Increased 99mTc MDP activity in the costovertebral and costotransverse joints on SPECT-CT: is it predictive of associated back pain or response to percutaneous treatment?

PURPOSEPain related to costovertebral and costotransverse joints is likely an underrecognized and potentially important cause of thoracic back pain. On combined single-photon emission computed tomography and computed tomography (SPECT-CT), increased technetium-99m methylene diphosphonate (99mTc MDP) activity at these articulations is not uncommon. We evaluated whether this activity corresponds with thoracic back pain and whether it predicts response to percutaneous injection.METHODSAll 99mTc MDP SPECT-CT spine examinations completed at our institution from March 2008 to March 2014 were retrospectively reviewed to identify those with increased 99mTc MDP activity in the costovertebral or costotransverse joints. The presence of corresponding thoracic back pain, percutaneous injection performed at the relevant joint(s), and response to injection were recorded.RESULTSA total of 724 99mTc MDP SPECT-CT examinations were identified. Increased 99mTc MDP activity at costovertebral or costotransverse joints was reported in the examinations of 55 patients (8%). Of these, 25 (45%) had corresponding thoracic back pain, and nine of 25 patients (36%) underwent percutaneous injection of the joint(s) with increased activity. At clinical follow-up two days to 12 weeks after injection, one patient (11%) had complete pain relief, two (22%) had partial pain relief, and six (67%) had no pain relief.CONCLUSIONThe findings suggest that increased activity in costovertebral and costotransverse joints on 99mTc MDP SPECT-CT is only variably associated with the presence and location of thoracic back pain; it does not predict pain response to percutaneous injection.The findings suggest that increased activity in costovertebral and costotransverse joints on 99mTc MDP SPECT-CT is only variably associated with the presence and location of thoracic back pain; it does not predict pain response to percutaneous injection

Histopathological characterization of intimal lesions and arterial wall calcification in the arteries of the leg of elderly cadavers

Introduction: Although arteries of the leg have been studied in extensively diseased amputation specimens, little is known about the composition of vascular lesions present in the general population. The aim of this study was to describe the natural development of adaptive intimal thickening, atherosclerotic lesion development and vascular calcification in the leg of a general elderly population. Materials and Methods: Two hundred and seventy postmortem samples from the popliteal and posterior tibial arteries of 14 elderly cadavers were studied histologically. Results: Atherosclerotic lesions were more frequently observed in the popliteal (60%) than in the posterior tibial artery (34%; p <.0005). These atherosclerotic plaques were most often nonatheromatous (80% and 83% for popliteal and posterior tibial plaques, respectively). The atheroma's that were present were small (most <25% of plaque area). Atherosclerotic plaque calcification was observed more often in the popliteal (39%) than in the posterior tibial samples (17%; p <.0005). Medial arterial calcification was observed more often in the posterior tibial (62%) than in the popliteal samples (46%; p =.008). Plaque calcification and medial arterial calcification were not associated with lumen stenosis. Conclusions: In the leg of elderly cadavers, the presence of atherosclerotic plaque and intimal calcification decreases from the proximal popliteal artery to the more distal posterior tibial artery and most atherosclerotic lesions are of the fibrous nonatheromatous type. In contrast, the presence and severity of medial calcification increases from proximal to distal

Predicting High-Flow Spinal CSF Leaks in Spontaneous Intracranial Hypotension Using a Spinal MRI-Based Algorithm: Have Repeat CT Myelograms Been Reduced?

ABSTRACT BACKGROUND AND PURPOSE: We adopted an imaging algorithm in 2011 in which extradural fluid on spinal MR imaging directs dynamic CT myelography. We assessed algorithm compliance and its effectiveness in reducing repeat or unnecessary dynamic CT myelograms

Pin1 and WWP2 regulate GluR2 Q/R site RNA editing by ADAR2 with opposing effects

While the essential role of the adenosine deaminase ADAR2 in RNA editing is well established, how it is regulated remains largely unknown. Here, the prolyl isomerase Pin1 and the E3 ubiquitin ligase WWP2 are shown to play a role in regulating ADAR2 localisation and stability

Consequences of Economic Partnership Agreements between East and Southern African Countries and the EU for Inter- and Intra-regional Integration

The European Union is currently negotiating Economic Partnership Agreements (EPAs) with six African, Caribbean and Pacific country groupings, aiming at establishing mutual free trade. This paper empirically assesses the impact of the EPAs on trade flows and government revenues for 22 East and Southern African countries and discusses implications for intra-regional integration. The results indicate that while moderate trade effects can be expected, relatively large budget effects are likely to occur in a number of these countries, exposing them to considerable structural and financial adjustment requirements. Also, EPAs would strengthen the need to consolidate overlapping intra-regional integration schemes

Productivity growth, Smith effects and Ricardo effects in Euro Area's manufacturing industries

We analyse the determinants of labour productivity across (a sample of) EA member states. We focus on the divergent dynamics before and after the financial crisis, and of core countries relative to peripheral countries. We ground our empirical analysis in Paolo Sylos‐Labini's productivity equations. We test different models, including a Panel 2S‐LS model and a Panel vector autoregression model. Our preliminary findings confirm and strengthen Sylos‐Labini's main insights. Labour productivity in manufacturing industries is strongly and positively correlated with the market size (Smith effect), the relative cost of labour (Ricardo effect), the absolute cost of labour (organization effect) and past investment, whereas it is negatively correlated with current investment. Furthermore, we find evidence that the crisis has affected the size of these effects. Focusing on the core periphery dichotomy, the signs of the effects are the same for both groups of countries, although the Smith, Ricardo and long‐run investment effects are usually stronger for core countries compared to peripheral countries. The opposite holds for the organization effect, while investment effects are less clear

The La Marca model revisited: Structuralist goodwin cycles with evolutionary supply side and balance of payments constraints

This research is aimed at investigating the causes of volatility that affect middle‐income countries by studying the La Marca model. Drawing from the open‐economy Goodwin tradition, this model demonstrates that economic activity, income distribution and accumulation of foreign assets dynamically interact, resulting in a pattern of dampened cycles. The study consists in analyzing the characteristics of the model by initially imposing: (I) a constant real exchange rate; (II) a constant net external asset to capital ratio, which is in line with the balance of payments dominance theory and (III) a fixed income distribution. We then (IV) expand the original model by adding an evolutionary supply‐side in which productivity is at the center of the economic dynamic through international technology transfer and the Kaldor‐Verdoorn effect. The results show that (1) the model always converges. (2) The restrictions (I) and (II) remove the cyclical component of the model, which highlights a central difference between La Marca and the original Goodwin model. (3) Fixed income distribution leads to a monotonic trajectory that reduces oscillations. (4) The inclusion of productivity dynamics generates new sources of volatility in the relationship between productivity, capacity utilization and net external assets and is in line with the structuralist argument of structural fragility

The nexus between prices, employment and output growth: a global and national evidence

This paper investigates how output growth, employment growth and inflation influence each other in the short/long run. It builds on Phillips (1962) and Blanchard Fischer (1989) assessment that empirical links between output, employment and prices are central issue in modern macroeconomics. This paper brings a global perspective on short and long term links between employment growth, inflation and output growth using panel cointegration framework with non-stationary heterogeneous panel (119 countries over 1970–2010). The empirical results (on global and national level) strongly support the existence of a long-run equilibrium relationship between output growth, employment growth and inflation. A central finding is that possible trade-off effects between growth, employment and prices varies significantly among economies. Therefore, universal answers to questions Is inflation good for growth or Is there a trade-off between employment and growth are not straightforward for general macroeconomic theory. Each country must design own economic policy (targeting) taking into account the quantitative relationships between growth, employment and prices. This has important policy implications also for price setting policies, cost management, market strategy and risk management through productivity-demand disturbances effects on the business environment