Primary hyperparathyroidism diagnosed after surgical ablation of a costal mass mistaken for giant-cell bone tumor: a case report

<p>Abstract</p> <p>Introduction</p> <p>Primary hyperparathyroidism is a common endocrine disorder characterized by elevated parathyroid hormone levels, which cause continuous osteoclastic bone resorption. Giant cell tumor of bone is an expansile osteolytic tumor that contains numerous osteoclast-like giant cells. There are many similarities in the radiological and histological features of giant cell tumor of bone and brown tumor. This is a rare benign focal osteolytic process most commonly caused by hyperparathyroidism.</p> <p>Case presentation</p> <p>We report the unusual case of a 40-year-old Caucasian woman in which primary hyperparathyroidism was diagnosed after surgical ablation of a costal mass. The mass was suspected of being neoplastic and histopathology was compatible with a giant cell tumor of bone. On the basis of the biochemical results (including serum calcium, phosphorous and intact parathyroid hormone levels) primary hyperparathyroidism was suspected and a brown tumor secondary to refractory hyperparathyroidism was diagnosed.</p> <p>Conclusions</p> <p>Since giant cell tumor is a bone neoplasm that has major implications for the patient, the standard laboratory tests in patients with bone lesions are important for a correct diagnosis.</p

A mixed integer linear programming model to support e-fulfillment strategies in warehouse-based supermarket chains

The use of the online channel has greatly increased the logistics costs of supermarket chains. Even the difficulty of managing order picking and delivery processes has increased due to the short delivery times and the preservation of perishable products. Against that backdrop, the proposed approach presents a mathematical model for planning the e-fulfillment activities with the objective of ensuring maximum efficiency. The linear programming model has been designed for e-grocers that prepare their online orders at central warehouses. The mathematical model determines both the time windows during which picking and transport should take place and the assignment of trucks to delivery routes. The allocation of online orders is performed taking into account the conservation requirement of each type of product and the availability of means. Considering this planning tool, managers can improve the decision-making process guaranteeing the quality of service while reducing the e-fulfillment cost for joint picking and delivery point of view. Motivated by a cooperation with a supermarket chain, results bring great insight based on the simulation of different logistics alternatives. Companies and researchers can compare the strategy of leveling the workload and the strategy of reducing the number of means, a common alternative in logistics outsourced to third parties. In addition, the different scenarios developed make it possible to determine the substantial savings achieved by modifying the delivery services and advancing the order preparation. As a result, managerial insights are identified highlighting the importance of efficient order planning to improve the profitability of online sales