PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Background: Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods: All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results: A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion: Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions

Treatment Discontinuation Following Bariatric Surgery in Obstructive Sleep Apnea: a Controlled Cohort Study

International audienceUncontrolled studies looking at the discontinuation of obstructive sleep apnea (OSA) treatment after bariatric surgery (BS) have suggested that surgery improves OSA. However, this discontinuation of OSA treatment by BS patients has never been compared to a matched population without BS. The objectives of this study are to evaluate whether BS increases OSA treatment discontinuation compared to that in matched patients without BS and to identify predictive factors of OSA treatment discontinuation in BS patients. The study took place in an ambulatory, tertiary hospital

Socioeconomic development and changing reasons for using desert kites to kill gazelles

Possible reasons for using kites to kill gazelles are comprehensively reviewed in this article. Even though they are now well inventoried and documented, desert kites are still not well understood, as exemplified by the recurrent controversies about their function and dating. According to the dominant view, kites were hunting structures used to drive and to mass kill large herds of wild ungulates, particularly gazelles. Although kites were intensively used during the Early Bronze Age, some of them could have been built and used before that. Beyond these issues, the cultural and socioeconomic aspects of the kites phenomenon are even less understood, and therefore, we focus on changing reasons for the long-lasting use of kites as hunting devices. We contend that the reasons why they were used during the period of utilization for hunting gazelles changed, in most cases, in response to socioeconomic development. It is hypothesized, for example, that, as a result of urban development, kites may have been increasingly (but not exclusively) used to kill gazelles to trade their products with urban communities and farmers, even though they had other uses as well which are also considered. The main hypothesis presented in this article enables diverse opinions about the types of uses and reasons for utilizing desert kites to be reconciled, including in particular varied reasons given in the literature about why they were used for killing gazelles