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Severe Alcoholic Pancreatitis-Associated Acute Lung Injury in Veterans: Risks, Mechanisms, Prediction, and Therapeutic Relevance


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Background: Acute pancreatitis is a painful, potentially life-threatening condition of the pancreas with an unpredictable course. In this study we hope to identify and propose simple and reliable ways to predict and treat acute pancreatitis. Hypothesis: Alcohol increases systemic bioavailability of unsaturated fatty acids(UFAs). This, along with the resulting hypocalcemia and hypoalbuminemia worsen cell injury. We propose to test a novel yet simple ratio as a reliable predictor and therapeutic target in the management of alcoholic AP. Objective: To compare the [Serum free fatty acid/ (Serum calcium x albumin)] ratio as a predictor of severe alcoholic pancreatitis in veterans vs. other classical and proposed predictors. Methods: Patients admitted with acute pancreatitis are enrolled and laboratory results are recorded. Total of 7 patients and controls have been enrolled to date. Serum samples are obtained and sent to Mayo Clinic, Site 1, for analysis of FFA and circulating dead inflammatory cells. Echocardiogram is done within 24 hours of admission. Control groups include patients who abuse alcohol but do not have pancreatitis and healthy patients. We plan to study the strength of associations of various risk factors for severe acute pancreatitis in comparison to the [Serum free fatty acid/ (Serum calcium x albumin)] ratio. Conclusion: If our hypothesis is true, it would change the paradigm of managing serum calcium and albumin in acute pancreatitis. This would provide a better, novel yet simple predictor and approach to treatment for severe alcoholic pancreatitis, and potentially acute pancreatitis in general.



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