Aggressive fluid therapy in Acute Pancreatitis is harmful

Enrique de-Madaria, M.D., Ph.D., James L. Buxbaum, M.D., Patrick Maisonneuve, Dipl.Eng., Ana García García de Paredes, M.D et el published study in NEJM comparing aggressive versus moderate fluid therapy in Acute pancreatitis.  BACKGROUND Early aggressive hydration is widely recommended for the management of acute pancreatitis.  This is based on animal model observation of regional hypoperfusion … Read more

Tranexamic Acid fails to work in Gastrointestinal hemorrhage

Ian Roberts, Haleema Shakur-Still , Adefemi Afolabi, Christopher Hawkey et el (HALT-IT trial investigators) published a trial in Lancet  comparing tranexamic acid to placebo in gastrointestinal hemorrhage. Background Tranexamic acid(TXA) is known to prevent the  fibrinolysis.  Early use of TXA reduces surgical bleeding and death related to bleeding from traumatic injury and has reduced the … Read more

Enteral nutrition is better in Severe Pancreatitis : Another study

H Yao, C He, L Deng, G Liao et el  published in the European Journal of nutrition a meta analysis of small trials, comparing enteral versus parenteral nutrition in cases of severe pancreatitis. They analyzed the evidence from 348 patients from 5 small randomized trials. Meta-analysis showed significantly lower overall mortality risk with EN than with PN (risk ratio, 0.36; … Read more

New assay to diagnose late acetaminophen toxicity

Roberts DW, Lee WM, Hinson JA et el published a observational cohort study in Clinical Gastroenterology and Hepatology journal about utility of  point-of-care assay to detect acetaminophen protein adducts in patients suspected to have acetaminophen toxicity. They compared the accuracy of AcetaSTAT vs high-pressure liquid chromatography with electrochemical detection (HPLC-EC; a sensitive and specific quantitative analytic assay) to … Read more