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

Recent Advances in Sugarcane Industry Solid By-Products Valorization

Sugarcane is among the leading agricultural crop cultivated in tropical regions of the world. Industrial processing of sugarcane generates sugar; as well as various solid wastes (i.e. sugarcane bagasse, pressmud). Improvement of biotechnology in industrial level, offers opportunities for economic utilization of these solid residues. In the last few decades, sugarcane bagasse and pressmud have been explored in the theme of lignocellulosic bioconversion. The recalcitrance of biomass is a major drawback towards successful exploitation of lignocellulosic residues. Pretreatment by suitable/efficient processes can overcome this limitation. In this regards; physical, chemical and biological treatment systems are brought into our perspective. Chemical and physicochemical methods are capital-intensive but not environment-friendly, in contrast, method like biological treatment is eco-friendly but extremely slow. There are still major technological and economic challenges need to be addressed; e.g. bioprospecting, established more reliable genetically modified microorganisms, upgrade gene cloning and sequencing processes, yield improvement at large scale etc. Productions of value-added products from these solid wastes are discussed in such a way that pinpoints the most recent trends and the future directions. Biofuels, enzymes, organic acids and bio-sorbents production draw a clear sketch of the current and future bio-based products. Nano-biotechnology and genetic engineering could be future trends to improved processes and products. This review serves as a valuable reference material for a wide range of scientists and technologists in the relevant fields