EUS-guided rendezvous technique for difficult cannulation of an intradiverticular papilla

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Defining and Measuring Subjective Wellbeing for Sport Policy

This paper makes the case for assessing the value of sport based on people’s reports of subjective wellbeing (SWB), i.e. how they feel. We compare SWB to conventional definitions of wellbeing. We discuss how SWB is measured, distinguishing between evaluations (e.g., life-satisfaction) and experiences (feelings held moment to moment). We then consider evidence on the impact of sport on both evaluations and experiences of SWB, showing that the two give rise to different insights. We argue that measures that focus on how people feel as they go about their lives are better suited to accounting for the value of sport. We conclude by encouraging the measurement of experiences of SWB in sport policy

Multidisciplinary Conservative Treatment of Difficult Bile Duct Stones: A Real Alternative to Surgery

56 patients with large CBD or intrahepatic stones underwent endoscopic and/or percutaneous treatment followed by extracorporeal shock wave lithotripsy. Percutaneous access to the biliary tract was chosen when an endoscopic approach was not possible (hepaticojejunostomy in 5 patients, 1 juxtapapillary diverticulum and I inflammatory bile duct stricture). Visualization of stones was achieved radiologically in 32 patients and by ultrasound in 24. The procedure was successful in 47 of 56 treated patients (83.9%). Clearance of the biliary tract was obtained in 25 cases (53%), whereas in 22 cases (47%) complete clearing of biliary tract was obtained only after endoscopic extraction of fragments (17 cases) or percutaneous (5 cases). The median number of shock waves in each session was 1725 (range 300–3166), which were applied during one (n=30), two (n=22) or three sessions (n=4). The only complications were 1 case of symptomatic hyperamylasemia and 3 cases of macrohematuria. In conclusion, extracorporeal lithotripsy combined with endoscopic and/or percutaneous treatment is a real alternative to surgery for difficult stones

Contrast agents for hepatic magnetic resonance imaging.

The current availability of liver-specific contrast media (LSCM) allows the possibility to obtain an accurate diagnosis when studying focal liver lesions (FLL). It is necessary to have an in-depth knowledge of the biologic and histologic characteristics of FLL and the enhancement mechanism of LSCM to gain significant accuracy in the differential diagnosis of FLL. It is possible to subdivide FLL into three main groups according to the kinetics of contrast enhancement: hypervascular FLL, hypovascular FLL, and FLL with delayed enhancement. Dynamic contrast-enhanced magnetic resonance imaging is an important tool in the identification and characterization of FLL. LSCM with a first phase of extracellular distribution give both dynamic (morphologic) and late phase (functional) information useful for lesion characterization. With LSCM it is possible to differentiate with high accuracy benign from malignant lesions and hepatocellular from nonhepatocellular lesions. To understand contrast behavior after injection of LSCM, it is necessary to correlate contrast enhancement with the biologic and histologic findings of FLL

Insulin, Hyperglycemia, and Severe Retinopathy of Prematurity in Extremely Low-Birth-Weight Infants

Objective This study aims to determine the association between hyperglycemia, insulin therapy, and severe retinopathy of prematurity (ROP) in extremely low-birth-weight (ELBW) infants. Study Design In this retrospective database study, we included all ELBW infants who were 180 mg/dL. Covariates were GA, small for GA status, discharge year, sex, Apgar score at 5 minutes, mechanical ventilation, oxygen use, bacteremia, and postnatal steroid exposure. We defined severe ROP as ROP requiring bevacizumab, cryotherapy, laser therapy, or vitrectomy. Sensitivity analysis using BG > 150 mg/dL and > 200 mg/dL was performed. Results A total of 24,548 infants were included; 2,547 (10%) had severe ROP. Hyperglycemia alone was not associated with severe ROP (odds ratio [OR], 0.88; 95% confidence interval [CI], 0.66-1.17). Hyperglycemia and insulin use were not associated with severe ROP (OR, 1.43; 95% CI, 0.91-2.23). BG > 150 mg/dL and insulin use were associated with severe ROP (OR, 1.34; 95% CI, 1.02-1.76). Conclusions Hyperglycemia alone was not associated with severe ROP in ELBW infants. However, we did observe a possible trend between the use of insulin and severe ROP.National Center for Advancing Translational Sciences of the National Institutes of Health (NIH)U.S. governmentNational Institute of Child Health and Human DevelopmentNIHNational Center for Advancing Translational Sciences of the NIHU.S. Food and Drug AdministrationCempra PharmaceuticalsDuke Univ, Dept Pediat, Sch Med, Durham, NC 27706 USADuke Univ, Sch Med, Duke Clin Res Inst, Durham, NC USAKK Womens & Childrens Hosp, Childrens Intens Care Unit, Singapore, SingaporeUniv Fed Sao Paulo, Ecola Paulista Med, Div Neonatal Med, Sao Paulo, BrazilUniv N Carolina, Dept Pediat, Chapel Hill, NC USAMEDNAX Inc, Pediat Med Grp, Jacksonville, FL USAUniv Fed Sao Paulo, Ecola Paulista Med, Div Neonatal Med, Sao Paulo, BrazilNIH: UL1TR001117U.S. government: HHSN267200700051CNational Institute of Child Health and Human Development: K23HD068497National Institute of Child Health and Human Development: HHSN275201000003INational Institute of Child Health and Human Development: 1R01-HD081044-01National Center for Advancing Translational Sciences of the NIH: UL1TR001117U.S. Food and Drug Administration: 1R18-FD005292-01Cempra Pharmaceuticals: HHS0100201300009CWeb of Scienc

Insulin, Hyperglycemia, and Severe Retinopathy of Prematurity in Extremely Low-Birth-Weight Infants

To determine the association between hyperglycemia, insulin therapy, and severe retinopathy of prematurity (ROP) in extremely-low-birth-weight (ELBW) infants

Information Literacy Needs Open Access or: Open Access is not Only for Researchers

The Open Access was initially (blandly) conceived in view not only of researchers but also of lay readers, then this perspective slowly faded out. The Information Literacy movement wants to teach citizens how to arrive at trustable information but the amount of paywalled knowledge is still big. So, their lines of development are somehow complementary: Information Literacy needs Open Access for the citizens to freely access high quality information while Open Access truly fulfils its scope when it is conceived and realized not only for the researchers (an aristocratic view which was the initial one) but for the whole society

Drivers of success in implementing sustainable tourism policies in urban areas

The existing literature in the field of sustainable tourism highlights a number of barriers that impede the implementation of policies in this area. Yet, not many studies have so far considered the factors that would contribute to putting this concept into practice, and few address the case of urban areas. The concept of sustainability has only received limited attention in urban tourism research, even though large cities are recognised as one of the most important tourist destinations that attract vast numbers of visitors. Adopting a case study approach, this paper discusses a number of drivers of success identified by policy-makers in London to contribute to the implementation of sustainable tourisms policies at the local level, and briefly looks at the relationship between these drivers and the constraints perceived by the respondents to hinder the implementation of such policies in practice. These findings may help policy-makers in other large cities to successfully develop and implement policies towards sustainable development of tourism in their area