Acute Cholecystitis as a Complication After Colonoscopy: A Case Report and Literature Review

Acute cholecystitis after colonoscopy is a rare event, with less than 10 cases described in the literature. We report the case of a male patient with silent gallstones who underwent colonoscopy for follow-up of his Crohn’s disease. The colonoscopy revealed erosions in the terminal ileum, from which biopsies were taken. A sessile polyp 4 mm in diameter at the recto-sigmoid junction was also removed. Less than 24 h after the colonoscopy, the patient complained of upper right quadrant pain, nausea and vomiting. Based on the clinical findings, laboratory data and ultrasonography, we diagnosed acute cholecystitis and excluded any complication after the colonoscopy. Laparoscopic cholecystectomy was performed and the patient was discharged.

Ovarian sertoli-leydig cell tumour with heterologous elements of gastrointestinal type associated with elevated serum alpha-fetoprotein level: an unusual case and literature review

Here we describe the case of a 19-year-old woman with a poorly differentiated ovarian Sertoli-Leydig cell tumor and an elevated serum alphafetoprotein level. The patient presented with diffuse abdominal pain and bloating. Physical examination, ultrasound, and magnetic resonance imaging revealed a right ovarian tumor that was histopathologically diagnosed as a poorly differentiated Sertoli-Leydig cell tumor with heterologous elements. Her alpha-fetoprotein serum level was undetectable after tumor resection. Sertoli-Leydig cell tumors are rare sex cord-stromal tumors that account for 0.5% of all ovarian neoplasms. Sertoli-Leydig cell tumors tend to be unilateral and occur in women under 30 years of age. Although they are the most common virilizing tumor of the ovary, about 60% are endocrineinactive tumors. Elevated serum levels of alpha-fetoprotein are rarely associated with Sertoli-Leydig cell tumors, with only approximately 30 such cases previously reported in the literature. The differential diagnosis should include common alpha-fetoprotein-producing ovarian entities such as germ cell tumors, as well as other non-germ cell tumors that have been rarely reported to produce this tumor marker.

Employability study of the graduates at the English Language and Literature School

El propósito de este Proyecto fue evaluar los principales factores que influyen en la empleabilidad de los graduados de la escuela de lengua y literatura inglesa de la universidad de cuenca. La población de este estudio fue constituida por titulados que trabajaban en el área educativa y pocos graduados desempleados. El trabajo de campo fue llevado a cabo por medio de una encuesta, la cual fue aplicada a 161 graduados de la carrera de los años 2000 a 2013. La encuesta recogió información personal de los profesionales así como también datos relacionados al conocimiento adquirido en la carrera, situación laboral entre otros. Las técnicas para el análisis de datos fueron: análisis cuantitativo y cualitativo. El estudio también examina los métodos usados por los graduados para obtener un trabajo, los requerimientos de las instituciones educativas y causas para el desempleo de los graduados así aspectos del currículo de inglés para mejorar. Algunosde los descubrimientos más importantes en este estudio fueron que más de la mitad de graduados tienen un alto grado de satisfacción con su empleo. También fue descubierto que 96.3% de los graduados están trabajando en el área de su especialidad consecuentemente un gran porcentaje de licenciados de inglés usan el conocimiento adquirido en la universidad en sus empleos.Se espera, por lo tanto, que la información publicada en esta investigación sea un importante recurso para estudios futuros.

An historical catalogue of portraits, representing distinguished persons in the history and literature of the United Kingdom.

Catalog of an exhibition held at the British Institution for Promoting the Fine Arts in the United Kingdom.

CULTURE AND LITERATURE IN FOREIGN LANGUAGES LEARNING

This brief article is an introduction to questions as multiculturalism, identity and prejudice, from a specific point of view: a reflection on the importance of didactics in foreign literature and culture, and the role of reading as a meaningful education form in the undergraduating study programs of "Letras Estrangeiras" in Brazil.

O complexo geográfico em os sertões de Euclides da Cunha

The relation between geography and literature if has shown sufficiently promising.When considering that as much geography how much literature, constructs representations of the space from its speeches we find initially the point of interaction between both.In this direction, the workmanship "Os Sertões‖ of Euclides of the Wedge in allows them to argue where measured the existing specifications in a literary composition they can directly interest geography in the construction of its representations about the space.However to construct this approach, we take as north the conceptions of the complexity in which we weave the idea of that the workmanship if constitutes a geographic complex.We detach thus, the language of "Os Sertões‖ as one of the aspects that specify the complex in the Euclidean narrative and that it can interest geography in the production of its knowledge.As well as the language, the imagination is understood while an element that in makes possible them to analyze, to understand and to find the direction of the images made use in the space hinterland

Caminhos de morte e de vida: o rio Severino de João Cabral de Melo Neto

Pós-graduação em Geografia - IGCE

Negative Effects of Relative Proximity and Absolute Geography on Open Innovation Practices in High-tech SMEs in the UK

© 2014 IEEE. This exploratory study addresses a gap in management literature by addressing the role of location in the continuously expanding field of open innovation research. In this context, we analyze potential negative effects of absolute geography and relative proximity on open innovation practices in high-tech small and medium-sized enterprises (SMEs) in the United Kingdom. Drawing upon cluster theory and business ecosystem literature, the analysis from three SME case studies in the East of England suggests that presumed 'favorable' location variables, such as close relative proximity between partners and the presence of economic clusters, can have certain negative effects on open innovation practices.

Place, policy and practitioners: on rehabilitation, independence and the therapeutic landscape in the changing geography of care provision to older people in the United Kingdom

A growing body of literature in geography and other social sciences considers the role of place in the provision of healthcare. Authors have focused on various aspects of place and care, with particular interests emerging around the role of the psychological, social and cultural aspects of place in care provision. As healthcare stretches increasingly beyond the traditional four walls of the hospital, so questions of the role of place in practices of care become ever more pertinent. In this paper, we examine the relationship between place and practice in the care and rehabilitation of older people across a range of settings, using qualitative material obtained from interviews and focus groups with nursing, care and rehabilitation staff working in hospitals, clients’ homes and other sites. By analysing their testimony on the characteristics of different settings, the aspects of place which facilitate or inhibit rehabilitation and the ways in which place mediates and is mediated by social interaction, we consider how various dimensions of place relate to the power-inscribed relationships between service users, informal carers and professionals as they negotiate the goals of the rehabilitation process. We seek to demonstrate how the physical, psychological and social meanings of place and the social processes engendered by the rehabilitation encounter interact to produce landscapes that are more or less therapeutic, considering in particular the structuring role of state policy and formal healthcare provision in this dynamic.

Best after rain : waterfall discharges and the tourist experience

Waterfalls attract tourists because they are aesthetically appealing landscape features that are not part of everyday experience. It is generally understood that falls are usually seen at their best when there is a copious flow of water, especially after heavy rain. Guidebooks often contain this observation when referring to waterfalls, sometimes warning readers that the flow may be severely reduced during dry periods. Indeed, many visitors are disappointed when they see falls at such times. Some are saddened when the discharge of a waterfall has been depleted by the abstraction of water upstream for power generation or other purposes. While, for those in search of the Sublime or merely the superlative, size is often important, small waterfalls can give great pleasure to lovers of landscape beauty. According to guidebooks, however, even these falls are usually best seen after rain. Drawing on tourist and travel literature and personal journals from the eighteenth century to the present, and with reference to examples from different parts of the world, this paper discusses the importance of discharge in the tourist experience of waterfalls.

De-colonising Shakespeare? : Agency and (masculine) authority in Gregory Rogers's The Boy, The Bear, The Baron, The Bard

Underlying social space are territories, lands,geographical domains, the actual geographical underpinnings of the imperial, and also the cultural contest. To think about distant places, to colonize them, to populate or depopulate them: all of this occurs on, about, or because of land. […] Imperialism and the culture associated with it affirm both the primacy of geography and an ideology about control of territory.