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Endocrine pancreatic insufficiency



Cystic fibrosis of the pancreas (cystic fibrosis) is a hereditary disease with a recessive type of inheritance. The frequency in the population is 2-8: 100 000 population. In patients with cystic fibrosis, the chlorine channel does not work on the apical part of the cell membrane, which leads to disruption of chlorine output from the cell, which promotes increased clearance of the sodium ions from the lumen to the interior of the cell, and behind it the aqueous component of the intercellular space. The consequence is the thickening of the secrets of the glands of external secretion (bronchopulmonary system, pancreas, salivary glands, sex glands). Most often, the respiratory system and pancreas are affected. The disease manifests itself respiratory and intestinal syndromes in the first year of life. The degree of interest of systems and bodies is different. Paraclinical markers are: coprogram - the presence of a large amount of neutral fat and almost always its predominance over muscle fibers and polysaccharides.

Ultrasound of the pancreas - diffuse compaction of the parenchyma, and with age, a decrease in the size of the pancreas.

High sweat chloride (60.0 and more mmol / l), repeatedly positive (not less than 3 times).

Molecular genetic examination. But it should be noted that the negative results of this study do not exclude the diagnosis of cystic fibrosis.

Syndrome Shvakhmana-Diamond (congenital hypoplasia of the pancreas, combined with neutropenia, low growth and bone anomaly).

Diagnosis based on the syndrome of pancreatic insufficiency in the first year of life, neutropenia, normal sweat chloride.

Chronic pancreatitis with exocrine insufficiency - the causes can be the transferred diseases, including epidemic parotitis, traumas, medications, toxins, diseases and anomalies of the biliary and pancreatic ducts, systemic diseases.

Specific enzyme defects (lipase, trypsinogen).

1.
Isolated deficiency of pancreatic lipase (Shedon-Rey syndrome) is manifested by fatty diarrhea due to neutral fats. Children have a good appetite, adequately develop in the physical and neuropsychic relationship.

Diagnosis: on the basis of fatty stool, neutral fat in the stool, normal sugar curve, test with d-xylose, a sharp decrease or absence of lipase in the pancreatic juice, no morphological changes in the pancreas, normal sweat chloride.

Treatment: substitution therapy.

2. Isolated insufficiency of trypsin occurs at a frequency of 1: 10,000; type of inheritance is autosomal recessive.

Clinically manifests itself shortly after birth with a mildew or watery stenchy stool on the background of natural feeding, poor development and increasing hypotrophy. In feces a large amount of protein and fats is found.

Treatment: substitution therapy.

3. Insufficiency of amylase - diagnosis based on clinical manifestations, watery, with a sour odor stool. Coprogram (starch). Decrease or absence of amylase activity. Effect on the background of elimination (starchless) diet.

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Endocrine pancreatic insufficiency

  1. Exocrine pancreatic insufficiency
    The most common cause of exocrine pancreatic insufficiency is chronic pancreatitis, which is usually a consequence of alcoholism. The development of chronic pancreatitis is usually gradual, so early diagnosis is often difficult. Over time, the disease progresses, there is a serious damage to the pancreas. With loss of exocrine pancreatic function disorder
  2. Pancreatic secretion
    The volume of the secretion of the pancreas is 1500 ml per day. It is secreted into the small intestine and contains enzymes that hydrolyze proteins, fats and starch. The main regulation of secretion is carried out by hormones. Cholecystokinin stimulates the secretion of enzymes, and secretin, above all, the secretion of bicarbonates. There is also regulation of secretion through the vagus nerve. Total secretion of the pancreas
  3. Stimulants of pancreatic secretion
    VIP and secretin stimulate pancreatic secretion by activating adenylate cyclase. As in other types of cells, adenylate cyclase promotes the formation of cAMP, resulting in the activation of protein kinase A, which enhances the secretion of pancreatic juice rich in bicarbonates. Other agonists (cholecystokinin, acetylcholine, gastrinilysing peptide, substance P) act through specific
  4. Characterization of endocrine glands in children, the effects of their hormones on organs and target cells, the semiotic of insufficiency or redundancy in the activity of the endocrine glands.
    Characteristics of endocrine glands in children, the effects of their hormones on organs and target cells, semiotics of insufficiency or redundancy of endocrine activity
  5. Diseases of the endocrine glands. Diseases of the endocrine part of the pancreas. Diabetes. Diseases of the thyroid gland. Thyroid gland tumors
    1. Etiological factors of diabetes mellitus 1. intoxication 2. tobacco smoking 3. helminth infections 4. viral infections 5. genetic predisposition 2. pathogenetic mechanisms of development of acute pancreatitis 1. dyskinesia of ducts 4. poisoning with fungi 2. biliary reflux 5. alcohol poisoning 3. gastroduodenal reflux 6. overeating 3. To establish conformity on the functional
  6. Endocrine function
    There are four types of endocrine cells. B cells (P) are the most numerous in the islets of Langerhans, they secrete insulin and are localized in the center of the islets. Other endocrine cells are located along the periphery of the islets around the B cells: A-cells (a) secreting glucagon; D-cells secreting somatostatin; F cells (PP) producing a pancreatic polypeptide. The ratio of A-, D- and
  7. Endocrine infertility
    Endocrine infertility is characterized by the absence of ovulation, caused by hormonal disorders. The cause of endocrine infertility can be pathological processes in the female sex glands - ovaries, as well as diseases of the endocrine organs: central organs that are in the brain - the pituitary gland, the hypothalamus, and the peripheral - the thyroid gland, the adrenal glands, etc. Endocrine disorders
  8. ENDOCRIN PART OF THE PANCREAS
    The pancreas consists of the exocrine and endocrine parts. The endocrine part is represented by groups of epithelial cells (islets of Langerhans), separated from the exocrine gland by thin connective tissue layers. Most of the islets are concentrated in the pancreatic tail. The dimensions of pancreatic islets range from 0.1 to 0.3 mm, and the total mass of them
  9. DISEASES OF THE ENDOCRINE SYSTEM
    The endocrine system is a collection of organs, cellular populations and individual cells that produce hormones. Hormones (in the broad sense) are called any biologically active substances of unfermented origin, released into the extracellular environment. The structure of the endocrine system includes three main components: central regulatory formations (hypothalamus, epiphysis, pituitary gland),
  10. ENDOCRINE RAW MATERIALS
    Veterinary and sanitary requirements for the collection, primary processing and conservation of endocrine raw materials. Preparations from organs, tissues and glands, obtained from slaughter animals, are called organopreparations. Raw materials for their production are divided into three groups: endocrine, enzymatic and special. The endocrine raw material is considered to be the pituitary gland, thyroid and parathyroid glands, the adrenal glands, the pancreas,
  11. Endocrine system
    The nervous system controls rapidly changing processes in the body by direct activation of muscles and glands. The endocrine system acts more slowly and indirectly on the work of groups of cells throughout the body through substances called hormones. Hormones are released into the bloodstream by various endocrine glands and transferred to other parts of the body, where they exert specific effects on
  12. Multiple endocrine neoplasias.
    This is a group of hereditary diseases characterized by tumors and / or hyperplasia of endocrine cells of several organs. The development of multiple endocrine neoplasias is probably associated with mutations inherited by an autosomal dominant type. In addition to the defeat of the endocrine glands, combined changes in other organs and tissues are possible (Table 35.4). Multiple endocrine neoplasias of type I
  13. Endocrine system
    growth impairment (gigantism and nanism) and body weight (obesity, malnutrition), distribution of the subcutaneous fat layer. Palpation of the thyroid gland. Sexual organs: secondary sexual characteristics (severity, formula). The state of the endocrine system can be judged on the basis of already conducted studies of the skin, subcutaneous tissue and somatometric measurements. With hormonal disorders can
  14. ENDOCRINE INFERTILITY IN WOMEN
    One of the most difficult and urgent problems of gynecology to date continues to be the problem of infertile marriage. According to epidemiological studies, the incidence of infertility in general in different countries of the world and in the territory of the Russian Federation fluctuates QJ 8 to 18%. At present, not only the structure of infertile marriage has been studied, but also the frequency and clinical significance of various
  15. Pathology of the endocrine system
    The pathology of the endocrine system can have a significant impact on the choice of anesthesia and special measures for patient safety during surgery and in the postoperative period. Pathology of the adrenal glands. For anesthesiologist, ensuring the safety of patients operated on the background of acute and chronic insufficiency of the adrenal cortex, primary
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