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  1. Article ; Online: Postoperative Pain Relief after Pancreatic Resection: Systematic Review and Meta-Analysis of Analgesic Modalities.

    Akter, Nasreen / Ratnayake, Bathiya / Joh, Daniel B / Chan, Sara-Jane / Bonner, Emily / Pandanaboyana, Sanjay

    World journal of surgery

    2021  Volume 45, Issue 10, Page(s) 3165–3173

    Abstract: Background: This systematic review explored the efficacy of different pain relief modalities used in the management of postoperative pain following pancreatoduodenectomy (PD) and distal pancreatectomy (DP) and impact on perioperative outcomes.: ... ...

    Abstract Background: This systematic review explored the efficacy of different pain relief modalities used in the management of postoperative pain following pancreatoduodenectomy (PD) and distal pancreatectomy (DP) and impact on perioperative outcomes.
    Methods: MEDLINE (OVID), Embase, Pubmed, Web of Science and CENTRAL databases were searched using PRISMA framework. Primary outcomes included pain on postoperative day 2 and 4 and respiratory morbidity. Secondary outcomes included operation time, bile leak, delayed gastric emptying, postoperative pancreatic fistula, length of stay, and opioid use.
    Results: Five randomized controlled trials and seven retrospective cohort studies (1313 patients) were included in the systematic review. Studies compared epidural analgesia (EDA) (n = 845), patient controlled analgesia (PCA) (n = 425) and transabdominal wound catheters (TAWC) (n = 43). EDA versus PCA following PD was compared in eight studies (1004 patients) in the quantitative meta-analysis. Pain scores on day 2 (p = 0.19) and 4 (p = 0.18) and respiratory morbidity (p = 0.42) were comparable between EDA and PCA. Operative times, bile leak, delayed gastric emptying, pancreatic fistula, opioid use, and length of stay also were comparable between EDA and PCA. Pain scores and perioperative outcomes were comparable between EDA and PCA following DP and EDA and TAWC following PD.
    Conclusions: EDA, PCA and TAWC are the most frequently used analgesic modalities in pancreatic surgery. Pain relief and other perioperative outcomes are comparable between them. Further larger randomized controlled trials are warranted to explore the relative merits of each analgesic modality on postoperative outcomes with emphasis on postoperative complications.
    MeSH term(s) Analgesia, Epidural ; Analgesia, Patient-Controlled ; Analgesics/therapeutic use ; Humans ; Pain, Postoperative/drug therapy ; Pain, Postoperative/etiology ; Pancreatectomy/adverse effects ; Retrospective Studies
    Chemical Substances Analgesics
    Language English
    Publishing date 2021-06-29
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Review ; Systematic Review
    ZDB-ID 224043-9
    ISSN 1432-2323 ; 0364-2313
    ISSN (online) 1432-2323
    ISSN 0364-2313
    DOI 10.1007/s00268-021-06217-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1336: Show issues Location:
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  2. Article ; Online: A selective anticoagulation policy for splanchnic vein thrombosis in acute pancreatitis is associated with favourable outcomes: experience from a UK tertiary referral centre.

    K, Thejasvin / Chan, Sara-Jane / Varghese, Chris / Lim, Wei B / Cheemungtoo, Gemisha M / Akter, Nasreen / Nayar, Manu / Pandanaboyana, Sanjay

    HPB : the official journal of the International Hepato Pancreato Biliary Association

    2022  Volume 24, Issue 11, Page(s) 1937–1943

    Abstract: Introduction: There is a paucity of data on the incidence, risk factors, and treatment of splanchnic vein thrombosis (SVT) in acute pancreatitis (AP).: Methods: All AP admissions between 2018 and 2021 across North East of England were included. ... ...

    Abstract Introduction: There is a paucity of data on the incidence, risk factors, and treatment of splanchnic vein thrombosis (SVT) in acute pancreatitis (AP).
    Methods: All AP admissions between 2018 and 2021 across North East of England were included. Anticoagulation was considered in the presence of superior mesenteric vein/portal vein (SMV/PV) thrombus or progressive splenic vein thrombus (SpVT). The impact of such a selective anticoagulation policy, on vein recanalisation rates and bleeding complications were explored.
    Results: 401 patients (median age 58) were admitted with AP. 109 patients (27.2%) developed SVT. The splenic vein in isolation was the most common site (n = 46) followed by SMV/PV (n = 36) and combined SMV/PV and SpVT (n = 27). On multivariate logistic regression alcohol aetiology (OR 2.64, 95% CI [1.43-5.01]) and >50% necrosis of the pancreas (OR 14.6, 95% CI [1.43-383.9]) increased the risk of developing SVT. The rate of recanalization with anticoagulation was higher for PVT (66.7%; 42/63) than in SpVT (2/11; p = 0.003). 5/74 of anticoagulated patients developed bleeding complications while 0/35 patients not anticoagulated had bleeding complications (p = 0.4).
    Conclusion: The risk of SVT increases with AP severity and with extent of pancreatic necrosis. A selective anticoagulation policy for PVT and progressive SpVT in AP is associated with favourable outcomes with no increased risk of bleeding complications.
    MeSH term(s) Humans ; Middle Aged ; Acute Disease ; Tertiary Care Centers ; Pancreatitis/complications ; Venous Thrombosis/diagnostic imaging ; Venous Thrombosis/drug therapy ; Portal Vein/diagnostic imaging ; Anticoagulants/adverse effects ; Policy ; United Kingdom/epidemiology
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2022-06-16
    Publishing country England
    Document type Journal Article
    ZDB-ID 2131251-5
    ISSN 1477-2574 ; 1365-182X
    ISSN (online) 1477-2574
    ISSN 1365-182X
    DOI 10.1016/j.hpb.2022.06.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6326: Show issues Location:
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  3. Article: Role of synoptic-scale forcing in cyclogenesis over the Bay of Bengal

    Akter, Nasreen / Tsuboki, Kazuhisa

    Climate dynamics. 2014 Nov., v. 43, no. 9-10

    2014  

    Abstract: The cyclone frequency distribution over the Bay of Bengal during 1990–2009 was distinctly bimodal, with a primary post-monsoon peak and a secondary pre-monsoon peak, despite the very high convective available potential energy (CAPE) during the pre- ... ...

    Abstract The cyclone frequency distribution over the Bay of Bengal during 1990–2009 was distinctly bimodal, with a primary post-monsoon peak and a secondary pre-monsoon peak, despite the very high convective available potential energy (CAPE) during the pre-monsoon. The location of the monsoon trough over the bay is a primary factor in tropical cyclogenesis. Because the trough was in the northernmost bay during the pre-monsoon season, cyclogenesis was inactive in the southern bay, where a strong southwesterly wind shear was found. In this season, moreover, a hot, dry air mass extending vertically from 950 to 600 hPa was advected from northwestern India toward the bay. Moist, warm southwesterly winds penetrating below the deep, dry air mass caused a prominent dryline to form aloft on the northwestern side of the bay. The synoptic-scale hot, dry air forcing to the bay suppressed the active convection necessary for cyclogenesis. The strength of the stable environmental layer, represented by convective inhibition (CIN), was extremely large, and acted as a cap over the northern and northwestern bay. Conversely, during the post-monsoon, there were no horizontal temperature or moisture gradients, and CAPE and CIN were fairly modest. The entire bay was covered by a very deep, moist layer from the surface to 700 hPa transported from the east. The monsoon trough position and the environmental CIN in combination can explain the lower frequency of cyclogenesis during the pre-monsoon compared with the post-monsoon season.
    Keywords air ; energy ; monsoon season ; temperature ; Bay of Bengal ; India
    Language English
    Dates of publication 2014-11
    Size p. 2651-2662.
    Publishing place Springer-Verlag
    Document type Article
    ZDB-ID 1471747-5
    ISSN 1432-0894 ; 0930-7575
    ISSN (online) 1432-0894
    ISSN 0930-7575
    DOI 10.1007/s00382-014-2077-9
    Database NAL-Catalogue (AGRICOLA)

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  4. Article ; Online: Meta-Analysis and Meta-Regression of Risk Factors for Surgical Site Infections in Hepatic and Pancreatic Resection.

    Mentor, Keno / Ratnayake, Bathiya / Akter, Nasreen / Alessandri, Giorgio / Sen, Gourab / French, Jeremy J / Manas, Derek M / Hammond, John S / Pandanaboyana, Sanjay

    World journal of surgery

    2020  Volume 44, Issue 12, Page(s) 4221–4230

    Abstract: Background: The risk factors for surgical site infection (SSI) after HPB surgery are poorly defined. This meta-analysis aimed to quantify the SSI rates and risk factors for SSI after pancreas and liver resection.: Methods: The PUBMED, MEDLINE and ... ...

    Abstract Background: The risk factors for surgical site infection (SSI) after HPB surgery are poorly defined. This meta-analysis aimed to quantify the SSI rates and risk factors for SSI after pancreas and liver resection.
    Methods: The PUBMED, MEDLINE and EMBASE databases were systematically searched using the PRISMA framework. The primary outcome measure was pooled SSI rates. The secondary outcome measure was risk factor profile determination for SSI.
    Results: The overall rate of SSI after pancreatic and liver resection was 25.1 and 10.4%, respectively (p < 0.001). 32% of pancreaticoduodenectomies developed SSI vs 23% after distal pancreatectomy (p < 0.001). The rate of incisional SSI in the pancreatic group was 9% and organ/space SSI 16.5%. Biliary resection during liver surgery was a risk factor for SSI (25.0 vs 15.7%, p = 0.002). After liver resection, the incisional SSI rate was 7.6% and the organ space SSI rate was 10.2%. Pancreas-specific SSI risk factors were pre-operative biliary drainage (p < 0.001), chemotherapy (p < 0.001) and radiotherapy (p = 0.007). Liver-specific SSI risk factors were smoking (p = 0.046), low albumin (p < 0.001) and significant blood loss (p < 0.001). The rate of organ/space SSI in patients with POPF was 47.7% and in patients without POPF 7.3% (p < 0.001). Organ/space SSI rate was 43% in patients with bile leak and 10% in those without (p < 0.001).
    Conclusions: The risk factors for SSI following pancreatic and liver resections are distinct from each other, with higher SSI rates after pancreatic resection. Pancreaticoduodenectomy has increased risk of SSI compared to distal pancreatectomy. Similarly, biliary resections during liver surgery increase the rates of SSI.
    MeSH term(s) Hepatectomy/adverse effects ; Humans ; Liver ; Pancreatectomy/adverse effects ; Risk Factors ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/etiology
    Language English
    Publishing date 2020-08-18
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Review
    ZDB-ID 224043-9
    ISSN 1432-2323 ; 0364-2313
    ISSN (online) 1432-2323
    ISSN 0364-2313
    DOI 10.1007/s00268-020-05741-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1336: 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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  5. Article: Role of synoptic-scale forcing in cyclogenesis over the Bay of Bengal

    Akter, Nasreen / Tsuboki, Kazuhisa

    Climate dynamics

    Volume v. 43,, Issue no. 9

    Abstract: The cyclone frequency distribution over the Bay of Bengal during 1990–2009 was distinctly bimodal, with a primary post-monsoon peak and a secondary pre-monsoon peak, despite the very high convective available potential energy (CAPE) during the pre- ... ...

    Abstract The cyclone frequency distribution over the Bay of Bengal during 1990–2009 was distinctly bimodal, with a primary post-monsoon peak and a secondary pre-monsoon peak, despite the very high convective available potential energy (CAPE) during the pre-monsoon. The location of the monsoon trough over the bay is a primary factor in tropical cyclogenesis. Because the trough was in the northernmost bay during the pre-monsoon season, cyclogenesis was inactive in the southern bay, where a strong southwesterly wind shear was found. In this season, moreover, a hot, dry air mass extending vertically from 950 to 600 hPa was advected from northwestern India toward the bay. Moist, warm southwesterly winds penetrating below the deep, dry air mass caused a prominent dryline to form aloft on the northwestern side of the bay. The synoptic-scale hot, dry air forcing to the bay suppressed the active convection necessary for cyclogenesis. The strength of the stable environmental layer, represented by convective inhibition (CIN), was extremely large, and acted as a cap over the northern and northwestern bay. Conversely, during the post-monsoon, there were no horizontal temperature or moisture gradients, and CAPE and CIN were fairly modest. The entire bay was covered by a very deep, moist layer from the surface to 700 hPa transported from the east. The monsoon trough position and the environmental CIN in combination can explain the lower frequency of cyclogenesis during the pre-monsoon compared with the post-monsoon season.
    Keywords monsoon season ; air ; energy ; temperature
    Language English
    Document type Article
    ISSN 0930-7575
    Database AGRIS - International Information System for the Agricultural Sciences and Technology

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