A Gestão Autônoma da Medicação e o Exercício do Cuidado

Este artigo foi construído a partir das análises produzidas na Pesquisa Intervenção que se realizou em interface com o projeto brasileiro da Estratégia da Gestão Autônoma da Medicação (GAM), especificamente em Vitória (Espírito Santo) em um Centro de Atenção Psicossocial Infanto-Juvenil (CAPSi). Esta escrita enuncia um desdobramento da GAM em sua experiência inédita com Grupo de Intervenção com Familiares (GIFs) de crianças e adolescentes. A GAM tem contribuído para a efetivação das políticas públicas de saúde, como um exercício de ampliação de possibilidades de cuidado, disparando processos de autonomia e protagonismo, democratização nos serviços de saúde, criando e sustentando formas de tratamento coletivamente. Percebemos os efeitos da GAM quando produzem interferência nos processos de gestão, reconfigurando as relações entre usuários, familiares, profissionais e também pesquisadores. São efeitos mapeáveis pela reciprocidade, interdependência, confiança e reposicionamento no cuidado de si e do outro

COMPLICAÇÕES E MANEJO DO ACRETISMO PLACENTÁRIO: UMA REVISÃO INTEGRATIVA

Introduction: Placental accreta is a severe and complex obstetric condition that is becoming more common due to the increase in cesarean sections and other uterine interventions. This condition occurs when the placenta adheres abnormally to the uterine muscle, varying in severity as placenta accreta, increta, and percreta. It can cause serious complications, such as heavy bleeding and the need for a hysterectomy. Early diagnosis, made by ultrasound and magnetic resonance imaging, is crucial for proper management. The increased incidence is linked to risk factors such as previous cesarean sections, multiparity, advanced maternal age, and a history of uterine curettage. Methodology: Ten relevant scientific articles were selected, published in Portuguese, English and Spanish, found in databases such as PubMed, SciELO and Google Scholar, using terms such as "placental accreta", "diagnosis", "clinical management" and "complications". Original studies, systematic reviews, and case reports on the diagnosis, management, and complications of placental accreta were included, excluding studies with non-human populations, non-full-text articles, and publications prior to 2010. Results: The integrative review resulted in the selection of ten relevant scientific articles that address the management and complications of placental accreta. The main topics include diagnosis, clinical management and treatment, with emphasis on medical management and the multidisciplinary team. The most frequent complications identified were postpartum hemorrhage, need for hysterectomy, and damage to other organs. The introduction of multidisciplinary teams and new surgical techniques has been shown to be effective in reducing maternal morbidity. Conclusions: The creation of specialized teams has been shown to be effective in reducing maternal morbidity in severe cases. Major complications, such as postpartum hemorrhage and the need for hysterectomy, can be better managed with proper planning and timely interventions. Diagnostic tools, such as ultrasound and magnetic resonance imaging, are essential for early detection. The implementation of protocols and new surgical techniques has also shown promise. However, there is a need for further studies with larger samples to consolidate the evidence and improve management strategies for this complex condition.Introduction: Placental accreta is a severe and complex obstetric condition that is becoming more common due to the increase in cesarean sections and other uterine interventions. This condition occurs when the placenta adheres abnormally to the uterine muscle, varying in severity as placenta accreta, increta, and percreta. It can cause serious complications, such as heavy bleeding and the need for a hysterectomy. Early diagnosis, made by ultrasound and magnetic resonance imaging, is crucial for proper management. The increased incidence is linked to risk factors such as previous cesarean sections, multiparity, advanced maternal age, and a history of uterine curettage. Methodology: Ten relevant scientific articles were selected, published in Portuguese, English and Spanish, found in databases such as PubMed, SciELO and Google Scholar, using terms such as "placental accreta", "diagnosis", "clinical management" and "complications". Original studies, systematic reviews, and case reports on the diagnosis, management, and complications of placental accreta were included, excluding studies with non-human populations, non-full-text articles, and publications prior to 2010. Results: The integrative review resulted in the selection of ten relevant scientific articles that address the management and complications of placental accreta. The main topics include diagnosis, clinical management and treatment, with emphasis on medical management and the multidisciplinary team. The most frequent complications identified were postpartum hemorrhage, need for hysterectomy, and damage to other organs. The introduction of multidisciplinary teams and new surgical techniques has been shown to be effective in reducing maternal morbidity. Conclusions: The creation of specialized teams has been shown to be effective in reducing maternal morbidity in severe cases. Major complications, such as postpartum hemorrhage and the need for hysterectomy, can be better managed with proper planning and timely interventions. Diagnostic tools, such as ultrasound and magnetic resonance imaging, are essential for early detection. The implementation of protocols and new surgical techniques has also shown promise. However, there is a need for further studies with larger samples to consolidate the evidence and improve management strategies for this complex condition.Introdução: O acretismo placentário é uma condição obstétrica grave e complexa que está se tornando mais comum devido ao aumento das cesarianas e outras intervenções uterinas. Esta condição ocorre quando a placenta adere anormalmente ao músculo uterino, variando em gravidade como placenta acreta, increta e percreta. Ela pode causar complicações sérias, como hemorragias intensas e a necessidade de histerectomia. O diagnóstico precoce, feito por ultrassonografia e ressonância magnética, é crucial para um manejo adequado. O aumento da incidência está ligado a fatores de risco como cesarianas anteriores, multiparidade, idade materna avançada e histórico de curetagem uterina. Metodologia: Foram selecionados dez artigos científicos relevantes, publicados em português, inglês e espanhol, encontrados em bases de dados como PubMed, SciELO e Google Scholar, usando termos como "acretismo placentário", "diagnóstico", "manejo clínico" e "complicações". Incluíram-se estudos originais, revisões sistemáticas e relatos de casos sobre o diagnóstico, manejo e complicações do acretismo placentário, excluindo estudos com populações não humanas, artigos sem texto completo e publicações anteriores a 2010. Resultados: A revisão integrativa resultou na seleção de dez artigos científicos relevantes que abordam o manejo e as complicações do acretismo placentário. Os principais temas incluem diagnóstico, manejo clínico e tratamento, com ênfase na conduta médica e da equipe multiprofissional. As complicações mais frequentes identificadas foram hemorragia pós-parto, necessidade de histerectomia e lesões a outros órgãos. A introdução de equipes multidisciplinares e novas técnicas cirúrgicas mostrou-se eficaz na redução da morbidade materna. Conclusões: A criação de equipes especializadas mostrou-se eficaz na redução da morbidade materna em casos graves. As principais complicações, como hemorragia pós-parto e necessidade de histerectomia, podem ser melhor gerenciadas com planejamento adequado e intervenções oportunas. Ferramentas diagnósticas, como ultrassonografia e ressonância magnética, são essenciais para a detecção precoce. A implementação de protocolos e novas técnicas cirúrgicas também se mostrou promissora. No entanto, há necessidade de mais estudos com amostras maiores para consolidar as evidências e aprimorar as estratégias de manejo dessa condição complexa

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

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

Probing effective field theory operators in the associated production of top quarks with a Z boson in multilepton final states at root s=13 TeV

Peer reviewe

Measurement of the top quark mass using events with a single reconstructed top quark in pp collisions at root s=13 TeV

Abstract:A measurement of the top quark mass is performed using a data sample en-riched with single top quark events produced in thetchannel. The study is based on proton-proton collision data, corresponding to an integrated luminosity of 35.9 fb−1, recorded at√s= 13TeV by the CMS experiment at the LHC in 2016. Candidate events are selectedby requiring an isolated high-momentum lepton (muon or electron) and exactly two jets,of which one is identified as originating from a bottom quark. Multivariate discriminantsare designed to separate the signal from the background. Optimized thresholds are placedon the discriminant outputs to obtain an event sample with high signal purity. The topquark mass is found to be172.13+0.76−0.77GeV, where the uncertainty includes both the sta-tistical and systematic components, reaching sub-GeV precision for the first time in thisevent topology. The masses of the top quark and antiquark are also determined separatelyusing the lepton charge in the final state, from which the mass ratio and difference aredetermined to be0.9952+0.0079−0.0104and0.83+1.79−1.35GeV, respectively. The results are consistentwithCPTinvariance

Measurements of the Electroweak Diboson Production Cross Sections in Proton-Proton Collisions at root s=5.02 TeV Using Leptonic Decays

The first measurements of diboson production cross sections in proton-proton interactions at a center-of-mass energy of 5.02 TeV are reported. They are based on data collected with the CMS detector at the LHC, corresponding to an integrated luminosity of 302 pb(-1). Events with two, three, or four charged light leptons (electrons or muons) in the final state are analyzed. The WW, WZ, and ZZ total cross sections are measured as sigma(WW) = 37:0(-5.2)(+5.5) (stat)(-2.6)(+2.7) (syst) pb, sigma(WZ) = 6.4(-2.1)(+2.5) (stat)(-0.3)(+0.5)(syst) pb, and sigma(ZZ) = 5.3(-2.1)(+2.5)(stat)(-0.4)(+0.5) (syst) pb. All measurements are in good agreement with theoretical calculations at combined next-to-next-to-leading order quantum chromodynamics and next-to-leading order electroweak accuracy

Measurements of Higgs boson production cross sections and couplings in the diphoton decay channel at root s=13 TeV

Measurements of Higgs boson production cross sections and couplings in events where the Higgs boson decays into a pair of photons are reported. Events are selected from a sample of proton-proton collisions at root s = 13TeV collected by the CMS detector at the LHC from 2016 to 2018, corresponding to an integrated luminosity of 137 fb(-1). Analysis categories enriched in Higgs boson events produced via gluon fusion, vector boson fusion, vector boson associated production, and production associated with top quarks are constructed. The total Higgs boson signal strength, relative to the standard model (SM) prediction, is measured to be 1.12 +/- 0.09. Other properties of the Higgs boson are measured, including SM signal strength modifiers, production cross sections, and its couplings to other particles. These include the most precise measurements of gluon fusion and vector boson fusion Higgs boson production in several different kinematic regions, the first measurement of Higgs boson production in association with a top quark pair in five regions of the Higgs boson transverse momentum, and an upper limit on the rate of Higgs boson production in association with a single top quark. All results are found to be in agreement with the SM expectations.Peer reviewe

Measurement of the W gamma Production Cross Section in Proton-Proton Collisions at root s=13 TeV and Constraints on Effective Field Theory Coefficients

A fiducial cross section for W gamma production in proton-proton collisions is measured at a center-of-mass energy of 13 TeV in 137 fb(-1) of data collected using the CMS detector at the LHC. The W -> e nu and mu nu decay modes are used in a maximum-likelihood fit to the lepton-photon invariant mass distribution to extract the combined cross section. The measured cross section is compared with theoretical expectations at next-to-leading order in quantum chromodynamics. In addition, 95% confidence level intervals are reported for anomalous triple-gauge couplings within the framework of effective field theory.Peer reviewe

Observation of tW production in the single-lepton channel in pp collisions at root s=13 TeV

A measurement of the cross section of the associated production of a single top quark and a W boson in final states with a muon or electron and jets in proton-proton collisions at root s = 13 TeV is presented. The data correspond to an integrated luminosity of 36 fb(-1) collected with the CMS detector at the CERN LHC in 2016. A boosted decision tree is used to separate the tW signal from the dominant t (t) over bar background, whilst the subleading W+jets and multijet backgrounds are constrained using data-based estimates. This result is the first observation of the tW process in final states containing a muon or electron and jets, with a significance exceeding 5 standard deviations. The cross section is determined to be 89 +/- 4 (stat) +/- 12 (syst) pb, consistent with the standard model.Peer reviewe