Bowersabbott6081

Background and Aim Endoscopic stone removal has some complications. Although the life expectancy of elderly patients has increased dramatically worldwide, little information is available on the necessity of complete endoscopic stone removal in extremely elderly patients. This study aimed to evaluate the safety and efficacy of complete endoscopic stone removal in extremely elderly patients. Methods All extremely elderly patients (>90 years) who underwent endoscopic stone removal for choledocholithiasis at our hospital between January 2012 and January 2017 were retrospectively evaluated. The included patients were divided into complete stone removal and incomplete stone removal groups. Complication rate, overall survival (OS), and disease-specific survival (DSS) rates were compared between the two groups. Results Overall, 73 patients were included in this study. The median number of stones was one (range, 0-10) and two (range, 1-12) (P = 0.043), while the median diameter of the largest stones was 9 (range, 0-27) and 14 (range, 5-46) mm (P = 0.001) in the complete and incomplete stone removal groups, respectively. During the follow-up period, OS was 60% and 39% and DSS was 95% and 97% in the complete and incomplete stone removal groups, respectively. Kaplan-Meier analysis found no significant difference in OS and DSS between the two groups (P = 0.052 and P = 0.646, respectively). read more Conclusion Complete stone removal might not always be necessary in extremely elderly patients aged ≥90 years. © 2019 The Authors. JGH Open An open access journal of gastroenterology and hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.The incidence of inflammatory bowel disease (IBD) has increased annually in newly industrialized countries. In mainland China, there is also a trend of increasing incidence and prevalence of IBD. Epidemiological studies have shown that the incidence of IBD in mainland China is higher in the south and lower in the north. However, the existing research results are affected by the factor of floating population. Some socioeconomic factors also seem to play a role in the rising trend of IBD incidence and prevalence. These underlying factors provide opportunities and challenges for our IBD epidemiological studies over the next decade. © 2019 The Authors. JGH Open An open access journal of gastroenterology and hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.Since the last decade, endoscopic submucosal dissection (ESD) has been used as the standard treatment for superficial gastrointestinal neoplasms. Trainees learning ESD frequently encounter difficulties such as vascularity, peristalsis, and fibrosis during the procedure. Because individual vascularity differs, it generally cannot be consistently avoided. Given that massive hemorrhages can prolong the procedure time and diminish treatment efficacy and that insufficient vessel handling may also increase postoperative bleeding, hemorrhage control during ESD becomes important to ensure procedure safety. This article discusses methods for controlling hemorrhage during gastric ESD. Endoscopists should have a basic understanding of the vascular architecture and the high-density areas in blood vessels, which are susceptible to intraoperative hemorrhage. Efficient preventative coagulation should be performed in addition to mastering the techniques for hemorrhage control using hemostatic forceps. Techniques useful for preventing intraoperative hemorrhage at every step (e.g. submucosal injection, mucosal incision, and dissection) should be learned. Gaining procedural competence and learning hemorrhage control techniques not only during ESD but also in daily work would help provide safe and effective treatment. © 2019 The Authors. JGH Open An open access journal of gastroenterology and hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.Background Bihar state in India has one of the highest rates of maternal and infant mortality in South Asia. Microfinance-based self-help groups (SHGs), involving rural women, are being utilized to improve maternal and child health practice and reduce mortality. SHG members receive information on key maternal and child health practices as well as encouragement for their practice. This study measures the association of health messaging to SHG members with their antenatal care (ANC) behaviors. Methods The study was conducted in eight districts of Bihar in 2016. A three-stage cluster sampling design (with a random selection of blocks, villages, and SHGs) selected the sample of 1204 SHG members who had an infant child; of these, 597 women were members of SHGs that received dedicated sessions on health messages, while 607 women belonged to SHGs that did not. To examine the impact of the health intervention on ANC practice, radius caliper method of propensity score matching controlled for various socio-demographic microfinance-based SHGs for improved maternal health services, the approach's sustainability needs to be further examined. © The Author(s) 2020.Halide perovskites have shown great potential for light emission and photovoltaic applications due to their remarkable electronic properties. Although the device performances are promising, they are still limited by microscale heterogeneities in their photophysical properties. Here, we study the impact of these heterogeneities on the diffusion of charge carriers, which are processes crucial for efficient collection of charges in light-harvesting devices. A photoluminescence tomography technique is developed in a confocal microscope using one- and two-photon excitation to distinguish between local surface and bulk diffusion of charge carriers in methylammonium lead bromide single crystals. We observe a large dispersion of local diffusion coefficients with values between 0.3 and 2 cm2·s-1 depending on the trap density and the morphological environment-a distribution that would be missed from analogous macroscopic or surface measurements. This work reveals a new framework to understand diffusion pathways, which are extremely sensitive to local properties and buried defects. Copyright © 2019 American Chemical Society.The incidence of small- and medium-size renal stones is rising. Stone clearance, bleeding, urine leak, and infectious complications are major concerns for urologists. They can choose the best technique from a list of armamentarium available. Minimally invasive approach like percutaneous nephrolithotomy (PCNL) has significantly influenced renal stone management since 1976. link2 Miniaturization of the instruments innovate more effective and safer alternatives for urolithasis management. The outcome of mini-PCNL is explored and compared with standard PCNL in this review. Original research articles were reviewed using a systematic approach (keyword electronic database search). Duplicates were excluded in each step and 19 original articles out of 156 hits were analyzed. Mini-PCNL has significantly less bleeding complications and hospital stay. There were no significant difference in stone free rate between mini-PCNL and standard PCNL. The stone-free rate and complications rates were less dependent on the technique of puncture, tract dilatation, and energy used to fragment stones. The total operative time became slightly longer in mini-PCNL attributed to the sheath size and stone fragments retrieval. We found that mini-PCNL is as effective as standard PCNL with fewer complications. Stone burden is the key factor responsible for overall stone-free rate. However, the recommendation is limited by quality of study and the sample sizes.Background In Oregon in the United States' Pacific Northwest, Native Hawaiians/Pacific Islanders including Micronesian Islanders (MI) substantially grew by 68%; however, research is sparse. This is often due to data aggregation as Asian and Pacific Islanders and community members' reluctance and wariness to participate in research due to a history of unethical research in the Pacific. The MI community experienced miscarriages, stillbirths, and intellectual and developmental disabilities. Organizational MI community leaders expressed a need to explore the voices of MI parent leaders (MIPLs). The purpose of the community-based participatory qualitative descriptive pilot study was to explore the perceptions and experiences of MIPLs with maternal and children's health, the school system, and the influence of culture. Methods A trained MI community health worker recruited eight MIPLs from an urban area of the Pacific northwest in the United States. A group level assessment included illustrative storytelling and ised to have a culturally specific understanding of the MI community and must consider their needs, culture, and language barriers. Asian/Pacific Island Nursing Journal, Volume 4(4) 173–182, ©Author(s) 2020, https//kahualike.manoa.hawaii.edu/apin/.Health disparities in pain care continue to exist among non-English-speaking Chinese-Americans. The Pain Care Quality?© (PainCQ) surveys, a valid instrument measuring the quality of pain care from the patient's perspective, is available only in English currently. This study generated a Chinese version of the PainCQ (C-PainCQ) following a cross-cultural translation approach to address health equity in pain care. A multicultural, bilingual expert team produced a good quality, prefinal version of C-PainCQ. Chinese-speaking patients (n = 55) evaluated conceptual and content equivalence while bilingual participants (n = 13) reviewed semantic equivalence of C-PainCQ items. Feedback from participants, including adding a new item related to education on medication compliance, was used to revise the tool. This C-PainCQ is ready for future research to examine the reliability and construct validity with a large sample of Chinese-speaking patients. Asian/Pacific Island Nursing Journal, Volume 4(4) 165–172, ©Author(s) 2020, https//kahualike.manoa.hawaii.edu/apin/.In Mongolia, cardiovascular disease is the leading cause of death, and prevalence of hypertension is very high. The aim of this study was to investigate the association between hypertension and sociodemographic factors and health-related behaviors among men in Darkhan-Uul Province, Mongolia. This cross-sectional study was conducted between November 2015 and January 2016. Men whose wives were pregnant with ≤ 20 weeks gestation and had attended antenatal health checkups at public health facilities were recruited in this study. The data were collected as part of a survey of pregnant women and their partners. Data were collected using self-administered questionnaires, anthropometry, and spot urine samples. A total of 224 men participated in the survey, and data from 209 participants were included in the analysis. Multiple logistic regression analysis showed that men with higher BMI had higher odds of hypertension than those with lower BMI (adjusted odds ratio [AOR] 1.14, 95% CI 1.03-1.26). Those with urinary cotinine > 100 ng/ml (smokers) had a lower risk of hypertension (AOR 0.24, 95% CI 0.09-0.67) compared to participants with urinary cotinine/ml (nonsmokers). This is the first study to investigate the association between hypertension and sociodemographic factors and health-related behaviors among men in Mongolia. link3 Based on the findings of this study, clinicians responsible for public health in Mongolia should provide health education regarding the importance of weight control in preventing hypertension. Asian/Pacific Island Nursing Journal, Volume 4(4) 151–158, ©Author(s) 2020, https//kahualike.manoa.hawaii.edu/apin/.