Angeítis granulomatosa del sistema nervioso central. Informe de autopsia

The medical history and post-mortem findings of a 29-year-old male who was admitted to the Neurology Department due to headache and bilateral amaurosis are reported. His evolution was torpid, with sustained headache, behavioral changes, visual hallucinations and psychomotor agitation. The patient died at 18 days of hospital stay. At necropsy, it was found a granulomatous angiitis of the central nervous system with extensive hemorrhagic infarcts in the bilateral temporo-occipital lobes and the brainstem associated with severe cerebral edema.Se presentaron la historia clínica y los hallazgos post-mortem de un varón de 29 años de edad que fue admitido en el Servicio de Neurología por cefalea y amaurosis bilateral. Su evolución fue tórpida, con cefalea mantenida, alteraciones conductuales, alucinaciones visuales y excitación psicomotriz; falleció a los 18 días de estadía hospitalaria. En la necropsia realizada se comprobó una angeítis granulomatosa del sistema nervioso central con infartos hemorrágicos extensos en los lóbulos temporo-occipitales bilaterales y el tallo encefálico asociado a edema cerebral severo

Informe anatomo-patológico de un tumor óseo de células gigantes en localización no habitual

The case of a male, aged 29, which showed destruction of the L5 vertebral body and was diagnosed with giant cell tumor of bone (osteoclastoma) is presented. Imaging studies and morphological elements of the tumor are shown. The unusual presentation in vertebra and the existence of other tumoral and tumor like lesions of bone which contained giant cells motivated us to review the literature to establish the pathological discussion with reference to histopathological criteria and other aspects that are necessary for the differential diagnosis.Se presenta un varón de 29 años de edad en el que se demostró la destrucción del cuerpo vertebral de L5 y se diagnosticó un tumor de células gigantes de hueso (osteoclastoma); se muestran estudios de imagen y elementos morfológicos del tumor. La presentación no habitual en vértebra y la existencia de otras lesiones pseudotumorales y tumorales de hueso que contienen células gigantes motivaron a revisar la literatura médica para establecer la discusión patológica y tomar como referencia criterios histopatológicos  y otros aspectos necesarios para el diagnóstico diferencial

Acantoma de células claras. Presentación de un paciente

The clear cell acanthoma is a rare benign epidermal tumor that occurs in adults, and is more common between 50 and 70 years of age. The typical lesion is a well-defined nodule, reddish, with some crusting and peripheral scales, measuring 1-2cm in diameter and usually has a collar. There are pigmented variants. A patient with this condition is reported. The treatment was surgical removal, which in turn is diagnostic and therapeutic.El acantoma de células claras es un raro tumor epidérmico benigno que ocurre en adultos y es más frecuente entre los 50-70 años de edad. La lesión típica es un nódulo bien delimitado, rojizo, con algunas costras y escamas periféricas, que mide de 1-2cm de diámetro y suele tener un collarete; existen variantes pigmentadas. Se presenta un paciente con esta afección donde el tratamiento fue la extirpación quirúrgica, que a su vez es diagnóstica y terapéutica

Carcinoma anaplásico del tiroides

Female patient, 44 years of age, with a palpable mass in the right breast, supraclavicular lymph nodes and tumor in the left adrenal gland. She was admitted to hospital and evolved unfavorably. She was hypotensive, with abdominal pain despite painkillers. She also began with episodes of disorientation. At the eleventh day of admission she started sweating profusely and showed marked deterioration of the general condition. It was necessary to call the doctor on guard duty. When arriving to bed, the patient had a cardiac arrest and, despite resuscitation measures, the patient was declared deceased. With the necropsy, it was found, as the underlying cause of death, an anaplastic thyroid carcinoma with multiple metastases to organ and systems.Paciente femenina de 44 años de edad con una masa palpable en mama derecha, adenopatías supraclaviculares y tumor en la glándula suprarrenal izquierda que ingresó y evolucionó desfavorablemente; estaba hipotensa y con dolor abdominal a pesar de los analgésicos, además comenzó con episodios de desorientación. Al onceno día de su ingreso comenzó con sudoración profusa y toma marcada del estado general y fue necesario localizar a la guardia médica; al llegar al lecho la enferma cae en paro cardiorespiratorio y, a pesar de las medidas de reanimación cardiopulmonar, la paciente fue declarada fallecida. En la necropsia se constató como causa básica de la muerte un carcinoma anaplásico del tiroides con múltiples metástasis a sistemas y órganos

Poliangeítis microscópica

A white elderly patient, with a history of hypertension, gout and type 2 diabetes mellitus was admitted with severe cough, dyspnea, marked asthenia and hematemesis. She evolved unfavorably presenting hemoptysis, basic acid imbalances and died in irreversible shock with a clinical diagnosis of Goodpasture syndrome; at necropsy, it was concluded to be a microscopic polyangiitis.Paciente anciana, blanca, con antecedentes de hipertensión arterial, gota y diabetes mellitus tipo 2 que ingresó con tos intensa, disnea, hematemesis y astenia marcada, evolucionó desfavorablemente con hemoptisis, desequilibrios ácido básicos y falleció en choque irreversible con el diagnóstico clínico de síndrome de Goodpasture; en la necropsia se concluyó poliangeítis microscópica

Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

Measurement of the tt¯tt¯ production cross section in pp collisions at √s=13 TeV with the ATLAS detector

A measurement of four-top-quark production using proton-proton collision data at a centre-of-mass energy of 13 TeV collected by the ATLAS detector at the Large Hadron Collider corresponding to an integrated luminosity of 139 fb−1 is presented. Events are selected if they contain a single lepton (electron or muon) or an opposite-sign lepton pair, in association with multiple jets. The events are categorised according to the number of jets and how likely these are to contain b-hadrons. A multivariate technique is then used to discriminate between signal and background events. The measured four-top-quark production cross section is found to be 26+17−15 fb, with a corresponding observed (expected) significance of 1.9 (1.0) standard deviations over the background-only hypothesis. The result is combined with the previous measurement performed by the ATLAS Collaboration in the multilepton final state. The combined four-top-quark production cross section is measured to be 24+7−6 fb, with a corresponding observed (expected) signal significance of 4.7 (2.6) standard deviations over the background-only predictions. It is consistent within 2.0 standard deviations with the Standard Model expectation of 12.0 ± 2.4 fb

Alignment of the ATLAS Inner Detector in Run 2

The performance of the ATLAS Inner Detector alignment has been studied using pp collision data at v s = 13 TeV collected by the ATLAS experiment during Run 2 (2015-2018) of the Large Hadron Collider (LHC). The goal of the detector alignment is to determine the detector geometry as accurately as possible and correct for time-dependent movements. The Inner Detector alignment is based on the minimization of track-hit residuals in a sequence of hierarchical levels, from global mechanical assembly structures to local sensors. Subsequent levels have increasing numbers of degrees of freedom; in total there are almost 750,000. The alignment determines detector geometry on both short and long timescales, where short timescales describe movementswithin anLHCfill. The performance and possible track parameter biases originating from systematic detector deformations are evaluated. Momentum biases are studied using resonances decaying to muons or to electrons. The residual sagitta bias and momentum scale bias after alignment are reduced to less than similar to 0.1 TeV-1 and 0.9 x 10(-3), respectively. Impact parameter biases are also evaluated using tracks within jets

Measurements of W+W−+ ≥ 1 jet production cross-sections in pp collisions at s \sqrt{s} = 13 TeV with the ATLAS detector

Fiducial and differential cross-section measurements of W+W− production in association with at least one hadronic jet are presented. These measurements are sensitive to the properties of electroweak-boson self-interactions and provide a test of perturbative quantum chromodynamics and the electroweak theory. The analysis is performed using proton-proton collision data collected at p s = 13TeV with the ATLAS experiment, corresponding to an integrated luminosity of 139 fb−1. Events are selected with exactly one oppositely charged electron-muon pair and at least one hadronic jet with a transverse momentum of pT > 30 GeV and a pseudorapidity of |�| < 4.5. After subtracting the background contributions and correcting for detector effects, the jet-inclusive W+W−+ � 1 jet fiducial cross-section and W+W−+ jets differential cross-sections with respect to several kinematic variables are measured. These measurements include leptonic quantities, such as the lepton transverse momenta and the transverse mass of the W+W− system, as well as jet-related observables such as the leading jet transverse momentum and the jet multiplicity. Limits on anomalous triple-gauge-boson couplings are obtained in a phase space where interference between the Standard Model amplitude and the anomalous amplitude is enhanced

A search for the dimuon decay of the Standard Model Higgs boson with the ATLAS detector

A search for the dimuon decay of the Standard Model (SM) Higgs boson is performed using data corresponding to an integrated luminosity of 139 fb(-1) collected with the ATLAS detector in Run 2 pp collisions at root s = 13 TeV at the Large Hadron Collider. The observed (expected) significance over the background-only hypothesis for a Higgs boson with a mass of 125.09 GeV is 2.0 sigma (1.7 sigma). The observed upper limit on the cross section times branching ratio for pp -&gt; H -&gt; mu mu is 2.2 times the SM prediction at 95% confidence level, while the expected limit on a H -&gt; mu mu signal assuming the absence (presence) of a SM signal is 1.1(2.0). The best-fit value of the signal strength parameter, defined as the ratio of the observed signal yield to the one expected in the SM, is mu = 1.2 +/- 0.6. (C) 2020 The Author(s). Published by Elsevier B.V