IMPORTÂNCIA DA CORRETA ASSOCIAÇÃO DE EXAMES CLÍNICOS, IMAGINOLÓGICOS E HISTOPATOLÓGICOS NO DIAGNÓSTICO DE OSTEOSSARCOMA

O osteossarcoma, neoplasia maligna caracterizada pela produção de tecido osteóide e osso imaturo que se prolifera através do estroma celular, é uma doença rara de alta agressividade associada a quadros severos de morbidade e mortalidade. Em relação à região craniofacial, os osteossarcomas pertencem a menos de 1% de todas as neoplasias malignas, sendo a mandíbula o principal osso afetado. No processo diagnóstico há semelhança com lesões benignas, o que exige análise clínica detalhada e exames complementares para o diagnóstico definitivo. O tratamento baseia-se na remoção cirúrgica radical da lesão com margens de segurança, associada ou não à radioterapia e/ou quimioterapia. Os osteossarcomas de cabeça e pescoço afetam normalmente indivíduos entre a terceira e quarta década de vida, com maior prevalência para o gênero feminino. Este trabalho tem como objetivo esclarecer os métodos empregados para o diagnóstico, tratamento e acompanhamento de paciente com osteossarcoma em mandíbula  Relato de caso: Paciente do gênero feminino, 35 anos, compareceu ao Centro de Estomatologia e de Pacientes com Alterações Sistêmicas (CEPAS) queixando-se de dor intermitente, mobilidade dentária com secreção purulenta e assimetria facial. O processo do diagnóstico consistiu em exames clínico, radiográfico, tomográfico e histopatológico, numa abordagem transdisciplinar. Como tratamento foi realizada a mandibulectomia parcial, quimioterapia e radioterapia. Conclusões: Este estudo vislumbra a discussão da complexidade do diagnóstico e prognóstico de pacientes com osteossarcoma, assim como a necessidade da atuação humanizada das equipes de saúde, para proporcionar uma assistência ao paciente sem focar apenas na doença.Justificación: El osteosarcoma, una neoplasia maligna caracterizada por la producción de tejido osteoide y hueso inmaduro que prolifera a través del estroma celular, es una enfermedad rara de alta agresividad asociada a condiciones graves de morbilidad y mortalidad. En cuanto a la región craneofacial, los osteosarcomas pertenecen a menos del 1% de todas las neoplasias malignas, siendo la mandíbula el principal hueso afectado. En el proceso diagnóstico hay similitud con las lesiones benignas, lo que requiere un análisis clínico detallado y pruebas complementarias para el diagnóstico definitivo. El tratamiento se basa en la extirpación quirúrgica radical de la lesión con márgenes de seguridad, asociada o no a radioterapia y/o quimioterapia. Los osteosarcomas de cabeza y cuello normalmente afectan a individuos entre la tercera y cuarta década de la vida, con mayor prevalencia para las mujeres. Este estudio tiene como objetivo aclarar los métodos utilizados para el diagnóstico, tratamiento y seguimiento de un paciente con osteosarcoma en la mandíbula. Caso clínico: Paciente femenina de 35 años que acudió al Centro de Estomatología y Pacientes con Alteraciones Sistémicas (CEPAS) quejándose de dolor intermitente, movilidad dental con secreción purulenta y asimetría facial. El proceso diagnóstico consistió en exámenes clínicos, radiográficos, tomográficos e histopatológicos, en un abordaje transdisciplinario. Se realizó mandibulectomía parcial, quimioterapia y radioterapia como tratamiento. Conclusiones: Este estudio contempla la discusión de la complejidad del diagnóstico y pronóstico de los pacientes con osteosarcoma, así como la necesidad de una acción humanizada de los equipos de salud.Osteosarcoma, a malignant neoplasm characterized by the production of osteoid tissue and immature bone that proliferates through the cellular stroma, is a rare disease of high aggressiveness associated with severe conditions of morbidity and mortality. Regarding the craniofacial region, osteosarcomas belong to less than 1% of all malignant neoplasms, with the mandible being the main affected bone. In the diagnostic process there is similarity with benign lesions, which requires detailed clinical analysis and complementary tests for definitive diagnosis. Treatment is based on radical surgical removal of the lesion with safety margins, associated or not with radiotherapy and/or chemotherapy. Head and neck osteosarcomas normally affect individuals between the third and fourth decade of life, with higher prevalence for females. This study aims to clarify the methods used for the diagnosis, treatment and follow-up of a patient with osteosarcoma in the mandible. Case report: A 35-year-old female patient attended the Center for Stomatology and Patients with Systemic Alterations (CEPAS) complaining of intermittent pain, tooth mobility with purulent secretion and facial asymmetry. The diagnosis process consisted of clinical, radiographic, tomographic and histopathological examinations, in a transdisciplinary approach. Partial mandibulectomy, chemotherapy and radiotherapy were performed as treatment. Conclusions: This study envisions the discussion of the complexity of diagnosis and prognosis of patients with osteosarcoma, as well as the need for humanized action of health teams, to provide patient care without focusing so on the disease.O osteossarcoma, neoplasia maligna caracterizada pela produção de tecido osteóide e osso imaturo que se prolifera através do estroma celular, é uma doença rara de alta agressividade associada a quadros severos de morbidade e mortalidade. Em relação à região craniofacial, os osteossarcomas pertencem a menos de 1% de todas as neoplasias malignas, sendo a mandíbula o principal osso afetado. No processo diagnóstico há semelhança com lesões benignas, o que exige análise clínica detalhada e exames complementares para o diagnóstico definitivo. O tratamento baseia-se na remoção cirúrgica radical da lesão com margens de segurança, associada ou não à radioterapia e/ou quimioterapia. Os osteossarcomas de cabeça e pescoço afetam normalmente indivíduos entre a terceira e quarta década de vida, com maior prevalência para o gênero feminino. Este trabalho tem como objetivo esclarecer os métodos empregados para o diagnóstico, tratamento e acompanhamento de paciente com osteossarcoma em mandíbula  Relato de caso: Paciente do gênero feminino, 35 anos, compareceu ao Centro de Estomatologia e de Pacientes com Alterações Sistêmicas (CEPAS) queixando-se de dor intermitente, mobilidade dentária com secreção purulenta e assimetria facial. O processo do diagnóstico consistiu em exames clínico, radiográfico, tomográfico e histopatológico, numa abordagem transdisciplinar. Como tratamento foi realizada a mandibulectomia parcial, quimioterapia e radioterapia. Conclusões: Este estudo vislumbra a discussão da complexidade do diagnóstico e prognóstico de pacientes com osteossarcoma, assim como a necessidade da atuação humanizada das equipes de saúde, para proporcionar uma assistência ao paciente sem focar apenas na doença

Differential cross section measurements for the production of a W boson in association with jets in proton–proton collisions at √s = 7 TeV

Measurements are reported of differential cross sections for the production of a W boson, which decays into a muon and a neutrino, in association with jets, as a function of several variables, including the transverse momenta (pT) and pseudorapidities of the four leading jets, the scalar sum of jet transverse momenta (HT), and the difference in azimuthal angle between the directions of each jet and the muon. The data sample of pp collisions at a centre-of-mass energy of 7 TeV was collected with the CMS detector at the LHC and corresponds to an integrated luminosity of 5.0 fb[superscript −1]. The measured cross sections are compared to predictions from Monte Carlo generators, MadGraph + pythia and sherpa, and to next-to-leading-order calculations from BlackHat + sherpa. The differential cross sections are found to be in agreement with the predictions, apart from the pT distributions of the leading jets at high pT values, the distributions of the HT at high-HT and low jet multiplicity, and the distribution of the difference in azimuthal angle between the leading jet and the muon at low values.United States. Dept. of EnergyNational Science Foundation (U.S.)Alfred P. Sloan Foundatio

Penilaian Kinerja Keuangan Koperasi di Kabupaten Pelalawan

This paper describe development and financial performance of cooperative in District Pelalawan among 2007 - 2008. Studies on primary and secondary cooperative in 12 sub-districts. Method in this stady use performance measuring of productivity, efficiency, growth, liquidity, and solvability of cooperative. Productivity of cooperative in Pelalawan was highly but efficiency still low. Profit and income were highly, even liquidity of cooperative very high, and solvability was good

Juxtaposing BTE and ATE – on the role of the European insurance industry in funding civil litigation

One of the ways in which legal services are financed, and indeed shaped, is through private insurance arrangement. Two contrasting types of legal expenses insurance contracts (LEI) seem to dominate in Europe: before the event (BTE) and after the event (ATE) legal expenses insurance. Notwithstanding institutional differences between different legal systems, BTE and ATE insurance arrangements may be instrumental if government policy is geared towards strengthening a market-oriented system of financing access to justice for individuals and business. At the same time, emphasizing the role of a private industry as a keeper of the gates to justice raises issues of accountability and transparency, not readily reconcilable with demands of competition. Moreover, multiple actors (clients, lawyers, courts, insurers) are involved, causing behavioural dynamics which are not easily predicted or influenced. Against this background, this paper looks into BTE and ATE arrangements by analysing the particularities of BTE and ATE arrangements currently available in some European jurisdictions and by painting a picture of their respective markets and legal contexts. This allows for some reflection on the performance of BTE and ATE providers as both financiers and keepers. Two issues emerge from the analysis that are worthy of some further reflection. Firstly, there is the problematic long-term sustainability of some ATE products. Secondly, the challenges faced by policymakers that would like to nudge consumers into voluntarily taking out BTE LEI

Search for stop and higgsino production using diphoton Higgs boson decays

Results are presented of a search for a "natural" supersymmetry scenario with gauge mediated symmetry breaking. It is assumed that only the supersymmetric partners of the top-quark (stop) and the Higgs boson (higgsino) are accessible. Events are examined in which there are two photons forming a Higgs boson candidate, and at least two b-quark jets. In 19.7 inverse femtobarns of proton-proton collision data at sqrt(s) = 8 TeV, recorded in the CMS experiment, no evidence of a signal is found and lower limits at the 95% confidence level are set, excluding the stop mass below 360 to 410 GeV, depending on the higgsino mass

Severe early onset preeclampsia: short and long term clinical, psychosocial and biochemical aspects

Preeclampsia is a pregnancy specific disorder commonly defined as de novo hypertension and proteinuria after 20 weeks gestational age. It occurs in approximately 3-5% of pregnancies and it is still a major cause of both foetal and maternal morbidity and mortality worldwide1. As extensive research has not yet elucidated the aetiology of preeclampsia, there are no rational preventive or therapeutic interventions available. The only rational treatment is delivery, which benefits the mother but is not in the interest of the foetus, if remote from term. Early onset preeclampsia (<32 weeks’ gestational age) occurs in less than 1% of pregnancies. It is, however often associated with maternal morbidity as the risk of progression to severe maternal disease is inversely related with gestational age at onset2. Resulting prematurity is therefore the main cause of neonatal mortality and morbidity in patients with severe preeclampsia3. Although the discussion is ongoing, perinatal survival is suggested to be increased in patients with preterm preeclampsia by expectant, non-interventional management. This temporising treatment option to lengthen pregnancy includes the use of antihypertensive medication to control hypertension, magnesium sulphate to prevent eclampsia and corticosteroids to enhance foetal lung maturity4. With optimal maternal haemodynamic status and reassuring foetal condition this results on average in an extension of 2 weeks. Prolongation of these pregnancies is a great challenge for clinicians to balance between potential maternal risks on one the eve hand and possible foetal benefits on the other. Clinical controversies regarding prolongation of preterm preeclamptic pregnancies still exist – also taking into account that preeclampsia is the leading cause of maternal mortality in the Netherlands5 - a debate which is even more pronounced in very preterm pregnancies with questionable foetal viability6-9. Do maternal risks of prolongation of these very early pregnancies outweigh the chances of neonatal survival? Counselling of women with very early onset preeclampsia not only comprises of knowledge of the outcome of those particular pregnancies, but also knowledge of outcomes of future pregnancies of these women is of major clinical importance. This thesis opens with a review of the literature on identifiable risk factors of preeclampsia

Search for anomalous production of events with three or more leptons in pp collisions at √s = 8TeV

Published by the American Physical Society under the terms of the Creative Commons Attribution 3.0 License. Further distribution of this work must maintain attribution to the author(s) and the published articles title, journal citation, and DOI.A search for physics beyond the standard model in events with at least three leptons is presented. The data sample, corresponding to an integrated luminosity of 19.5fb-1 of proton-proton collisions with center-of-mass energy s=8TeV, was collected by the CMS experiment at the LHC during 2012. The data are divided into exclusive categories based on the number of leptons and their flavor, the presence or absence of an opposite-sign, same-flavor lepton pair (OSSF), the invariant mass of the OSSF pair, the presence or absence of a tagged bottom-quark jet, the number of identified hadronically decaying τ leptons, and the magnitude of the missing transverse energy and of the scalar sum of jet transverse momenta. The numbers of observed events are found to be consistent with the expected numbers from standard model processes, and limits are placed on new-physics scenarios that yield multilepton final states. In particular, scenarios that predict Higgs boson production in the context of supersymmetric decay chains are examined. We also place a 95% confidence level upper limit of 1.3% on the branching fraction for the decay of a top quark to a charm quark and a Higgs boson (t→cH), which translates to a bound on the left- and right-handed top-charm flavor-violating Higgs Yukawa couplings, λtcH and λctH, respectively, of |λtcH|2+|λctH|2<0.21

Measurement of associated W plus charm production in pp collisions at √s=7 TeV

Peer reviewe

Search for new particles in events with energetic jets and large missing transverse momentum in proton-proton collisions at root s=13 TeV

A search is presented for new particles produced at the LHC in proton-proton collisions at root s = 13 TeV, using events with energetic jets and large missing transverse momentum. The analysis is based on a data sample corresponding to an integrated luminosity of 101 fb(-1), collected in 2017-2018 with the CMS detector. Machine learning techniques are used to define separate categories for events with narrow jets from initial-state radiation and events with large-radius jets consistent with a hadronic decay of a W or Z boson. A statistical combination is made with an earlier search based on a data sample of 36 fb(-1), collected in 2016. No significant excess of events is observed with respect to the standard model background expectation determined from control samples in data. The results are interpreted in terms of limits on the branching fraction of an invisible decay of the Higgs boson, as well as constraints on simplified models of dark matter, on first-generation scalar leptoquarks decaying to quarks and neutrinos, and on models with large extra dimensions. Several of the new limits, specifically for spin-1 dark matter mediators, pseudoscalar mediators, colored mediators, and leptoquarks, are the most restrictive to date.Peer reviewe

Combined searches for the production of supersymmetric top quark partners in proton-proton collisions at root s=13 TeV

A combination of searches for top squark pair production using proton-proton collision data at a center-of-mass energy of 13 TeV at the CERN LHC, corresponding to an integrated luminosity of 137 fb(-1) collected by the CMS experiment, is presented. Signatures with at least 2 jets and large missing transverse momentum are categorized into events with 0, 1, or 2 leptons. New results for regions of parameter space where the kinematical properties of top squark pair production and top quark pair production are very similar are presented. Depending on themodel, the combined result excludes a top squarkmass up to 1325 GeV for amassless neutralino, and a neutralinomass up to 700 GeV for a top squarkmass of 1150 GeV. Top squarks with masses from 145 to 295 GeV, for neutralino masses from 0 to 100 GeV, with a mass difference between the top squark and the neutralino in a window of 30 GeV around the mass of the top quark, are excluded for the first time with CMS data. The results of theses searches are also interpreted in an alternative signal model of dark matter production via a spin-0 mediator in association with a top quark pair. Upper limits are set on the cross section for mediator particle masses of up to 420 GeV