SUMMARY / RELATED TOPICS

Pancreatitis

Pancreatitis is a condition characterized by inflammation of the pancreas. The pancreas is a large organ behind the stomach that produces digestive enzymes and a number of hormones. There are acute pancreatitis and chronic pancreatitis. Signs and symptoms of pancreatitis include pain in the upper abdomen and vomiting; the pain goes into the back and is severe. In acute pancreatitis a fever may occur and symptoms resolve in a few days. In chronic pancreatitis weight loss, fatty stool, diarrhea may occur. Complications may include infection, diabetes mellitus, or problems with other organs; the two most common causes of acute pancreatitis are a gallstone blocking the common bile duct after the pancreatic duct has joined. Other causes include direct trauma, certain medications, infections such as mumps, tumors. Chronic pancreatitis may develop as a result of acute pancreatitis, it is most due to many years of heavy alcohol use. Other causes include high levels of blood fats, high blood calcium, some medications, certain genetic disorders such as cystic fibrosis among others.

Smoking increases the risk of both chronic pancreatitis. Diagnosis of acute pancreatitis is based on a threefold increase in the blood of either amylase or lipase. In chronic pancreatitis these tests may be normal. Medical imaging such as ultrasound and CT scan may be useful. Acute pancreatitis is treated with intravenous fluids, pain medication, sometimes antibiotics. Eating and drinking are disallowed, a nasogastric tube is placed in the stomach. A procedure known as an endoscopic retrograde cholangiopancreatography may be done to examine the distal common bile duct and remove a gallstone if present. In those with gallstones the gallbladder is also removed. In chronic pancreatitis, in addition to the above, temporary feeding through a nasogastric tube may be used to provide adequate nutrition. Long-term dietary changes and pancreatic enzyme replacement may be required, and surgery is done to remove parts of the pancreas. Globally, in 2015 about 8.9 million cases of pancreatitis occurred. This resulted in 132,700 deaths, up from 83,000 deaths in 1990.

Acute pancreatitis occurs in about 30 per 100,000 people a year. New cases of chronic pancreatitis develop in about 8 per 100,000 people a year and affect about 50 per 100,000 people in the United States, it is more common in men than women. Chronic pancreatitis starts between the ages of 30 and 40 while it is rare in children. Acute pancreatitis was first described on autopsy in 1882 while chronic pancreatitis was first described in 1946; the most common symptoms of pancreatitis are severe upper abdominal or left upper quadrant burning pain radiating to the back and vomiting, worse with eating. The physical examination will vary depending on presence of internal bleeding. Blood pressure may be decreased by dehydration or bleeding. Heart and respiratory rates are elevated; the abdomen is tender but to a lesser degree than the pain itself. As is common in abdominal disease, bowel sounds may be reduced from reflex bowel paralysis. Fever or jaundice may be present. Chronic pancreatitis can lead to diabetes or pancreatic cancer.

Unexplained weight loss may occur from a lack of pancreatic enzymes hindering digestion. Early complications include shock, systemic inflammatory response syndrome, low blood calcium, high blood glucose, dehydration. Blood loss and fluid leaking into the abdominal cavity can lead to kidney failure. Respiratory complications are severe. Pleural effusion is present. Shallow breathing from pain can lead to lung collapse. Pancreatic enzymes may attack the lungs. Severe inflammation can lead to intra-abdominal hypertension and abdominal compartment syndrome, further impairing renal and respiratory function and requiring management with an open abdomen to relieve the pressure. Late complications include recurrent pancreatitis and the development of pancreatic pseudocysts—collections of pancreatic secretions that have been walled off by scar tissue; these may cause pain, become infected and bleed, block the bile duct and cause jaundice, or migrate around the abdomen. Acute necrotizing pancreatitis can lead to a pancreatic abscess, a collection of pus caused by necrosis and infection.

This happens in 3% of cases, or 60% of cases involving more than two pseudocysts and gas in the pancreas. Eighty percent of cases of pancreatitis are caused by alcohol or gallstones. Gallstones are the single most common cause of acute pancreatitis. Alcohol is the single most common cause of chronic pancreatitis. Triglyceride levels greater than 1000 mg/dL is another important cause. There are seven classes of medications associated with acute pancreatitis: statins, ACE inhibitors, oral contraceptives/hormone replacement therapy, antiretroviral therapy, valproic acid, oral hypoglycemic agents. Mechanisms of these drugs causing pancreatitis are not known exactly. Meanwhile, ACE inhibitors cause angioedema of the pancreas through the accumulation of bradykinin. Birth control pills and HRT cause arterial thrombosis of the pancreas through the accumulation of fat. Diuretics such as furosemide have a direct toxic effect on the pancreas. Meanwhile, thiazide diuretics cause hypertriglyceridemia and hypercalcemia, where the latter is the risk factor for pancreatic stones.

HIV infection itself can cause a person to be more to get pancreat

Mount Mulligan, Queensland

Mount Mulligan is a former mining town and rural locality in Shire of Mareeba, Australia. It is the site of Queensland's worst mining disaster, it was a coal mining town from 1910 until 19 September 1921 when an underground explosion killed 75 miners. The mine closed, but reopened in 1923 and continued in production until 1957 when a hydro-electric scheme eliminated the need for the coal; the town's coal was mined from shafts dug into a Permian layer within the cliff face or escarpment of a large 18 kilometres x 6.5 kilometres free-standing conglomerate and sandstone massif known by the name given it by the small group of prospectors who first sighted it in 1874 while searching the Hodgkinson River for gold, under the leadership of James Venture Mulligan. The conglomerate and sandstone massif known to local Djungan aboriginal peoples as Ngarrabullgan was given James Mulligan's surname; the name Mount Mulligan was given to the township that grew in the shadows of the massif's escarpment. The area of the township is no longer gazetted, but is now a ghost town, with a single cemetery, a single occupied residence, a single chimney stack, the overgrown remains of the once busy mining operations and electricity generator.

At the 2006 census, Mount Mulligan and the surrounding area had a population of 55. Mount Mulligan Post Office opened by July 1914 and closed in 1959. A Mount Mulligan RailPost Office was open between 1916 and 1920. A railway connected Mount Mulligan with Dimbulah on the Chillagoe Railway, it opened on 7 April 1915 and was closed in January 1958. Nearby towns are Julatten, Mount Carbine and Mount Molloy. Ngarrabullgan Media related to Mount Mulligan, Queensland at Wikimedia Commons

Valley of Eagles

Valley of Eagles is a 1951 British thriller film written and directed by Terence Young and starring Jack Warner, Nadia Gray and John McCallum. The screenplay concerns a Swedish scientist, whose crucial new invention is stolen by his wife who tries to take it to the Soviet Union; the setting is Stockholm, Sweden, "this year". Dr Nils Ahlen, working at the "Institute of Technical Research", is about to leave his home to give a talk at Uppsala University on his new invention and he discusses arrangements for his absence with his assistant, Sven Nystrom. Nystrom intends to work from home, but Ahlen shows him where he has hidden the key to his laboratory "just in case". While they are talking, Ahlen's wife, complains that the couple will miss a dinner engagement with friends. Ahlen tells her she could go on her own and Helga replies that she could. At Uppsala University, Ahlen's demonstration of his invention creates enormous interest, not the least from a colonel in the Swedish Army, it is a device which allows huge amounts of energy to be stored, as audio recordings, on barium discs.

When played back, the discs release enough power to fuel a small town or "propel a rocket or flying bomb across the Atlantic". The military are interested in this and request that Ahlen provide them with the specifications for his recorder "by yesterday". Returning home from Uppsala, Ahlen finds his apartment disturbed and his wife and the key to his laboratory both missing. A search of the lab reveals, he alerts the police and the head of his institute, an investigation begins. Ahlen, soon becomes impatient with the attitude of police inspector Peterson and, having established that his assistant Nystom is missing, begins an investigation of his own; this takes him to a rendezvous with a mysterious baroness in Karlstad, with whom Nystrom has been in correspondence. The baroness denies all knowledge of Nystrom, although she answers to the description of a frequent visitor that Nystrom has had; as Ahlen is leaving her house, the baroness' manservant tells her. Peterson has traced the trail to the baroness, meets up with Ahlen in his car.

The two agree to work together. They find out that a plane has been forced to make a landing at Leksand and that Nystrom and Helga were on board; the pair are heading north for the border with Finland in Swedish Lapland to take the invention to the Soviet Union, although this is never made explicit. From now on, the action switches between Ahlen and Peterson and Nystrom and Helga in their race for the border; when a blizzard begins, Ahlen remarks that the weather is visited on the just and unjust alike and wonders which of them is which. The chase takes all four protagonists into the territory of the local Sami people, referred to here as Lapps. Nystrom and Helga have hired three Sami as guides, while Ahlen and Peterson join a large family group who are taking their reindeer across the border. Right from the start, the presence of Ahlen and Peterson causes discord amongst the Sami, many of whom regard them as bad luck and resent the distraction of involving themselves in the chase, but their leader, named Anders, is supportive of Ahlen and Peterson and persuades the rest to accept them.

Nystrom and Helga lay a false trail which leads Ahlen's group over a cliff, destroying their reindeer herd. Anders takes his own life out of the group disbands. Ahlen and Peterson are left with a small group led by the young Sami woman Kara Niemann; when Ahlen and Peterson criticise the "savagery" of the Lapp culture, Kara defends it and reveals that she is the granddaughter of Anders. Ahlen warms to her and the two begin to fall in love. However, Kara's group is soon in deep trouble, as they have attracted the attention of two different packs of wolves and lack the firepower to defend themselves. Just all seems lost, one of their party spots a group of birds circling overhead. One of them kills a wolf, it is an eagle, controlled by one of a group of Sami hunters. More birds descend and the wolves are driven off; the group is taken to the eagle hunters' village in "the hidden valley", a kind of local Shangri La. The valley is a refuge, but is under constant threat of avalanches from the mountains which overhang it.

This is why the hunters hunt with eagles and why the children in the village can never laugh or play. Nystrom and Helga are here and Peterson places them both under arrest. Ahlen talks to Helga, she mocks him for caring more about glass wires than about flesh and blood. Ahlen begs Peterson to let the pair go free. Peterson refuses, but there is a strong suggestion that he will "turn a blind eye". Before any plan can be made, Nystrom takes matters into his own hands, he and Helga attempt to escape by crossing the mountains above the village. Fearing an avalanche, the locals give chase with their eagles. Peterson and Ahlen try to persuade Nystrom to turn back but he fires at them, starting an avalanche which kills the fugitives but spares the village; the locals reflect that they have been needlessly living in fear for generations and Ahlen and Niemann are free to enjoy their newfound love. Jack Warner as Inspector Peterson Nadia Gray as Kara Niemann John McCallum as Doctor Nils Ahlen Anthony Dawson as Sven Nystrom Mary Laura Wood as Helga Ahlen Naima Wifstrand as Baroness Erland Norman Macowan as ferry pilot Alfred Maurstad as Trerik, a Sami Martin Boddey as Chief of the Lost Valley Fritiof Billquist as Colonel Strand Christopher Lee as Detective Holt Ewen Solon as Detective Anderson Peter Blitz as Anders Gösta Cederlund as Professor