Risk Factors for Immediate and Delayed-Onset Fever After Percutaneous Transhepatic Biliary Drainage

Objectives To prospectively investigate the pre and intraprocedural risk factors for immediate (IF) and delayedonset (DOF) fever development after percutaneous transhepatic biliary drainage (PTBD). Methods Institutional review board approval and informed patient consent were obtained. Between February 2013 and February 2014, 97 afebrile patients (77 at the Sapienza University of Rome, Italy and 20 at the Sun Yatsen University of Guangzhou, China) with benign (n = 31) and malignant (n = 66) indications for a first PTBD were prospectively enrolled. Thirty pre- and intra-procedural clinical/radiological characteristics, including the amount of contrast media injected prior to PTBD placement, were collected in relation to the development of IF (within 24 h) or DOF (after 24 h). Fever was defined as C37.5 C. Binary logistic regression analysis was used to assess independent associations with IF and DOF. Results Fourteen (14.4 %) patients developed IF and 17 (17.5 %) developed DOF. At multivariable analysis, IF was associated with pre-procedural absence of intrahepatic bile duct dilatation (OR 63.359; 95 % CI 2.658–1510.055; P = 0.010) and low INR (OR 4.7 9 10-4 ; 95 % CI 0.000–0.376; P = 0.025), while DOF was associated with unsatisfactory biliary drainage at the end of PTBD (OR 4.571; 95 % CI 1.161–17.992; P = 0.030)

Metabolic syndrome and cardiovascular risk after liver transplantation: a single-center experience.

Excessive weight gain, hypertension, hyperlipidemia, and diabetes are frequently observed among orthotopic liver transplantation (OLT) patients. These alterations, which are probably multifactorial in origin, contribute to posttransplantation metabolic syndrome (PTMS), which increases the risk of cardiovascular events. We assessed the prevalence of PTMS (diagnosed according to modified NCEP Adult Treatment Panel III criteria) in 156 OLT patients undergoing regular follow-up after transplantation (median 68 months; range, 6 to 234 months). Several pre- and post-OLT data were collected to identify the factors associated with the presence of PTMS which was found in 28% of cases. The only independent predictive factors for PTMS were diabetes mellitus and patients who were overweight or obese before-OLT. The prevalence of PTSM was lower among patients on tacrolimus immunosuppression. In our population, 21% of patients showed a high cardiovascular risk score with a 4% incidence of cardiovascular events, which was higher among subjects with PTMS. Close follow-up is mandatory to prevent the development of PTMS mainly among overweight and diabetic patients before transplantation

Facilitating the Serendipitous Discovery of Information: Planning and Weeding the Fine Art Collection

As many academic libraries face shrinking space, weeding collections has become a necessity. At Western Carolina University plans for a library renovation provided the opportunity to do a library-wide weeding project of the print collection. This article explains the collaborative undertaking of the arts liaison and the collection development librarian in weeding the fine art print collection. Included are some best practices for weeding an academic library,the importance of creating a collection that is smaller but well utilized by undergraduate students, and a description of the weeding process

Op Ed — Ivory Tower vs. the Dark Side: A Rebuttal to “Joining the Dark Side"

The April, 2012, issue of Against the Grain included an article by Laura Harris, “Joining the Dark Side,”1 which I read with interest.Harris described her transition from working in an academic library to working for Spring share, the developer and vendor for the wonderful LibGuides. The article held interest for me personally, since I experienced a similar change earlier in my career.I had spent seven years in academic libraries when I received an unexpected and unsolicited job offer from EBSCO Subscription Services (later EBSCO Information Services). Like Laura,I had not considered working for a vendor. Well, that’s not quite true. I had actually talked with a couple of folks at EBSCO before, but only for a possible position at their headquarters in Birmingham, AL. I thought I was completely uninterested in any sort of customer-facing position. And yet,that is what I ended up doing (in three different positions) for fifteen years

Champagne Wishes, Caviar Dreams: Incorporating E-readers into Leisure Reading While on a Beer Budget

In the spring of 2010, staff at Western Carolina University’s Hunter Library began investigating how to use end of year funds. One of the chosen ideas was to experiment with circulating Kindles loaded with leisure reading titles. The pilot program was initiated as a result of the convergence of the Dean of Library Services’ enduring interest in the positive impact reading has on society; the library’s need to spend its money wisely, but quickly; and a growing interest in innovation. The Kindle lending program became a successful service, but it was not without its challenges. This article covers the setup required for lending Kindles pre-loaded with electronic titles

Worlds beyond

For several years, Trinity University has had a summer reading program. While everyone - students, faculty and staff - is encouraged to participate, the incoming first-year students are the primary targets so that they may have a shared literary experience. The book for the summer of 2008 is Three Cups of Tea, and the program is being promoted more strongly than usual because the co-author and subject of the book, Greg Mortenson, will be on campus during the first week of classes to give a lecture and to meet with smaller groups of students. The book is the story of how Mortenson, a former high altitude mountain climber, became involved in building schools in Pakistan, and later in Afghanistan. I was particularly interested to learn that one of his early supporters and board member of his Central Asia Institute is Julia Bergman, library system administrator at City College of San Francisco

Il problema dell'individuazione nella fenomenologia di Hedwig Conrad Martius

La ricerca intende cogliere a partire dall'opera Die Geistseele des Menschen pubblicata nel 1960 gli aspetti salienti e originali del pensiero di Conrad Martius, riconducibili soprattutto a “un accordo straordinario” tra la ricerca scientifica e la filosofia. Il lavoro approfondisce alcuni temi fondamentali della fenomenologia realista di Conrad Martius, in particolare l’ontologia e l’antropologia declinate secondo il metodo fenomenologico, per far emergere il tema dell’individuazione come elemento connettivo fra le scoperte scientifiche della prima metà del Novecento e la riflessione filosofica sul senso ultimo delle cose. In tal senso il tema dell’individuazione rappresenta il punto d’incontro dei capisaldi della filosofia della Conrad Martius: i fondamenti dell’essere e i contributi della scienza, della biologia e della fisica in particolare. La convinzione che sta alla base della riflessione della nostra autrice è la presenza in tutti gli esseri viventi di un nucleo personale che fonda e guida lo sviluppo di ogni singolo individuo in modo teleologico. Questo nucleo che possiede sia la determinazione secondo la specie, sia quella propria dell’individuo è definito dalla Conrad Martius “il sé stesso originario [Ursprungsselbst]”

Mini-profile: a day in the life of a sales manager in Africa

“South Africa? Wow, how exotic!”I’ve received this comment, or a variation on it,several times. But the truth of the matter is thatJohannesburg is a big, modernized city like manyof the ones you live in. True, the weather is near perfect:as we approach winter, day-time temperatureswill usually be between 18–23°C and,night-time, 9–14°C. Just as in many other big cities,we have our share of crime, traffic and other urbanproblems. And, like many of you, my day beginswith e-mail