Obstructive jaundice of a parasitic etiology

We present the case of a patient with colic pain in the epigastrium and right hypochondrium, which was accompanied by choluria and acholia and slightly elevated levels of bilirubin and eosinophilia. Abdominal echography and magnetic resonance imaging identified a biliary obstruction and endoscopic retrograde cholangiopancreatography was used to extract 3 adult worms identified as Fasciola hepatica. This case highlights the need to consider the suspicion of biliary obstruction caused by Fasciola hepatica in the presence of obstructive jaundice, with or without eosinophilia

Design and Construction Methods of Caisson-Type Maritime Infrastructures Using GFRP

Glass-fiber-reinforced polymers (GFRPs) are commonly used in various applications in civil-engineering projects. However, they are not common in the construction of civil-marine structures. The GFRP caisson technology was developed for the construction of two mooring dolphins in Puerto el Rosario (Fuerteventura, Spain). Ultraviolet-protected glass-fiber and epoxy resin coats were used to build a 12-m diameter, 13.3-m high cylindrical structure. A finite-element model was used to verify the sandwich composite configuration using the Tsai?Hill criteria?the shear strength of the skins and honeycomb core and the buckling and local failure modes with respect to the composite configuration. This is the first time that the two caissons were designed and built of polymeric materials and installed in a seaport. Accordingly, the construction technique marks a milestone in civil engineering because of its highly innovative nature in addition to significantly reducing the time associated with and the complexity of construction operations

Quality improvement activities associated with organisational capacity in general practice

Copyright © 2007 Australian College of General Practitioners Copyright to Australian Family Physician. Reproduced with permission. Permission to reproduce must be sought from the publisher, The Royal Australian College of General Practitioners.BACKGROUND Clinical audit is recognised worldwide as a useful tool for quality improvement. METHODS A feedback report profiling capacity for chronic disease care was sent to 97 general practices. These practices were invited to complete a clinical audit activity based on that feedback. Data were analysed quantitatively and case studies were developed based on the free text responses. RESULTS Eighty-two (33%) of 247 general practitioners participated in the clinical audit process, representing 57 (59%) of 97 general practices. From the data in their feedback report, 37 (65%) of the 57 practices recognised the area most in need of improvement. This was most likely where the need related to clinical practice or teamwork, and least likely where the need related to linkages with other services, and business and finance. Only 25 practices (46%) developed an action plan related to their recognised area for improvement, and 22 (39%) practices implemented their chosen activity. Participating GPs judged that change activity focused on teamwork was most successful. DISCUSSION The clinical audit process offered participating GPs and practices an opportunity to reflect on their performance across a number of key areas and to implement change to enhance the practice’s capacity for quality chronic disease care. The relationship between need and action was weak, suggesting a need for greater support to overcome barriers.Cheryl Amoroso, Judy Proudfoot, Tanya Bubner, Edward Swan, Paola Espinel, Christopher Barton, Justin Beilby and Mark Harri

Leishmaniose en Equateur : 4. Infestation naturelle du chien par Leishmania panamensis

Dans deux stations de la plaine côtière d'Equateur, région endémique de leishmaniose à #Leishmania panamensis, 34 chiens ont été contrôlés aux plans clinique, sérologique et parasitologique; des tests d'immunofluorescence indirecte et d'électrosynérèse, des ponctions ganglionnaires, des biopsies de lésions ont été pratiqués. De deux chiens présentant des lésions suspectes, un seul avait des lésions de la truffe et du scrotum infectées par des #Leishmania. La souche isolée a été rapportée à #L. panamensis (complexe #L. guyanensis). L'atteinte leishmanienne était strictement tégumentaire. Dans la zone d'étude, le chien semble un hôte accidentel. (Résumé d'auteur

Intraoperative Liver Surface Completion with Graph Convolutional VAE

In this work we propose a method based on geometric deep learning to predict the complete surface of the liver, given a partial point cloud of the organ obtained during the surgical laparoscopic procedure. We introduce a new data augmentation technique that randomly perturbs shapes in their frequency domain to compensate the limited size of our dataset. The core of our method is a variational autoencoder (VAE) that is trained to learn a latent space for complete shapes of the liver. At inference time, the generative part of the model is embedded in an optimisation procedure where the latent representation is iteratively updated to generate a model that matches the intraoperative partial point cloud. The effect of this optimisation is a progressive non-rigid deformation of the initially generated shape. Our method is qualitatively evaluated on real data and quantitatively evaluated on synthetic data. We compared with a state-of-the-art rigid registration algorithm, that our method outperformed in visible areas

Rediscovery of Rubus pendulus Rusby (Rosaceae) and a new record for the flora of Ecuador and Peru

We report the rediscovery of Rubus pendulus Rusby, “Mora India”, described in 1933 from Colombia and not mentioned again until the present study. We also update its distribution with eight new localities in Colombia, seven in Ecuador and one in Peru, being a new record for the flora of the latter two countries. This is the first time that R. pendulus’ stipules and flowers are found and detailed through a botanical description, illustrations and photographs. Rubus pendulus is morphologically differentiated from R. bogotensis Benth., R. mollifrons Focke, R. porphyromallos Focke and R. urticifolius Poir., with whom it was previously confused and we give a brief explanation on the type specimen status of R. mollifrons and R. porphyromallos

DESARROLLO DE UN SOFTWARE PARA UN SISTEMA INTEGRADO DE MONITOREO Y CONTROL BOVINO MEDIANTE DISPOSITIVOS DE RASTREO Y TECNOLOGÍAS DE TELECOMUNICACIONES

According to the Cattle Census in Colombia, carried out by the Colombian Agricultural Institute- ICA (2021), the bovine population is distributed in 633,408 farms and totals 27,973,390 animals. Of the 633,408 properties in the country, Boyacá has 14.0% destined for cattle [1], a percentage that offers a great opportunity for the development of technologies that can impact on an improvement of its management and production, this is how the idea of ​​implementing an integrated bovine monitoring and control system arises through the articulation of software development, tracking devices and telecommunications technologies. The development consists of the creation of a mobile application-type software that managesbovine vaccination cycles, allowing information to be stored and processed, thus contributing to increasing the competitiveness of ranchers in the department of Boyacá by preventing diseases and improving immunity to the same In addition, the system allows the monitoring of cattle through GPS location devices, located in each cattle, which send the information using the GSM network, this gives the farmer the possibility of identifying conditions escape or theft of bovines. The methodology implemented for the development of the project is raised in the following stages: 1. Search and analysis of information, 2. Know the opinion of the livestock producers, 3. Design and development of the application. The software contributes to the farmer in the implementation of good farming practices by allowing the administration of the bovine inventory, management of vaccination, access to information on diseases, knowing the delimitation of the property and generating reports of each one of the bovines, allowing timely and pertinent decision-making in eventualities.Según Censo bovino en Colombia, realizado por Instituto Colombiano Agropecuario-ICA (2021), la población bovina está distribuida en 633.408 predios ytotaliza 27.973.390 animales. De los 633.408 predios en el país, Boyacá tieneel 14,0% destinado a bovinos [1], porcentaje que brinda una gran oportunidadpara el desarrollo de tecnologías que puedan impactar en una mejora de su gestión yproducción, es así como surge la idea de implementar un sistema integrado de monitoreoy control bovino mediante la articulación de un desarrollo de software, dispositivosde rastreo y tecnologías de telecomunicaciones.El desarrollo consiste en la creación de un software tipo aplicación móvil que gestionalos ciclos de vacunación de los bovinos, permitiendo almacenar y procesar la información,contribuyendo así al aumento de la competitividad de los ganaderos en el departamentode Boyacá mediante prevención de enfermedades y mejora de la inmunidada las mismas. Además, el sistema permite el monitoreo de los bovinos mediante dispositivoslocalización GPS, ubicados en cada bovino, los cuales envían la información utilizandola red GSM, esto brinda al ganadero la posibilidad de identificar condicionesde fuga o hurto de los bovinos.La metodología implementada para el desarrollo del proyecto está planteada en lassiguientes etapas: 1. Búsqueda y análisis de información, 2. Conocer la opinión de losproductores ganaderos, 3. Diseño y desarrollo de la aplicación.El software aporta al ganadero en la implementación de buenas prácticas ganaderasal permitir administrar el inventario bovino, gestionar la vacunación, acceder a informaciónsobre enfermedades, conocer la delimitación del predio y generar informes decada uno de los bovinos, permitiendo la toma de decisiones oportunas y pertinentesen las eventualidades

Relationship between Serum Concentration of Uric Acid and Insulin Secretion among Adults with Type 2 Diabetes Mellitus

To determine the relationship between serum concentrations of uric acid and insulin secretion with hyperglycaemic clamp technique among adults with type 2 diabetes mellitus (DM2) without hyperuricemia, we carried out a cross-sectional study on 45 patients of both gender. We observed correlation between uric acid with male gender r = 0.710 (P = 0.001). Also correlation between uric acid and total insulin secretion was positive r = 0.295 (P = 0.049). As well as a positive correlation adjusted for body mass index was demonstrated for the first, second, and total phases of insulin secretion, respectively, r = 0.438 (P = 0.022), r = 0.433 (P = 0.022), and r = 0.439 (P = 0.024). Serum concentration of uric acid showed a positive relationship with the total phase of insulin secretion; even in states prior to hyperuricemia, uric acid can play an important role in the function of the beta cell in patients with DM2

D-index as a Risk Factor for Invasive Fungal Infections in Patients With Acute Lymphoblastic Leukemia From a Reference Hematology Center in Bogota

Los pacientes con neoplasias hematológicas son huéspedes susceptibles al desarrollo de hongos invasivos. Infección (IFI), una de las principales complicaciones infecciosas potencialmente mortales que enfrentan estos pacientes. Actualmente, Contamos con estrategias de profilaxis antimicótica y esquemas de tratamiento antimicótico y reconocemos que el principal El factor de riesgo implicado es la neutropenia profunda y prolongada. El índice D y el índice D acumulativo son parámetros cuantitativos, que determinan la magnitud de la neutropenia, en función de la duración y profundidad y su valor se correlaciona con la aparición de IFI. material y métodos Se ingresó a un estudio de casos y controles en pacientes mayores de 18 años con leucemia linfoblástica aguda (LLA) entre 2009 y 2019 en el Instituto Nacional del Cáncer para inducción, consolidación y rescate quimioterapia. Resultados Se incluyeron un total de 167 pacientes, quienes recibieron 288 ciclos de quimioterapia, estos últimos fueron considerados la unidad de análisis. Se diseñó un modelo de ecuaciones de estimación generalizadas (GEE) para analizar datos; En este modelo se incluyeron tres variables cuantitativas y continuas de interés: edad (años), Dindex y neutropenia profunda (días). Para el índice D de la población, un odds ratio (OR) = 1,000227 (IC del 95 % 1,0002-1,0004); Se obtuvo p < 0,001. Conclusión El índice D se asocia con el desarrollo de IFI en pacientes con LLA, con un aumento exponencial del OR a medida que aumenta el valor absoluto del índice D.Patients with hematologic malignancies are susceptible hosts for the development of invasive fungal infection (IFI), one of the main life-threatening infectious complications faced by these patients. Currently, we have antifungal prophylaxis strategies and antifungal treatment schemes and we recognize that the main risk factor involved is profound and prolonged neutropenia. D-index and cumulative D-index are quantitative parameters, which determine the magnitude of neutropenia, as a function of duration and depth and their value correlates with the occurrence of IFI. Material and methods A case-control study in patients older than 18 years with acute lymphoblastic leukemia (ALL) was admitted between 2009 and 2019 at the National Cancer Institute for induction, consolidation and salvage chemotherapy. Results A total of 167 patients were included, who received 288 cycles of chemotherapy, the latter were considered the unit of analysis. A generalized estimating equations (GEE) model was designed to analyze correlated data; three quantitative and continuous variables of interest were included in this model: age (years), Dindex and deep neutropenia (days). For the population D-index, an odds ratio (OR) = 1.000227 (95% CI 1.0002-1.0004); p < 0.001 was obtained. Conclusion D-index is associated with the development of IFI in patients with ALL, with an exponential increase in OR as the absolute value of the D-index increases.Revista Internacional - No indexadaS