TAMI Industries (France)

BackgroundLumbar ribs (LR) are a rare and relatively unknown anatomical abnormality of the lumbar spine. The literature provides better understanding regarding other spinal congenital variations like cervical ribs or lumbosacral transitional vertebrae, which are rather commonly recognised conditions. Thus, this meta-analysis aimed to provide data on prevalence and key characteristics of LR.MethodsRelevant databases were systematically searched for studies reporting the prevalence, laterality and geographic distribution of LR. No exclusion criteria based on language and date of original articles were employed. The pooled prevalence estimates (PPE) were calculated using a random-effects model. To assess the between-study heterogeneity, the I2 statistic and Chi-square test were utilized. Throughout the investigation, the PRISMA guidelines were adhered to scrupulously. Evaluation of the included studies’ reliability was made with the AQUA tool.ResultsIn total, 9 studies were included in this meta-analysis. The pooled prevalence estimate (PPE) of LR was 2.1% (95%CI: 1.0-4.6). In studies based on CT imaging, LR were found in 1.6% (95%CI: 0.6–4.3) of patients and in Xray based studies in 2.1% (95%CI: 0.4–11.1) of patients. Lumbar ribs were bilateral in majority of individuals (65.4%, 95%CI: 39.4–84.6) and could be most frequently encountered in Europe with PPE of 2.8% (95%CI: 3.0–20.0), then in East Asia with PPE of 1.5% (95%CI: 1.0-19.2) and Middle East with PPE of 1.1% (95%CI: 0.6–20.0).ConclusionsThe findings of our study indicate that LR are a common anatomical variation of lumbar spine, contrary to previous beliefs. In a clinical practice, when a patient presents with a non-specific low back pain, a possible occurrence of LR should be taken into consideration. The presence of LR may be misleading for surgeons and result in wrong-level spine surgeries.

de diplomă, subliniază diversitatea modurilor în care studenții ar putea înțelege și urmări, în manieră proprie, aceste criterii.

Choriocarcinoma accompanied with pulmonary embolism (PE) is rare and difficult to diagnose and treat. There are about 25 cases reported in literature, which presented variable clinical characteristics and prognosis. We reported a case of choriocarcinoma presenting PE as the first manifestation in a 26-year-old Chinese female. Four months before her admission to our hospital, she presented to a local hospital with respiratory manifestations, and was first diagnosed as bronchitis and treated with antibiotics without improvement, and subsequently suspected of having pulmonary tuberculosis and receive anti-tuberculosis therapy, with no response. Upon admission to our hospital, spiral computed tomography-pulmonary angiography revealed complete occlusion of right pulmonary artery, leading to PE. She received thrombolysis and anticoagulant therapy, without improvement. Further interrogation of the patient revealed a history of irregular vaginal bleeding and multiple pregnancies and abortions. Following the laboratory report of a significantly elevated level of serum beta-human chorionic gonadotropin (β-HCG) combined with other clinical and laboratory findings, a diagnosis of choriocarcinoma accompanied with PE was established based on the criteria formulated by the International Federation of Gynecology and Obstetrics and guideline of European Society for Medical Oncology. With 1 cycle of chemotherapy with etoposide-methotrexateactinomycin D-cyclophosphamide-vincristine (EMA-CO), her dyspnea and other symptoms improved, with a significant decrease in the serum β-HCG level and pulmonary artery pressure. Unfortunately, she showed bone marrow inhibition, could not continue further chemotherapy, and finally died after discharging. We reviewed 25 similar cases in the literature, and found that all 17 cases receiving chemotherapy showed complete recovery while 6 of 8 cases without chemotherapy died during hospitalization. This case report illustrates the challenges in diagnosis of choriocarcinoma presenting with respiratory manifestations, and highlights the importance of early diagnosis and timely appropriate chemotherapy in management of this disease.

Abstract This article focuses on organic bromine compounds with industrial application. The organic bromine compounds are prepared and produced either by substitutive or additive bromination. Organic bromine compounds, in which the bromine atom is retained in the final molecular structure, and where its presence contributes to the properties of the desired products, are the largest segment in terms of consumed volumes. This segment includes mainly flame retardants (50%), biocides (mostly for water treatment), gasoline additives, halons, bromobutyl rubber, pharmaceuticals, and dyes. New process developments resulted in new applications in ultraviolet (UV) sunscreens, high‐performance polymers, and others.

The prototype of a communicating undercloth for medical remote monitoring was realized. It delivers physiological information on the subject (cardiac frequency, breathing frequency, mid-temperature) as well as the environment and activity parameters (ambient temperature, fall detection). It also enables the automatic data transfer when an event occurs, with the localization of the subject.

Although risk factors for first stroke have been identified, the predictors of long-term stroke recurrence are less well understood. We performed the present study to determine whether dementia diagnosed three months after stroke onset is an independent risk factor for long-term stroke recurrence. We examined 242 patients (age = 72.0 +/- 8.7 years) hospitalized with acute ischemic stroke who had survived the first three months without recurrence and followed them to identify predictors of long-term stroke recurrence. We diagnosed dementia three months after stroke using modified DSM-III-R criteria based on neuropsychological and functional assessments. The effects of conventional stroke risk factors and dementia status on survival free of recurrence were estimated using Kaplan-Meier analyses, and the relative risks (RR) of recurrence were calculated using Cox proportional hazards models. Dementia (RR = 2.71, 95% CI = 1.36 to 5.42); cardiac disease (RR = 2.18, CI = 1.15 to 4.12); and sex, with women at higher risk (RR = 2.03, CI = 1.01 to 4.10), were significant independent predictors of recurrence, while education (RR = 1.90, CI = 0.77 to 4.68), admission systolic blood pressure >160 mm Hg (RR = 1.80, CI = 0.94 to 3.44) and alcohol intake exceeding 160 grams per week (RR = 1.86, CI = 0.79 to 4.38) were weakly related. Our results suggest that dementia significantly increases the risk of long-term stroke recurrence, with additional independent contributions by cardiac disease and sex. Cognitive impairment may be a surrogate marker for multiple vascular risk factors and larger infarct volume that may serve to increase the risk of recurrence. Alternatively, less aggressive medical management of stroke patients with cognitive impairment or noncompliance of such patients with medical therapy may be bases for an increased rate of stroke recurrence.

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