0 stringlengths 12 494 | embeddings listlengths 384 384 |
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Chronic\tcholecystitis\tis\tlongstanding\tinflammation\tof\tthe\tgallbladder.\tIt\tis\tcaused\tby\trepeated,\tmild\tattacks\tof\nacute\tcholecystitis.\tThis\tleads\tto\tthickening\tof\tthe\twalls\tof\tthe\tgallbladder.\tThe\tgallbladder\tbegins\n\tto\tshrink\tand\neventually\tloses\tthe\tability\tto\tperform\tits\tfunc... | [
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0.015075... |
may\taggravate\tthe\tsymptoms\tof\tcholecystitis\tbecause\tbile\tis\tneeded\tto\tdigest\tsuch\tfoods.\tChronic\tcholecystitis\noccurs\tmore\toften\tin\twomen\tthan\tin\tmen,\tand\tthe\tincidence\tincreases\tafter\tthe\tage\tof\t40.\tRisk\tfactors\tinclude\tthe\npresence\tof\tgallstones\tand\ta\thistory\tof\n\tacute\tch... | [
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0.0283163... |
acute\tcholecystitis.\nSurgical\tmanagement\nAcute\tcholecystitis\trequires\tsurgical\tintervention\tunless\tmedically\tcontraindicated.\tWithout\tsurgery,\tthe\tcondition\nmay\teither\tsubside\tor\tprogress\tto\tgangrene.\nMedical\tnutrition\ttherapy\nAcute\tcholecystitis. | [
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0.04469172... |
Medical\tnutrition\ttherapy\nAcute\tcholecystitis.\nIn\tan\tacute\tattack,\toral\tfeedings\tare\ttemporarily\tdiscontinued.\tPN\tmay\tbe\tindicated\tif\tthe\tpatient\tis\tmalnourished\nand\tit\tis\tanticipated\tthat\n\tthey\twill\tnot\tbe\ttaking\tanything\torally\tfor\ta\tprolonged\tperiod.\tWhen\tfeedings\tare\tresum... | [
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0.00787546206265688,
0.025509176775813103,
-0.0072363466... |
a\tlow-fat\tdiet\tis\trecommended\tto\tdecrease\tgallbladder\tstimulation.\tA\thydrolyzed\tlow-fat\tformula\tor\tan\toral\tlow-fat\ndiet\tconsisting\tof\t30\tto\t45\tg\tof\tfat\tper\tday\tcan\tbe\tgiven.\t\nTable\t28.8\n\tshows\ta\tfat-restricted\tdiet.\nTABLE\t28.8\nFat-Restricted\tDiet\nFood\tAllowed\nFood\tto\tLimit... | [
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0.031... |
Fat-Restricted\tDiet\nFood\tAllowed\nFood\tto\tLimit\tor\tExclude\nBeverages\nSkim\tmilk\tor\tbuttermilk\tmade\twith\tskim\tmilk;\tcoffee,\ttea,\nPostum,\tfruit\tjuice,\tsoft\tdrinks,\tcocoa\tmade\twith\tcocoa\npowder\tand\tskim\tmilk\nWhole\tmilk,\tbuttermilk\tmade\twith\twhole\tmilk,\tchocolate\nmilk,\tcream\tin\texc... | [
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0.10514909029006958,
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0.06465158611536026,
-... |
Bread\tand\tCereal\tProducts\nPlain,\tnonfat\tcereals;\tspaghetti,\tnoodles,\trice,\tmacaroni;\tplain\nwhole\tgrain\tor\tenriched\tbreads,\tair-popped\tpopcorn,\tbagels,\nEnglish\tmuffins\nBiscuits,\tbreads,\tegg\tor\tcheese\tbread,\tsweet\trolls\tmade\nwith\tfat;\tpancakes,\tdoughnuts,\twaffles,\tfritters,\npopcorn\tp... | [
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0.0029702563770115376,
0.07398881763219833,
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0.09068857878446579,
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0.04805813357234001,
-0.... |
popcorn\tprepared\twith\tfat;\tmuffins,\tnatural\tcereals\tand\nbreads\tto\twhich\textra\tfat\tis\tadded\nCheese\nFat-free\tor\tlow-fat\tcottage\tcheese,\t¼\tc\tto\tbe\tused\tas\tsubstitute\nfor\t1\toz\tof\tcheese,\tor\tlow-fat\tcheeses\tcontaining\tless\tthan\t5%\nbutterfat\nWhole-milk\tcheeses\nDesserts\nSherbet\n\tm... | [
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0.04738708585500717,
0.0029587773606181145,
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0.06802718341350555,
0.003539077704772353,
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0.11461470276117325,
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0.030721228569746017,
-0.01... |
Desserts\nSherbet\n\tmade\twith\tskim\tmilk;\tnonfat\tfrozen\tyogurt;\tnonfat\nfrozen\tnondairy\tdesserts;\tfruit\tice;\tsorbet;\tgelatin;\trice,\nbread,\tcornstarch,\ttapioca,\tor\tpudding\tmade\twith\tskim\tmilk;\nfruit\twhips\twith\tgelatin,\tsugar,\tand\tegg\twhite;\tfruit;\tangel\nfood\tcake;\tgraham\tcrackers;\tv... | [
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0.00942891277372837,
0.12051601707935333,
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0.039509180933237076,
-0.06... |
food\tcake;\tgraham\tcrackers;\tvanilla\twafers;\tmeringues\nCake,\tpie,\tpastry,\tice\tcream,\tor\tany\tdessert\tcontaining\nshortening,\tchocolate,\tor\tfats\tof\tany\tkind,\tunless\nespecially\n\tprepared\tusing\tpart\tof\tfat\tallowance\nEggs\nThree\tper\tweek\tprepared\tonly\twith\tfat\tfrom\tfat\tallowance;\tegg\... | [
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0.04194120317697525,
-0.0419... |
whites\tas\tdesired;\tlow-fat\tegg\tsubstitutes\nMore\tthan\tone/day\tunless\tsubstituted\tfor\tpart\tof\tthe\tmeat\nallowed\nFats | [
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Choose\tup\tto\tthe\tlimit\tallowed\tamong\tthe\tfollowing\t(1\tserving\tin\nthe\tamount\tlisted\tequals\t1\tfat\tchoice):\n1\ttsp\tbutter\tor\tmargarine\n1\ttsp\tshortening\tor\toil\n1\ttsp\tmayonnaise\n2\ttsp\tItalian\tor\tFrench\tdressing\n1\tTbsp\treduced-fat\tsalad\tdressing\n1\tstrip\tcrisp\tbacon\n1/8\tavocado\t... | [
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0.04994495213031769,
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0.06915446370840073,
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0.05052665248513222,
0.0... |
2\tTbsp\tlight\tcream\n1\tTbsp\theavy\tcream\n6\tsmall\tnuts\n5\tsmall\tolives\nAny\tin\texcess\tof\tamount\tprescribed\ton\tdiet;\tall\tothers\nFruits\nAs\tdesired\nAvocado\tin\texcess\tof\tamount\tallowed\ton\tfat\tlist\nLean\tMeat,\tFish,\tPoultry,\tand\tMeat\tSubstitutes\nChoose\tup\tto\tthe\tlimit\tallowed\n\tamon... | [
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0.05610445514321327,
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0.06593220680952072,
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0.04284268617630005,
0.0955342948436737,
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-0.0231... |
Choose\tup\tto\tthe\tlimit\tallowed\n\tamong\tthe\tfollowing:\tpoultry\nwithout\tskin,\tfish,\tveal\t(all\tcuts),\tliver,\tlean\tbeef,\tpork,\tand\nlamb,\tall\twith\tvisible\tfat\tremoved—1\toz\tcooked\tweight\tequals\n1\tequivalent;\t¼\tc\twater-packed\ttuna\tor\tsalmon\tequals\n1\tequivalent;\ttofu\tor\ttempeh—3\toz\... | [
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0.050452396273612976,
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0.08113966137170792,
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0.07100898772478104,
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0.027307722717523575,
0... |
Fried\tor\tfatty\tmeats,\tsausage,\tscrapple,\tfrankfurters,\npoultry\tskins,\tstewing\thens,\tspareribs,\tsalt\tpork,\tbeef\nunless\tlean,\tduck,\tgoose,\n\tham\thocks,\tpig’s\tfeet,\nluncheon\tmeats\t(unless\treduced\tfat),\tgravies\tunless\tfat\nfree,\ttuna\tand\tsalmon\tpacked\tin\toil,\tpeanut\tbutter\nMilk\nSkim,... | [
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0.07438919693231583,
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0.050822045654058456,
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0.08922756463289261,
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0.06174519658088684,
-... |
Milk\nSkim,\tbuttermilk,\tor\tyogurt\tmade\tfrom\tskim\tmilk\nWhole,\t2%,\t1%,\tchocolate,\tbuttermilk\tmade\twith\twhole\nmilk\nSeasonings\nAs\tdesired\nNone\nSoups\nBouillon,\tclear\tbroth,\tfat-free\tvegetable\tsoup,\tcream\tsoup\tmade\nwith\tskim\tmilk,\tpackaged\tdehydrated\tsoups\nAll\n\tothers\nSweets\nJelly,\tj... | [
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0.0525871105492115,
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0.041578780859708786,
0.015823597088456154,
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0.009279687888920307,
0.07226086407899857,
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0.0712788924574852,
-0.01558... |
Jelly,\tjam,\tmarmalade,\thoney,\tsyrup,\tmolasses,\tsugar,\thard\tsugar\ncandies,\tfondant,\tgumdrops,\tjelly\tbeans,\tmarshmallows,\ncocoa\tpowder,\tfat-free\tchocolate\tsauce,\tred\tand\tblack\tlicorice\nAny\tcandy\tmade\twith\tchocolate,\tnuts,\tbutter,\tcream,\tor\tfat\nof\tany\tkind\nVegetables\nAll\tplainly\tpre... | [
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0.059273235499858856,
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0.011853630654513836,
0.1141723170876503,
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0.030810942873358727,
0.08759797364473343,
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0.07854986935853958,
-0.00... |
Potato\tchips;\tbuttered,\tau\tgratin,\tcreamed,\tor\tfried\npotatoes\tand\tother\tvegetables\n\tunless\tmade\twith\nallowed\tfat;\tcasseroles\tor\tfrozen\tvegetables\tin\tbutter\nsauce\nDaily\tFood\tAllowances\tfor\t40-g\tFat\tDiet\nFood\nAmount\nApproximate\tFat\nContent\t(g)\nSkim\tmilk\n2\tc\tor\tmore\n0\nLean\tmea... | [
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0.050383806228637695,
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0.024238215759396553,
0.12416166067123413,
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0.02960449829697609,
... |
6\toz\tor\t6\tequivalents\n18\nWhole\tegg\tor\tegg\tyolks\n3\tper\tweek\n2\nVegetables\n3\tservings\tor\tmore,\tat\tleast\t1\tor\tmore\ndark\tgreen\tor\tdeep\tyellow\n0\nFruits\n3\tor\tmore\tservings,\tat\tleast\n\t1\tcitrus\n0\nBreads,\tcereals\nAs\tdesired,\tfat\tfree\n0\nFat\texchanges\n*\n4-5\texchanges\tdaily\n20-... | [
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0.07163301855325699,
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0.0... |
As\tdesired\tfrom\tpermitted\tlist\n0\nTotal\tFat\n38-43\n*\nFat\tcontent\tcan\tbe\treduced\tfurther\tby\treducing\tthe\tfat\texchanges.\t1\tfat\texchange\t=\t5\tg\tof\tfat.\nAfter\tcholecystectomy,\tpatients\tmay\texperience\tsymptoms\tof\tgastritis\tsecondary\tto\tduodenogastric\treflux\tof\tbile\nacids.\tThe\n\trefl... | [
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0.017666475847363472,
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0.00009649971616454422,
0.0... |
acids.\tThe\n\treflux\talso\tmay\tbe\tresponsible\tfor\tsymptoms\tin\tthis\t\npostcholecystectomy\tsyndrome\n.\tAt\tpresent,\tthere\nare\tno\twell-established\tpharmacologic\tapproaches\tin\tthe\tmanagement\tof\tpostcholecystectomy\tgastritis.\tThe\nsymptoms\tare\tnot\tcaused,\tbut\texacerbated,\tby\tthe\tcholecystecto... | [
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0.05766318738460541,
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0.04906705766916275,
0.04086220636963844,
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0.026233652606606483,
0.05620711296796799,
0.04475034400820732,
0.031145570799708366,
0.024714... |
Chinese\therbs\thave\tbeen\tsuggested\t(\nZhang\tet\tal,\t2017\n).\tHowever,\tefficacy\tof\ttheir\n\tuse\tis\tlimited.\tThe\taddition\tof\nsoluble\tfiber\tto\tthe\tdiet\tmay\tact\tas\ta\tsequestering\tagent\tand\tbind\tthe\tbile\tin\tthe\tstomach\tbetween\tmeals\tto\tavoid\ngastritis.\nChronic\tcholecystitis. | [
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0.0014066919684410095,
0.07509111613035202,
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0.08515524119138718,
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0.01209313329309225,
0.08453170955181122,
0.15399301052093506,
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0.04734046757221222,
0.0207... |
gastritis.\nChronic\tcholecystitis.\nPatients\twith\tchronic\tconditions\tmay\trequire\ta\tlong-term,\tlow-fat\tdiet\tthat\tcontains\t25%\tto\t30%\tof\ttotal\tkilocalories\nas\tfat\t(see\t\nTable\t28.7\n).\tStricter\tlimitation\tis\tundesirable\tbecause\tfat\tin\tthe\tintestine\tis\timportant\n\tfor\tsome\tstimulation | [
0.04979376867413521,
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0.02188328094780445,
0.038147587329149246,
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0.06706429272890091,
0.05983281508088112,
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0.0800... |
for\tsome\tstimulation\nand\tdrainage\tof\tthe\tbiliary\ttract.\tAdditionally,\tsaturated\tfats\tshould\tbe\treplaced\twith\tfish\toil\tand\tpolyunsaturated\tfats\nto\treduce\tthe\trisk\tof\tgallstone\tformation\t(\nLee\tand\tJang,\t2012\n;\t\nStinton\tet\tal,\t2010\n;\t\nBerr\tet\tal,\t1992\n).\tThe\tdegree\tof | [
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0.031729862093925476,
0.03626096621155739,
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0.... |
;\t\nStinton\tet\tal,\t2010\n;\t\nBerr\tet\tal,\t1992\n).\tThe\tdegree\tof\nfood\tintolerance\tvaries\twidely\tamong\tpersons\twith\tgallbladder\tdisorders;\tmany\tcomplain\tof\tfoods\tthat\tcause\nflatulence\tand\tbloating.\tFor\n\tthis\treason,\tit\tis\tbest\tto\tdetermine\twith\tthe\tpatient\twhich\tfoods\tshould\tb... | [
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0.013073177076876163,
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0.07754052430391312,
0.011096931993961334,
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0.15218761563301086,
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0.06569969654083252,
... |
(see\t\nChapter\t27\n\tfor\ta\tdiscussion\tof\tpotential\tgas-forming\tfoods).\tAdministration\tof\twater-soluble\tforms\tof\tfat-soluble\nvitamins\tmay\tbe\tof\tbenefit\tin\tpatients\twith\tchronic\tgallbladder\tconditions\tor\tin\tthose\tin\twhom\tfat\tmalabsorption\tis\nsuspected.\nCholangitis\nPathophysiology\tand\... | [
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0.012993658892810345,
0.09764718264341354,
0.007130834273993969,
0.024795006960630417,
0.06... |
Inflammation\n\tof\tthe\tbile\tducts\tis\tknown\tas\t\ncholangitis\n.\tPatients\twith\tacute\tcholangitis\tneed\tresuscitation\twith\tfluids\nand\tbroad-spectrum\tantibiotics.\tIf\tthe\tpatient\tdoes\tnot\timprove\twith\tconservative\ttreatment,\tplacement\tof\ta\npercutaneous\tbiliary\tstent\tor\tcholecystectomy\tmay\... | [
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0.0331382192671299,
0.02653014101088047,
0.064124695956707,
0.1027679... |
Sclerosing\tcholangitis\tcan\tresult\tin\tsepsis\tand\tliver\tfailure.\tMost\tpatients\thave\tmultiple\tintrahepatic\tstrictures,\nwhich\n\tmakes\tsurgical\tintervention\tdifficult,\tif\tnot\timpossible.\tPatients\tare\tgenerally\ton\tbroad-spectrum\tantibiotics.\nPercutaneous\tductal\tdilation\tmay\tprovide\tshort-ter... | [
0.0316164530813694,
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0.04402463510632515,
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0.023843679577112198,
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0.008030042052268982,
0.07960370928049088,
-0.017320189625024796,
0.050055116415023804,
0.05505... |
patients\tmay\trequire\tchronic\tantibiotic\ttherapy\t(see\t\nPrimary\tSclerosing\tCholangitis\n).\nComplementary\tand\tintegrative\tmedicine\tfor\tgallstones\nPatients\toften\tseek\tcomplementary\n\tand\tintegrative\tapproaches\tto\tgallbladder\tdisease,\tincluding\tvarious\tnutritional | [
-0.0005892209010198712,
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0.0018619929905980825,
0.05669490247964859,
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... |
supplements,\therbal\tmedications,\tand\tgallbladder\tflushes.\tVitamin\tC\tdeficiency\thas\tbeen\tlinked\tto\tgallstone\nformation\tin\tanimal\tmodels\t(\nJenkins,\t1978\n).\tThe\tdata\tin\thumans\tare\tlimited,\tbut\tvitamin\tC\tsupplementation\thas\tbeen\nassociated\twith\ta\tdecreased\trisk\tof\tgallstones\tin\tpos... | [
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0.0014768121764063835,
0.... |
Simon\tet\tal,\t1998\n)\nand\tmay\tprotect\tagainst\tgallstones\t(\nWalcher\tet\tal,\t2009\n).\tIn\ta\tcross-sectional\tstudy\tof\t582\telderly\tpeople,\thigher\ncirculating\tlevels\tof\tvitamin\tE\twas\tassociated\twith\ta\tlower\tprobability\tof\tgallstone\tdisease\t(\nWaniek\tet\tal,\t2018\n). | [
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0.08480702340602875,
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0.005424332804977894,
0.07095233350992203,
-0.0569319948554039,
-0.045796751976013184,
-0.0184... |
Waniek\tet\tal,\t2018\n).\nCholeretic\t(substances\tthat\tincrease\tthe\tvolume\tof\tsecretion\tof\tbile\tfrom\tthe\tliver)\therbs\tsuch\tas\tmilk\tthistle,\ndandelion\troot,\tartichoke,\tturmeric,\tgreater\tcelandine,\n\tand\tOregon\tgrape\tstimulate\tbile\tflow\tand\treduce\tthe\tamount | [
-0.002325203735381365,
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0.04321134835481644,
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0.06951307505369186,
0.06921930611133575,
-0.04936628043651581,
0.025320325046777725,
0.038360... |
and\tOregon\tgrape\tstimulate\tbile\tflow\tand\treduce\tthe\tamount\nof\tcholesterol\tin\tbile.\tVarious\therbs\thave\tbeen\tsuggested\tas\ttreatment\toptions\tfor\tcholestasis\tand\tother\thepatobiliary\ndisorders\t(\nSpiridonov,\t2012\n).\tHowever,\tdata\tfrom\twell-conducted\trandomized\tcontrolled\ttrials\tis\tlimi... | [
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0.026286132633686066,
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0.017503654584288597,
0.03772585093975067,
0.07673704624176025,
0.0029089124873280525,
0.02879626862704754,
0.0... |
The\tuse\tof\tacupuncture\thas\tbeen\tproposed\tfor\tthe\ttreatment\tof\tgallstones\t(\nMoga,\t2003\n).\tIt\tis\tthought\tthat\nacupuncture\n\taids\tin\tthe\tremoval\tof\tstones.\tHowever,\tit\tmay\tbe\tthat\tacupuncture\taids\tin\tthe\trelief\tof\tpain\tmore\tso\nthan\tthe\tremoval\tof\tstones.\nPhysiology\tand\tfunct... | [
0.0152431083843112,
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0.04859881475567818,
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0.03727347031235695,
0.05265778675675392,
-0.009340008720755577,
-0.01659974828362465,
0.0584... |
Physiology\tand\tfunctions\tof\tthe\texocrine\tpancreas\nThe\tpancreas\tis\tan\telongated,\tflattened\tgland\tthat\tlies\tin\tthe\tupper\tabdomen\tbehind\tthe\tstomach.\tThe\thead\tof\tthe\npancreas\tis\tin\tthe\tright\tupper\tquadrant\tbelow\tthe\tliver\twithin\tthe\tcurvature\tof\tthe\tduodenum,\tand\tthe\n\ttapering... | [
0.021317731589078903,
-0.07964281737804413,
0.03663620725274086,
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0.002298018429428339,
0.0774039775133133,
0.0018922905437648296,
0.009337363764643669,
0.10229826718568802,
0.08984322100877762,
-0.053506165742874146,
-0.0011322855716571212,
0.04... |
slants\tupward\tto\tthe\thilum\tof\tthe\tspleen\t(see\t\nFig.\t28.6\n).\tThis\tglandular\torgan\thas\tan\tendocrine\tand\texocrine\nfunction.\tPancreatic\tcells\tmanufacture\tglucagon,\tinsulin,\tand\tsomatostatin\tfor\tabsorption\tinto\tthe\tbloodstream\n(endocrine\tfunction)\tfor\tregulation\tof\tglucose\thomeostasis... | [
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0.02894371747970581,
-0.03366432711482048,
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0.013874813914299011,
0.0944145992398262,
0.02817598171532154,
-0.02220272831618786,
0.07121370732784271,
0.09295190870761871,
-0.04168616235256195,
-0.005663441959768534,
0.024795... |
Chapter\t29\n).\tOther\tcells\tsecrete\tenzymes\tand\tother\nsubstances\tdirectly\tinto\tthe\tintestinal\tlumen,\n\twhere\tthey\taid\tin\tdigesting\tproteins,\tfats,\tand\tcarbohydrates\t(exocrine\nfunction).\nIn\tmost\tpeople,\tthe\tpancreatic\tduct,\twhich\tcarries\tthe\texocrine\tpancreatic\tsecretions,\tmerges\twit... | [
0.018687328323721886,
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0.05079568177461624,
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0.049645885825157166,
0.11404581367969513,
0.02033446915447712,
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0.0539160780608654,
0.09604596346616745,
-0.05493732914328575,
0.00785233173519373,
-0.014787... |
bile\tduct\tinto\ta\tunified\topening\tthrough\twhich\tbile\tand\tpancreatic\tjuices\tdrain\tinto\tthe\tduodenum\tat\tthe\tampulla\tof\nVater.\tMany\tfactors\tregulate\texocrine\tsecretion\tfrom\tthe\tpancreas.\tNeural\tand\thormonal\n\tresponses\tplay\ta\trole,\twith\nthe\tpresence\tand\tcomposition\tof\tingested\tfoo... | [
0.06220513582229614,
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0.05169623717665672,
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0.006322943605482578,
0.06948275864124298,
0.002830618293955922,
0.020587336272001266,
0.061875637620687485,
0.11793232709169388,
-0.03214271739125252,
0.0261054877191782,
0.00163851... |
pancreatic\tsecretion\tare\tsecretin\tand\tCCK\t(see\t\nChapter\t1\n).\nFactors\tthat\tinfluence\tpancreatic\tsecretions\tduring\ta\tmeal\tcan\tbe\tdivided\tinto\tthree\tphases:\t(1)\tthe\tcephalic\tphase,\nmediated\tthrough\tthe\tvagus\tnerve\tand\tinitiated\tby\tthe\tsight,\tsmell,\ttaste,\tand\tanticipation\n\tof\tf... | [
0.02932005375623703,
-0.05220570042729378,
0.06689497828483582,
-0.032021522521972656,
-0.10117877274751663,
0.03255726024508476,
0.11490345746278763,
0.008346901275217533,
0.03507526218891144,
0.0624079629778862,
0.07230087369680405,
-0.0696568638086319,
0.03684018924832344,
0.01224683411... |
of\tfood\tthat\tleads\tto\tthe\nsecretion\tof\tbicarbonate\tand\tpancreatic\tenzymes;\t(2)\tgastric\tdistention\twith\tfood\tinitiates\tthe\tgastric\tphase\tof\npancreatic\tsecretion,\twhich\tstimulates\tenzyme\tsecretion;\tand\t(3)\tthe\tintestinal\tphase,\tmediated\tby\tthe\trelease\tof\nCCK,\twith\tthe\tmost\tpotent... | [
0.03782852739095688,
-0.09383568912744522,
0.0066068596206605434,
-0.037736404687166214,
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-0.011050401255488396,
0.10115215182304382,
0.020038967952132225,
-0.003812540788203478,
0.06464151293039322,
0.11551264673471451,
-0.030975056812167168,
0.03261873126029968,
0.026... |
Diseases\tof\tthe\texocrine\tpancreas\nPancreatitis\nPathophysiology\tand\tmedical\tmanagement\nPancreatitis\n\tis\n\tan\tinflammation\tof\tthe\tpancreas\tand\tis\tcharacterized\tby\tedema,\tcellular\texudate,\tand\tfat\tnecrosis.\nThe\tdisease\tcan\trange\tfrom\tmild\tand\tself-limiting\tto\tsevere,\twith\ttissue\taut... | [
-0.00010411223047412932,
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0.020396044477820396,
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0.01713215373456478,
0.09045657515525818,
0.03891042247414589,
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0.05641590803861618,
0.07784122228622437,
-0.009163515642285347,
0.009401208721101284,
0.0... |
pancreatic\ttissue.\tVarious\tprognostic\tscoring\tsystems\thave\tbeen\tdeveloped\tsuch\tas\tRanson,\tacute\tphysiology\tand\nchronic\thealth\tevaluation\t(APACHE)-II,\tbedside\tindex\tfor\tseverity\tin\tacute\n\tpancreatitis\t(BISAP)\tscores,\tand\tcomputed\ntomography\tseverity\tindex\t(CTSI)\t(\nBanks\tet\tal,\t2013... | [
-0.0031435834243893623,
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0.0419892817735672,
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0.0943203717470169,
0.030377807095646858,
0.007573788519948721,
0.04806600138545036,
0.0989556759595871,
-0.04960943013429642,
0.03657696396112442,
0.03204... |
;\t\nRanson,\t1974\n;\t\nLarvin\tand\tMcMahon,\t1989\n;\t\nBalthazar\tet\tal,\n1990\n;\t\nWu\tet\tal,\t2008\n;\t\nPetrov\tet\tal,\t2009\n).\tThese\tcan\thelp\tpredict\tthe\tmortality\tof\tacute\tpancreatitis\t(\nCho\tet\tal,\t2015\n).\nThere\tmay\tbe\tdifferences\tin\tthese\tscores\tbut\tthey\thelp\tto\tpredict\tthe\ts... | [
-0.03174542635679245,
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0.048341214656829834,
-0.06704597920179367,
-0.08950340747833252,
0.05727311223745346,
0.06533723324537277,
0.01960354670882225,
-0.009069542400538921,
0.045106250792741776,
0.12806354463100433,
-0.03504709154367447,
0.04947520047426224,
0.04402... |
as\n\teither\tacute\tor\tchronic,\tthe\tlatter\twith\tpancreatic\tdestruction\tso\textensive\tthat\texocrine\tand\tendocrine\tfunction\nare\tseverely\tdiminished,\tand\tmaldigestion\tand\tdiabetes\tmellitus\tmay\tresult.\nThe\tsymptoms\tof\tpancreatitis\tcan\trange\tfrom\tcontinuous\tor\tintermittent\tpain\tof\tvarying... | [
0.045690782368183136,
-0.04035593941807747,
0.05760015919804573,
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0.004298538900911808,
0.10708704590797424,
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0.06379320472478867,
0.10268186777830124,
-0.025951413437724113,
0.0333077497780323,
0.034077... |
abdominal\tpain,\twhich\tmay\tradiate\tto\tthe\tback.\tSymptoms\tmay\tworsen\twith\tthe\tingestion\tof\tfood.\n\tClinical\npresentation\talso\tmay\tinclude\tnausea,\tvomiting,\tabdominal\tdistention,\tand\tsteatorrhea.\tSevere\tcases\tare\ncomplicated\tby\thypotension,\toliguria,\tand\tdyspnea.\tThere\tis\textensive\td... | [
0.07451780140399933,
-0.08878188580274582,
0.018351461738348007,
-0.025843573734164238,
-0.08836784213781357,
-0.032555270940065384,
0.05175260826945305,
0.005970221012830734,
-0.02924877591431141,
0.04357605054974556,
0.09071820974349976,
0.02333911694586277,
0.03794611245393753,
0.031281... |
subsequent\tfibrosis,\tenzyme\tproduction\tis\tdiminished,\tand\tserum\tamylase\tand\tlipase\tmay\tappear\tnormal.\tHowever,\nabsence\tof\tenzymes\tto\taid\tin\tthe\tdigestion\tof\tfood\tleads\tto\tsteatorrhea\n\tand\tmalabsorption.\t\nTable\t28.9\n\tdescribes\nseveral\ttests\tused\tto\tdetermine\tthe\textent\tof\tpanc... | [
0.019362006336450577,
-0.09401314705610275,
0.03024834208190441,
-0.03262165188789368,
-0.06592710316181183,
0.00720021640881896,
0.09112818539142609,
0.057099539786577225,
0.0014905169373378158,
0.060431819409132004,
0.1245606392621994,
-0.0025856529828161,
0.042786791920661926,
0.0337025... |
TABLE\t28.9\nSome\tTests\tof\tPancreatic\tFunction\nTest\nSignificance\nSecretin\nstimulation\ntest\nMeasures\tpancreatic\tsecretion,\tparticularly\tbicarbonate,\tin\tresponse\tto\tsecretin\tstimulation\nGlucose\ntolerance\ntest\nAssesses\tendocrine\tfunction\tof\tthe\tpancreas\tby\tmeasuring\tinsulin\tresponse\n\tto\t... | [
0.03584761172533035,
-0.09005103260278702,
-0.005202149506658316,
-0.007832217961549759,
-0.10863892734050751,
0.010204956866800785,
0.0766926184296608,
0.08381041884422302,
-0.04135657101869583,
0.05439869686961174,
0.07670623064041138,
-0.039902642369270325,
0.029408391565084457,
0.04184... |
to\ta\tglucose\tload\n72-hr\tstool\tfat\ntest\nAssesses\texocrine\tfunction\tof\tthe\tpancreas\tby\tmeasuring\tfat\tabsorption\tthat\treflects\tpancreatic\tlipase\nsecretion\nFecal\telastase\nEnzyme\tmost\tcommonly\tused\tto\tdetermine\tpancreatic\tfunction;\tindirect\ttest.\tLevels\t>200\tmcg/g\tare | [
-0.008002985268831253,
-0.06828182190656662,
0.008695694617927074,
-0.04659976437687874,
-0.09729354828596115,
-0.036719273775815964,
0.10097663849592209,
0.0754464715719223,
-0.03395397588610649,
0.031997501850128174,
0.08025141060352325,
-0.03373010829091072,
0.0019245881121605635,
0.020... |
considered\tnormal;\tconcentration\t<15\tmcg/g\tof\tfeces\tconsistent\twith\tpancreatic\texocrine\tinsufficiency\nMedical\tnutrition\n\ttherapy\nAlcohol\tuse,\tsmoking,\tbody\tweight,\tdiet,\tgenetic\tfactors,\tand\tmedications\taffect\tthe\trisk\tof\tdeveloping\tpancreatitis. | [
0.04521159455180168,
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0.020189281553030014,
0.041759178042411804,
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0.11297906190156937,
0.052075598388910294,
-0.04623229801654816,
-0.0044014835730195045,
0.08873815834522247,
-0.03848772868514061,
-0.006148151122033596,
0.0... |
Thus\tdiet\tmodification\thas\tan\timportant\trole\tafter\tdiagnosis.\tDietary\trecommendations\tdiffer,\tdepending\ton\twhether\nthe\tcondition\tis\tacute\tor\tchronic.\tObesity\tappears\tto\tbe\ta\trisk\tfactor\tfor\tthe\tdevelopment\tof\tpancreatitis\tand\tfor | [
0.03925655409693718,
-0.03998711705207825,
0.03268776461482048,
-0.04652606323361397,
-0.08531495928764343,
0.009335491806268692,
0.11411559581756592,
0.017083710059523582,
-0.014643479138612747,
0.08668395131826401,
0.12951348721981049,
-0.036189548671245575,
0.02646813727915287,
0.081009... |
increased\tseverity\t(\nMartinez\tet\tal,\t2004\n;\t\nKatuchova\tet\tal,\t2014\n).\nDepressed\tserum\tcalcium\tlevels\tare\tcommon.\tHypoalbuminemia\toccurs,\twith\tsubsequent\tedema\t(also\tknown\tas\nthird\tspacing\tof\tfluid).\tThe\tcalcium,\twhich\tis\tbound\tto\talbumin,\tis\tthus\taffected\tand\tmay\tappear\tarti... | [
-0.0009479767177253962,
-0.04875359684228897,
0.0391865000128746,
-0.0006741039105691016,
-0.04801572114229202,
0.03613825887441635,
0.06214366480708122,
0.06791353970766068,
0.03572646528482437,
0.06263530254364014,
0.060762230306863785,
-0.023065509274601936,
0.0562058724462986,
0.037003... |
Another\toccurrence\tis\t“soap”\tformation\tin\tthe\tgut\tby\tcalcium\tand\tfatty\tacids,\tcreated\tby\tthe\tfat\tnecrosis\tthat\tresults\nin\tless\tcalcium\tabsorption.\tChecking\tan\tionized\tcalcium\n\tlevel\tis\ta\tmethod\tof\tdetermining\tavailable\tcalcium.\nAcute\tpancreatitis. | [
0.010445935651659966,
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0.05935807526111603,
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0.10061507672071457,
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0.04448694735765457,
0.10038888454437256,
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0.05838187783956528,
0.0... |
Acute\tpancreatitis.\nPain\tassociated\twith\tacute\tpancreatitis\t(AP)\tis\tpartially\trelated\tto\tthe\tsecretory\tmechanisms\tof\tpancreatic\tenzymes\nand\tbile.\tTherefore,\tnutrition\ttherapy\tis\tadjusted\tto\tprovide\tminimum\tstimulation\tof\tthese\tsystems\t(\nInternational\nAssociation\tof\tPancreatology,\t20... | [
0.007162185851484537,
-0.08915697038173676,
0.047318797558546066,
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0.011149032972753048,
0.07457183301448822,
0.08889053761959076,
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0.08353538811206818,
0.11150740832090378,
0.002338907215744257,
0.02194766141474247,
0.063415... |
)\t(see\t\nPathophysiology\tand\tCare\tManagement\tAlgorithm:\n\tPancreatitis\n).\tThe\tbasis\nfor\tnutrition\ttherapy\tis\tto\tput\tthe\tpancreas\t“at\trest.”\tIn\tpatients\twith\tAP,\tearly\t(within\t24\thours)\toral\tfeeding\tas\ntolerated\tshould\tbe\tinitiated\trather\tthan\tkeeping\tthe\tpatient\tnil\tper\tos\t(N... | [
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0.08668070286512375,
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0.018568379804491997,
0.07941973209381104,
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0.014300791546702385,
0.008274916559457779,
0.08370887488126755,
-0.004309757146984339,
0.052004795521497726,
0.0458... |
Crockett\tet\tal,\n2018\n;\t\nVege\tet\tal,\t2018\n).\tSuccess\tof\tearly\tfeeding\thas\tbeen\tdemonstrated\tusing\ta\tvariety\tof\tdiets,\tincluding\tlow\tfat,\nnormal\tfat\tcontent,\tand\tsoft\tor\tsolid\n\tconsistency,\tand\tthus\tstarting\twith\ta\tclear\tliquid\tdiet\tis\tnot\trequired\t(\nLankisch\tet\nal,\t2015 | [
-0.023746782913804054,
-0.05201248452067375,
0.06523861736059189,
-0.0726003348827362,
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0.04791119322180748,
0.06280676275491714,
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0.022332865744829178,
0.07049092650413513,
-0.03712936118245125,
0.04434310272336006,
-0.00679... |
Lankisch\tet\nal,\t2015\n).\tEarly\tfeeding\tis\tnot\tsuccessful\tin\tall\tAP\tdue\tto\tpain,\tvomiting,\tor\tileus\t(lack\tof\tperistalsis\tin\tthe\tgut),\tand\nfeeding\tmay\tneed\tto\tbe\tdelayed\tbeyond\t24\thours\tin\tsome\tcases.\tSome\tpatients\twho\tare\tintolerant\tof\toral\tfeeding\nmay\trequire\tplacement\tof... | [
-0.0013048698892816901,
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0.08035974949598312,
-0.025545179843902588,
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-0.002592571312561631,
0.07065354287624359,
0.012139435857534409,
-0.013498269952833652,
0.028024230152368546,
0.12689168751239777,
0.0002568313211668283,
0.039136048406362534,
... |
is\tprogressed\tas\ttolerated\tto\teasily\ndigested\tfoods\twith\ta\tlow-fat\tcontent\twith\tmore\tfat\tadded\tas\ttolerated.\tFoods\tmay\tbe\tbetter\ttolerated\tif\tthey\tare\ndivided\tinto\tsix\tsmall\tmeals\t(see\t\nTable\t28.8\n).\nSevere\tacute\tpancreatitis\t(SAP)\tresults\tin\ta\thypermetabolic,\tcatabolic\tstat... | [
0.0026871580630540848,
-0.07226839661598206,
0.04002316668629646,
0.01580577716231346,
-0.07599230855703354,
0.0025442237965762615,
0.08149095624685287,
0.04809681326150894,
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0.02808118239045143,
0.12744086980819702,
-0.03521350398659706,
0.021834734827280045,
0.03287... |
in\tthe\tpancreas\tand\tin\tremote\torgans.\tMetabolic\tdemands\tare\tsimilar\tto\tthose\tof\tsepsis.\n\tAmino\tacids\tare\treleased\nfrom\tmuscle\tand\tused\tfor\tgluconeogenesis.\tThese\tpatients\toften\texhibit\tsigns\tof\tstress-induced\tmalnutrition\tsuch\tas\ndecreased\tserum\tlevels\tof\talbumin,\ttransferrin,\t... | [
-0.007525798864662647,
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0.007939661853015423,
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0.008040908724069595,
0.060682665556669235,
0.10007909685373306,
0.0155095923691988,
0.06891809403896332,
0.0919211134314537,
0.00586988590657711,
0.040337927639484406,
0.0707743... |
Chapter\n7\n).\tSAP\tis\tassociated\twith\tsignificant\tmorbidity\tand\tmortality.\tThese\tpatients\toften\tdevelop\tcomplications\tsuch\tas\nfluid\tcollections,\tpseudocysts,\n\tpancreatic\tnecrosis,\tand\tinfection\tor\tmultisystem\torgan\tfailure.\nThe\toptimal\troute\tand\ttiming\tof\tnutrition\tin\tSAP\thas\tbeen\... | [
0.010947584174573421,
0.028274258598685265,
0.04628251865506172,
-0.06814096122980118,
-0.09905211627483368,
0.05654323473572731,
0.08103790879249573,
0.0751723200082779,
-0.0240479689091444,
0.043033137917518616,
0.10303482413291931,
0.010678929276764393,
0.03571631386876106,
0.0288205128... |
effective\tin\tterms\tof\tdays\tto\tnormalization\tof\tserum\tamylase\tlevels,\tdays\tto\tresumption\tof\toral\tfeeding,\tdays\tto\tclear\nnosocomial\tinfections,\tand\tthe\tclinical\toutcome\tin\tpatients\twith\tmild\tto\tmoderate\tpancreatitis\t(\nWu\tet\tal,\t2014\n).\tThe\nfavorable\teffect\tof\teither\tEN\tor\tPN\... | [
0.0023805040400475264,
-0.030116580426692963,
0.022529682144522667,
-0.016268445178866386,
-0.08194886893033981,
0.0252730380743742,
0.09776598960161209,
0.07235952466726303,
-0.03420928865671158,
0.014852984808385372,
0.11896727234125137,
0.033986639231443405,
0.09943583607673645,
0.07126... |
inflammation\tsuch\tas\targinine,\tglutamine,\tomega-3\tfatty\tacids,\tor\tprobiotics\tand\tsystemic\timmunity\t(\nMcClave\tet\tal,\n2006\n;\t\nMcClave\tet\tal,\t2016\n)\t(see\t\nChapter\t7\n).\tHowever,\tfailure\tto\tuse\tthe\tGIT\tin\tpatients\twith\tSAP\tmay\texacerbate\tthe\nstress\tresponse\tand\tdisease\tseverity... | [
-0.024278273805975914,
-0.06696625053882599,
0.008537101559340954,
0.015666943043470383,
-0.06019357591867447,
0.0477130264043808,
0.04316740483045578,
0.12414054572582245,
-0.0120906513184309,
0.03413989767432213,
0.05591632053256035,
0.025538867339491844,
0.05926808714866638,
0.082098551... |
complications\tand\tprolonged\thospitalization;\tthus\tEN\tis\npreferred\tfor\tnutrition\ttherapy\t(\nAl-Omran\tet\tal,\t2010\n;\t\nMcClave,\t2013\n;\t\nMirtallo\tet\tal,\t2012\n;\t\nCrockett\tet\tal,\t2018\n;\t\nVege\net\tal,\t2018\n).\tSome\tdata\tsupport\tthe\tuse\tof\tearly\tEN\tin\tAP\t(\nZou\tet\tal,\t2014\n).\tI... | [
-0.074873186647892,
0.006548039149492979,
0.019615279510617256,
-0.052227217704057693,
-0.09687086194753647,
0.01381978951394558,
0.006410473491996527,
0.1190577894449234,
0.0035905290860682726,
0.031928736716508865,
0.08979715406894684,
0.04073113203048706,
-0.026738803833723068,
0.062749... |
Zou\tet\tal,\t2014\n).\tIn\ta\tmeta-analysis\tof\tobservational\tdata\nfrom\tindividuals\twith\tAP,\tstarting\tEN\twithin\t24\thours\tafter\thospital\tadmission,\tcompared\twith\tafter\t24\n\thours,\twas\nassociated\twith\ta\treduction\tin\tcomplications\t(\nBakker\tet\tal,\t2014\n).\tEarly\tEN\tin\tpatients\twith\tAP\... | [
-0.029410123825073242,
-0.006938721053302288,
0.0415227971971035,
-0.07263755053281784,
-0.10952241718769073,
-0.0008839232614263892,
0.0771520659327507,
0.04093444347381592,
-0.006472432985901833,
0.030411111190915108,
0.11089149862527847,
-0.000923242827411741,
0.043668944388628006,
0.02... |
).\tEarly\tEN\tin\tpatients\twith\tAP\tmay\treduce\tlength\tof\nhospital\tstay\twithout\tadverse\tevents\tfor\tpatients\twith\tmild\tto\tmoderate\tpancreatitis\t(\nVaughn\tet\tal,\t2017\n).\tIn\tanother\nmeta-analysis,\tearly\tEN\twas\tassociated\twith\ta\tsignificant\tdecrease\tin\tthe\tincidence\tof\tmultiple\torgan\... | [
-0.003226995002478361,
-0.007418171036988497,
0.07345762103796005,
-0.04158027842640877,
-0.10256519168615341,
0.014786961488425732,
0.07847091555595398,
-0.004308497067540884,
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0.02350507490336895,
0.1104041039943695,
-0.025558404624462128,
0.02798224799335003,
0.041... |
not\tsignificant\tfor\tother\tcomplications\n\tand\tmortality\tcompared\twith\tdelayed\tEN\t(\nFeng\tet\tal,\t2017\n).\nNasogastric\tEN\thas\tbeen\tshown\tto\tbe\tefficacious\tin\tSAP\t(\nNally\tet\tal,\t2014\n).\tHowever,\tto\tminimize\tpancreatic\nstimulation\tit\tis\tbest\tto\tplace\tjejunal\tfeeding\ttubes\tendosco... | [
0.02093423716723919,
-0.047510337084531784,
0.06514113396406174,
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0.08388861268758774,
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0.04210616275668144,
0.140713170170784,
-0.03065343201160431,
0.04352089762687683,
0.04947... |
more\tthan\t40\tcm\tpast\tthe\tligament\tof\tTreitz\t(\nO’Keefe\tet\tal,\t2001\n).\nEN\tresults\tin\ta\tsubstantial\tcost\tsavings\twith\n\tfewer\tseptic\tcomplications\tand\toverall\treduction\tof\tmorbidity\tand\nmortality\t(\nPetrov\tet\tal,\t2008\n;\t\nSun\tet\tal,\t2013\n).\tThe\tlocation\tof\tthe\tfeeding\tand\tt... | [
0.01656622439622879,
-0.019624978303909302,
0.07241430133581161,
-0.05601442977786064,
-0.11158674955368042,
0.03335805982351303,
0.04229593276977539,
0.0002471936750225723,
0.03213415667414665,
0.0781225711107254,
0.08705254644155502,
-0.03557730093598366,
0.06108981743454933,
0.033827621... |
).\tThe\tlocation\tof\tthe\tfeeding\tand\tthe\tcomposition\tof\tthe\tformula\tis\nthought\tto\tdetermine\tthe\tdegree\tof\tpancreatic\tstimulation.\tInfusion\tinto\tthe\tjejunum\teliminates\tthe\tcephalic\tand\ngastric\tphases\tof\texocrine\tpancreatic\tstimulation\twhich\tis\toptimal\tin\tAP.\tThe\tuse\tof\tjejunal\tf... | [
0.06304541230201721,
-0.05906742811203003,
0.0681721493601799,
-0.057000916451215744,
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0.011449865065515041,
0.07725033164024353,
-0.021531792357563972,
0.04227767512202263,
0.08311256021261215,
0.08490153402090073,
-0.039877187460660934,
0.03915366530418396,
0.0381823... |
may\tbe\tbetter\ntolerated\tand\tallow\tfor\tan\tincrease\tin\tthe\tamount\tof\tnutrition\tthat\tis\tdelivered\tin\tthe\tface\tof\tAP.\tHowever,\tno\ncontrolled\ttrial\thas\tclearly\tdemonstrated\ta\tsignificant\timprovement\tof\tfeeding\ttolerance,\tmortality,\tor\tlength\tof\nintensive\tcare\tunit\t(ICU)\tstay\twith\... | [
0.019311215728521347,
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0.09459609538316727,
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0.02497229538857937,
0.08798397332429886,
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0.0012317844666540623,
0.0629834532737732,
0.11170215904712677,
-0.011602554470300674,
0.05672771483659744,
0.0359362... |
Zhang\tet\tal,\t2013\n).\nBecause\tthe\tplacement\tof\ta\tnasogastric\tfeeding\n\ttube\tis\teasier\tthan\ta\tjejunal\ttube,\tit\tis\treasonable\tto\tconsider\tgastric\nfeedings\tfor\tAP\tand\treserve\tjejunal\tfeedings\tfor\tthose\twho\tare\tintolerant\tto\tgastric\tfeeding\t(\nPetrov,\t2014\n).\tFor\tthose | [
-0.018708793446421623,
0.024309860542416573,
0.06558943539857864,
-0.0009360671974718571,
-0.06005648896098137,
0.03392167389392853,
0.09285759180784225,
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0.036406997591257095,
0.020317349582910538,
0.12145759165287018,
-0.03505239263176918,
-0.007995355874300003,
0.00... |
Petrov,\t2014\n).\tFor\tthose\npatients\twith\tSAP\tcomplicated\tby\torgan\tfailure,\tpancreatic\tnecrosis,\tor\tfluid\tcollections,\tnasojejunal\tfeeding\tis\tthe\npreferred\tmethod\tof\tdelivery\t(\nSeminerio\tand\tO’Keefe,\t2014\n)\tto\tminimize\tpancreatic\tstimulation\n\t(see\t\nChapter\t12\n\tfor\njejunal\tfeedin... | [
-0.01500795129686594,
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0.04567161574959755,
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0.0667271688580513,
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0.04974888265132904,
0.06530403345823288,
0.11789152771234512,
-0.014096010476350784,
0.026641204953193665,
0.0474... |
(see\t\nChapter\t12\n\tfor\njejunal\tfeeding\tdetails).\nAlthough\tvarious\tformulations\thave\tbeen\tused\tin\tpancreatitis,\tno\tstudies\thave\tdetermined\tthe\trelative\tmerits\tof\nstandard,\tpartially\tdigested,\telemental,\tor\t“immune-enhanced”\tformulations.\tPolymeric\tformulas\tinfused\tat\tvarious | [
0.021281281486153603,
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0.06295975297689438,
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0.06797580420970917,
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0.06600653380155563,
0.12201209366321564,
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0.04141991585493088,
0.0... |
sections\tof\tthe\tgut\tstimulate\tthe\tpancreas\tmore\tthan\telemental\tand\thydrolyzed\tformulas.\tPeptide-based\tformula\tcan\nbe\tused\tsafely\n\tand\tstandard\tformulas\tcan\tbe\ttried\tif\tthe\tpatient\tis\ttolerant\t(\nMirtallo\tet\tal,\t2012\n).\tClose\tobservation\nfor\tpatient\ttolerance\tis\timportant.\tTole... | [
0.0066292136907577515,
-0.013874176889657974,
0.03695607930421829,
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0.026446403935551643,
0.036152467131614685,
0.029643645510077477,
0.0015495502157136798,
0.02919248305261135,
0.12732985615730286,
0.01985730417072773,
0.02227824367582798,
0.0398... |
during\tenteral\tfeeding\t(\nBerry,\t2014\n).\tThese\tcan\tbe\tprovided\tby\tmouth,\tmixed\twith\twater\tand\tdelivered\tvia\tthe\nfeeding\ttube,\tor\tadded\tdirectly\tto\tthe\tenteral\tformula.\tAn\tenteral\tin-line\n\tlipase\tcartridge\tis\talso\tavailable\twhich\thas\nbeen\tshown\tto\thydrolyze\ta\tmajority\tof\tthe... | [
-0.021655570715665817,
-0.06688930094242096,
0.0673532634973526,
-0.006256159394979477,
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0.07503081113100052,
0.008622340857982635,
0.02721570059657097,
0.020160192623734474,
0.0996578112244606,
-0.006712772883474827,
0.03498897701501846,
0.06785... |
Freedman,\n2017\n).\tWhen\tthe\tpatient\tis\tallowed\tto\teat,\tsupplemental\tpancreatic\tenzymes\tmay\talso\tbe\trequired\tto\ttreat\nsteatorrhea.\tIn\tsevere,\tprolonged\tcases,\tPN\tmay\tbe\tnecessary.\nPatients\twith\tmild\tto\tmoderate\tstress\tcan\ttolerate\tdextrose-based\tsolutions,\n\twhereas\tpatients\twith\t... | [
-0.00738021032884717,
-0.03385843336582184,
0.05722701922059059,
-0.026523208245635033,
-0.11220540851354599,
0.03589877113699913,
0.09058444947004318,
-0.004952706396579742,
0.014121885411441326,
0.04327335208654404,
0.12403492629528046,
-0.013967815786600113,
0.00915050134062767,
0.02032... |
whereas\tpatients\twith\tmore\tsevere\nstress\trequire\ta\tmixed\tfuel\tsystem\tof\tdextrose\tand\tlipid\tto\tavoid\tcomplications\tof\tglucose\tintolerance.\tLipid\temulsion\nshould\tnot\tbe\tincluded\tin\ta\tPN\tregimen\tif\thypertriglyceridemia\tis\tthe\tcause\tof\tthe\tpancreatitis\t(\nPatel\tet\tal,\t2014\n).\tA | [
0.02476482093334198,
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0.029062943533062935,
-0.05273999273777008,
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0.08291897922754288,
0.05978778749704361,
0.057906851172447205,
0.012280871160328388,
0.09961722046136856,
0.0043539609760046005,
0.030259909108281136,
0.054... |
Patel\tet\tal,\t2014\n).\tA\nserum\ttriglyceride\tlevel\tshould\tbe\tobtained\tbefore\tlipid-containing\tPN\tis\tinitiated.\tLipids\tmay\tbe\tshould\tonly\tgiven\tto\npatients\n\twith\ttriglyceride\tvalues\tless\tthan\t400\tmg/dL.\tBecause\tof\tthe\tpossibility\tof\tpancreatic\tendocrine\nabnormalities\tand\ta\trelativ... | [
-0.01298342552036047,
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0.06971188634634018,
0.02294180914759636,
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0.03896621614694595,
0.08237628638744354,
-0.0020610566716641188,
0.03080928511917591,
0.04955... |
2\n-receptor\tantagonists\nmay\tbe\tprescribed\tto\tdecrease\thydrochloric\tacid\tproduction,\twhich\treduce\tstimulation\tof\tthe\tpancreas.\tThe\thormone\nsomatostatin\tis\tconsidered\tthe\tbest\tinhibitor\tof\tpancreatic\tsecretion\n\tand\tmay\tbe\tused\tin\tconjunction\twith\tPN.\nChronic\tpancreatitis. | [
0.045499950647354126,
-0.09289325028657913,
0.01694338582456112,
-0.02136794663965702,
-0.07138983905315399,
0.03881881386041641,
0.10745609551668167,
0.04344284161925316,
0.025943147018551826,
0.10872995853424072,
0.11688564717769623,
-0.06736309081315994,
0.01860864646732807,
0.066748067... |
and\tmay\tbe\tused\tin\tconjunction\twith\tPN.\nChronic\tpancreatitis.\nIn\tcontrast\tto\tSAP,\tchronic\tpancreatitis\t(CP)\tevolves\tinsidiously\tover\tmany\tyears.\tCP\tis\tcharacterized\tby\trecurrent\nattacks\tof\tepigastric\tpain\tof\tlong\tduration\tthat\tmay\tradiate\tinto\tthe\tback.\tThe\tpain\tcan\tbe\tprecip... | [
-0.005973038263618946,
-0.061367280781269073,
0.054870568215847015,
-0.037288155406713486,
-0.12919585406780243,
-0.022343304008245468,
0.09668084233999252,
0.006763075944036245,
0.00571353267878294,
0.04744536057114601,
0.10776284337043762,
-0.012552092783153057,
0.04833834245800972,
0.05... |
Associated\tnausea,\tvomiting,\tor\tdiarrhea\tmake\tit\tdifficult\tto\tmaintain\tadequate\tnutrition\tstatus\t(\nVerhaeqh\tet\tal,\n2013\n).\nPatients\twith\tCP\tare\tat\tincreased\trisk\tof\tdeveloping\tprotein-calorie\tmalnutrition\tbecause\tof\tpancreatic\ninsufficiency\tand\tinadequate\toral\tintake.\tPatients\twit... | [
-0.017235785722732544,
-0.02950444258749485,
0.03967072442173958,
0.00909340474754572,
-0.07913139462471008,
-0.002748936414718628,
0.05330515652894974,
0.07292938977479935,
-0.007255745120346546,
0.0034719405230134726,
0.11393653601408005,
-0.04028042405843735,
0.05412314459681511,
0.0215... |
malnutrition,\tincreased\tenergy\trequirements,\tweight\tloss,\tdeficits\tof\tlean\tmuscle\tand\tadipose\ttissue,\tvisceral\tprotein\ndepletion,\timpaired\timmune\tfunction,\tand\tvitamin\tdeficiencies\t(\nDuggan\tet\tal,\t2014\n). | [
0.012858117930591106,
-0.0006454413523897529,
0.0528053417801857,
0.00943884439766407,
-0.09262121468782425,
0.0555276945233345,
0.11499270796775818,
0.08336108922958374,
-0.10100039094686508,
0.028886452317237854,
0.07629796117544174,
-0.05251375585794449,
0.013585811480879784,
0.02758601... |
The\tobjective\tof\ttherapy\tfor\tpatients\tis\tto\tprevent\tfurther\tdamage\tto\tthe\tpancreas,\tdecrease\tthe\tnumber\tof\tattacks\nof\tacute\tinflammation,\talleviate\tpain,\tdecrease\tsteatorrhea,\tand\tcorrect\tmalnutrition.\tDietary\tintake\tshould\tbe\tas\nliberal\tas\tpossible,\tbut\tmodifications\tmay\tbe\tnec... | [
0.03913513571023941,
-0.05944699048995972,
0.014843332581222057,
-0.022921619936823845,
-0.12048503756523132,
0.027549084275960922,
0.09339629113674164,
0.014809766784310341,
0.01556028239428997,
0.04232367128133774,
0.09709210693836212,
-0.00664024380967021,
0.07138704508543015,
0.0398251... |
The\tfirst\tgoal\tof\tMNT\tis\tto\tprovide\toptimal\tnutrition\tsupport,\tand\tthe\tsecond\tis\tto\n\tdecrease\tpain\tby\tminimizing\nstimulation\tof\tthe\texocrine\tpancreas.\tBecause\tCCK\tstimulates\tsecretion\tfrom\tthe\texocrine\tpancreas,\tone\tapproach\tis\nto\tdecrease\tCCK\tlevels.\tIf\tpostprandial\tpain\tis\... | [
0.04065065085887909,
-0.0941612720489502,
0.012093396857380867,
-0.050102416425943375,
-0.12418634444475174,
0.030632102862000465,
0.0713772401213646,
0.007994183339178562,
0.0011821193620562553,
0.06478509306907654,
0.09476687759160995,
-0.025905802845954895,
0.030533233657479286,
0.00657... |
the\tligament\tof\tTreitz,\tthat\tminimally\tstimulate\tthe\tpancreas\tare\twarranted.\tNutrition\tcounseling,\tantioxidants,\tand\npancreatic\tenzymes\n\tmay\tplay\ta\trole\tin\teffective\tmanagement\tof\tCP\tas\twell\t(\nAfghani\tet\tal,\t2014\n).\nWhen\tpancreatic\tfunction\tis\tdiminished\tby\tapproximately\t90%,\t... | [
0.0024997189175337553,
-0.008206200785934925,
0.04352134093642235,
-0.02001822181046009,
-0.042534369975328445,
0.04639599844813347,
0.08686311542987823,
0.005244235973805189,
-0.0075765494257211685,
0.06929253786802292,
0.09397132694721222,
-0.05902843549847603,
0.02746601030230522,
0.032... |
maldigestion\tand\tmalabsorption\tof\tprotein\tand\tfat\tthus\tbecome\ta\tproblem.\tIn\tgeneral,\tlarge\tmeals\twith\thigh-fat\nfoods\tand\talcohol\tshould\tbe\tavoided.\tHowever,\tthere\tis\ta\tlot\tof\tvariation\tamong\tthese\tpatients\tand\n\tthe\tdiet\tshould\tbe\nliberalized\tas\tmuch\tas\tpossible.\tFor\texample,... | [
0.035910870879888535,
-0.05016225576400757,
0.08269952982664108,
-0.004896425176411867,
-0.07279504090547562,
-0.007818623445928097,
0.12099038809537888,
0.008251731283962727,
-0.021794788539409637,
0.011989147402346134,
0.09580659121274948,
-0.005158502608537674,
0.03732286021113396,
0.03... |
in\tsome\tpatients.\nThe\tpatient\tmay\tpresent\twith\tweight\tloss\tdespite\tadequate\tenergy\tintake\tand\twill\tcomplain\tof\tbulky,\tgreasy\tstools.\nThis\tis\tdefinitely\tthe\tcase\twith\tidiopathic\tCP\tassociated\twith\ta\tcystic\tfibrosis\tgene\tmutation;\ttherapies\tdirected\ntoward\tcystic\n\tfibrosis\tmay\tb... | [
0.012969866394996643,
-0.0601968988776207,
0.05480261892080307,
-0.005358719266951084,
-0.10785583406686783,
-0.011345895938575268,
0.0807853490114212,
0.06202900409698486,
-0.0017556508537381887,
-0.0013399908784776926,
0.09455935657024384,
0.02336590737104416,
0.07390432804822922,
0.0641... |
toward\tcystic\n\tfibrosis\tmay\tbenefit\tthese\tpatients\t(see\t\nChapter\t33\n).\tOf\tthese\ttherapies,\tpancreatic\tenzyme\nreplacement\thas\tbeen\tshown\tto\tbe\tefficacious\t(\nde\tla\tIglesia-Garcia\tet\tal,\t2016\n).\tPancreatic\tenzyme\treplacements\tare\ngiven\torally\twith\tmeals;\tthe\tdosage\tshould\tbe\tat... | [
0.014019682072103024,
-0.04983441159129143,
0.012673490680754185,
-0.029018884524703026,
-0.1414089798927307,
0.005350805353373289,
0.0489502027630806,
0.03407886624336243,
-0.00004175249705440365,
0.014565541408956051,
0.10321029275655746,
0.0031675451900810003,
0.042326364666223526,
0.02... |
the\tlevel\tof\tfat\tin\tthe\tdiet\tshould\tbe\tthe\tmaximum\ta\tpatient\tcan\ttolerate\n\twithout\tincreased\tsteatorrhea\tor\tpain.\nAdditional\ttherapies\tto\tmaintain\tnutrition\tstatus\tand\tminimize\tsymptoms\tin\tpatients\twith\tmaximum\tenzyme\nsupplementation\tinclude\ta\tlower-fat\tdiet\t(40\tto\t60\tg/day)\t... | [
-0.006240440998226404,
-0.024419305846095085,
0.06905675679445267,
0.030873451381921768,
-0.07866878062486649,
-0.009289027191698551,
0.05440840497612953,
0.07737331092357635,
-0.03751751407980919,
-0.025230005383491516,
0.1053282618522644,
-0.004146201070398092,
0.03962700068950653,
0.069... |
Table\t28.7\n)\tor\tsubstitution\tof\tsome\tdietary\tfat\twith\nMCT\toil\tto\timprove\tfat\tabsorption\tand\tweight\tgain\t(see\t\nChapter\t12\n).\tA\tlower-fat\tdiet,\tprimarily\tfrom\tvegetable-based\noils\tsuch\tas\tolive\n\toil\tmay\thelp\treduce\tpain\tand\tease\tnausea\tas\twell\tas\teating\tsmall\tfrequent\tmeal... | [
0.013007326982915401,
-0.06243380159139633,
0.03139907121658325,
0.024610202759504318,
-0.09747272729873657,
0.004449186380952597,
0.08359983563423157,
0.010473602451384068,
-0.01805131696164608,
0.04258916154503822,
0.1052938774228096,
-0.04913022369146347,
0.04828880354762077,
-0.0069560... |
found\tin\tcommercially\tbaked\tgoods\tand\tother\tprocessed\tfoods,\tcan\tincrease\tinflammation\tand\tare\tnot\trecommended.\nMalabsorption\tof\tthe\tfat-soluble\tvitamins\tmay\toccur\tin\tpatients\twith\tsignificant\tsteatorrhea.\tAlso,\tdeficiency\tof\npancreatic\tprotease,\tnecessary\tto\tcleave\tvitamin\tB\n12\n\... | [
-0.004740721546113491,
-0.10755032300949097,
0.04540519416332245,
-0.01295304112136364,
-0.06309880316257477,
0.031722914427518845,
0.08876035362482071,
0.02821042388677597,
-0.007544183637946844,
0.03930649533867836,
0.10495386272668839,
-0.005340995732694864,
0.03925627842545509,
0.06154... |
12\n\tfrom\tits\tcarrier\n\tprotein,\tpotentially\tcould\tlead\tto\tvitamin\tB\n12\ndeficiency.\tAppropriate\tsupplemental\tenzyme\ttherapy\twill\timprove\tvitamin\tabsorption;\thowever,\tthe\tpatient\tshould\ncontinue\tto\tbe\tmonitored\tperiodically\tfor\tvitamin\tdeficiencies.\tWater-miscible\tforms\tof\tthe\tfat-so... | [
-0.008860643021762371,
-0.08722260594367981,
0.03926817327737808,
-0.05411301180720329,
-0.08499762415885925,
-0.014719506725668907,
0.06298881024122238,
0.1050797626376152,
-0.05216888710856438,
0.014916614629328251,
0.07967372983694077,
0.0006884041358716786,
0.042606331408023834,
0.0788... |
parenteral\tadministration\tof\tvitamin\tB\n12\n\tmay\tbe\tnecessary.\tSome\tevidence\tindicates\tthat\tincreasing\tintake\tof\nantioxidants\n\t(found\tin\tfruits\tand\tvegetables)\tmay\thelp\tprotect\tagainst\tpancreatitis\tor\talleviate\tsymptoms\tof\tthe\ncondition\t(\nAhmed\tet\tal,\t2014\n). | [
0.02964063361287117,
-0.059635911136865616,
0.06906744092702866,
-0.04531985893845558,
-0.03308079019188881,
0.03987064212560654,
0.07517599314451218,
0.012692872434854507,
0.028710993006825447,
0.11587610840797424,
0.12370532751083374,
-0.04199928417801857,
0.04825892299413681,
0.07997076... |
condition\t(\nAhmed\tet\tal,\t2014\n).\nBecause\tpancreatic\tbicarbonate\tsecretion\tis\tfrequently\tdefective,\tmedical\tmanagement\talso\tmay\tinclude\nmaintenance\tof\tan\toptimal\tintestinal\tpH\tto\tfacilitate\tenzyme\tactivation.\tAntacids,\tH\n2\n-receptor\tantagonists,\tor\tproton\npump\tinhibitors\tthat\treduc... | [
0.02737179771065712,
-0.09694798290729523,
0.009225914254784584,
-0.01237797923386097,
-0.08438953012228012,
0.02985185571014881,
0.10760222375392914,
0.05855631083250046,
0.01573561318218708,
0.0712713748216629,
0.12805476784706116,
-0.03266369178891182,
0.040440671145915985,
0.0663906931... |
may\tbe\tused\tto\tachieve\tthis\teffect.\nIn\tCP\twith\textensive\tpancreatic\tdestruction,\tthe\tinsulin-secreting\tcapacity\tof\tthe\tpancreas\tdecreases,\tand\tglucose\nintolerance\tdevelops.\tTreatment\twith\tinsulin\tand\tnutrition\ttherapy\tis\tthen\trequired\t(see\t\nChapter\t29\n).\tManagement\tis\ndelicate\ta... | [
-0.003373110434040427,
-0.05689534544944763,
0.07321873307228088,
0.01110152993351221,
-0.06188972666859627,
0.0076951016671955585,
0.16081920266151428,
0.04044279083609581,
-0.01472798828035593,
0.053549278527498245,
0.10706433653831482,
-0.007997967302799225,
0.04287414252758026,
0.04420... |
Effort\tshould\tbe\tmade\tto\tcater\tto\tthe\tpatient’s\ttolerances\n\tand\tpreferences\tfor\tnutritional\tmanagement;\thowever,\nalcohol\tis\tdiscouraged\tbecause\tof\tthe\tpossibility\tof\texacerbating\tthe\tpancreatic\tdisease.\tThere\tis\tevidence\tthat\tthe\nprogressive\tdestruction\tof\tthe\tpancreas\twill\tbe\ts... | [
0.05680706724524498,
-0.03315715491771698,
0.06077819690108299,
-0.00031491415575146675,
-0.07984103262424469,
0.03276515752077103,
0.08668873459100723,
-0.010690439492464066,
-0.009665526449680328,
0.008833333849906921,
0.08163844048976898,
-0.008141063153743744,
0.036606643348932266,
0.0... |
Nordback\net\tal,\t2008\n;\t\nYadav\tet\tal,\t2009\n).\nComplementary\tand\tintegrative\tmedicine\tfor\tpancreatic\tdisorders\nThe\trole\n\tof\tcomplementary\tand\tintegrative\tmedicine\tin\tthe\ttreatment\tof\tpancreatic\tdisorders\tremains\tunclear\n(\nSaxena\tet\tal,\t2014\n).\tOver\tthe\tcounter\tdigestive\tenzymes... | [
0.037991415709257126,
-0.038215793669223785,
0.04153406620025635,
-0.02659020572900772,
-0.0639956146478653,
0.03411887586116791,
0.08051157742738724,
0.03832486271858215,
0.011903728358447552,
0.04369562119245529,
0.05055387690663338,
-0.0076024532318115234,
0.03406788781285286,
0.0126816... |
is\tnot\tsupported\tby\tevidenced-based\tresearch,\tthe\tcomposition\tis\toften\tnot\tguaranteed\tdue\tto\tthe\tway\tthey\tare\nregulated,\tthey\tcan\tbe\tcostly,\tand\tthey\tare\toften\tinactivated\tin\tthe\tstomach\n\tdue\tto\tthe\tpH.\tThe\tstandard\tof\tcare\tin\npancreatic\tdisease\tis\tprescription\tpancreatic\te... | [
0.007491977419704199,
-0.07176264375448227,
0.03489280119538307,
-0.058956485241651535,
-0.0746578723192215,
0.030143944546580315,
0.0949946865439415,
0.016899485141038895,
0.007235562428832054,
0.06499111652374268,
0.09192559868097305,
0.02268020622432232,
0.07381951063871384,
0.040871713... |
Natural\tMedicines\tDatabase,\t2019\n).\tThere\tis\nlittle\tto\tno\tresearch\ton\tintegrative\tapproaches\tfor\tpancreatic\tdisease.\tIn\tChina,\tthere\tare\tsome\tstudies\tinvolving | [
0.0092353830114007,
-0.06649110466241837,
0.03839370235800743,
-0.033465009182691574,
-0.10187306255102158,
0.04718504101037979,
0.0784512534737587,
0.08561026304960251,
0.005645281169563532,
0.09355650097131729,
0.07295915484428406,
-0.04648718237876892,
-0.011820921674370766,
0.030184252... |
herbal\tpreparations,\tmany\tof\twhich\tare\tnot\treadily\tavailable\tin\tother\tcountries.\tSome\tof\tthe\tstudies\tare\tnon-\nrandomized\tand\tnon-controlled.\n\tFor\ttraditional\tChinese\tinterventions,\tconsider\treferring\tpatients\tto\ta\tlicensed\nChinese\tmedicine\tprovider\tor\tlicensed\tacupuncturist.\tBecaus... | [
-0.0372723825275898,
-0.014330597594380379,
0.05707179009914398,
0.002033046679571271,
-0.10515708476305008,
0.039929505437612534,
0.10888275504112244,
0.03173637390136719,
-0.029807759448885918,
0.019783692434430122,
0.09941957890987396,
0.013670818880200386,
0.0007398634916171432,
0.0177... |
of\tthe\tmost\tcommon\tintegrative\tapproaches\tis\ta\tnutritionally\tadequate\tanti-inflammatory\tdiet\t(see\t\nAppendix\t22\n\tand\nchapter\t7\n),\talthough\tthere\tis\tno\tdirect\tscientific\tevidence\tsupporting\tits\tuse\tin\tthe\n\tmedical\tliterature.\tSome\tstudies\nsuggest\tmelatonin\tmay\thave\ta\tprotective\... | [
0.017019640654325485,
-0.05325685068964958,
0.05231690779328346,
0.001668184413574636,
-0.07837136834859848,
0.05139785632491112,
0.08726898580789566,
0.037530142813920975,
0.036527473479509354,
0.08199527114629745,
0.0856604129076004,
0.02254514768719673,
0.014511089771986008,
0.059125546... |
Belyaev\tet\tal,\t2011\n;\t\nJaworek\net\tal,\t2012\n;\t\nJin\tet\tal,\t2013\n).\tSee\t\nchapter\t11\n\tfor\tmore\tinformation\tabout\tsafely\trecommending\tdietary\tand\therbal\nsupplements.\nPancreatic\tsurgery\nA\tsurgical\tprocedure\toften\tused\tfor\tpancreatic\tcarcinoma\tis\ta\t\npancreaticoduodenectomy\t(Whippl... | [
-0.0015264536486938596,
-0.033056989312171936,
0.007192314602434635,
-0.093460813164711,
-0.10691235959529877,
0.022655263543128967,
0.10030494630336761,
0.01624233089387417,
0.006891623139381409,
0.05517951771616936,
0.09026481211185455,
0.012326098047196865,
0.030099665746092796,
0.00662... |
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