Editorial: Ensuring the Future of Rheumatology: A Multi‐Dimensional Challenge and Call to Action

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144253/1/art40431.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144253/2/art40431_am.pd

Endoscopic Management of Pediatric Airway and Esophageal Foreign Bodies

The use of endoscopy is critical to the management of pediatric tracheobronchial and esophageal foreign bodies. Children may present with nonspecific symptoms, and the diagnosis can be difficult when the ingestion or aspiration events go unwitnessed. Advances in endoscopic techniques and the use of optical graspers in the removal of foreign bodies in children have helped decrease morbidity and mortality. In this chapter, the history, clinical presentations, workup, and management for pediatric aerodigestive foreign bodies are discussed

ESPEN Guideline: Clinical Nutrition in inflammatory bowel disease

Introduction: The ESPEN guideline presents a multidisciplinary focus on clinical nutrition in inflammatory bowel disease (IBD). Methodology: The guideline is based on extensive systematic review of the literature, but relies on expert opinion when objective data were lacking or inconclusive. The conclusions and 64 recommendations have been subject to full peer review and a Delphi process in which uniformly positive responses (agree or strongly agree) were required. Results: IBD is increasingly common and potential dietary factors in its aetiology are briefly reviewed. Malnutrition is highly prevalent in IBD – especially in Crohn's disease. Increased energy and protein requirements are observed in some patients. The management of malnu-trition in IBD is considered within the general context of support for malnourished patients. Treatment of iron deficiency (parenterally if necessary) is strongly recommended. Routine provision of a special diet in IBD is not however supported. Parenteral nutrition is indicated only when enteral nutrition has failed or is impossible. The recommended perioperative man-agement of patients with IBD undergoing surgery accords with general ESPEN guidance for patients having abdominal surgery. Probiotics may be helpful in UC but not Crohn's disease. Primary therapy using nutrition to treat IBD is not supported in ulcerative colitis, but is mod-erately well supported in Crohn's disease, especially in children where the adverse conse-quences of steroid therapy are proportionally greater. However, exclusion diets are generally not recommended and there is little evidence to support any particular formula feed when nutritional regimens are constructed. Conclusions: Available objective data to guide nutritional support and primary nutritional therapy in IBD are presented as 64 recommendations, of which 9 are very strong recom-mendations (grade A), 22 are strong recommendations (grade B) and 12 are based only on sparse evidence (grade 0); 21 recommendations are good practice points (GPP)

Banking, law, and American liberalism: the rise and regulation of bank holding companies in the twentieth century

“Banking, Law, and American Liberalism: The Rise and Regulation of Bank Holding Companies in the Twentieth Century” excavates the history of the bank holding company, a corporation that owns or controls one or more United States banks, and the movement to prevent its monopolistic expansion in the twentieth century. Utilizing the battle for bank holding company reform as a lens through which to trace the development of antimonopoly law and policy, this dissertation argues that banking played a generative role in the origins and endurance of the American antimonopoly tradition. That tradition, it contends, neither began in the late nineteenth century with the advent of antitrust laws nor comprised a singular modality of reform. From the public provision of currency and credit to delegating and dispersing the privilege of money creation, from central banking to public utility regulation, antimonopolists pioneered differing methods and legal tools to combat the concentration of financial power. By the dawn of the twentieth century, powerful antimonopoly impulses had contributed to the entrenchment of a decentralized banking system comprised of predominantly small, local banks largely prohibited from expanding geographically or engaging in commercial business. The emergence of the holding company as a means of concentrating capital and control in the Gilded Age therefore served as an invaluable mechanism for evading the regulatory constraints of federal and state banking law. Through a bank holding company, enterprising bankers could acquire the stock of innumerable banks and businesses despite restrictions on branch banking and mixing banking and commerce. Though early efforts to prevent the use of the bank holding company device to escape regulation arose in the first decades of the twentieth century, they were largely ineffective. Rather, a wide-ranging and potent antimonopoly movement premised upon the danger bank holding companies posed to American democracy succeeded only in the aftermath of World War II. Culminating in the Bank Holding Company Act of 1956, the movement for bank holding company reform represents a pivotal, yet virtually unacknowledged, chapter of the American antimonopoly tradition. Challenging longstanding narratives of political economy that portray World War II as the “end of reform” and the antitrust movement as a faded passion, this dissertation argues that antimonopoly ideals survived long after their supposed demise and continued to structure national policymaking well into the postwar decades. Tracing the rise and regulation of bank holding companies ultimately reveals the complexity, breadth, and remarkable resiliency of American antimonopoly law and policy as it evolved across centuries.2024-11-03T00:00:00

Improving cirrhosis care: the potential for telemedicine and mobile health technologies.

Decompensated cirrhosis is a condition associated with significant morbidity and mortality. While there have been significant efforts to develop quality metrics that ensure high-value care of these patients, wide variations in clinical practice exist. In this opinion review, we discuss the quality gap in the care of patients with cirrhosis, including low levels of compliance with recommended cancer screening and other clinical outcome and patient-reported outcome measures. We posit that innovations in telemedicine and mobile health (mHealth) should play a key role in closing the quality gaps in liver disease management. We highlight interventions that have been performed to date in liver disease and heart failure-from successful teleconsultation interventions in the care of veterans with cirrhosis to the use of telemonitoring to reduce hospital readmissions and decrease mortality rates in heart failure. Telemedicine and mHealth can effectively address unmet needs in the care of patients with cirrhosis by increasing preventative care, expanding outreach to rural communities, and increasing high-value care. We aim to highlight the benefits of investing in innovative solutions in telemedicine and mHealth to improve care for patients with cirrhosis and create downstream cost savings