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| 1 | Impact of a clinical pathway on treatment outcome in patients with acute pancreatitis显示文摘AIM:To determine the impact of a clinical pathway(CP) on acute pancreatitis(AP) treatment outcome.METHODS:A retrospective analysis of medical records was performed. We compared the results of AP treatment outcome over two time periods in our centre,before(2006-2007) and after(2010-2012) the implementation of a CP. The CP comprised the following indicators of quality:performance of all laboratory tests on admission(including lipids and carbohydrate deficient transferrin),determination of AP aetiology,abdomen ultrasound(US) within the first 24 h after admission,contrast-enhanced computed tomography of the abdomen in all cases of suspected pancreatic necrosis,appropriately selected and sufficiently used antibiotic therapy(if necessary),pain control,adequate hydration,control of haemodynamic parameters and transfer to the Intensive Care Unit(ICU)(if necessary),endoscopic retrograde cholangiopancreatography(ERCP) in biliary AP,surgical treatment(if necessary),and advice on outpatient follow-up after discharge. A comparison of the length of stay with that in other Slovenian hospitals was also performed.RESULTS:There were 139 patients treated in the three-year period after the introduction of a CP,of which 81(58.3%) were male and 58(41.7%) female. The patients' mean age was 59.6 ± 17.3 years. The most common aetiologies were alcoholism and gallstones(38.8% each),followed by unexplained(11.5%),drug-induced,hypertriglyceridemia,post ERCP(2.9% each) and tumours(2.2%). Antibiotic therapy was prescribed in 72(51.8%) patients. Abdominal US was performed in all patients within the first 24 h after admission. Thirty-two(23.0%) patients were treated in the ICU. Four patients died(2.9%). In comparison to 2006-2007,we found an increased number of alcoholic and biliary AP and an associateddecrease in the number of unexplained aetiology cases. The use of antibiotics also significantly decreased after the implementation of a CP(from 70.3% to 51.8%; P = 0.003). There was no statistically significant difference in mortality(1.8% vs 2.9%). The length of stay was significantly shorter when compared to the Slovenian average(P = 0.018).CONCLUSION:The introduction of a CP has improved the treatment of patients with AP,as assessed by all of the observed parameters. | Miroslav Vujasinovic Jana Makuc Bojan Tepes Apolon Marolt Zdenko Kikec Nace Robac | 2015 | World Journal of Gastroenterology2015，21，30： | 13 |
| 2 | Pancreatic exocrine insufficiency, diabetes mellitus and serum nutritional markers after acute pancreatitis显示文摘AIM:To investigate impairment and clinical significance of exocrine and endocrine pancreatic function in patients after acute pancreatitis(AP).METHODS:Patients with AP were invited to participate in the study.Severity of AP was determined by the Atlanta classification and definitions revised in2012.Pancreatic exocrine insufficiency(PEI)was diagnosed by the concentration of fecal elastase-1.An additional work-up,including laboratory testing of serum nutritional markers for determination ofmalnutrition,was offered to all patients with low levels of fecal elastase-1 FE.Hemoglobin A1c or oral glucose tolerance tests were also performed in patients without prior diabetes mellitus,and type 3c diabetes mellitus(T3c DM)was diagnosed according to American Diabetes Association criteria.RESULTS:One hundred patients were included in the study:75%(75/100)of patients had one attack of AP and 25%(25/100)had two or more attacks.The most common etiology was alcohol.Mild,moderately severe and severe AP were present in 67,15 and 18%of patients,respectively.The mean time from attack of AP to inclusion in the study was 2.7 years.PEI was diagnosed in 21%(21/100)of patients and T3c DM in14%(14/100)of patients.In all patients with PEI,at least one serologic nutritional marker was below the lower limit of normal.T3c DM was more frequently present in patients with severe AP(P=0.031),but was also present in some patients with mild and moderately severe AP.PEI was present in all degrees of severity of AP.There were no statistically significantly differences according to gender,etiology and number of AP attacks.CONCLUSION:As exocrine and endocrine pancreatic insufficiency can develop after AP,routine follow-up of patients is necessary,for which serum nutritional panel measurements can be useful. | Miroslav Vujasinovic Bojan Tepes Jana Makuc Sasa Rudolf Jelka Zaletel Tjasa Vidmar Maja Seruga Bostjan Birsa | 2014 | World Journal of Gastroenterology2014，20，48： | 10 |
| 3 | Chronological trend in blood lead levels between 1976 and 1980显示文摘 | Annest J L Pirkle J L Makuc D | 1983 | N Engl J Med1983，308，23： | 1 |
| 4 | A Review of Oxidative Stress Related Genes and New Antioxidant Therapy in Diabetic Nephropathy显示文摘 | Jana Makuc Danijel Petrovic | 2011 | Cardiovascular and Hematological Agents in Medicinal Chemistry (Formerly Current Medicinal Chemistry - Cardiovascular and Hematological Agents)2011，，： | 1 |
| 5 | Erythrocyte sedimentation rate and coronary heart disease: The NHANES I epidemiologic follow up study显示文摘 | Gillum R F Mussolino M E Makuc D M | 1995 | Journal of Clinical Epidemiology1995，48，： | 1 |
| 6 | Pulse rate,coronary heart disease,anddeath:the NHANES I epidemiologic follow-up study显示文摘 | Gillum RF Makuc DM Feldman JJ | 1991 | Am Heart J1991，121，： | 1 |
| 7 | Drug poi- soning deaths in the United States, 1980-2008显示文摘 | Margaret Warner Li Hui Chen l)iane M Makuc | 2011 | NCHS Data Brief2011，，81： | 1 |
| 8 | A review of oxidative stress related genes and new antioxidant therapy in diabetic nephropathy 显示文摘 | Makuc J Petrovic D | 2011 | Cardiovasc HematolAgentsMedChem2011，9，4： | 1 |
| 9 | 显示文摘 | Gillum RF Makuc DM Feldman JJ | 1991 | Am Heart J1991，121，： | 1 |
| 10 | Pulse rate, coronary heart disease and death: The NHANES I Epidemiologic Follow-up Study 显示文摘 | Gillum RF Makuc DM Feldman JJ | 1991 | Am Heart J1991，121，： | 1 |
| 11 | Relation between serum albumin concentration and stroke incidence and death: the NHANES I Epidemiologie Follow-up Study显示文摘 | Gillum RF lngram DD Makuc DM | 1994 | Am J Epidemiol1994，140，10： | 1 |
| 12 | Evaluation of white mat?ter damage in patients with Alzheimer's disease and in patients with mild cognitive impairment by using diffusion tensor imag?ing 显示文摘 | Ukmar M Makuc E Onor ML | 2008 | Radiol Med2008，113，6： | 1 |
| 13 | A review of oxidative stress related genes and new antioxidant therapy in diabetic nephropathy 显示文摘 | MAKUC J PETROVI~ D | 2011 | Cardiovasc Hematol Agents Med Chem2011，9，4： | 1 |
| 14 | Ambulatory health care visitsby children: principal diagnosis and place of visit显示文摘 | Freid VM Makuc DM Rooks RN | 1998 | Vital Health Stat1998，137，： | 1 |
| 15 | Serum albumin, coronary heart disease,and death显示文摘 | Gillum RF Makuc DM | 1992 | Am Heart J1992，123，2： | 1 |
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