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  1. Article ; Online: Guideline adherence in acute pancreatitis: Still a long way to go.

    Mahapatra, Soumya Jagannath / Olesen, Søren Schou

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

    2024  Volume 24, Issue 3, Page(s) 325–326

    MeSH term(s) Humans ; Pancreatitis/surgery ; Guideline Adherence ; Acute Disease ; Cholecystectomy
    Language English
    Publishing date 2024-03-02
    Publishing country Switzerland
    Document type Editorial
    ZDB-ID 2056680-3
    ISSN 1424-3911 ; 1424-3903
    ISSN (online) 1424-3911
    ISSN 1424-3903
    DOI 10.1016/j.pan.2024.03.001
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  2. Article ; Online: Development and Validation of a Machine Learning Model to Predict Weekly Risk of Hypoglycemia in Patients with Type 1 Diabetes Based on Continuous Glucose Monitoring.

    Cichosz, Simon Lebech / Jensen, Morten Hasselstrøm / Olesen, Søren Schou

    Diabetes technology & therapeutics

    2024  

    Abstract: Aim: The aim of this study was to develop and validate a prediction model based on CGM data to identify a week-to-week risk profile of excessive hypoglycemia.: Methods: We analyzed, trained, and internally tested two prediction models using CGM data ... ...

    Abstract Aim: The aim of this study was to develop and validate a prediction model based on CGM data to identify a week-to-week risk profile of excessive hypoglycemia.
    Methods: We analyzed, trained, and internally tested two prediction models using CGM data from 205 type 1 diabetes patients with long-term CGM monitoring. A binary classification approach (XGBoost) combined with feature engineering deployed on the CGM signals was utilized to predict excessive hypoglycemia risk defined by two targets (TBR > 4% and the upper TBR 90th percentile limit) of time below range (TBR) the following week. The models were validated in two independent cohorts with a total of 253 additional patients.
    Results: A total of 61,470 weeks of CGM data were included in the analysis. The XGBoost models had a ROC-AUC of 0.83-0.87 (95% confidence interval [CI]; 0.83-0.88) in the test dataset. The external validation showed ROC-AUCs of 0.81-0.90. The most discriminative features included the low blood glucose index (LBGI), the glycemic risk assessment diabetes equation (GRADE), hypoglycemia, the TBR, waveform length, the CV and mean glucose during the previous week. This highlights that the pattern of hypoglycemia combined with glucose variability during the past week contains information on the risk of future hypoglycemia.
    Conclusion: Prediction models based on real-world CGM data can be used to predict the risk of hypoglycemia in the forthcoming week. The models showed good performance in both the internal and external validation cohorts.
    Language English
    Publishing date 2024-01-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1452816-2
    ISSN 1557-8593 ; 1520-9156
    ISSN (online) 1557-8593
    ISSN 1520-9156
    DOI 10.1089/dia.2023.0532
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  3. Article ; Online: Reply.

    Cook, Mathias Ellgaard / Bruun, Niels Henrik / Olesen, Søren Schou

    Gastroenterology

    2024  

    Language English
    Publishing date 2024-02-29
    Publishing country United States
    Document type Letter
    ZDB-ID 80112-4
    ISSN 1528-0012 ; 0016-5085
    ISSN (online) 1528-0012
    ISSN 0016-5085
    DOI 10.1053/j.gastro.2024.02.036
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  4. Article ; Online: Metabolic Sequelae and All-Cause Mortality in Chronic Pancreatitis With and Without Prior Acute Pancreatitis: A Nationwide Population-Based Cohort Study.

    Cook, Mathias Ellgaard / Bruun, Niels Henrik / Davidsen, Line / Vestergaard, Peter / Drewes, Asbjørn Mohr / Olesen, Søren Schou

    The American journal of gastroenterology

    2024  

    Abstract: Objectives: To investigate the risk of metabolic sequelae and all-cause mortality in a population-based cohort of chronic pancreatitis (CP) patients with and without prior acute pancreatitis (AP).: Methods: We used nationwide health registries to ... ...

    Abstract Objectives: To investigate the risk of metabolic sequelae and all-cause mortality in a population-based cohort of chronic pancreatitis (CP) patients with and without prior acute pancreatitis (AP).
    Methods: We used nationwide health registries to identify all Danish residents (>18 years) with incident CP from 2000-2018. Information on AP/CP diagnoses, metabolic sequelae (post-pancreatitis diabetes mellitus (PPDM), exocrine pancreatic dysfunction (EPD), and osteoporosis), and all-cause mortality were obtained from Danish national health registries. CP cases were stratified based on the presence of AP prior to CP diagnosis. The risk of metabolic sequelae and all-cause mortality was expressed as hazard ratios (HRs) with 95% confidence intervals (CIs), calculated using multivariate Cox proportional hazards models.
    Results: A total of 9655 CP patients were included. Among CP patients, 3913 (40.5%) had a prior AP diagnosis. Compared to patients without a history of AP, patients with prior AP had a decreased risk of death (HR 0.79 (95% CI, 0.74-0.84)), which was largely confined to the initial period after CP diagnosis. Patients with prior AP had an increased risk of PPDM (HR 1.53 (95% CI, 1.38-1.69)), which persisted for up to a decade after CP diagnosis. No overall differences in risk were observed for EPD (HR 0.97 (95% CI, 0.87-1.07)) and osteoporosis (HR 0.87 (95% CI, 0.74-1.02)).
    Conclusions: This nationwide study revealed that the majority of CP patients have no prior episode(s) of AP, indicating that an attack of AP sensitizing the pancreas is not essential for CP development. CP patients with and without prior AP have different risk profiles of PPDM and all-cause mortality.
    Language English
    Publishing date 2024-04-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 390122-1
    ISSN 1572-0241 ; 0002-9270
    ISSN (online) 1572-0241
    ISSN 0002-9270
    DOI 10.14309/ajg.0000000000002799
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  5. Article ; Online: Sialadenitis in a patient with ulcerative colitis and autoimmune pancreatitis type 2.

    Detlefsen, Sönke / Olesen, Søren Schou

    Pathology, research and practice

    2020  Volume 216, Issue 9, Page(s) 153072

    Abstract: Autoimmune pancreatitis (AIP) is a distinct form of chronic pancreatitis that has been increasingly recognised over the last decades and shows a good response to corticosteroid treatment. Two different forms of AIP have been characterized. Type 1 AIP is ... ...

    Abstract Autoimmune pancreatitis (AIP) is a distinct form of chronic pancreatitis that has been increasingly recognised over the last decades and shows a good response to corticosteroid treatment. Two different forms of AIP have been characterized. Type 1 AIP is the pancreatic manifestation of IgG4-related disease and often affects multiple organ systems. In contrast, type 2 AIP is confined to the pancreas and involvement of extra-pancreatic organs has previously only very rarely been reported, except for an association with inflammatory bowel disease. The hallmark lesion of type 2 AIP is the granulocyte epithelial lesion (GEL), showing infiltration of neutrophilic granulocytes in the epithelium of pancreatic ducts and their accumulation in the duct lumen. We present a 61-year-old female patient who underwent pancreaticoduodenectomy with a postoperative histological diagnosis of type 2 AIP. Three months later, she underwent colectomy and was diagnosed with ulcerative colitis. One year later, she presented with swelling and pain of the right-sided submandibular salivary gland which was resected. Sialadenitis with lymphoplasmacytic inflammation, obliterative phlebitis, fibrosis and frequent accumulation of neutrophilic granulocytes in ducts, reminiscent of GELs, without IgG4-positivity or epitheloid cell granulomas, was found. Later, she presented with swelling and pain related to the left-sided submandibular gland, which resolved after steroid treatment. We describe the clinical, histological and immunohistochemical findings in this patient. It may be hypothesized that the sialadenitis may represent a rare extrapancreatic manifestation of, alternatively a rare association with, type 2 AIP or ulcerative colitis.
    MeSH term(s) Autoimmune Diseases/immunology ; Autoimmune Pancreatitis/diagnosis ; Autoimmune Pancreatitis/immunology ; Autoimmune Pancreatitis/pathology ; Colitis, Ulcerative/complications ; Colitis, Ulcerative/diagnosis ; Colitis, Ulcerative/pathology ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/immunology ; Diabetes Mellitus, Type 2/pathology ; Female ; Granulocytes/pathology ; Humans ; Middle Aged ; Pancreas/pathology ; Pancreatic Ducts/pathology ; Pancreatitis, Chronic/diagnosis ; Pancreatitis, Chronic/pathology ; Sialadenitis/diagnosis ; Sialadenitis/pathology
    Language English
    Publishing date 2020-06-18
    Publishing country Germany
    Document type Case Reports ; Journal Article
    ZDB-ID 391889-0
    ISSN 1618-0631 ; 0344-0338
    ISSN (online) 1618-0631
    ISSN 0344-0338
    DOI 10.1016/j.prp.2020.153072
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  6. Article: Spinal Excitability in Patients with Painful Chronic Pancreatitis.

    Knoph, Cecilie Siggaard / Nedergaard, Rasmus Bach / Olesen, Søren Schou / Kuhlmann, Louise / Drewes, Asbjørn Mohr

    Journal of pain research

    2023  Volume 16, Page(s) 2287–2298

    Abstract: Purpose: Abdominal pain is common in patients with chronic pancreatitis (CP), but management is challenging - possibly due to altered pain processing within the central nervous system rendering conventional treatments ineffective. We hypothesized that ... ...

    Abstract Purpose: Abdominal pain is common in patients with chronic pancreatitis (CP), but management is challenging - possibly due to altered pain processing within the central nervous system rendering conventional treatments ineffective. We hypothesized that many patients with painful CP have generalized hyperalgesia correlating with central neuronal hyperexcitability.
    Patients and methods: Seventeen CP patients with pain and 20 matched healthy controls underwent experimental pain testing, including repeated pain stimuli (temporal summation), pressure algometry performed in dermatomes with same spinal innervation as the pancreatic gland (pancreatic areas) and remote dermatomes (control areas), a cold pressor test and a conditioned pain modulation paradigm. To probe central neuronal excitability, the nociceptive withdrawal reflex was elicited by electrical stimulation of the plantar skin, and electromyography was obtained from the ipsilateral anterior tibial muscle together with somatosensory evoked brain potentials.
    Results: Compared to healthy controls, patients with painful CP had generalized hyperalgesia as evidenced by 45% lower pressure pain detection thresholds (P<0.05) and decreased cold pressor endurance time (120 vs 180 seconds, P<0.001). In patients, reflex thresholds were lower (14 vs 23 mA, P=0.02), and electromyographic responses were increased (16.4 vs 9.7, P=0.04) during the withdrawal reflex, reflecting predominantly spinal hyperexcitability. Evoked brain potentials did not differ between groups. A positive correlation was found between reflex thresholds and cold pressor endurance time (
    Conclusion: We demonstrated somatic hyperalgesia in patients with painful CP associated with spinal hyperexcitability. This highlights that management should be directed at central mechanisms using, eg, gabapentinoids or serotonin-noradrenaline reuptake inhibitors.
    Language English
    Publishing date 2023-07-05
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2495284-9
    ISSN 1178-7090
    ISSN 1178-7090
    DOI 10.2147/JPR.S408523
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  7. Article ; Online: Multistate Model of the Natural History of Inflammatory Pancreatic Diseases: A Nationwide Population-based Cohort Study.

    Cook, Mathias Ellgaard / Bruun, Niels Henrik / Davidsen, Line / Drewes, Asbjørn Mohr / Olesen, Søren Schou

    Gastroenterology

    2023  Volume 165, Issue 6, Page(s) 1547–1557.e4

    Abstract: Background & aims: Understanding the nature of inflammatory pancreatic diseases is essential for planning health care system requirements and interventions. The aim of this study was to quantify the trajectories of inflammatory pancreatic diseases and ... ...

    Abstract Background & aims: Understanding the nature of inflammatory pancreatic diseases is essential for planning health care system requirements and interventions. The aim of this study was to quantify the trajectories of inflammatory pancreatic diseases and their association with pancreatic cancer in a population-based setting.
    Methods: National health registries were used to identify all Danish residents (18 years or older) in the period from 2000 through 2018 with incident cases of acute pancreatitis (AP), recurrent acute pancreatitis (RAP), chronic pancreatitis (CP), and pancreatic cancer. We used a multistate model to examine transitions from a healthy state to intermediate states of acute pancreatic inflammation (AP and RAP) to chronic states (CP and pancreatic cancer) and, ultimately, death. Results were reported as transition incidence rates per 1000 person-years with 95% CIs.
    Results: There were 4,663,864 individuals included (mean age, 46 years; 51% were women). During a mean follow-up of 16.8 years, 31,396 individuals were diagnosed with incident AP, 5546 with RAP, 8898 with CP, and 18,182 with pancreatic cancer. The cumulative incidence of pancreatitis (acute and chronic) during the study period was 0.80% (95% CI, 0.79%-0.80%). The transition incidence rates to CP were 12.1 (95% CI, 8.1-18.1) from AP, 46.8 (95% CI, 31.6-69.3) from RAP, and 0.07 (95% CI, 0.04-0.13) from a healthy state. Similar patterns were observed for transitions to pancreatic cancer. Most patients diagnosed with CP (64.2%) and pancreatic cancer (96.4%) transitioned directly from a healthy state. Among patients with pancreatitis, 41.0% (95% CI, 40.5%-41.5%) died during follow-up.
    Conclusions: The study findings revealed an increased risk of CP and pancreatic cancer in patients with a history of AP. However, most patients with CP and pancreatic cancer transitioned directly from a healthy state.
    MeSH term(s) Humans ; Female ; Middle Aged ; Male ; Acute Disease ; Cohort Studies ; Pancreatic Diseases ; Pancreatic Neoplasms/epidemiology ; Pancreatitis, Chronic/epidemiology ; Pancreatic Neoplasms
    Language English
    Publishing date 2023-09-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80112-4
    ISSN 1528-0012 ; 0016-5085
    ISSN (online) 1528-0012
    ISSN 0016-5085
    DOI 10.1053/j.gastro.2023.08.042
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  8. Article ; Online: Varenicline for Smoking Cessation in Patients With Chronic Pancreatitis.

    Knoph, Cecilie Siggaard / Kamronn, Terese Matthesen / Drewes, Asbjørn Mohr / Nielsen, Lars Peter / Olesen, Søren Schou

    Pancreas

    2023  Volume 51, Issue 10, Page(s) e117–e118

    MeSH term(s) Humans ; Varenicline/therapeutic use ; Smoking Cessation ; Smoking ; Pancreatitis, Chronic/drug therapy
    Chemical Substances Varenicline (W6HS99O8ZO)
    Language English
    Publishing date 2023-04-20
    Publishing country United States
    Document type Letter
    ZDB-ID 632831-3
    ISSN 1536-4828 ; 0885-3177
    ISSN (online) 1536-4828
    ISSN 0885-3177
    DOI 10.1097/MPA.0000000000002201
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  9. Article ; Online: Co-existence of hepatic and pancreatic fibrosis in chronic pancreatitis patients including associated risk factors: a magnetic resonance elastography study.

    Nauser, Serena / Steinkohl, Emily / Olesen, Søren Schou / Drewes, Asbjørn Mohr / Frøkjær, Jens Brøndum

    Scandinavian journal of gastroenterology

    2023  Volume 59, Issue 1, Page(s) 100–107

    Abstract: Objectives: To investigate the co-existence of hepatic and pancreatic fibrosis using magnetic resonance elastography (MRE) in chronic pancreatitis (CP), including the association between hepatic and pancreatic MRE-derived stiffness and exploration of ... ...

    Abstract Objectives: To investigate the co-existence of hepatic and pancreatic fibrosis using magnetic resonance elastography (MRE) in chronic pancreatitis (CP), including the association between hepatic and pancreatic MRE-derived stiffness and exploration of potential etiological risk factors.
    Materials and methods: Fifty-four CP patients and 35 healthy controls underwent hepatic and pancreatic MRE with measurements of tissue stiffness. Clinical parameters including stage (probable or definite CP), etiology of CP, the presence of diabetes or exocrine insufficiency, and previous history of common bile duct stenosis were assessed. Uni- and multivariate regression models were used to investigate risk factors associated with hepatic fibrosis/stiffness in CP patients.
    Results: Fifteen percent of CP patients and none of the controls had abnormal liver stiffness (>2.5 kPa),
    Conclusions: Only a modest co-existence of hepatic and pancreatic fibrosis was observed in CP. However, the positive association between hepatic and pancreatic stiffness indicates some level of common pathophysiology. Especially, alcoholic etiology of CP was related to increased hepatic stiffness.
    MeSH term(s) Humans ; Elasticity Imaging Techniques ; Constriction, Pathologic ; Liver/pathology ; Liver Cirrhosis/complications ; Liver Cirrhosis/diagnostic imaging ; Liver Cirrhosis/pathology ; Pancreatitis, Chronic/complications ; Pancreatitis, Chronic/diagnostic imaging ; Pancreatitis, Chronic/pathology ; Magnetic Resonance Imaging ; Diabetes Mellitus/epidemiology
    Language English
    Publishing date 2023-08-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 82042-8
    ISSN 1502-7708 ; 0036-5521
    ISSN (online) 1502-7708
    ISSN 0036-5521
    DOI 10.1080/00365521.2023.2250496
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  10. Article ; Online: Reply.

    Drewes, Asbjørn Mohr / Olesen, Søren Schou / Juel, Jacob

    Pancreas

    2020  Volume 49, Issue 9, Page(s) e82–e83

    MeSH term(s) Acupuncture Therapy ; Cross-Over Studies ; Humans ; Pain ; Pancreatitis, Chronic
    Language English
    Publishing date 2020-09-28
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 632831-3
    ISSN 1536-4828 ; 0885-3177
    ISSN (online) 1536-4828
    ISSN 0885-3177
    DOI 10.1097/MPA.0000000000001641
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