Visma (Norway)

Introdução: O carcinoma medular é um tipo raro de adenocarcinoma colorretal, correspondendo a menos de 3% dentre todos os tumores nessa localização. Relato de caso: Paciente do sexo masculino, 88 anos, apresentou lesão em região cervical posterior cuja biópsia evidenciou histologia compatível com adenoma metastático. Foi realizada investigação com PET-CT, que evidenciou espessamento parietal hipermetabólico do cólon ascendente, fortemente sugestivo de neoplasia primária e também uma colonoscopia, em que foi visualizada uma lesão ulcerada, vegetante, infiltrativa e semi-oclusiva, com aspecto endoscópico típico de adenocarcinoma em cólon ascendente. O paciente foi submetido a uma hemicolectomia oncológica por via laparoscópica de forma assertiva e com resultados satisfatórios. O exame anatomopatológico da peça cirúrgica evidenciou um carcinoma medular com infiltração angiolinfática. Conclusão: Mesmo com os avanços propedêuticos na atualidade, o diagnóstico de alguns tipos raros de tumores continua desafiador. Palavras-chave: Carcinoma Medular. Neoplasias colorretais. Metástase Neoplásica. Colectomia. Relatos de Casos.

A representative collection of diamonds from the Gusinyi Ruchey (Anabar, Yakutia) placer has been studied by morphological analysis, infrared spectroscopy and electron paramagnetic resonance methods. Typomorphic features of Gusinyi Ruchey diamonds are the relatively high content of crystals of V and VII varieties according to the classification of Y.L. Orlov, even for Anabar placers, with a decrease in the proportion of curved dodecahedroids. The latter correlates with a decrease in the prevalence of sculptures and hatching on the surface of crystals. Also, the characteristic features include an increased content of diamonds with the presence of gray tones in the color and with graphite inclusions. The proportion of colorless crystals is only 5.9%. More than 11% of crystals are able to luminesce when excited by ultraviolet radiation at a wavelength of 254 nm. The diamonds of the Gusinyi Ruchey placer partially enrich the “Nizhniy “ section of the Ebelakh placer, this increases its diamond content, but not the quality of the rough diamonds.

The quality and timeliness of public health data is a topic of prime concern in this information age. Many epidemiologists, health scientists and researchers in the public health domain have consistently emphasized on the importance of the need for the right timely data for the right decision-making at the right time. In other words, there is an urgent need to ensure that the right data reaches the right people at the right time. However, this urgent need appears to be misleading and not achievable in the current public health practices and workflow processes. The workflow processes in the current healthcare environments enable data collection to be delayed and only to be captured when the events have already occurred. In this paper, a systematic review of relevant scientific literature was used to not only explore the complexity and uniqueness of public health data, but also explain why improving the quality and timeliness of public health data is a challenging endeavor for many epidemiologists, health scientists and researchers. Recommendations for streamlining the public health workflow processes to support the generation of high-quality and timely public health data were also discussed in the paper.

<strong>In recent years, a number of well-known diseases that can safely be called "old diseases", well known in the clinical pediatrics are starting to show up with a rather atypical clinical picture. It is difficult to find the exact cause of this phenomenon. The most probable reason is the influence of exogenous factories - a severe pathogenicity of etiological factors (viruses, bacteria, parasites), but also of many environmental factors. What is more, the dramatic change in the genome of the individual and a change in immunogenicity requires a long period of time and solid evidence. In support of the highly debatable issues in the altered clinical picture, we present a clinical case with a manifestation of two nosological units with atypical, oligosymptomatic onset, but also with complications in clinical development that posed a serious risk to the patient's life. The first nosological unit is colonization in the CNS of a parasitic echinococcosis cyst, followed by the manifestation of a systemic form of rheumatoid arthritis. The complexities of success in diagnostic, clinical, and therapeutic behavior in this case are evidence of the need for a multi-team approach.</strong>

Pancreatic ductal adenocarcinoma (PDAC) is a challenging tumor entity with an increasing incidence and a dismal prognosis...

Bilişim teknolojilerinde yaşanan gelişmeler, tüketicilerin satın alma karar sürecini etkilemektedir. Teknolojinin tüketicilere sunduğu en önemli avantajlardan biri, çevrimiçi alışveriştir. Çevrimiçi alışveriş, tüketicilere zamandan tasarruf etme, ürün çeşitliliği, ürünleri karşılaştırma, mağazalara göre daha fazla indirim, farklı ödeme seçeneği ve teslimatta kolaylık gibi birçok avantaj sunmaktadır. Ancak bu avantajların yanı sıra tüketiciler çevrimiçi alışverişte, güvenlik, kalite ve fiyat gibi risklerle de karşılaşabilmektedirler. Tüketicilerin algıladığı risk, güven duygusunu ve dolayısıyla satın alma davranışını olumsuz yönde etkileyebilmektedir. Çalışmanın amacı, pazarlama stratejileri olarak ele alınan ürün pazarlama stratejileri ve web pazarlama stratejilerinin algılanan risk üzerindeki etkisini, algılanan riskin tüketici güvenine etkisini incelemek; tüketici güveninin de satın alma eğilimine olan etkisini analiz etmektir. Bu amaçla gerçekleştirilen ve Kocaeli’de 18 yaş ve üzeri kullanıcıları kapsayan araştırma neticesinde, tüketicilerin çevrimiçi alışverişte karşılaştıkları ürün pazarlama stratejilerine ilişkin algıları ne kadar olumlu ise ürünle ilgili fiyat ve kalite riskleri azalmakta; bu riskler azaldıkça ürüne duyulan güven artmakta; söz konusu güven ise satın alma kararını olumlu yönde etkilemektedir. Aynı şekilde, tüketicilerin web pazarlama stratejilerine ilişkin algıları ne kadar olumlu ise, web sitesinin kalite ve güvenlik ile ilgili riskleri azalmakta; bu riskler azaldıkça web sitesine duyulan güven artmakta; söz konusu güven ise satın alma kararını olumlu yönde etkilemektedir.

Since the Government of Indonesia made deregulation in several aspect of aviation industry early of this century, the development of airline industry shows thremendestly. There are many new Low Cost Air Carrier “growing up like mushrum in the rainy season”. Some of side effect of this fast growing are concerning with flight safety, especialy in maintenance, human resources and operational aspects. Flight Safety is mandatory in all aspect of aviation industry, there is no room for relaxation or dispensation regarding safety. Air crew especialy Pilot has huges responsibility in Flight Safety during flight, their healthy condition and eligibility of technical of flight should be maintain at all times. Missuse of narcotic will jeoperdize both healthy and ability in their profesional perform. In this journal we will focus on human resources aspect regarding legislation of missuse of narcotic among flight crew and implementation of safety management of aviation personel.

A total of 20 heparinized pig kidneys were investigated at 10 intrapelvic hydrostatic pressure steps (0-90 mmHg). SWE (ARFI; Virtual TouchTM IQ, Siemens) measurements were taken at three different measuring regions and in two measuring sequences using a linear ultrasonography probe (9L4, Siemens). Median values of 10 shear-wave speed (SWS) measurements were calculated for each pressure step. Logarithmic transformed median SWS values were analyzed in a linear mixed model. SWS increased significantly with increasing intrapelvic pressure. Median SWS for all kidneys in both measuring sequences and all measuring regions was 1.47 m/s (interquartile range [IQR], 0.38 m/s) at 0 mmHg, 1.94 m/s (IQR, 0.42 m/s) at 30 mmHg, 2.07 m/s (IQR, 0.43 m/s) at 60 mmHg, 2.24 m/s (IQR, 0.49 m/s) at 90 mmHg. The correlation between pelvic pressure increase and median SWS values for the central parenchyma was significantly higher compared with the peripheral parenchyma. Acutely increased renal pelvic pressure correlates with increasing SWS values in ARFI elastography in an ex vivo porcine kidney model.