Development of pancreatic diseases during long-term follow-up after acute pancreatitis:a post-hoc analysis of a prospective multicenter cohort

Background and Aim: More insight into the incidence of and factors associated with progression following a first episode of acute pancreatitis (AP) would offer opportunities for improvements in disease management and patient counseling. Methods: A long-term post hoc analysis of a prospective cohort of patients with AP (2008–2015) was performed. Primary endpoints were recurrent acute pancreatitis (RAP), chronic pancreatitis (CP), and pancreatic cancer. Cumulative incidence calculations and risk analyses were performed. Results: Overall, 1184 patients with a median follow-up of 9 years (IQR: 7–11) were included. RAP and CP occurred in 301 patients (25%) and 72 patients (6%), with the highest incidences observed for alcoholic pancreatitis (40% and 22%). Pancreatic cancer was diagnosed in 14 patients (1%). Predictive factors for RAP were alcoholic and idiopathic pancreatitis (OR 2.70, 95% CI 1.51–4.82 and OR 2.06, 95% CI 1.40–3.02), and no pancreatic interventions (OR 1.82, 95% CI 1.10–3.01). Non-biliary etiology (alcohol: OR 5.24, 95% CI 1.94–14.16, idiopathic: OR 4.57, 95% CI 2.05–10.16, and other: OR 2.97, 95% CI 1.11–7.94), RAP (OR 4.93, 95% CI 2.84–8.58), prior pancreatic interventions (OR 3.10, 95% CI 1.20–8.02), smoking (OR 2.33, 95% CI 1.14–4.78), and male sex (OR 2.06, 95% CI 1.05–4.05) were independently associated with CP. Conclusion: Disease progression was observed in a quarter of pancreatitis patients. We identified several risk factors that may be helpful to devise personalized strategies with the intention to reduce the impact of disease progression in patients with AP.</p

Feedback between erosion and active deformation : geomorphic constraints from the frontal Jura fold-and-thrust belt (eastern France)

A regional tectono-geomorphic analysis indicates a Pliocene to recent rock uplift of the outermost segment of the Jura fold-and-thrust belt, which spatially coincides with the intra-continental Rhine-Bresse Transfer Zone. Elevated remnants of the partly eroded Middle Pliocene Sundgau-Foreˆt de Chaux Gravels identified by heavy mineral analyses allow for a paleo-topographic reconstruction that yields minimum regional Latest Pliocene to recent rock uplift rates of 0.05 ± 0.02 mm/year. This uplift also affected the Pleistocene evolution of the Ognon and Doubs drainage basins and is interpreted as being tectonically controlled. While the Ognon River was deflected from the uplifted region the Doubs deeply incised into it. Focused incision of the Doubs possibly sustained ongoing deformation along anticlines which were initiated during the Neogene evolution of the thin-skinned Jura fold-and-thrust belt. At present, this erosion-related active deformation is taking place synchronously with thick-skinned tectonics, controlling the inversion of the Rhine-Bresse Transfer Zone. This suggests local decoupling between seismogenic basement faulting and erosion-related deformation of the Mesozoic cover sequences