Publications by authors named "R R SPITZER"
Article Synopsis
- Difficult biliary cannulation (DBC) significantly raises the risk of post-ERCP pancreatitis (PEP), especially when combined with high pre-procedure risk factors.
- In a study with 1,601 participants, those undergoing DBC faced a PEP rate of 20.7% when they also had high pre-procedure risk, compared to lower rates for non-DBC groups.
- Prophylactic measures, such as combining rectal indomethacin with pancreatic duct stenting, were found to effectively reduce the risk of PEP, even with an increasing number of PD wire passages during DBC.
Introduction: Prophylactic pancreatic stent placement (PSP) is effective for preventing pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) in high-risk cases, but the optimal technical approach to this intervention remains uncertain.
Methods: In this secondary analysis of 787 clinical trial patients who underwent successful stent placement, we studied the impact of (i) whether pancreatic wire access was achieved for the sole purpose of PSP or naturally during the conduct of the case, (ii) the amount of effort expended on PSP, (iii) stent length, (iv) stent diameter, and (v) guidewire caliber. We used logistic regression models to examine the adjusted association between each technical factor and post-ERCP pancreatitis (PEP).
Article Synopsis
- Understanding the nutritional properties of foods is crucial for managing wildlife populations, specifically moose, as they balance macronutrients like protein and carbohydrates while foraging.
- A study in Norway highlighted that moose primarily derive their energy from carbohydrates (74.2%), mostly from deciduous tree browse, particularly willows, which made up 51% of their average diet over a 5-day period in summer.
- Moose regulate their nutrient intake by choosing foods that closely match their macronutrient targets and demonstrated flexibility in their feeding strategies, indicating that even small variations in diet can help them achieve nutritional balance.
Article Synopsis
- Low- and middle-income countries lack sufficient subspecialist care, particularly in maternal-fetal medicine.
- Moi University School of Medicine and Moi Teaching and Referral Hospital in Kenya have established a groundbreaking fellowship program to train specialists in this field.
- The program successfully retains skilled practitioners who now offer essential care to a previously underserved population in Eastern Africa.
Animals representing a wide range of taxonomic groups are known to select specific food combinations to achieve a nutritionally balanced diet. The nutrient balancing hypothesis suggests that, when given the opportunity, animals select foods to achieve a particular target nutrient balance, and that balancing occurs between meals and between days. For wild ruminants who inhabit landscapes dominated by human land use, nutritionally imbalanced diets can result from ingesting agricultural crops rich in starch and sugar (nonstructural carbohydrates [NCs]), which can be provided to them by people as supplementary feeds.
View Article and Find Full Text PDF