The American journal of gastroenterology

2021 Volume 116, Issue 10, Page(s) 2026–2028

Abstract: Abstract: Pain perception in chronic pancreatitis (CP) is governed by the transmission of nociceptive inputs into the pain processing centers of the brain. These regions of the brain overlap with those that regulate and process emotions and cognition. ... ...

Abstract	Abstract: Pain perception in chronic pancreatitis (CP) is governed by the transmission of nociceptive inputs into the pain processing centers of the brain. These regions of the brain overlap with those that regulate and process emotions and cognition. Disorders in these regions also result in psychiatric conditions such as depression, anxiety, and posttraumatic stress disorder. The present study by Dunbar et al. evaluated 24 single nucleotide polymorphisms associated with anxiety and/or posttraumatic stress disorder and found correlations with constant and severe pain phenotypes in CP patients from a large cross-sectional cohort study. Although causation cannot be proven, the findings suggest that there may be a role for neuromodulator drugs for the treatment of pain in CP based on individual genetic susceptibility.
MeSH term(s)	Anxiety Disorders ; Cross-Sectional Studies ; Disease Susceptibility ; Humans ; Pain/genetics ; Pancreatitis, Chronic/complications ; Pancreatitis, Chronic/genetics
Language	English
Publishing date	2021-08-28
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	390122-1
ISSN	1572-0241 ; 0002-9270
ISSN (online)	1572-0241
ISSN	0002-9270
DOI	10.14309/ajg.0000000000001491
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Article ; Online: Complications to Chronic Pancreatitis and Etiological Risk Factors: A Continental Divide?

Olesen, Søren S / Drewes, Asbjørn M

The American journal of gastroenterology

2019 Volume 114, Issue 8, Page(s) 1353

MeSH term(s)	Humans ; Pancreatitis ; Pancreatitis, Chronic ; Risk Factors
Language	English
Publishing date	2019-06-18
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	390122-1
ISSN	1572-0241 ; 0002-9270
ISSN (online)	1572-0241
ISSN	0002-9270
DOI	10.14309/ajg.0000000000000302
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Article ; Online: Tapentadol and oxycodone affect resting-state functional brain connectivity: A randomized, placebo-controlled trial.

Croosu, Suganthiya S / Frøkjaer, Jens B / Drewes, Asbjørn M / Hansen, Tine M

Journal of neuroimaging : official journal of the American Society of Neuroimaging

2021 Volume 31, Issue 5, Page(s) 956–961

Abstract: Background and purpose: The changes in functional brain connectivity induced by treatment with analgesics are poorly investigated. Unfortunately, results from clinical studies investigating treatments in patients with pain are often confounded by co- ... ...

Abstract	Background and purpose: The changes in functional brain connectivity induced by treatment with analgesics are poorly investigated. Unfortunately, results from clinical studies investigating treatments in patients with pain are often confounded by co-medication and comorbidity. Thalamus is central in sensory processing, and we hypothesized that functional connectivity between thalamus and other brain areas in healthy volunteers was different in treatment with oxycodone, representing a pure opioid, compared to treatment with tapentadol, which has a dual effect on the opioidergic and adrenergic systems. Methods: Twenty-one healthy male volunteers were included in a randomized, double-blind, three-armed, placebo-controlled, cross-over study. All received tapentadol (50 mg extended release), oxycodone (10 mg extended release), or placebo twice daily for 14 days. Resting-state functional magnetic resonance imaging data were obtained before and after treatment. Seed-based functional connectivity analyses were performed between thalamus and other brain regions. Results: Compared to placebo, tapentadol increased functional connectivity between left thalamus and precentral cortex (P = .048), whereas oxycodone decreased functional connectivity between bilateral thalamus and the anterior cingulate cortex (P ≤ .005). Conclusions: This study has shown that the functional connectivity between thalamus and other brain areas central in pain processing was different for the tapentadol and oxycodone treatments compared to placebo. This supports that the two treatments exert different mechanism of action. Further studies with larger sample sizes need to be carried out in order to validate this.
MeSH term(s)	Analgesics, Opioid/pharmacology ; Brain/diagnostic imaging ; Cross-Over Studies ; Double-Blind Method ; Humans ; Male ; Oxycodone/pharmacology ; Phenols/pharmacology ; Tapentadol
Chemical Substances	Analgesics, Opioid ; Phenols ; Oxycodone (CD35PMG570) ; Tapentadol (H8A007M585)
Language	English
Publishing date	2021-07-01
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	1071724-9
ISSN	1552-6569 ; 1051-2284
ISSN (online)	1552-6569
ISSN	1051-2284
DOI	10.1111/jon.12902
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Zs.A 3211: Show issues

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Article ; Online: Risk of Major Adverse Cardiovascular Events, Severe Hypoglycemia, and All-Cause Mortality in Postpancreatitis Diabetes Mellitus Versus Type 2 Diabetes: A Nationwide Population-Based Cohort Study.

Olesen, Søren S / Viggers, Rikke / Drewes, Asbjørn M / Vestergaard, Peter / Jensen, Morten H

Diabetes care

2022 Volume 45, Issue 6, Page(s) 1326–1334

Abstract: Objective: Postpancreatitis diabetes mellitus (PPDM) is a frequent complication of pancreatitis and associates with poor glycemic control. We investigated the risk of adverse diabetes-related outcomes in PPDM compared with type 2 diabetes.: Research ... ...

Abstract	Objective: Postpancreatitis diabetes mellitus (PPDM) is a frequent complication of pancreatitis and associates with poor glycemic control. We investigated the risk of adverse diabetes-related outcomes in PPDM compared with type 2 diabetes. Research design and methods: In this Danish population-based cohort study, we included adults (>18 years) with incident PPDM or type 2 diabetes between 1998 and 2018 through national health registries. PPDM was further divided into acute (PPDM-A) and chronic (PPDM-C) subtypes. We ascertained risk of major adverse cardiovascular events (MACE), severe hypoglycemia, and all-cause mortality as well as incidence rates of severe hypoglycemia. We compared risk and incidence rates across diabetes subgroups using multivariate Cox and Poisson regression analyses. Results: We identified 383,325 people with incident type 2 diabetes, 3,418 with PPDM-A, and 2,461 with PPDM-C. Compared with type 2 diabetes, PPDM-C was associated with increased risks of severe hypoglycemia (hazard ratio [HR] 5.27, 95% CI 4.62-6.00, P < 0.001) and all-cause mortality (HR 1.54, 95% CI 1.45-1.64, P < 0.001). Similar patterns were observed for people with PPDM-A. Incidence rate ratios (IRRs) for severe hypoglycemia were increased in both PPDM-C (IRR 7.38, 95% CI 6.75-8.08, P < 0.001) and PPDM-A (IRR 3.76, 95% CI 3.36-4.21, P < 0.001) compared with type 2 diabetes. Findings were consistent in an analysis restricted to people on insulin and in an analysis including pancreatitis patients without diabetes as comparator group. Conclusions: Compared with type 2 diabetes, PPDM is associated with excess risk of adverse diabetes-related outcomes. This has important implications for management.
MeSH term(s)	Adult ; Cardiovascular Diseases/complications ; Cardiovascular Diseases/etiology ; Cohort Studies ; Diabetes Mellitus, Type 2/epidemiology ; Humans ; Hypoglycemia/complications ; Hypoglycemia/epidemiology ; Hypoglycemic Agents ; Pancreatitis/complications ; Risk Factors
Chemical Substances	Hypoglycemic Agents
Language	English
Publishing date	2022-03-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	441231-x
ISSN	1935-5548 ; 0149-5992
ISSN (online)	1935-5548
ISSN	0149-5992
DOI	10.2337/dc21-2531
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Zs.A 1434: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Opioids in the Treatment of Chronic Idiopathic Diarrhea in Humans-A Systematic Review and Treatment Guideline.

Graven-Nielsen, Christoffer S / Knoph, Cecilie S / Okdahl, Tina / Høyer, Katrine L / Krogh, Klaus / Hellström, Per M / Drewes, Asbjørn M

Journal of clinical medicine

2023 Volume 12, Issue 7

Abstract: In patients with chronic idiopathic diarrhea resistant to standard treatment, opioids are often used as rescue therapy. This systematic review investigated opioid effects on gut function in chronic diarrhea. PubMed and Embase were searched regarding ... ...

Abstract	In patients with chronic idiopathic diarrhea resistant to standard treatment, opioids are often used as rescue therapy. This systematic review investigated opioid effects on gut function in chronic diarrhea. PubMed and Embase were searched regarding effects of opioid agonists on the gastrointestinal tract in humans with chronic or experimentally induced diarrhea. A total of 1472 relevant articles were identified and, after thorough evaluation, 11 clinical trials were included. Generally, studies reported a reduction in stool frequency and an increase in transit time during treatment with the opioid receptor agonists loperamide, asimadoline, casokefamide, and codeine compared with placebo. Loperamide and diphenoxylate significantly improved stool consistency compared with placebo, whereas asimadoline showed no such effects. Compared with placebo, loperamide treatment caused less abdominal pain and urgency. Asimadoline showed no significant subjective improvements, but fedotozine was superior to placebo in reducing abdominal pain and bloating in selected patients. Only two relevant studies were published within the last 20 years, and standardized endpoint measures are lacking. Most trials included few participants, and further evidence is needed from larger, prospective studies. Likewise, consensus is needed to standardize endpoints for stool frequency, transit time, and consistency to conduct future meta-analyses on opioids in management of chronic idiopathic diarrhea.
Language	English
Publishing date	2023-03-24
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12072488
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Article ; Online: Clinical Course of Medically Managed Patients With Large and Small Duct Chronic Pancreatitis.

Mahdi, Marco B / Steinkohl, Emily / Singh, Vikesh K / Drewes, Asbjørn M / Frøkjær, Jens B / Olesen, Søren S

Clinical and translational gastroenterology

2023 Volume 14, Issue 1, Page(s) e00537

Abstract: Introduction: Pancreatic duct obstruction is the primary indication for endoscopic and/or surgical therapy in patients with chronic pancreatitis (CP). However, the clinical course of medically managed patients in relation to pancreatic duct obstruction ... ...

Abstract	Introduction: Pancreatic duct obstruction is the primary indication for endoscopic and/or surgical therapy in patients with chronic pancreatitis (CP). However, the clinical course of medically managed patients in relation to pancreatic duct obstruction is largely unknown. Methods: This was a retrospective cohort study of medically managed patients with CP. We classified patients based on pancreatic duct obstruction from a stricture or stone using cross-sectional imaging (i.e., large vs small duct CP). We compared prevalence of diabetes and exocrine insufficiency (EPI) between subgroups at inclusion and investigated risk of new-onset diabetes, EPI, and all-cause mortality over a follow-up period of 5 years. Changes in pancreatic morphology were studied in patients who underwent follow-up imaging. Results: A total of 198 patients (mean age 58 ± 12 years, 70% male, 60% alcoholic etiology, 38% large duct CP) were evaluated. At inclusion, patients with large vs small duct CP had a higher prevalence of both diabetes (43% vs 24%, P = 0.004) and EPI (47% vs 28%, P = 0.007). There was an increased risk of new-onset EPI in patients with large duct CP (hazard ratio 1.72; 95% confidence interval [1.05-2.80], P = 0.031) and higher rates of pancreatic atrophy ( P < 0.001). No differences between groups were observed for new-onset diabetes and all-cause mortality. Conversion from small to large duct CP or vice versa during follow-up was observed in 14% of patients. Discussion: In a medically managed cohort of patients, large duct CP was associated with increased risk of EPI and pancreatic atrophy compared with small duct CP.
MeSH term(s)	Humans ; Male ; Middle Aged ; Aged ; Female ; Retrospective Studies ; Pancreatitis, Chronic/epidemiology ; Pancreatitis, Chronic/therapy ; Pancreatitis, Chronic/complications ; Pancreatic Diseases ; Diabetes Mellitus ; Atrophy/complications ; Disease Progression
Language	English
Publishing date	2023-01-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2581516-7
ISSN	2155-384X ; 2155-384X
ISSN (online)	2155-384X
ISSN	2155-384X
DOI	10.14309/ctg.0000000000000537
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Article: Iatrogenic Side Effects of Pain Therapies.

Gharibo, Christopher / Drewes, Asbjørn M / Breve, Frank / Rekatsina, Martina / Narvaez Tamayo, Marco Antonio / Varrassi, Giustino / Paladini, Antonella

Cureus

2023 Volume 15, Issue 9, Page(s) e44583

Abstract: Pain regimens, particularly for chronic cancer and noncancer pain, must balance the important analgesic benefits against potential risks. Many effective and frequently used pain control regimens are associated with iatrogenic adverse events. ... ...

Abstract	Pain regimens, particularly for chronic cancer and noncancer pain, must balance the important analgesic benefits against potential risks. Many effective and frequently used pain control regimens are associated with iatrogenic adverse events. Interventional procedures can be associated with nerve injuries, vascular injuries, trauma to the spinal cord, and epidural abscesses. Although rare, these adverse events are potentially catastrophic. Pharmacologic remedies for pain must also consider potential side effects that can occur even at therapeutic doses of over-the-counter remedies such as paracetamol (acetaminophen) or nonsteroidal anti-inflammatory drugs. Opioids are effective pain relievers but are associated with many side effects, some of which can be treatment limiting. A prevalent and distressing side effect of opioid therapy is constipation. Opioid-induced constipation is caused by binding to opioid receptors in the gastrointestinal system, making conventional laxatives ineffective. Peripherally acting mu-opioid receptor antagonists are a new drug class that offers the benefits of preserving opioid analgesia without side effects in the gastrointestinal system. An important safety concern, particularly among geriatric patients is the increasingly prevalent condition of polypharmacy. Many senior patients take five or more medications, including some that may be contraindicated in geriatric patients, duplicative of other drugs, have potential pharmacokinetic drug-drug interactions, or may not be the optimal choice for the patient's age and condition. Careful assessment of medications in the elderly, including possibly deprescribing with tapering of certain drugs, may be warranted but should be done systematically and under clinical supervision.
Language	English
Publishing date	2023-09-02
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.44583
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