Isolated ligamentum flavum ossification in primary hypoparathyroidism

Basckground: The ligamenta flava can undergo ossification and calcification resulting in myelopathy. Only seven cases of ligamentumflavum ossification in association with hypoparathyroidism have been reported, most of which had concurrent osseous changes in other spinal ligaments. Here, we report a patient with hypoparathyroidism who presented ith ligamentum flavum ossification causing both cervical and thoracic myelopathy. Case description: A 43-year-old male presented with backache, urinary retention, and lower limb weakness for the last few days. Magnetic resonance imaging scan showed ossification of the ligamentum flavum in the cervical and thoracic regions, with severe spinal stenosis. Following spinal decompressive surgery, the patient made a complete recovery. Primary hypoparathyroidism was found to be the underlying cause for ligamentum flavum ossification. Conclusion: Ossification of ligamentum flavum secondary to hypoparathyroidism should be considered as a possible cause of myelopathy in all patients presenting with symptoms of spinal cord compression

Enteric cyst in the left posterior mediastinum mimicking a hydatid cyst on chest computed tomography scan

Abstract Mediastinal enteric cysts are a rare occurrence among adults and are usually asymptomatic. In most cases they are an incidental finding in the right hemi-mediastinum and are associated with vertebral anomalies. We report the unusual case of a 23 year old male who had a mediastinal mass on chest X-ray as an incidental finding. Chest Computed Tomography (CT) scan revealed no vertebral anomalies and a cystic mass in the left posterior mediastinum with features similar to those of a hydatid cyst.Posterolateral thoracotomy was done and the cyst was excised. Histopathology report revealed it to be an enteric cyst

Significance of Tumor Marker CA15-3 in Metastatic Breast Cancer

Secondary spread of cancer to bones is commonest and frequent phenomenon and enhances the need of special care for sufferers. Bone metastases mostly are the first complication of different variety of cancers which increase the need of care and expensive facilities. Blood dissemination is another common route, might be due to the venous drainage from visceral organs directly into the axial bones. CA 15-3 is a mucinous tumor markers derived from MUC1 gene, provides better guide line about the treatment, recurrence and prognosis. Aim: Aim of the study was to signify the role of tumor marker CA15-3 in metastatic breast cancer. Methods: Hundred females of breast cancer (any age) with different stages of breast cancer with and without bone metastasis were tested for their serum level of CA 15-3 (biomarker of breast cancer). Bone scan was done to check the secondary metastasis to bones. Intravenous dye Ttechnicium 99 MDP has been used. Serum levels of ca15-3 were measured with the help of Gama Counter with computerized system and IRMA kit (Immunoradiometric Assay) by IMMUNOTECH. Ultrasound of whole abdomen and X ray/CT scan were used to detect liver and pulmonary metastasis respectively. Results: Results indicate a high statistical significant relationship between bone metastasis and elevated levels of tumor marker CA 15-3 in breast cancer patients. Elevated levels of tumor marker CA 15-3 is strongly correlated with positive bone scan. An elevated level of tumor marker CA 15-3 is also correlated with positive pulmonary metastasis CA 15-3 is highly sensitive to detect bone metastasis and also sensitive to detect pulmonary metastasis. A lesser extent of high CA 15-3 serum levels is determinant of liver metastasis. Bone scan is essential tool to detect bone metastasis but need assistance of chemical biomarkers. Conclusions: CA 15-3 as a tumor marker proved a help full determinant of tumor burden in metastatic breast cancer. Its significance is more to detect bone metastasis than to pulmonary and then to liver metastasis. Future studies upon CA15-3 in association with imaging techniques and other organ related specific tumor markers to detect specific metastasis or overall body tumor burden will be blessing for patients and physicians

Učinak duljine skladištenja na kvalitetu jaja i valivost kokoši Rhode Island Red.

In this research study, hatchability results and some internal egg quality characteristics of 0, 2, 3, 5, 7 and 9 d stored eggs in RIR were examined. It was determined that the effect of storage time on hatchability, hatchability of fertile eggs, embryonic mortality, chick weight, albumen weight, yolk weight, albumen index, yolk index and Haugh unit was significant (P<0.05). There was no positive or negative effect of storage time on the fertility rates, but there was a negative effect of storage time on egg weight, hatchability, embryonic development and chick weight on d 3 (P<0.05). It was determined that prolonged storage time caused a decrease in the albumen weight, yolk weight, albumen index, yolk index and Haugh unit value of Rhode Island Red eggs. Rhode Island Red eggs should not be stored more than 3 d.U radu su istraženi valivost i karakteristike jaja pasmine Rhode Island Red u uvjetima različite duljine skladištenja od 0, 2, 3, 5, 7 i 9 dana. Duljina skladištenja statistički je značajno (P<0,05) utjecala na valivost, valivost oplođenih jaja, smrtnost embrija, masu pilića, masu bjelanjka, masu žumanjka, indeks bjelanjka, indeks žumanjka te na vrijednost Haughove jedinice. Nije utvrđen ni pozitivan ni negativan učinak duljine skladištenja na stopu plodnosti, ali je duljina skladištenja od 3 dana značajno utjecala (P<0,05) na masu jaja, valivost, razvoj embrija i masu pilića. Ustanovljeno je da u jaja Rhode Island Red kokoši produženo vrijeme skladištenja dovodi do smanjenja mase bjelanjka, mase žumanjka, indeksa bjelanjka, indeksa žumanjka i vrijednost Haughove jedinice. Zaključeno je da jaja kokoši Rhode Island Red ne bi trebalo skladištiti dulje od 3 dana

Effect of Salinity Stress on Physiological Changes in Winter and Spring Wheat

Salinity is a leading threat to crop growth throughout the world. Salt stress induces altered physiological processes and several inhibitory effects on the growth of cereals, including wheat (Triticum aestivum L.). In this study, we determined the effects of salinity on five spring and five winter wheat genotypes seedlings. We evaluated the salt stress on root and shoot growth attributes, i.e., root length (RL), shoot length (SL), the relative growth rate of root length (RGR-RL), and shoot length (RGR-SL). The ionic content of the leaves was also measured. Physiological traits were also assessed, including stomatal conductance (gs), chlorophyll content index (CCI), and light-adapted leaf chlorophyll fluorescence, i.e., the quantum yield of photosystem II (Fv′/Fm′) and instantaneous chlorophyll fluorescence (Ft). Physiological and growth performance under salt stress (0, 100, and 200 mol/L) were explored at the seedling stage. The analysis showed that spring wheat accumulated low Na+ and high K+ in leaf blades compared with winter wheat. Among the genotypes, Sakha 8, S-24, W4909, and W4910 performed better and had improved physiological attributes (gs, Fv′/Fm′, and Ft) and seedling growth traits (RL, SL, RGR-SL, and RGR-RL), which were strongly linked with proper Na+ and K+ discrimination in leaves and the CCI in leaves. The identified genotypes could represent valuable resources for genetic improvement programs to provide a greater understanding of plant tolerance to salt stress.Salinity is a leading threat to crop growth throughout the world. Salt stress induces altered physiological processes and several inhibitory effects on the growth of cereals, including wheat (Triticum aestivum L.). In this study, we determined the effects of salinity on five spring and five winter wheat genotypes seedlings. We evaluated the salt stress on root and shoot growth attributes, i.e., root length (RL), shoot length (SL), the relative growth rate of root length (RGR-RL), and shoot length (RGR-SL). The ionic content of the leaves was also measured. Physiological traits were also assessed, including stomatal conductance (gs), chlorophyll content index (CCI), and light-adapted leaf chlorophyll fluorescence, i.e., the quantum yield of photosystem II (Fv′ /Fm′ ) and instantaneous chlorophyll fluorescence (Ft). Physiological and growth performance under salt stress (0, 100, and 200 mol/L) were explored at the seedling stage. The analysis showed that spring wheat accumulated low Na+ and high K+ in leaf blades compared with winter wheat. Among the genotypes, Sakha 8, S-24, W4909, and W4910 performed better and had improved physiological attributes (gs, Fv′ /Fm′, and Ft) and seedling growth traits (RL, SL, RGR-SL, and RGR-RL), which were strongly linked with proper Na+ and K+ discrimination in leaves and the CCI in leaves. The identified genotypes could represent valuable resources for genetic improvement programs to provide a greater understanding of plant tolerance to salt stress

Experimental Aspects of Synthesis

We discuss the problem of experimentally evaluating linear-time temporal logic (LTL) synthesis tools for reactive systems. We first survey previous such work for the currently publicly available synthesis tools, and then draw conclusions by deriving useful schemes for future such evaluations. In particular, we explain why previous tools have incompatible scopes and semantics and provide a framework that reduces the impact of this problem for future experimental comparisons of such tools. Furthermore, we discuss which difficulties the complex workflows that begin to appear in modern synthesis tools induce on experimental evaluations and give answers to the question how convincing such evaluations can still be performed in such a setting.Comment: In Proceedings iWIGP 2011, arXiv:1102.374

The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Cirrhosis and other chronic liver diseases (collectively referred to as cirrhosis in this paper) are a major cause of morbidity and mortality globally, although the burden and underlying causes differ across locations and demographic groups. We report on results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 on the burden of cirrhosis and its trends since 1990, by cause, sex, and age, for 195 countries and territories. Methods We used data from vital registrations, vital registration samples, and verbal autopsies to estimate mortality. We modelled prevalence of total, compensated, and decompensated cirrhosis on the basis of hospital and claims data. Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost due to premature death and years lived with disability. Estimates are presented as numbers and age-standardised or age-specific rates per 100 000 population, with 95% uncertainty intervals (UIs). All estimates are presented for five causes of cirrhosis: hepatitis B, hepatitis C, alcohol-related liver disease, non-alcoholic steatohepatitis (NASH), and other causes. We compared mortality, prevalence, and DALY estimates with those expected according to the Socio-demographic Index (SDI) as a proxy for the development status of regions and countries. Findings In 2017, cirrhosis caused more than 1.32 million (95% UI 1.27-1.45) deaths (440000 [416 000-518 000; 33.3%] in females and 883 000 [838 000-967 000; 66.7%] in males) globally, compared with less than 899 000 (829 000-948 000) deaths in 1990. Deaths due to cirrhosis constituted 2.4% (2.3-2.6) of total deaths globally in 2017 compared with 1.9% (1.8-2.0) in 1990. Despite an increase in the number of deaths, the age-standardised death rate decreased from 21.0 (19.2-22.3) per 100 000 population in 1990 to 16.5 (15.8-18-1) per 100 000 population in 2017. Sub-Saharan Africa had the highest age-standardised death rate among GBD super-regions for all years of the study period (32.2 [25.8-38.6] deaths per 100 000 population in 2017), and the high-income super-region had the lowest (10.1 [9.8-10-5] deaths per 100 000 population in 2017). The age-standardised death rate decreased or remained constant from 1990 to 2017 in all GBD regions except eastern Europe and central Asia, where the age-standardised death rate increased, primarily due to increases in alcohol-related liver disease prevalence. At the national level, the age-standardised death rate of cirrhosis was lowest in Singapore in 2017 (3.7 [3.3-4.0] per 100 000 in 2017) and highest in Egypt in all years since 1990 (103.3 [64.4-133.4] per 100 000 in 2017). There were 10.6 million (10.3-10.9) prevalent cases of decompensated cirrhosis and 112 million (107-119) prevalent cases of compensated cirrhosis globally in 2017. There was a significant increase in age-standardised prevalence rate of decompensated cirrhosis between 1990 and 2017. Cirrhosis caused by NASH had a steady age-standardised death rate throughout the study period, whereas the other four causes showed declines in age-standardised death rate. The age-standardised prevalence of compensated and decompensated cirrhosis due to NASH increased more than for any other cause of cirrhosis (by 33.2% for compensated cirrhosis and 54.8% for decompensated cirrhosis) over the study period. From 1990 to 2017, the number of prevalent cases snore than doubled for compensated cirrhosis due to NASH and more than tripled for decompensated cirrhosis due to NASH. In 2017, age-standardised death and DALY rates were lower among countries and territories with higher SDI. Interpretation Cirrhosis imposes a substantial health burden on many countries and this burden has increased at the global level since 1990, partly due to population growth and ageing. Although the age-standardised death and DALY rates of cirrhosis decreased from 1990 to 2017, numbers of deaths and DALYs and the proportion of all global deaths due to cirrhosis increased. Despite the availability of effective interventions for the prevention and treatment of hepatitis B and C, they were still the main causes of cirrhosis burden worldwide, particularly in low-income countries. The impact of hepatitis B and C is expected to be attenuated and overtaken by that of NASH in the near future. Cost-effective interventions are required to continue the prevention and treatment of viral hepatitis, and to achieve early diagnosis and prevention of cirrhosis due to alcohol-related liver disease and NASH. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd.Peer reviewe

Age-sex differences in the global burden of lower respiratory infections and risk factors, 1990-2019 : results from the Global Burden of Disease Study 2019

BACKGROUND: The global burden of lower respiratory infections (LRIs) and corresponding risk factors in children older than 5 years and adults has not been studied as comprehensively as it has been in children younger than 5 years. We assessed the burden and trends of LRIs and risk factors across all age groups by sex, for 204 countries and territories. METHODS: In this analysis of data for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we used clinician-diagnosed pneumonia or bronchiolitis as our case definition for LRIs. We included International Classification of Diseases 9th edition codes 079.6, 466-469, 470.0, 480-482.8, 483.0-483.9, 484.1-484.2, 484.6-484.7, and 487-489 and International Classification of Diseases 10th edition codes A48.1, A70, B97.4-B97.6, J09-J15.8, J16-J16.9, J20-J21.9, J91.0, P23.0-P23.4, and U04-U04.9. We used the Cause of Death Ensemble modelling strategy to analyse 23 109 site-years of vital registration data, 825 site-years of sample vital registration data, 1766 site-years of verbal autopsy data, and 681 site-years of mortality surveillance data. We used DisMod-MR 2.1, a Bayesian meta-regression tool, to analyse age-sex-specific incidence and prevalence data identified via systematic reviews of the literature, population-based survey data, and claims and inpatient data. Additionally, we estimated age-sex-specific LRI mortality that is attributable to the independent effects of 14 risk factors. FINDINGS: Globally, in 2019, we estimated that there were 257 million (95% uncertainty interval [UI] 240-275) LRI incident episodes in males and 232 million (217-248) in females. In the same year, LRIs accounted for 1·30 million (95% UI 1·18-1·42) male deaths and 1·20 million (1·07-1·33) female deaths. Age-standardised incidence and mortality rates were 1·17 times (95% UI 1·16-1·18) and 1·31 times (95% UI 1·23-1·41) greater in males than in females in 2019. Between 1990 and 2019, LRI incidence and mortality rates declined at different rates across age groups and an increase in LRI episodes and deaths was estimated among all adult age groups, with males aged 70 years and older having the highest increase in LRI episodes (126·0% [95% UI 121·4-131·1]) and deaths (100·0% [83·4-115·9]). During the same period, LRI episodes and deaths in children younger than 15 years were estimated to have decreased, and the greatest decline was observed for LRI deaths in males younger than 5 years (-70·7% [-77·2 to -61·8]). The leading risk factors for LRI mortality varied across age groups and sex. More than half of global LRI deaths in children younger than 5 years were attributable to child wasting (population attributable fraction [PAF] 53·0% [95% UI 37·7-61·8] in males and 56·4% [40·7-65·1] in females), and more than a quarter of LRI deaths among those aged 5-14 years were attributable to household air pollution (PAF 26·0% [95% UI 16·6-35·5] for males and PAF 25·8% [16·3-35·4] for females). PAFs of male LRI deaths attributed to smoking were 20·4% (95% UI 15·4-25·2) in those aged 15-49 years, 30·5% (24·1-36·9) in those aged 50-69 years, and 21·9% (16·8-27·3) in those aged 70 years and older. PAFs of female LRI deaths attributed to household air pollution were 21·1% (95% UI 14·5-27·9) in those aged 15-49 years and 18·2% (12·5-24·5) in those aged 50-69 years. For females aged 70 years and older, the leading risk factor, ambient particulate matter, was responsible for 11·7% (95% UI 8·2-15·8) of LRI deaths. INTERPRETATION: The patterns and progress in reducing the burden of LRIs and key risk factors for mortality varied across age groups and sexes. The progress seen in children younger than 5 years was clearly a result of targeted interventions, such as vaccination and reduction of exposure to risk factors. Similar interventions for other age groups could contribute to the achievement of multiple Sustainable Development Goals targets, including promoting wellbeing at all ages and reducing health inequalities. Interventions, including addressing risk factors such as child wasting, smoking, ambient particulate matter pollution, and household air pollution, would prevent deaths and reduce health disparities. FUNDING: Bill & Melinda Gates Foundation

Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Funding: F Carvalho and E Fernandes acknowledge support from Fundação para a Ciência e a Tecnologia, I.P. (FCT), in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences UCIBIO and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy i4HB; FCT/MCTES through the project UIDB/50006/2020. J Conde acknowledges the European Research Council Starting Grant (ERC-StG-2019-848325). V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006.proofepub_ahead_of_prin