This manuscript represents an official Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE) aiming to guide general gastroenterologists to develop and maintain skills in optical diagnosis during endoscopy. In general, this requires additional training beyond the core curriculum currently provided in each country. In this context, ESGE have developed a European core curriculum for optical diagnosis practice across Europe for high quality optical diagnosis training. 1  ESGE suggests that every endoscopist should have achieved general competence in upper and/or lower gastrointestinal (UGI/LGI) endoscopy before commencing training in optical diagnosis of the UGI/LGI tract, meaning personal experience of at least 300 UGI and/or 300 LGI endoscopies and meeting the ESGE quality measures for UGI/LGI endoscopy. ESGE suggests that every endoscopist should be able and competent to perform UGI/LGI endoscopy with high definition white light combined with virtual and/or dye-based chromoendoscopy esophagus, esophageal squamous cell carcinoma, early gastric cancer, diminutive colorectal lesions, early colorectal cancer, and neoplasia in inflammatory bowel disease. Condition-specific recommendations are provided in the main document.This review aims to provide an overview of metabolic and endocrine challenges in the setting of intensive care medicine. These are a group of heterogeneous clinical conditions with a high degree of overlap, as well as nonspecific signs and symptoms. Several diseases involve multiple organ systems, potentially causing catastrophic dysfunction and death. In the majority of cases, endocrine challenges accompany other organ failures or manifest as a complication of prolonged intensive care unit stay and malnutrition. However, when endocrine disorders present as an isolated syndrome, they are a rare and extreme manifestation. As they are uncommon, these can typically challenge both with diagnosis and management. Acute exacerbations may be elicited by triggers such as infections, trauma, surgery, and hemorrhage. In this complex scenario, early diagnosis and prompt treatment require knowledge of the specific endocrine syndrome. Here, we review diabetic coma, hyponatremia, hypercalcemia, thyroid emergencies, pituitary insufficiency, adrenal crisis, and vitamin D deficiency, highlighting diagnostic tools and tricks, and management pathways through defining common clinical presentations.
   To evaluate the influence of patient alignment and thereby heel effect on the image quality (IQ) of C-arm flat-panel detector computed tomography (CACT).
 
   An ACR phantom placed in opposite directions along the z-axis (setup A and B) on the patient support was imaged using CACT. Image acquisition was performed with three different image acquisition protocols. The images were reconstructed with four convolution kernels. IQ was assessed in terms of high contrast using the modulation transfer function (MTF) and low contrast by assessing the image noise, signal-to-noise ratio (SNR) and contrast-to-noise ratios (CNR) as well as the reliability of density measurements. Furthermore, the dose intensity profiles were measured free-in-air.
 
   The MTF in setup B is higher than the MTF measured in setup A (p < 0.01). The image noises measured in setup A for the air and bone inserts were higher compared to those measured in setup B (p > 0.05). Opposite behavior has been observed for the polyethylene, water-equiv, Renne J, Maschke S et al. Impact of Patient Alignment on Image Quality in C-Arm Computed Tomography - Evaluation Using an ACR Phantom. Fortschr Röntgenstr 2020; DOI 10.1055/a-1238-2802.
   The term "carpal instability" describes different debilitating wrist conditions, in which the carpus is unable to maintain its physiological range of motion and load transfer. Depending on the cause and location of the dysfunction, four groups can be defined dissociative, non-dissociative, complex, and adaptive carpal instability. As the most common form by far, dissociative carpal instability can further be categorized as dorsal or palmar intercalated segment instability, contingent on the afflicted interosseous ligament.
 
   This review article outlines the different entities of carpal instability, their pathophysiology, and their clinical presentation. It further discusses the diagnostic significance of different imaging methods as well as the established treatment options for each form of instability in context with the current literature.
 
   Early detection and treatment of carpal instability are essential for preventing carpal osteoarthritis. Traumatic lesions of the scapholunate interosseous ligament are the most frequent cause of instability. They can occur in an isolated fashion or in context with other carpal injuries. While stress imaging and fluoroscopy facilitate the differentiation between dynamic and static forms of carpal instability, only MRI and CT/MR arthrography can directly reveal the extent of ligament discontinuity.
 
  · Carpal instability can manifest only in motion (dynamic) or at rest (static).. · Dissociative forms must be distinguished from non-dissociative, adaptive, or complex entities.. · Most instabilities are related to traumatic injuries or CPPD arthropathy.. · Fluoroscopy, stress imaging, and MR and CT arthrography are helpful for diagnosis..
 
  · Grunz JP, Gietzen CH, Grunz K et al. Imaging of Carpal Instabilities. Fortschr Röntgenstr 2021; 193 139 - 150.
 · Grunz JP, Gietzen CH, Grunz K et al. Imaging of Carpal Instabilities. Fortschr Röntgenstr 2021; 193 139 - 150.
   The purpose of this article is to demonstrate the potential indications, procedural technique and initial results of the transarterial periarticular embolization (TAPE).
 
   TAPE was performed in three patients with chronic pain in different joints. In the first case the patient suffered from osteoarthritis of the shoulder, in the second case from epicondylitis humeri ulnaris ("golfer-elbow") and in the third case from patellar tendinitis ("jumpers-knee"). Clinical as well as pain assessment was performed pre and post-interventionally.
 
   TAPE was performed with technical success in all three patients. For vessel access, either a transradial or transfemoral access was chosen.  https://www.selleckchem.com/products/apx2009.html  The joint supplying vessels were catheterized superselectively with microcatheters and embolized with Imipenem/Cilastatin diluted in contrast medium. After embolization of the knee the patient demonstrated skin redness, which disappeared within one week. No further complications were noted. All patients reported significant pain relief within the first day after intervention.