Mortalidad por neoplasia maligna de hígado y vías biliares intrahepáticas en Brasil, 1980-2010

O objetivo deste trabalho foi analisar a tendência da mortalidade por neoplasia maligna do fígado e das vias biliares intra-hepáticas no Brasil, entre 1980 e 2010. Trata-se de um estudo de séries temporais com dados do Sistema de Informações sobre Mortalidade. Coeficientes de mortalidade brutos, padronizados, específicos por idade, região de residência e sexo foram calculados e as tendências analisadas utilizando-se modelos de regressão polinomial. Tendência crescente da mortalidade foi observada no Brasil, para ambos os sexos. O coeficiente médio de mortalidade para o país foi de 3,59 óbitos por 100 mil habitantes com aumento linear anual de 0,020 (R2 = 0,588; p < 0,001), sendo para o sexo masculino de 4,20 óbitos por 100 mil homens, com aumento linear de 0,044 (R2 = 0,81; p < 0,001) ao ano e, para o sexo feminino, de 2,98 por 100 mil mulheres, com aumento de 0,0194 (R2 = 0,35; p = 0,008) ao ano. Discutem-se possíveis causas desse aumento bem como vieses de informação.This study aimed to analyze trends in mortality due to malignant neoplasms of the liver and intrahepatic bile ducts in Brazil from 1980 to 2010. This was a time series study using data provided by the Mortality Information System. Crude and standardized mortality rates were calculated according to age, area of residence, and gender. Trends were analyzed using polynomial regression models. An increasing trend in mortality was observed for both males and females in Brazil. Mean overall mortality was 3.59, with a linear increase of 0.020 (R2 = 0.588; p < 0.001). The rate for males was 4.20 deaths per 100,000 inhabitants with a linear annual increase of 0.044 (R2 = 0.81; p < 0,001), and for females, 2.98 per 100,000 inhabitants with a linear annual increase of 0.0194 (R2 = 0.35; p = 0.008). The article discusses possible explanations for this increase, as well as potential information bias.El objetivo del presente trabajo fue analizar la tendencia de la mortalidad por neoplasia maligna de hígado y vías biliares intrahepáticas en Brasil, entre 1980 y 2010. Se trata de un estudio de series temporales con datos del Sistema de Información sobre Mortalidad. Se calcularon las tasas brutas y estandarizadas de mortalidad específicas por edad, región de residencia y sexo. Se analizaron las tendencias, utilizando modelos de regresión polinomial. Fue observada una tendencia creciente de la mortalidad en el país para ambos sexos. La tasa general de mortalidad fue 3,59 muertes /100 mil habitantes, mostrando aumento lineal anual de 0,020 (R2 = 0,588; p < 0,001); para el sexo masculino: 4,2 muertes /100 mil hombres, con aumento lineal anual de 0,044 (R2 = 0,81; p < 0,001); para el sexo femenino: 2,98 por 100 mil mujeres, con un aumento anual de 0,0194 (R2 = 0,35; p = 0,008). Se discuten posibles causas de tal aumento, así como sesgos en la información

The Art of Storytelling

In recent years, the telecommunications sector in Portugal has experienced increasing competition and consumer demand for more personalised and affordable services. In response, major brands have adopted emotionally engaging and immersive storytelling in their digital advertising strategies, particularly during seasonal campaigns. This study explores how storytelling in audiovisual campaigns can influence consumer engagement and evoke positive emotions. Through a literature review and qualitative analysis of two video campaigns by Vodafone and NOS, this paper examines the role of narrative structures and emotional appeal in shaping brand perception. The campaigns on YouTube were analysed in terms of narrative content, emotional tone, and audience engagement. Vodafone’s campaign, focusing on disconnection from technology to foster family bonds, achieved strong viewer interaction and empathy through relatable themes and nostalgic visuals. NOS’s campaign centred on traditional Portuguese values and the emotional power of a holiday message, resonating with audiences through music, familial imagery, and themes of longing. Both campaigns highlighted the strategic use of storytelling to humanise brands and deepen emotional connections with consumers. Despite growing academic interest, literature on narrative advertising in the digital environment, specifically within the telecommunications sector, remains limited. This study contributes to bridging this gap, providing insight into how storytelling can be an effective branding tool in a saturated and competitive market.In recent years, the telecommunications sector in Portugal has experienced increasing competition and consumer demand for more personalised and affordable services. In response, major brands have adopted emotionally engaging and immersive storytelling in their digital advertising strategies, particularly during seasonal campaigns. This study explores how storytelling in audiovisual campaigns can influence consumer engagement and evoke positive emotions. Through a literature review and qualitative analysis of two video campaigns by Vodafone and NOS, this paper examines the role of narrative structures and emotional appeal in shaping brand perception. The campaigns on YouTube were analysed in terms of narrative content, emotional tone, and audience engagement. Vodafone’s campaign, focusing on disconnection from technology to foster family bonds, achieved strong viewer interaction and empathy through relatable themes and nostalgic visuals. NOS’s campaign centred on traditional Portuguese values and the emotional power of a holiday message, resonating with audiences through music, familial imagery, and themes of longing. Both campaigns highlighted the strategic use of storytelling to humanise brands and deepen emotional connections with consumers. Despite growing academic interest, literature on narrative advertising in the digital environment, specifically within the telecommunications sector, remains limited. This study contributes to bridging this gap, providing insight into how storytelling can be an effective branding tool in a saturated and competitive market

two rare case reports

BACKGROUND: This study describes the successful treatment of two clinical settings of grade V pancreaticoduodenal blunt trauma only possible due to the prompt collaboration of a peripheral trauma hospital and a central hepatobiliary and pancreatic unit. CASE PRESENTATION: We reviewed the clinical records of two male patients aged 17 and 47 years old who underwent a two-stage pancreaticoduodenectomy after a previous Damage-Control Surgery (DCS). Both patients were transferred to our Hepatobiliopancreatic Unit 2 days after immediate DCS with haemostasis, debridement, duodenostomy, gastroenterostomy, external drainage and laparostomy. One day after, they both underwent a two-stage Whipple's procedure with external cannulation of the main bile duct and the main pancreatic duct with seized calibre silicone drains through the skin. The reconstructive phase was performed two weeks later. The first patient had an uneventful post-operative course and was discharged on post-operative day 8. The second patient developed a high debt biliary fistula on post-operative day 5 being submitted to a relaparotomy with extensive peritoneal lavage. After conservative measures the fistula underwent a progressive closure in 15 days, and the patient was discharged at post-operative day 50 without any limitations. CONCLUSIONS: Pancreaticoduodenectomy is a life-saving operation in selected grade V pancreaticoduodenal trauma lesions. DCS is a salvage approach, often performed in peripheral hospitals, making an early referral to an hepatobiliopancreatic centre mandatory to achieve survival in these severely injured patients. A two-staged Whipple's operation for severe duodenal / pancreatic trauma can be performed safely and may represent a life-saving option under these very unusual circumstances.publishersversionpublishe

Type IX Superior Labrum Anterior and Posterior Lesion in a Professional Football Player: A Rare Pattern of Shoulder Instability in a Non-throwing Athlete

Anterior shoulder instability is the most frequent type of glenohumeral instability, especially among young athletes. Superior labral anterior-posterior (SLAP) injuries involve the superior glenoid labrum where the long head of the biceps tendon (LHBT) inserts. There is still some debate regarding the pathogenesis, clinical presentation, and treatment of these lesions. We report a clinical case of an 18-year-old male professional football player with a rare type IX SLAP lesion. Given the recurrence of instability after prior nonoperative management, surgical treatment was seen as the best option, and a pan-labral arthroscopic repair suture anchor fixation was performed. Three months after undergoing a personalized postoperative rehabilitation program, he was able to return to full sport with the same competitive level, and no recurrent instability or other symptoms were reported throughout the 18-month follow-up periodinfo:eu-repo/semantics/publishedVersio

Modelo de avaliação de desempenho de uma unidade de cirurgia colorrectal: uma proposta

Este trabalho aborda o tema da avaliação de desempenho em organizações de saúde, focando-se no caso específico da cirurgia colorrectal. Tendo por base a revisão da literatura existente, o trabalho propõe um modelo específico de avaliação de desempenho para esta área, no contexto do Grupo de Cirurgia Colorrectal de Portimão. A proposta apresentada possibilita uma abordagem multidimensional da equipa, partindo da interligação do modelo de Maxwell (1984) com o modelo de Donabedian (1980) e os objetivos internos e externos da unidade hospitalar onde a equipa está enquadrada. O modelo considera 107 indicadores, estando organizado em torno de 6 áreas de atuação basilares (consulta; internamento; bloco operatório; serviços de suporte; auditoria e inquérito; formação e investigação) de modo a conseguir disponibilizar a informação relevante de forma intuitiva e dinâmica. O trabalho discute as vantagens de construir um modelo específico de avaliação de desempenho para uma unidade colorrectal e aponta caminhos para a sua implementação efetiva. Uma vez validado, espera-se que este modelo possa ser aplicado, com as necessárias adaptações, a outras unidades semelhantes.This paper addresses the theme of performance evaluation in health organizations, focusing on colorectal surgery. Drawing on the existing literature, the work proposes a specific model of performance evaluation for this area, in the context of the Colorectal Surgery Group of Portimão. The models allows a multidimensional approach of the team, starting from the interconnection between the Maxwell's (1984) Donabedian’s (1980) models and the internal and external objectives of the hospital where the team is based at. The model considers 107 indicators, which are organized around 6 basic areas of activity (consultation, hospitalization, operating room, support services, audit and survey, training and research) in order to provide the relevant information intuitively and dynamically. The paper discusses the advantages of building a specific performance evaluation model for a colorrectal unit and points out paths towards its effective implementation. Upon validation and after some customization, the model should be applicable to similar units

Effects of carbohydrate and glutamine supplementation on oral mucosa immunity after strenuous exercise at high altitude: a double-blind randomized trial

This study analyzed the effects of carbohydrate and glutamine supplementation on salivary immunity after exercise at a simulated altitude of 4500 m. Fifteen volunteers performed exercise of 70% of VO2peak until exhaustion and were divided into three groups: hypoxia placebo, hypoxia 8% maltodextrin (200 mL/20 min), and hypoxia after six days glutamine (20 g/day) and 8% maltodextrin (200 mL/20 min). All procedures were randomized and double-blind. Saliva was collected at rest (basal), before exercise (pre-exercise), immediately after exercise (post-exercise), and two hours after exercise. Analysis of Variance (ANOVA) for repeated measures and Tukey post hoc test were performed. Statistical significance was set at p < 0.05. SaO(2)% reduced when comparing baseline vs. pre-exercise, post-exercise, and after recovery for all three groups. There was also a reduction of SaO(2)% in pre-exercise vs. post-exercise for the hypoxia group and an increase was observed in pre-exercise vs. recovery for both supplementation groups, and between post-exercise and for the three groups studied. There was an increase of salivary flow in post-exercise vs. recovery in Hypoxia + Carbohydrate group. Immunoglobulin A (IgA) decreased from baseline vs. post-exercise for Hypoxia + Glutamine group. Interleukin 10 (IL-10) increased from post-exercise vs. after recovery in Hypoxia + Carbohydrate group. Reduction of tumor necrosis factor alpha (TNF-alpha) was observed from baseline vs. post-exercise and after recovery for the Hypoxia + Carbohydrate group a lower concentration was observed in pre-exercise vs. post-exercise and recovery. TNF-alpha had a reduction from baseline vs. post-exercise for both supplementation groups, and a lower secretion between baseline vs. recovery, and pre-exercise vs. post-exercise for Hypoxia + Carbohydrate group. Five hours of hypoxia and exercise did not change IgA. Carbohydrates, with greater efficiency than glutamine, induced anti-inflammatory responses.Univ Fed Sao Paulo, Dept Psychobiol, BR-04032020 Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Biosci, BR-11015020 Santos, BrazilUniv Fed Sao Paulo, Dept Psychobiol, BR-04032020 Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Biosci, BR-11015020 Santos, BrazilWeb of Scienc

Measurements of integrated and differential cross sections for isolated photon pair production in pp collisions at √s=8 TeV with the ATLAS detector

A measurement of the production cross section for two isolated photons in proton-proton collisions at a center-of-mass energy of √s=8 TeV is presented. The results are based on an integrated luminosity of 20.2 fb−1 recorded by the ATLAS detector at the Large Hadron Collider. The measurement considers photons with pseudorapidities satisfying |ηγ|40GeV and EγT,2>30 GeV for the two leading photons ordered in transverse energy produced in the interaction. The background due to hadronic jets and electrons is subtracted using data-driven techniques. The fiducial cross sections are corrected for detector effects and measured differentially as a function of six kinematic observables. The measured cross section integrated within the fiducial volume is 16.8 ± 0.8  pb . The data are compared to fixed-order QCD calculations at next-to-leading-order and next-to-next-to-leading-order accuracy as well as next-to-leading-order computations including resummation of initial-state gluon radiation at next-to-next-to-leading logarithm or matched to a parton shower, with relative uncertainties varying from 5% to 20%

Charged-particle distributions at low transverse momentum in √s=13 13 TeV pp interactions measured with the ATLAS detector at the LHC

Measurements of distributions of charged particles produced in proton–proton collisions with a centre-of-mass energy of 13 TeV are presented. The data were recorded by the ATLAS detector at the LHC and correspond to an integrated luminosity of 151 μb −1 μb−1 . The particles are required to have a transverse momentum greater than 100 MeV and an absolute pseudorapidity less than 2.5. The charged-particle multiplicity, its dependence on transverse momentum and pseudorapidity and the dependence of the mean transverse momentum on multiplicity are measured in events containing at least two charged particles satisfying the above kinematic criteria. The results are corrected for detector effects and compared to the predictions from several Monte Carlo event generators

Measurement of the inelastic proton-proton cross section at √s=13 TeV with the ATLAS detector at the LHC

This Letter presents a measurement of the inelastic proton-proton cross section using 60  μb −1 of pp collisions at a center-of-mass energy √s of 13 TeV with the ATLAS detector at the LHC. Inelastic interactions are selected using rings of plastic scintillators in the forward region (2.0710 −6 , where M X is the larger invariant mass of the two hadronic systems separated by the largest rapidity gap in the event. In this ξ range the scintillators are highly efficient. For diffractive events this corresponds to cases where at least one proton dissociates to a system with M X >13  GeV . The measured cross section is compared with a range of theoretical predictions. When extrapolated to the full phase space, a cross section of 78.1±2.9  mb is measured, consistent with the inelastic cross section increasing with center-of-mass energy