title: Early differential diagnosis of the severity of acute pancreatitis.
abstract: There is a great need for early verification of the severity of acute pancreatitis (AP). The early stage of pathogenesis of AP is characterized by endothelial dysfunction which could be determined by wavelet analysis of skin temperature (WAST) technique. The aim is to investigate whether the dysregulation of microvascular tone caused by endothelial dysfunction and detected by WAST can be a significant indicator in early differential diagnosis of AP severity. The WAST performed in the frequency range of 0.0095-0.02 Hz during the contralateral cold test. Forty nine patients with AP aged 19-65 participated in this study. The control group included 12 healthy volunteers aged 20-65. Dysregulation of vascular tone during the contralateral cold test was observed in all patients with AP. The basal amplitudes of skin temperature oscillations in patients with AP were much lower than in healthy volunteers and progressively decreased as the disease severity increased. In patients with mild and moderate AP only the vasodilator component is destroyed, but vasoconstriction still operates. In patients with severe AP both mechanisms of endothelial vascular tone regulation are destroyed. Patients with AP have abnormal microvascular reactions related to the endothelial mechanism of vascular tone regulation. Based on the initial values of amplitudes and the indices of vasoconstriction and postcold vasodilatation, the WAST method makes it possible to evaluate two related but different characteristics of the endothelial dysfunction in patients with AP on admission which can be a significant indicator in early differential diagnosis of AP severity.
authors.affiliation: Hospital Surgery Department, Perm State Medical University, Petropavlovskaya Street 26, Perm, Russian Federation, 614000.|Laboratory of Physical Hydrodynamics, Institute of Continuous Media Mechanics, Ural Branch of Russian Academy of Science, Acad. Koroleva Street 1, Perm, Russian Federation, 614013.
authors.forename: Alexander
authors.initials: A
authors.lastname: Popov
authors.affiliation: Hospital Surgery Department, Perm State Medical University, Petropavlovskaya Street 26, Perm, Russian Federation, 614000. ershovaa@inbox.ru.|Laboratory of Physical Hydrodynamics, Institute of Continuous Media Mechanics, Ural Branch of Russian Academy of Science, Acad. Koroleva Street 1, Perm, Russian Federation, 614013. ershovaa@inbox.ru.
authors.forename: Anna
authors.initials: A
authors.lastname: Ershova
authors.affiliation: Laboratory of Physical Hydrodynamics, Institute of Continuous Media Mechanics, Ural Branch of Russian Academy of Science, Acad. Koroleva Street 1, Perm, Russian Federation, 614013.
authors.forename: Sergey
authors.initials: S
authors.lastname: Podtaev
authors.affiliation: Laboratory of Physical Hydrodynamics, Institute of Continuous Media Mechanics, Ural Branch of Russian Academy of Science, Acad. Koroleva Street 1, Perm, Russian Federation, 614013.
authors.forename: Peter
authors.initials: P
authors.lastname: Frick
authors.affiliation: Hospital Surgery Department, Perm State Medical University, Petropavlovskaya Street 26, Perm, Russian Federation, 614000.|Laboratory of Physical Hydrodynamics, Institute of Continuous Media Mechanics, Ural Branch of Russian Academy of Science, Acad. Koroleva Street 1, Perm, Russian Federation, 614013.
authors.forename: Nadezhda
authors.initials: N
authors.lastname: Zubareva
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010195:Pancreatitis / Q000175:diagnosis*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012881:Skin Temperature; D012984:Software; D014661:Vasoconstriction; D058067:Wavelet Analysis; D055815:Young Adult
keywords: Acute pancreatitis; Endothelial dysfunction; Endothelium; Microcirculation; Skin temperature oscillations