A Study on Prevalence of Subclinical Hypothyroidism in Systemic Sclerosis Patients

BACKGROUND: Systemic sclerosis is a rare connective tissue disorder, with multisystem involvement, progressive course, significant morbidity and premature death. With the disease specific pathology of diffuse microangiopathy, autoimmunity and inflammation, visceral and multiorgan vascular fibrosis, the prevalence of thyroid dysfunction in systemic sclerosis has been studied in various studies in centers. The presence of subclinical hypothyroidism, further increases morbidity and mortality in systemic sclerosis patients. Thus by detecting and treating it earlier, morbidity can be reduced in systemic sclerosis patients. OBJECTIVE: To evaluate the prevalence of subclinical hypothyroidism in systemic sclerosis patients, for early detection of subclinical hypothyroidism and early initiation of thyroid replacement therapy. METHODS: This study involved 50 patients both new and old cases of systemic sclerosis, visiting Rheumatology department in Government Rajaji Hospital, Madurai. Thyroid function tests, such as thyroid-stimulating hormone (TSH), free tri-iodothyronine (T3), free thyroxine (T4), were advised in all cases, and anti thyroid peroxidase (anti-TPO) antibody, thyroid gland ultrasonography in selected patients only. RESULTS: The prevalence of subclinical hypothyroidism was found to be 20% among the study population and statistically significant proportion of people had morbidity predicting risk factors like dyslipidaemia, proteinuria and ECHO changes among people with SCH than euthyroid population. CONCLUSION: The prevalence of subclinical hypothyroidism in systemic sclerosis patients warrants inclusion of TFT, anti-thyroid antibodies and imaging of thyroid if necessary in routine clinical profiling of systemic sclerosis patients

Young migrants’ narratives of collective identifications and belonging

The article sheds light on the intricate relationship between migration, ‘identity’ and belonging by focusing on young migrants in the context of Greek society. Based upon a qualitative study of youth identities, the key objective is to examine their collective identifications, formed through the dialectic of self-identification and categorization. The analysis of young migrants’ narratives unpacks how their sense of belonging and emotional attachments to their countries of origin and settlement are mediated by processes of racialization and ‘othering’

Seismic response of unanchored liquid storage tanks

Unanchored liquid storage tanks under strong earthquake loading tend to uplift. In the present study, the effects of base uplifting on the seismic response of unanchored tanks are presented with emphasis on elephant's foot buckling, base plate strength and shell-To-base connection capacity. Towards this purpose, base uplifting mechanics is analyzed through a detailed simulation of the tank using non-linear finite elements, and a static pushover analysis is conducted that considers the hydrodynamic pressure distribution due to seismic loading on the tank wall and the base plate. The uplifting provisions from EN 1998-4 and API 650 Appendix E standards are briefly described. Numerical results for a typical 27.8-meter-diameter steel tank are compared with the above design provisions. © 2013 ASME

Seismic response of unanchored liquid storage tanks

Unanchored liquid storage tanks under strong seismic loading may exhibit uplifting of their bottom plate, with significant effects on the dynamic behavior and the structural integrity of the tank. In the present paper, base uplifting mechanics is examined numerically through a two-step methodology: (a) a detailed finite element shell model of the tank for incremental static analysis, capable of describing the state of stress and deformation at different levels of loading and (b) a simplified modeling of the tank as a spring-mass system for dynamic analysis, enhanced by a nonlinear spring at its base to account for the effects of uplifting. Three cylindrical liquid storage tanks of different aspect ratios are modeled and examined both as anchored and unanchored. The results are aimed at possible revisions in the relevant seismic design provisions of EN 1998-4 and API 650. Copyright © 2013 by ASME