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