Pancreatic hyperamylasemia during acute gastroenteritis: incidence and clinical relevance

BACKGROUND: Many case reports of acute pancreatitis have been reported but, up to now, pancreatic abnormalities during acute gastroenteritis have not been studied prospectively. OBJECTIVES: To evaluate the incidence and the clinical significance of hyperamylasemia in 507 consecutive adult patients with acute gastroenteritis. METHODS: The clinical significance of hyperamylasemia, related predisposing factors and severity of gastroenteritis were assessed. RESULTS: Hyperamylasemia was detected in 10.2 % of patients studied. Although amylasemia was found over four times the normal values in three cases, the clinical features of acute pancreatitis were recorded in only one case (0.1%). Hyperamylasemia was more likely (17%) where a microorganism could be identified in the stools (p < 0.01). Among patients with positive stool samples, Salmonella spp. and in particular S. enteritidis, was the microorganism most frequently associated with hyperamylasemia [17/84 (20.2 %) and 10/45 (22.2%), respectively], followed by Rotavirus, Clostridium difficile and Campylobacter spp. Patients with hyperamylasemia had more severe gastroenteritis with an increased incidence of fever (80 % vs 50.6 %, O.R. 3.0; P < 0.01), dehydration (18% vs 8.5%; O.R. 2.5; P < 0.05), and a higher mean number of evacuations per day (9.2 vs 7.5; P < 0.05) than those with amylasemia in the normal range. Hyperamylasemia was significantly associated with cholelithiasis, (30.0 % vs 10.7%, O.R. 3.5; P < 0.01) and chronic gastritis or duodenal ulceration (22.0 % vs 10.2%, O.R. 2.4, P < 0.05). CONCLUSIONS: Hyperamylasemia is relatively frequent, and is associated with severe gastroenteritis. However, acute pancreatitis in the setting of acute gastroenteritis, is a rare event

A new technique for measuring the bed surface texture during flow and application to a degradational sand-gravel laboratory experiment

We present a new image analysis technique for measuring the grain size distribution (texture) of the bed surface during flow in a laboratory experiment. A camera and a floating device are connected to a carriage used to take images of the bed surface over the entire flume length. The image analysis technique, which is based on color segmentation, provides detailed data on spatial and temporal changes of the areal fraction content of each grain size at the bed surface. The technique was applied in a laboratory experiment conducted to examine a degradational reach composed of a well sorted two-fraction mixture of sand and gravel. The initial bed consisted of an upstream reach that was characterized by an imposed stepwise fining pattern (the bimodal reach) and a downstream sand reach. A lack of sediment supply and partial transport conditions led to the formation of a static armor in the bimodal reach, which resulted in a more abrupt spatial transition in the bed surface mean grain size. The associated spatial transition in slope led to a backwater effect over the bimodal reach, a streamwise reduction in sand mobility, and so a static armor that was governed by a downstream fining pattern. Although a morphodynamic equilibrium state under steady flow is generally characterized by normal flow, here the partial transport regime prevented the bed from adjusting toward normal flow conditions and the morphodynamic steady state was governed by a backwater. We applied a numerical morphodynamic sand-gravel model to reproduce the laboratory experiment. The numerical model captured the hydrodynamic and morphodynamic adjustment and the static armor well, yet the armoring occurred too slowly. Although the final configuration of the experiment shows features of a gravel-sand transition (i.e., a sudden transition in slope and mean grain size), we are hesitant to claim similarities between our results and the physical mechanisms governing a gravel-sand transition in the field.Environmental Fluid MechanicsRivers, Ports, Waterways and Dredging Engineerin