Zaburzenia czynności tarczycy i występowanie przeciwciał przeciwtarczycowych w dużej polskiej populacji losowo wybranych osób w podeszłym wieku - wyniki wieloośrodkowego przekrojowego badania “PolSenior”

Introduction: Data on the thyroid function of a randomly chosen elderly population was collected during a multicentre study performed in Poland (PolSenior) in 2007-2010. Material and methods: The population of 4,190 participants under study was divided into six age subgroups of > 65 to > 90 years of age and a younger group aged between 55 and 59 years. Assessment of thyroid function was based on hormonal measurements. Results: Concentrations of both TSH and fT4 were significantly higher in females than in males. No differences in TSH and fT4 concentrations between different age groups were found. Thyroid dysfunction was revealed in more than10% of participants, hypothyroidism in 7.95%, and hyperthyroidism in 2.95%. Both types of dysfunction were more prevalent in women, and in more than 80% both dysfunctions were subclinical. In 1,542 participants, concentrations of TPOAb were measured. Increased TPOAb was revealed in 19% of the cohort and the prevalence of thyroid autoimmunity was higher in women and also more often found in participants with hypothyroidism. Conclusions: Cross sectional survey revealed thyroid dysfunctions in over 10% of non selected elderly population. No age related differences were found in TSH concentrations, TPOAb positivity and prevalence of thyroid dysfunctions. (Endokrynol Pol 2012; 63 (5): 346-355)Wstęp: Podczas wieloośrodkowego badania przeprowadzonego Polsce w latach 2007-2010 (PolSenior) zgromadzono dane dotyczące czynności tarczycy w wybranej losowo populacji w podeszłym wieku. Materiał i metody: Grupa badana licząca 4190 uczestników została podzielona na sześć podgrup w wieku od > 65 lat do > 90 i jedną podgrupę młodszych uczestników między 55. a 59. rokiem życia. Czynność tarczyc określano na podstawie wyników oznaczeń hormonalnych. Wyniki: Stężenia TSH i fT4 były znamiennie wyższe u kobiet niż u mężczyzn. Nie wykazano różnic w stężeniach obydwu tych hormonów między grupami wiekowymi. Zaburzenia czynności tarczycy stwierdzono u ponad 10% badanych, niedoczynność u 7, 95%, a nadczynność - u 2,95%. Obydwa typy dysfunkcji były częstsze u kobiet. W ponad 80% zaburzenia czynności tarczyc miały charakter utajony. U 1542 uczestników oznaczono stężenia TPOAb. Podwyższone wartości - marker autoimmunologicznej choroby tarczycy stwierdzono u 19% tej populacji. Podwyższone TPOAb stwierdzano częściej u kobiet niż u mężczyzn, najczęściej w grupie osób z hipotyreozą. Wnioski: Zaburzenia czynności tarczycy stwierdzono u 10% losowo wybranych osób w podeszłym wieku. Nie stwierdzono zależnych od wieku różnic w stężeniach TSH ani w częstości występowania przeciwciał TPOAb i dysfunkcji tarczycy. (Endokrynol Pol 2012; 63 (5): 346-355

First Direct Evidence of Chalcolithic Footwear from the Near Eastern Highlands

In 2008, a well preserved and complete shoe was recovered at the base of a Chalcolithic pit in the cave of Areni-1, Armenia. Here, we discuss the chronology of this find, its archaeological context and its relevance to the study of the evolution of footwear. Two leather samples and one grass sample from the shoe were dated at the Oxford Radiocarbon Accelerator Unit (ORAU). A third leather sample was dated at the University of California-Irvine Accelerator Mass Spectrometry Facility (UCIAMS). The R_Combine function for the three leather samples provides a date range of 3627–3377 Cal BC (95.4% confidence interval) and the calibrated range for the straw is contemporaneous (3627–3377 Cal BC). The shoe was stuffed with loose, unfastened grass (Poaceae) without clear orientation which was more than likely used to maintain the shape of the shoe and/or prepare it for storage. The shoe is 24.5 cm long (European size 37), 7.6 to 10 cm wide, and was made from a single piece of leather that wrapped around the foot. It was worn and shaped to the wearer's right foot, particularly around the heel and hallux where the highest pressure is exerted in normal gait. The Chalcolithic shoe provides solid evidence for the use of footwear among Old World populations at least since the Chalcolithic. Other 4th millennium discoveries of shoes (Italian and Swiss Alps), and sandals (Southern Israel) indicate that more than one type of footwear existed during the 4th millennium BC, and that we should expect to discover more regional variations in the manufacturing and style of shoes where preservation conditions permit

The reference values of sex hormones and SHBG serum levels in subjects over 65 years old — The PolSenior Study

Wstęp: W ostatniej dekadzie wzrasta przewidywana długość życia społeczeństw. W Polsce brak danych o stężeniach hormonów płciowych (SH) u starzejących się osób. Celem naszej pracy było przedstawienie wartości referencyjnych SH w grupie osób uczestniczących w badaniu PolSenior w zależności od płci, wieku i czynników ryzyka chorób układu sercowo-naczyniowego (CVDRFs). Materiał i metody: Badania wykonano u 4352 osób (2168 mężczyzn i 2088 kobiet) w wieku od 55. do powyżej 90. roku życia, podzielonych na 5-letnie przedziały wieku. Osoby na przedpolu starości (wiek 55–59 lat) stanowiły grupę referencyjną. Oznaczano testosteron całkowity (TT), estradiol całkowity (TE2) i DHEAS metodami RIA, FSH i SHBG metodą IRMA wyliczono wskaźniki wolnych androgenów (FAI) i estrogenów (FEI). Odsetek tłuszczu ciała (%BF) oznaczano metodą bioimpedancji. CVDRFs analizowano w odniesieniu do wartości ciśnienia tętniczego oraz biochemicznych (stężenie glukozy, HDL i triglicerydów) i antropometrycznych (obwód talii) składowych zespołu metabolicznego. Wyniki: Prawie 20% mężczyzn miało stężenia TT poniżej normy, 78,2% w zakresie norm a 1,8% powyżej górnego zakresu normy. Stężenia TE2 poniżej normy dla kobiet po menopauzie miało 94,6% kobiet. Wiek i liczba CVDRFs istotnie zmieniały stężenia SH za wyjątkiem TE2 u mężczyzn i FSH i TT u kobiet. BMI i %BF istotnie wpływało na większość oznaczanych hormonów niezależnie od wieku. Wnioski: Przedstawiono wartości referencyjne dla stężeń SH u mężczyzn i kobiet od 65. do powyżej 90. roku życia. Nasze badania sugerują, że wartości referencyjne przedstawione w 5. letnich przedziałach wieku wydają się bardziej precyzyjne niż dla całej populacji powyżej 60. roku życia. Ich przydatność kliniczna zwiększa się, jeśli uwzględni się liczbę CVDRFs oraz BMI i %BF. (Endokrynol Pol 2013; 64 (2): 82–93)Introduction: Over the last decade, average life expectancy has continuously increased. There has been no data on normal sex hormone (SH) levels in a Polish elderly population. In this study, we assessed SH in the PolSenior cohort to determine normal reference ranges in relation to gender, age, and cardiovascular disease risk factors (CVDRFs). Material and methods: The study was performed with 4,352 participants (2,168 men and 2,088 women), aged from 55 to over 90 years, stratified in five-year age groups. Pre-elderly subjects (55–59 years of age) served as the reference group. We assessed total testosterone (TT), estradiol (TE2) and DHEA-S (by RIA) SHBG and FSH (by IRMA) and calculated free androgen and free estrogen indices (FAI and FEI). Percentage body fat (%BF) was measured by bioelectric impedance analysis. The CVDRFs assessment included blood pressure and biochemical (blood glucose, high-density lipoproteins, triglycerides) and anthropometric (waist circumference) components of the metabolic syndrome. Results: TT was low in 19.9%, normal in 78.2%, and high in 1.8% of men. TE2 was low in 94.6% of women. Age and CVDRFs significantly influenced values of SHBG, FSH, TT, FAI, FEI, and DHEA-S in men, while in women values of FSH, TT and TE2 did not change. BMI and %BF affected SH regardless of the age groups and CVDRFs. Conclusions: Our findings suggest that the reference ranges stratified by the five-year age bands seem more accurate than those given for the overall population over 60 years of age. The clinical relevance of these reference ranges increases when they are considered in relation to CVDRFs, BMI and %BF. (Endokrynol Pol 2013; 64 (2): 82–93

Contaminations of soil and two Capsicum annuum generations irrigated by reused urban wastewater treated by different reed beds

Background: In order to save potable water, this study aims to evaluate the contamination of soil and Capsicum annuum L. (chilli) watered with urban wastewater (sewage) pre-treated by various wetland systems. Methods: The appropriateness of wetland outflow for irrigation when applying reused wastewater with high contamination of minerals and pathogens was assessed. The impact of wastewaters pre-treated by various wetlands on soil and harvest was tested in terms of mineral and biological contamination risk. Results: The wetlands met the standards for irrigation water for most water quality variables. However, the thresholds for key water quality parameters were significantly (p < 0.05) exceeded. The highest values for total coliforms, ammonium-nitrogen, phosphorus and potassium were 157,072 CFU/100 mL, 8.5 mg/L, 5.0 mg/L, and 7.0 mg/L, respectively. The harvest was moderately polluted only by zinc according to vegetable quality standards (threshold of 50 mg/kg). Zinc concentrations for Filters 2, 4, 6, 7 and 8 were 35.8, 60.6, 65.1, 65.5 and 53.2 mg/kg, respectively. No bacterial contamination was detected. Conclusions: Treatment of domestic wastewater applying constructed wetlands and subsequent recycling of the treated wastewater for irrigation of crops is a good substitute to the traditional application of drinking water for irrigation purposes

Immunization programs to support primary health care and achieve universal health coverage

Gains in immunization coverage and delivery of primary health care service have stagnated in recent years. Remaining gaps in service coverage reflect multiple underlying reasons that may be amenable to improved health system design. Immunization systems and other primary health care services can be mutually supportive, for improved service delivery and for strengthening of Universal Health Coverage. Improvements require that dynamic and multi-faceted barriers and risks be addressed. These include workforce availability, quality data systems and use, leadership and management that is innovative, flexible, data driven and responsive to local needs. Concurrently, improvements in procurement, supply chain, logistics and delivery systems, and integrated monitoring of vaccine coverage and epidemiological disease surveillance with laboratory systems, and vaccine safety will be needed to support community engagement and drive prioritized actions and communication. Finally, political will and sustained resource commitment with transparent accountability mechanisms are required. The experience of the impact of COVID-19 pandemic on essential PHC services and the challenges of vaccine roll-out affords an opportunity to apply lessons learned in order to enhance vaccine services integrated with strong primary health care services and universal health coverage across the life course

Direct tactile stimulation of dorsal occipito-temporal cortex in a visual agnosic

The human occipito-temporal cortex is preferentially activated by images of objects as opposed to scrambled images [1]. Touching objects (versus textures) also activates this region [2–10]. We used neuropsychological fMRI to probe whether dorsal regions of the lateral occipital cortex (LO) are activated in tactile recognition without mediation through visual recognition. We tested a patient (HJA) with visual agnosia due to bilateral lesions of the ventral occipito-temporal cortex but spared dorsal LO. HJA's recognition of visual objects was impaired [11, 12]. Nevertheless, his tactile recognition was preserved. We measured brain activity while participants viewed and touched objects and textures. There was overlapping activity in regions including LO and cerebellum for both stimuli for control participants, including new regions not before considered bimodal. For HJA, there were overlapping regions in the intact dorsal LO. Within a subset of the regions found in control participants, HJA showed activity only for tactile objects, suggesting that these regions are specifically involved in successful multimodal recognition. Activation of dorsal LO by tactile input is not secondary to visual recognition but can operate directly through tactile input