Uncommon branching pattern of the hepatic arteries in a living donor: a case report and brief literature review

Numerous variations of the hepatic arteries are common in surgical patients. We present a 35-year-old woman who was admitted to our department in order to assess possibility of becoming living donor. Preoperative computed tomography scan revealed anomalous branching pattern of the hepatic arteries. In this case right posterior sectoral artery has been given off by the greater pancreatic artery, left hepatic artery has been replaced by the artery arising from the left gastric artery and double segment 4 branches have been observed. To the best of our knowledge, this pattern has not been described in the literature, yet

Health-related quality of life and psychosocial impacts of a diagnosis of non-specific genital infection in symptomatic heterosexual men attending UK sexual health clinics: a feasibility study.

Introduction Non-specific genital infection (NSGI; non-Chlamydia trachomatis, non-Neisseria gonorrhoeae-associated urethritis) is a common diagnosis in symptomatic heterosexual men attending UK sexual health clinics (SHCs). but little is known about the psychosocial impact of this diagnosis. Methods We conducted an observational study among symptomatic heterosexual men attending SHCs to evaluate the psychosocial impact of an NSGI diagnosis compared with a diagnosis of Chlamydia trachomatis (CT), Neisseria gonorrhoeae or no abnormalities detected focusing on the feasibility of our study methodology. Participants completed a computer-assisted self-interviewing (CASI) including two validated measures of psychosocial impact: the EQ-5D-5L health-related quality of life and Rosenberg Self-Esteem Scale, before diagnostic testing and 2 weeks after receiving test results (follow-up 1 (FU-1)) and a qualitative interview. We compared scores between diagnostic groups using paired t-tests, qualitative data were analysed thematically and feasibility was assessed by process analysis. Results 60 men completed the baseline CASI (75% response rate). 46 (76.6%) were eligible for follow-up; 11/46 (23.9%) completed the follow-up CASI, and 3/11 (27.3%) completed the qualitative interview. 81.7% of all participants left CASI feedback at baseline: 73.5% reported the questionnaire as ‘fine’ or ‘very good’. Qualitative interview participants reported the study was acceptable. Compared with baseline, among patients completing FU-1, only patients with a diagnosis of NSGI (p<0.05) or CT (p<0.05) showed increased EQ-5D-5L Index, whereas patients with a diagnosis of NSGI (p=0.05) showed decreased mean Rosenberg Self-Esteem Scale score. Conclusions Although most participants indicated study acceptability at baseline, and we employed measures to increase retention (CASI questionnaires, reminder messages and a focus on men’s health), we experienced high loss to follow-up. We found that heterosexual men attending SHCs with symptoms of urethritis experience both positive and negative psychosocial impacts following their clinic attendance, which warrants further investigation

Experimentally measured thermal masses of adsorption heat exchangers

The thermal masses of components influence the performance of many adsorption heat pump systems. However, typically when experimental adsorption systems are reported, data on thermal mass are missing or incomplete. This work provides original measurements of the thermal masses for experimental sorption heat exchanger hardware. Much of this hardware was previously reported in the literature, but without detailed thermal mass data. The data reported in this work are the first values reported in the literature to thoroughly account for all thermal masses, including heat transfer fluid. The impact of thermal mass on system performance is also discussed, with detailed calculation left for future work. The degree to which heat transfer fluid contributes to overall effective thermal mass is also discussed, with detailed calculation left for future work. This work provides a framework for future reporting of experimental thermal masses. The utilization of this framework will enrich the data available for model validation and provide a more thorough accounting of adsorption heat pumps

Wall contact thermal resistance and bulk thermal conductivity in activated carbon from adsorption generators

It is acknowledged that the commercial success of the adsorption heat pump or refrigeration systems depends crucially on heat and mass transfer in the sorbent bed. Good heat and mass transfer allows one to obtain greater specific heating or cooling power which reduces the capital costs. This study surveys the previously reported data on heat transfer in activated carbon beds, compares it with newly measured data, and draws conclusions on the way that the wall geometry, particle size distribution, and the bulk density affect the overall thermal performance. The thermal conductivity technique used in this study is a steady-state measurement in a heated plate device

Diagnostic value of transoesophageal echocardiography in suspected haemodynamically significant pulmonary embolism

OBJECTIVE—To assess the value of transoesophageal echocardiography (TOE) for diagnosing suspected haemodynamically significant pulmonary embolism and signs of right ventricular overload at standard echocardiography.
METHODS—113 consecutive patients (58 male; 55 female), mean (SD) age 53.6 (13.3) years, in whom there was clinical suspicion of pulmonary embolism and right ventricular overload on transthoracic echocardiography, underwent TOE in addition to routine diagnostic procedures to identify pulmonary artery thrombi.
RESULTS—TOE revealed thrombi in 32 of 51 patients who had suspected acute pulmonary embolism and in 31 of 62 with suspected chronic pulmonary embolism. In one patient a pulmonary angiosarcoma rather than chronic pulmonary embolism was found at surgery. The diagnosis of pulmonary embolism was confirmed in 77 patients by scintigraphy, spiral computed tomography, angiography, or necropsy (reference methods). While TOE failed to provide a diagnosis of pulmonary embolism in 15 of these 77 patients, no false positive findings were reported (sensitivity 80.5%, specificity 97.2%). In 11 and 26 cases, respectively, the thrombi were confined to the left or right pulmonary artery. Bilateral thrombi were found in 25( )patients. Mobile thrombi were observed only in acute pulmonary embolism (in 19 of 32 patients). No complications of TOE were noted.
CONCLUSIONS—TOE permits visualisation of pulmonary arterial thrombi, confirming the diagnosis in the majority of patients with pulmonary embolism and right ventricular overload. This may be useful for prompt decision making in patients with haemodynamic compromise considered for thrombolysis or embolectomy.


Keywords: pulmonary embolism; transoesophageal echocardiograph

Pancreatitis autoinmune asociada a colangitis esclerosante primaria. Hallazgos por tomografía computada multicorte de 64 canales y colangiorresonancia

Reportamos el caso de un paciente de 43 años de edad con antecedente de ictericia obstructiva crónica de más de un año de evolución, sin causa objetivable, y disminución de peso con sospecha clínica de neoplasia pancreática. Luego de la colocación de un stent endobiliar para resolver la ictericia y de varias ecografías abdominales, dos colangiopancreatografías retrógradas endoscópicas (CPRE), una colangiorresonancia y dos tomografías computadas multicorte (TCMC) dinámicas se arribó al diagnóstico presuntivo de pancreatitis autoinmune asociada a colangitis esclerosante. El propósito de este artículo es describir los hallazgos imagenológicos que hicieron posible sospechar este diagnóstico. Es muy importante reconocer el compromiso multiorgánico de esta entidad y estar familiarizados con los signos clínicos e imagenológicos, puesto que la respuesta es favorable con el tratamiento adecuado. En nuestro caso, el paciente fue finalmente derivado a un centro de mayor complejidad para hacer el diagnóstico de certeza. La biopsia confirmó el diagnóstico de pancreatitis autoinmune relacionada con la inmunoglobulina G4, en asociación con una colangitis esclerosante primaria

Specific IgG antibody response against antigens of Dirofilaria immitis and its Wolbachia endosymbiont bacterium in cats with natural and experimental infections.

Sera from three groups of cats under different experimental conditions were studied by ELISA to assess the host's immune response against synthetic peptides derived from Dirofilaria immitis (Dipp) and against the surface protein of its endosymbiont, Wolbachia (WSPr). In experimentally infected cats (Group 1), an increase of IgG antibody against both Dipp and WSPr was observed from 2 months post-infection until the end of the study, 6 months post-infection. In experimentally infected cats, treated against infective larvae (Group 2), anti-Dipp IgG decreased dramatically from 4 months post-infection (3 months post treatment), showing very low values till the end of the study (6.5 months from infection, 5.5 months from treatment), while anti-WSP IgG increased constantly till the end of the study. Of 49 outdoor, asymptomatic cats exposed to a high risk of natural infection (Group 3), 9 were positive for anti-Dipp IgG and for a validated, in-clinic commercial antibody diagnostic kit for cats. Two cats were also found positive for circulating antigens of adult female worm. Anti-WSPr IgG were found in five of nine anti-Dipp IgG-positive sera and from eight ELISADipp-negative sera. Our results confirm the strong IgG response in heartworm infected cats and demonstrate the involvement of the Wolbachia endosymbiont in the immune reaction to the parasite both in experimentally infected cats and in cats exposed to a high risk of natural infection