Subcapsular hepatic hematoma post-endoscopic retrograde cholangiopancreatography: a case report and literature review

A 23-year-old female with a history of long-standing obesity, recently was diagnosed with cholelithiasis, along with a 15 day development of jaundice. An ERCP (endoscopic retrograde cholangiopancreatography) was performed, during which resulted an unsuccessful sphincterotomy, this was followed by placing a 7-centimeter, 10 French Amsterdam-type stent, subsequently she experienced sudden abdominal pain, and a CT scan revealed a subcapsular hepatic hematoma, which required surgical management. The objective was to describe a clinical case of subcapsular hepatic hematoma, clinical presentation, and therapeutic conduct. The treatment of subcapsular hepatic hematoma will depend on the patient's hemodynamic stability. However, survival is uncertain due to its rarity, making it crucial to recognize its early signs and symptoms and act promptly.

Recent activity of the Be/X-ray binary system SAX J2103.5+4545

Aims. We present a multiwavelength study of the Be/X-ray binary system SAX J2103.5+4545 with the goal of better characterizing the transient behaviour of this source. Methods. SAX J2103.5+4545 was observed by Swift-XRT four times in 2007 from April 25 to May 5, and during quiescence in 2012 August 31. In addition, this source has been monitored from the ground-based astronomical observatories of El Teide (Tenerife, Spain), Roque de los Muchachos (La Palma, Spain) and Sierra Nevada (Granada, Spain) since 2011 August, and from the TUBITAK National Observatory (Antalya, Turkey) since 2009 June. We have performed spectral and photometric temporal analyses in order to investigate the different states exhibited by SAX J2103.5+4545. Results. In X-rays, an absorbed power law model provided the best fit for all the XRT spectra. An iron-line feature at ~6.42 keV was present in all the observations except for that taken during quiescence in 2012. The photon indexes are consistent with previous studies of SAX J2103.5+4545 in high/low luminosity states. Pulsations were found in all the XRT data from 2007 (2.839(2) mHz; MJD 54222.02), but not during quiescence. Both optical outbursts in 2010 and 2012 lasted for about 8/9 months (as the one in 2007 probably did and the current one in 2014 might do) and were most probably caused by mass ejection events from the Be star that eventually fed the circumstellar disc. All of these outbursts started about 3 months before the triggering of the X-ray activity, and about the same period before the maximum of the H_alpha line equivalent width (in emission) was reached at only ~ -5 \AA. In this work we found that the global correlation between the BV variability and the X-ray intensity was also observed at longer wavelengths in the IR domain.Comment: 11 pages, 7 figures, and online material (2 tables). Submitted to A&A in 2014 Januar

The INTEGRAL-OMC Scientific Archive

The Optical Monitoring Camera (OMC) on-board the INTEGRAL satellite has, as one of its scientific goals, the observation of a large number of variable sources previously selected. After almost 6 years of operations, OMC has monitored more than 100 000 sources of scientific interest. In this contribution we present the OMC Scientific Archive (http://sdc.laeff.inta.es/omc/) which has been developed to provide the astronomical community with a quick access to the light curves generated by this instrument.We describe the main characteristics of this archive, as well as important aspects for the users: object types, temporal sampling of light curves and photometric accuracy.Comment: 4 pages, 5 figures. "Highlights of Spanish Astrophysics V" Proceedings of the VIII Scientific Meeting of the Spanish Astronomical Society (SEA) held in Santander, July 7-11, 200

Direct medical costs of severe asthma in two colombian reference centers

Objectives: Severe asthma, although infrequent, generates an important clinical and economic burden in both patients and healthcare system. We aimed to describe demographic and clinical characteristics, exacerbations, healthcare resource utilization (HRU), and annual direct medical costs in a severe asthma patient cohort in Colombia. Methods: Cost ofillness study from payer perspective. Patients with clinicianconfirmed severe asthma diagnosis (GINA criteria) from two specialized reference centers between January 2014 and August 2018 were included. The last year within this period under GINA step 4/5 therapy was observed for each patient. Clinical information was extracted from medical records, and HRU from hospital invoices and public price lists. Results: 147 patients were included, 59% female. Mean (6SD) age and time with asthma diagnosis was 46615 and 21617 years, respectively. Most frequent comorbidities were allergic rhinitis (70%), conjunctivitis (27%) and hypertension (19%). Most common sensitization cause was house dust mite (61%). Median baseline blood eosinophil count was 260 cells/ml (range 10-4,040), mean total IgE serum level was 69761,893 IU/ml. The mean annual frequency of HRU was 5.064.0 for laboratory tests, 4.161.2 for medical visits, 1.061.5 for emergency visits, 0.360.7 for hospitalizations, and 0.160.3 for ICU. Omalizumab was prescribed in 42.2% of patients, with a mean among users of 30.2620.3 vials per year. Mean annual direct cost for outpatient care was 4,743.666,331.1 USD (range 256.7-31,286.1) (1 USD=2,956.4 COP); medications were responsible for 98% of costs. Data from 55 hospitalizations was obtained, 4 in ICU. Mean stay and cost per episode were 6.564.9 days and 1,010.561,379.9 USD in general ward, and 14.164.1 days and 3768.963748.2 USD in ICU. Conclusions: Severe asthma is a costly disease for the Colombian health system. Most of the direct outpatient medical costs in this cohort were caused by pharmacological therapy, particularly omalizumab. Funding: GSK (PRJ2813

Metodologia de amostragem para avaliação da qualidade das pastagens nativas consumidas por bovinos no Pantanal.

Interação bovino x planta do Pantanal; Estratégia de forrageamento; Comportamento de pastejo; Teste de metodologia; Descrição da metodologia proposta para a avaliação do valor nutritivo e composição botânica das pastagens nativas consumidas por bovinos no Pantanal.bitstream/item/37729/1/DOC31.pd

〈初期軍記〉における戦闘被害の表現-女の描かれ方をめぐって-

軍記・語り物研究会第374回例会(平成19年7月22日・於:法政大学)共同討議「初期軍記」研究の検証と展開-新たな「状況」と「変容」を探る-における基調報