@@patrickbilancione1201 Sorry for your loss. But yes, it is always fatal, along with other Prion diseases. Unfortunately as well scientists still don't know much about the diseases. Prions diseases can be inherited as well as transmitted.
This man is doing something great. Imagine how many students are learning because of him. I feel sorry for him, but without such heroes, how do you expect medicine to improve and students to become great doctors?❤
It’s tough to watch, but we should also offer him our gratitude, and not just sympathies. Creuzfeldt-Jakob is rare but inevitably fatal. These videos with different medical signs are not easy watching, even for med students, but important. The only way we will be able to treat or cure this illness is through study and he volunteered to assist with that, in a very public and vulnerable way, for the benefit of medicine and mankind. That’s a courageous, kind, amazing thing to do for your fellow human beings. It’s heroic and should be honored. I celebrate him for that.
i feel so bad :( he looked so scared and embarrassed that these things were happening to him and he couldn’t control it :( the worst part was when he took his other arm to stop it 😢 poor guy :C
i cant imagine the helplessness the patients of this disease feel when they are informed that there is no cure and that they are bound to die in a relatively short amount of time
Thankful for this, after watching this we figured out that my mom has it too . Mom passed away because of this 3 weeks ago. It was horrible watching her dealing with this disease for whole family. May God be with everybody dealing with this thing.❤️
Right now, my grandmother has this. She has always been sweet and kind but now she can’t even remember me and others. I am crying right now because the doctor said she only has a few months to live. Maybe you guys can help pray for my grandmother
@@somnuswaltz5586 at least he's saying rest in peace? he could be saying "haha look at that dumb tremor" like a moron but at least he paid some respects
@@somnuswaltz5586 saying "dude" does not show any lack of respect, it's just a bit more informal at best. You on the other hand, governing what people should say, is the one showing no respect
my momma was diagnosed with this, back in October. It took her life just a month later, in November. To see the night and day change from a normal adult to someone who needed 24/7 care... it's an unbearably excruciating experience to watch someone who you hold so close to your heart be ripped away by such a scary disease. I pray that one day we can prevent this kind of disease so that families and individuals don't go through what mine, and so many others, have.
A friend of mine died from this disease. I'd NEVER heard of this before and it's DEVASTATING 💔 My sincerest prayers to ANYONE affected by this terrible condition 🙏🏾
was studying this topic and this video really helped understanding the disease better but had to hold back my tears. there are times when it hits you really hard that people are so much more than their illnesses ...having a family and a complex life just like the rest of us. may his soul rest in peace
My mother nursed a couple of individuals with this disease back in her nursing days (late 70s/early 80s). Thankfully today we can make those who are succumbing to it a lot more comfortable.
God bless this man and his medical staff. I hope he was comfortable his last stretch of life. Praying we see a cure for this awful disease in the future.
my mom experience it now, in the phase of can not response anything but the myoclonus... we do the best we can to be with her, knowing that no cure or treatment can be done with the disease... my thoughts and prays to anyone and families with this disease...
Wow this is genuinely one of the hardest things I’ve ever had to watch man this man rest in peace, no one deserves that. Its even more heartbreaking reading the comments I’m sorry for all your losses we need a cure for these types of diseases soon. We need to better our entire society and use our resources on that before anything else.
Thank you, sir; gracias Señor. Your willingness to demonstrate the movements of this disease is helping to educate and provide others with answers across the globe. Que Dios te bendiga a ti y a tu familia.
Thank you for sharing this It is very helpful for medical students Watch the symptoms with your eyes and you'll never forget it.. respect for the patient
My grandmother died of CJD in 1984. It really messed my mom up watching it. To the point that she had to stop visiting her because she didn’t know who she was anymore. The blood banks won’t take my blood because of her death. I’ve researched it and it’s pretty scary how little they actually know about who gets it and why.
I thought that Parkinson was an horrible disease. Now, I learn about this disease and ffi, I am truly speechless, how the brain, human nature can do these things to us. So sad.
mi abuela falleció por esta terrible enfermedad. Que terrible fue verla deteriorarse tan rápido que ni tiempo me dio para despedirme. Espero que se encuentre alguna cura o tratamiento efectivo que pueda curar a todas las personas que sufren de esta enfermedad.
Devastating to see this type of vulnerability to such a horrendous disease on this man. I appreciate it, how regardless of it you didn´t mind being recorded and you did well. thanks for everything.
Thank you. My mother-in-law was just diagnosed with CJD. She's debilitating way too fast. I can't believe that she was here with our family, happy and strong, not so long ago. We're flying out in few days to see her and honestly don't know what to expect.
Hope you're doing ok. And yes, unfortunately once the symptoms start it can progress faster. Before the symptoms start it remains dormant in your system for years and sometimes, when inherited, only appears around the age of 60, possibly even less. Wish you all the best.
So sorry for your situation. I lost my sweet sister to this terrible disease and yes the speed of debilitation is shocking. What you will see how it affects a person will haunt you but be strong for your mother-in-law for the time she has remaining and give her every bit of love you have in you for your and her heart's sake. I still grieve deeply for my recent loss but know that "God" holds my sister in his arms as he will do so for your loved one as well. I will say a prayer for your mother-in-law and for you as well. You are not " alone". Please take care.
This man is doing something great. Imagine how many students are learning because of him. I feel sorry for him, but without such heroes, how do you expect medicine to improve and students to become great doctors?❤
Al caballero del video decirle que es todo un ejemplo de valentía y coraje por dejarse grabar en esta situacion de vulnerabilidad. Gracias por compartir y que la cura no se haga tardar ❤
My sister appears to have this. Technically no diagnosis from doctors yet until see movement specialist next month. She deteriorating by the weeks noticably. All the symptoms fit this disease. She's almost bedridden now, dementia and almost can't talk or hardly eat. Pray for her.😢
Eu moro no Brasil. Minha tia também está com essa doença. Vários diagnósticos inconclusivos, mas finalmente foi diagnosticado. Pouco se sabem dessa doença no mundo.
My father had Parkinson's dementia along with lewy bodies . I remember his involuntary movement . Sometimes grinding the tip of his Cane into the carpet for hrs wearing holes etc . RIP Dad .
I was hesitant to watch because I know it would be upsetting to watch. And that's exactly why I had to watch. I don't know how I would even handle fhe situation at all. This is real shit that happens to real people and it's heartbreaking. I wish the medical field good luck in making advanced and gaining more knowledge how to address it
The hospital in my city put this on my medical history And when I saw it on the computer screen and asked what creutzfeldt jacobs was she said it was another name for the disease I had just been diagnosed with (Charcot Marie tooth) I made her get a medical encyclopedia and check She pretended to read, said it was another name for my disease, and then left me alone in the room with the book. I was very upset when I read what it was. As far as I know It’s still on my medical history Avoid the hospitals in Nova Scotia, they might kill you.
Creutzfeldt-Jakob Disease (CJD) is a degenerative and fatal brain disorder caused by PRIONS, which are misfolded proteins. The global incidence of CJD is estimated to be about 1 case per 1 million people per year globally. However, this can vary by country and population. Types of CJD: Sporadic CJD: This is the most common form, accounting for about 85-90% of cases. It typically affects people in their 60s and occurs without any known cause or family history. Genetic (Familial) CJD: This form is inherited and accounts for about 5-10% of cases. It often presents earlier in life. Iatrogenic CJD: This occurs as a result of medical procedures, such as the use of contaminated surgical instruments or tissue transplants. This form is extremely rare. Variant CJD (vCJD): Associated with consumption of contaminated beef products, this type is much rarer and has been linked to the BSE (bovine spongiform encephalopathy) outbreak. It is much less common than sporadic CJD.
This poor man. I cannot imagine the terror and helplessness he felt going through this and knowing things will only get worse from there. I hope he is happy in Heaven now.
This hurts my heart, Prions are truly mysterious things. I wish we knew more about them since only way to kill Prions are to burn them above human limit plus they're unfortunately a guaranteed death because nothing can stop them these take years to kill and you go through last years with alot of pain, may he rest in peace.
My grandfather died because of this.... He was a prison guard... He was the only case of creutzfeldt jakob in Canada at this Time but i dont believe it.
@@adrianabeltran7409 cómo está tu mamá, a mi abuelita le diagnosticaron esto hace dos semanas aun hablaba y caminaba , ahora esta en cama ciega, sin mover piernas ni brazos, y no puede hablar, nos duele más verla sufrir que saber que fallecerá
Rest in peace to the man. I do enjoy, however, that he seems to have genuinely wanted to be recorded, and to let people understand what this looks like, rather than it be against his wishes!
Truly fascinating.. Hearing about it is one thing, but seeing it is something else. You can see body losing control after activating certain neurons and using precision. Thank you Sir, for being open to make footage before your death. We may be better one day because of it.
Click ja.ma/3djszUx to read "Creutzfeldt-Jakob Disease as a Novel Cause of Wing-Beating Tremor" in JAMA Neurology.
CJD is always terminal, correct? Spongeform encephalitis. A fried passed away from this disease. Very young, too. 43 years old.
In which country was this video recorded?
@@patrickbilancione1201 Sorry for your loss. But yes, it is always fatal, along with other Prion diseases. Unfortunately as well scientists still don't know much about the diseases. Prions diseases can be inherited as well as transmitted.
This man allowed himself to be filmed in an incredibly vulnerable state for the betterment of medicine. He's stronger than I'll ever be.
Kreuzfeld-Jakob Disease is sadly a death sentence…
prions are horrible. no permanent cure is known for any prion caused diseases
@@finnm.2582yes, you cannot survive this unless you don't need a brain to live. Poor guy
This man is doing something great. Imagine how many students are learning because of him. I feel sorry for him, but without such heroes, how do you expect medicine to improve and students to become great doctors?❤
@@finnm.2582 true 😥😥
It’s tough to watch, but we should also offer him our gratitude, and not just sympathies. Creuzfeldt-Jakob is rare but inevitably fatal. These videos with different medical signs are not easy watching, even for med students, but important. The only way we will be able to treat or cure this illness is through study and he volunteered to assist with that, in a very public and vulnerable way, for the benefit of medicine and mankind. That’s a courageous, kind, amazing thing to do for your fellow human beings. It’s heroic and should be honored. I celebrate him for that.
i feel so bad :( he looked so scared and embarrassed that these things were happening to him and he couldn’t control it :( the worst part was when he took his other arm to stop it 😢 poor guy :C
i know right 😢
The worst is that he won't survive. This disease has no treatment. :(
@@paulloeduard At least he’ll be at peace
and the fact that he answered so quickly and with that tone of sadness in his voice at this point in the video 0:52
Prions are highly resistance to high temperature such as 134 temperature won't destroy them or even disinfectant cannot destroy them@@paulloeduard
i cant imagine the helplessness the patients of this disease feel when they are informed that there is no cure and that they are bound to die in a relatively short amount of time
Thank you for posting this video. While my dad was sick with this horrible disease I made it my effort to inform whom I can host this horrific disease
Thankful for this, after watching this we figured out that my mom has it too . Mom passed away because of this 3 weeks ago. It was horrible watching her dealing with this disease for whole family. May God be with everybody dealing with this thing.❤️
same with me, mum passed on the 10th of December
How long your mother survived aftr diagnosed this, my father also diagnosed cjd
rip
3 months with my mum after diagnosis, very sad
That must be terrifying to see these movements from your own body that you don't mean to do, I feel so bad for this guy
U have no idea. It's worse to witness than u can imagine.
Right now, my grandmother has this. She has always been sweet and kind but now she can’t even remember me and others. I am crying right now because the doctor said she only has a few months to live. Maybe you guys can help pray for my grandmother
My father is also experiencing same symptoms. It is very sad and he is only 58.☹️
its been a year..
I can *feel* his frustration when he tries to do things but can’t. How is this not being talked about!? It hurts so *damn* much.
May this man find eternal peace. He is truly amazing for allowing himself to be filmed like this.
Just because of some proteins deciding to fold a slightly different way. Truly horrifying pathogen and disease, rest in peace my dude
Show some respect. He isn't your damn "dude" bro
@@somnuswaltz5586 at least he's saying rest in peace? he could be saying "haha look at that dumb tremor" like a moron but at least he paid some respects
Prion disease. Devastating mutation of Prion protein. Incredible how this kind of thing is possible.
@@patrickbilancione1201
Incredibly terrifying.. CWD is also a prion, seems to affect Moose and Deer, primarily.
@@somnuswaltz5586 saying "dude" does not show any lack of respect, it's just a bit more informal at best. You on the other hand, governing what people should say, is the one showing no respect
my momma was diagnosed with this, back in October. It took her life just a month later, in November. To see the night and day change from a normal adult to someone who needed 24/7 care... it's an unbearably excruciating experience to watch someone who you hold so close to your heart be ripped away by such a scary disease. I pray that one day we can prevent this kind of disease so that families and individuals don't go through what mine, and so many others, have.
A friend of mine died from this disease. I'd NEVER heard of this before and it's DEVASTATING 💔 My sincerest prayers to ANYONE affected by this terrible condition 🙏🏾
i appreciate him allowing this to be filmed.
Very informative. thank you to this brave patient
Poor guy.
was studying this topic and this video really helped understanding the disease better but had to hold back my tears. there are times when it hits you really hard that people are so much more than their illnesses ...having a family and a complex life just like the rest of us. may his soul rest in peace
My mother nursed a couple of individuals with this disease back in her nursing days (late 70s/early 80s). Thankfully today we can make those who are succumbing to it a lot more comfortable.
It's sad seeing him have to grab his arm in order to stop the tremor. But at least he was able to stop it.
God bless this man and his medical staff. I hope he was comfortable his last stretch of life. Praying we see a cure for this awful disease in the future.
my mom experience it now, in the phase of can not response anything but the myoclonus... we do the best we can to be with her, knowing that no cure or treatment can be done with the disease... my thoughts and prays to anyone and families with this disease...
My Dad too, he is suffering in hospital without any physical response. There is nothing to do except waiting for him to fly to the heaven.
CJD is a horrible disease, my mother passed away from it. May this man rest in peace, too
We should all thank him for having such courage to get filmed and teach us about his disease and its symptoms. You’re amazing ❤
Wow this is genuinely one of the hardest things I’ve ever had to watch man this man rest in peace, no one deserves that. Its even more heartbreaking reading the comments I’m sorry for all your losses we need a cure for these types of diseases soon. We need to better our entire society and use our resources on that before anything else.
:( Sending love to him and his loved ones. Broke my heart to see this. I hope a cure will be found soon
Thank you, sir; gracias Señor. Your willingness to demonstrate the movements of this disease is helping to educate and provide others with answers across the globe. Que Dios te bendiga a ti y a tu familia.
Imagine how awful it must feel after finding out that you’ve got a prion disease like CJD :(
I am sorry. Man so sweet. I hope he did or does not suffer badly by this terrible affliction. Love to people everywhere.
My mom died of CJD and I know how painful it's for the family.... As it's a fatal disease.
My condolences a very upsetting disease.
@@scollinsxo2843 🙏
@@sangeeta4645 which version of the cjd??
@@wistolla Sporadic
I’m sorry for your loss
CJD-
*chromosome 20
*PRPc (prion related protien)
*PRPsc (somatic mutation)
*Spongiform encephalopathy
VARIENT CJD-
*Consumption infected beef
#MAD COW DISEASE
#BOVIN ENCEPHALOPATHY
*EEG -Biphasic and triphasic wave
*CSF - 14-3-3 protien
*MRI- cortical ribboning 🎀.
No Treatment yet(only supportive care)
What an amazing selfless act to show the symptoms. god bless
Thank you for sharing this
It is very helpful for medical students
Watch the symptoms with your eyes and you'll never forget it..
respect for the patient
My grandmother died of CJD in 1984. It really messed my mom up watching it. To the point that she had to stop visiting her because she didn’t know who she was anymore. The blood banks won’t take my blood because of her death. I’ve researched it and it’s pretty scary how little they actually know about who gets it and why.
I thought that Parkinson was an horrible disease. Now, I learn about this disease and ffi, I am truly speechless, how the brain, human nature can do these things to us. So sad.
Poor grandpa.. Hope it will be cured completely one day
Could only bear watching to the wingbeat and had to stop. The man's a chad for allowing this, rip.
All thanks to you Sir, for allowing yourself to be vulnerable for the sake of awareness and medicine advancement. You're a hero.
mi abuela falleció por esta terrible enfermedad. Que terrible fue verla deteriorarse tan rápido que ni tiempo me dio para despedirme. Espero que se encuentre alguna cura o tratamiento efectivo que pueda curar a todas las personas que sufren de esta enfermedad.
Had to cry, this desease is just painfull and iam so sorry for people to have it.
Devastating to see this type of vulnerability to such a horrendous disease on this man.
I appreciate it, how regardless of it you didn´t mind being recorded and you did well.
thanks for everything.
Hope nobody gets this desease & may the souls of the loved ones rest in peace.
Hope they'll find a cure for this desease.
Wish him a speedy and full recovery. 🙏 🙏
the disease is 100% fatal. no medicine or immune response will treat the disease. he is most likely dead now. may he rest in peace 🕊️
Recovery? Man, do some research about prions and the diseases they cause
This illness is so sad....it progresses so fast and there's no treatment. 🥺
Bless this poor man, I hope he is at peace now.
Thank you Sir. You are our teacher. Much rescpect for you ❤
Just found out my uncle who i love like a dad has this.
Update?
@@osk-wg2disadly he died within 3 months. I still remain numb by it & how aggressive this disease is. Thank you for asking. 💕
@@shellbacksclubAfter showing symptoms just lived three months? 😢, this disease is so dangerous omg
Thank you. My mother-in-law was just diagnosed with CJD. She's debilitating way too fast. I can't believe that she was here with our family, happy and strong, not so long ago. We're flying out in few days to see her and honestly don't know what to expect.
Hope you're doing ok. And yes, unfortunately once the symptoms start it can progress faster. Before the symptoms start it remains dormant in your system for years and sometimes, when inherited, only appears around the age of 60, possibly even less. Wish you all the best.
i’m so sorry
So sorry for your situation. I lost my sweet sister to this terrible disease and yes the speed of debilitation is shocking. What you will see how it affects a person will haunt you but be strong for your mother-in-law for the time she has remaining and give her every bit of love you have in you for your and her heart's sake. I still grieve deeply for my recent loss but know that "God" holds my sister in his arms as he will do so for your loved one as well. I will say a prayer for your mother-in-law and for you as well. You are not " alone". Please take care.
This man is doing something great. Imagine how many students are learning because of him. I feel sorry for him, but without such heroes, how do you expect medicine to improve and students to become great doctors?❤
Fr 💔 this is a horrible disease and I'm grateful to this man for his effort to help us understand it...
Prions are absolutely horrifying. May this man rest in peace.
I hope this man’s in a better place he looked like a great guy, what a shame we couldn’t save him
Rest in Peace 🕊
Why does youtube put a COVID notification on this video? Is it related?
Al caballero del video decirle que es todo un ejemplo de valentía y coraje por dejarse grabar en esta situacion de vulnerabilidad. Gracias por compartir y que la cura no se haga tardar ❤
Very sad. You have my prayers🙏❤
When you can't touch your nose with a finger, you know something's wrong. This story got me.
Thank you kind Sir, for helping educate humanity on this unfair disease. My condolences to you, i hope youve found peace now ❤
Man. Rest in peace
My sister appears to have this. Technically no diagnosis from doctors yet until see movement specialist next month. She deteriorating by the weeks noticably. All the symptoms fit this disease. She's almost bedridden now, dementia and almost can't talk or hardly eat. Pray for her.😢
Eu moro no Brasil. Minha tia também está com essa doença. Vários diagnósticos inconclusivos, mas finalmente foi diagnosticado. Pouco se sabem dessa doença no mundo.
Any update of her situation? 😢
All the best for this man.
this is heartbreaking.
Thank u sir! Rest in peace
He looks so afraid. God be with this man.
this is one of the diseases I’m most terrified of. rest in peace to the patient in the video- as he has most likely passed.
I appreciate patients efforts
The fact this is invariably fatal puts this in a frightening and sad perspective.
Like ALS, Alzheimer diasease
My father had Parkinson's dementia along with lewy bodies . I remember his involuntary movement . Sometimes grinding the tip of his Cane into the carpet for hrs wearing holes etc . RIP Dad .
Well this is heartbreaking.
Poor man. May he rest in peace.
I was hesitant to watch because I know it would be upsetting to watch. And that's exactly why I had to watch. I don't know how I would even handle fhe situation at all. This is real shit that happens to real people and it's heartbreaking. I wish the medical field good luck in making advanced and gaining more knowledge how to address it
This poor man, what a horrifying disease this is.
oh my god i feel so bad for him. may he rest in peace
The hospital in my city put this on my medical history
And when I saw it on the computer screen and asked what creutzfeldt jacobs was she said it was another name for the disease I had just been diagnosed with (Charcot Marie tooth)
I made her get a medical encyclopedia and check
She pretended to read, said it was another name for my disease, and then left me alone in the room with the book. I was very upset when I read what it was. As far as I know It’s still on my medical history
Avoid the hospitals in Nova Scotia, they might kill you.
he look like he is a fighter
Creutzfeldt-Jakob Disease (CJD) is a degenerative and fatal brain disorder caused by PRIONS, which are misfolded proteins. The global incidence of CJD is estimated to be about 1 case per 1 million people per year globally. However, this can vary by country and population.
Types of CJD:
Sporadic CJD: This is the most common form, accounting for about 85-90% of cases. It typically affects people in their 60s and occurs without any known cause or family history.
Genetic (Familial) CJD: This form is inherited and accounts for about 5-10% of cases. It often presents earlier in life.
Iatrogenic CJD: This occurs as a result of medical procedures, such as the use of contaminated surgical instruments or tissue transplants. This form is extremely rare.
Variant CJD (vCJD): Associated with consumption of contaminated beef products, this type is much rarer and has been linked to the BSE (bovine spongiform encephalopathy) outbreak. It is much less common than sporadic CJD.
Great to see Google identifying credible health information like NSF and other health content like this within TH-cam!!
Respect for this gentleman.👍👍
This poor man. I cannot imagine the terror and helplessness he felt going through this and knowing things will only get worse from there. I hope he is happy in Heaven now.
Poor man.. I can just pray and hope than future scientist & medical advancement can someday find solution to this terminal desease.
hello..i m from india...my aunt suffering from cjd...she is unable to see,hear m speak due to this
We need to figure out how to make the immune system attack prions
This hurts my heart, Prions are truly mysterious things. I wish we knew more about them since only way to kill Prions are to burn them above human limit plus they're unfortunately a guaranteed death because nothing can stop them these take years to kill and you go through last years with alot of pain, may he rest in peace.
My grandfather died because of this.... He was a prison guard... He was the only case of creutzfeldt jakob in Canada at this Time but i dont believe it.
Was it variant?
Variant ? I only know that it was not hereditary.
Es degeneracion de hemisfero derecho? 😢💔❤️🩹❤
Que dura y terrible es esta enfermedad, mi padre murió hace 6 años de esta enfermedad y es durísima, tanto para él como para la familia
Mi madre lo tiene ya no camina, y es angustiante pensar si una lo tiene tbn, es desgastante ver a tu apagarse dia a dia
@@adrianabeltran7409 cómo está tu mamá, a mi abuelita le diagnosticaron esto hace dos semanas aun hablaba y caminaba , ahora esta en cama ciega, sin mover piernas ni brazos, y no puede hablar, nos duele más verla sufrir que saber que fallecerá
@@abigailabigail9459Cuánto tiempo vivió luego de ser diagnosticada con la enfermedad?
Heartbreaking. I pray blessings on you and your family. I know you are probably gone now. Peace to you
Worst thing is I heard it's painful.
Yes... my grandpa was diagnosed with CJD and he was in a lot of pain. Very heartbreaking.
@@ShayHorseLover I'm so sorry for your grandpa.
poor man. i hope he comes to peace in some way.
Rest in peace to the man.
I do enjoy, however, that he seems to have genuinely wanted to be recorded, and to let people understand what this looks like, rather than it be against his wishes!
Prions, Rabies, Cancers, etc. These gotta be the worst case.
May he rest in peace. Such a cruel oversight to let this horrible disease take place.
MUCHAS GRACIAS!!!! fue muy útil. Se entiende mucho mejor que una clase sin más, de verdad.
That is so sad. Let him rest in peace god. how do this gets spread?
:( He is so strong.
poor guy looks so scared.
Truly fascinating.. Hearing about it is one thing, but seeing it is something else.
You can see body losing control after activating certain neurons and using precision.
Thank you Sir, for being open to make footage before your death. We may be better one day because of it.
I am in 11th and when I study about jakob disease... I am confused how it look like and finally I understand what happens thanks for sharing this...
Respect for him❤
Is it the problem in left cerebellum? Bcs his problem seem like in left extremity. I am trying to understand.
This disease slowly takes over your brain
So this man's left cerebellum has already been infected and he doesn't have much time to live
Who is here after Canada cases?