Unclassified autoimmune pancreatitis mimicking pancreatic cancer

A 24-year-old black male presented with a 1-week obstructive jaundice and intermittent abdominal pain, with no significant weight loss and an unsuspicious abdominal exam. Blood chemistry showed a cholestatic pattern but a complete immunological and tumoral panel (anti-smooth muscle antibody, anti-mitochondrial antibody, anti-nuclear antibody, anti-neutrophil cytoplasmic antibody, anti-Smith, anti-double-stranded-DNA antibody (anti-dsDNA), complement C3/C4, carcinoembryonic antigen, CA 19-9 and IgG4) were all within normal limits. Abdominal ultrasound revealed dilatation of the intra and extra-hepatic bile ducts. CT scan showed an abnormal dilatation of the distal bile duct but no focal enlargement of the head of the pancreas. Endoscopic ultrasound suggested an inflammatory process but the magnetic resonance cholangio-pancreatography favored a neoplastic obstruction of the distal common bile duct. Fine-needle aspiration cytology was insufficient for definitive diagnosis and the patient underwent major surgery. Follow-up with mild exocrine pancreatic insufficiency treated with enzyme replacement.info:eu-repo/semantics/publishedVersio

A Amazônia e os desafios de sua ocupação.

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Sim, ainda temos analfabetos.

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Características da agricultura indígena e sua influência na produção familiar da Amazônia.

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Amazônia: laboratório do mundo.

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A hora e a vez da mandioca.

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O sapo e o meio ambiente.

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BRS Carimbó: a nova cultivar de cupuaçuzeiro da Embrapa Amazônia Oriental.

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Revealing hidden symmetries and gauge invariance of the massive Carroll-Field-Jackiw model

In this paper we have analyzed the improved version of the Gauge Unfixing (GU) formalism of the massive Carroll-Field-Jackiw model, which breaks both the Lorentz and gauge invariances, to disclose hidden symmetries to obtain gauge invariance, the key stone of the Standard Model. In this process, as usual, we have converted this second-class system into a first-class one and we have obtained two gauge invariant models. We have verified that the Poisson brackets involving the gauge invariant variables, obtained through the GU formalism, coincide with the Dirac brackets between the original second-class variables of the phase space. Finally, we have obtained two gauge invariant Lagrangians where one of them represents the Stueckelberg form.Comment: revised version. To appear in Europhysics Letter