The effect of prolonged incubation and temperature on oocyte activator phospholipase C-zeta activity of sperm

Objective: Fertilization capacity of capacitated sperm decreases exponentially over time, but the reason is still under investigation. The aim of the study was to analyze the effect of prolonged incubation and temperature on sperm fertilization capacity with motility and staining parameters of phospholipase C-zeta (PLCZ), which is considered to be the oocyte activation factor. Materials and Methods: Density gradient washing was applied to semen of 11 infertile patients without severe oligoasthenospermia out of 16 patients. The samples were divided and cultured either at room temperature or at 37°C for 3 days. The spermatozoons were evaluated for motility, PLCZ staining and intensity daily. Results: All parameters decreased both at room and body temperature with increased incubation time. There was a strong correlation between the change in motility and in the percentage of PLCZ stained sperms, but this correlation decreased with incubation time. Conclusion: Prolonged incubation results show the correlation between PLCZ staining parameters and motility. Routine use of PLCZ staining together with semen analysis, will be useful to predict fertilization capacity of the sperm especially for unexplained infertility and fertilization failure cases, and also can increase the success of assisted reproductive technologies (ART) cycles

Reliability of cord formation in BACTEC 12B/13A media for presumptive identification of Mycobacterium tuberculosis complex in laboratories with a high prevalence of Mycobacterium tuberculosis

A total of 1208 positive BACTEC vials were examined for the presence or absence of serpentine cording. A very high (92.9%) rate of laboratory prevalence was obtained for Mycobacterium tuberculosis complex. The sensitivity. specificity, positive and negative predictive values of this test were 92.7%. 95.3%, 99.6% and 50.0%, respectively. It was concluded that testing cord formation in laboratories that have a high prevalence of Mycobacterium tuberculosis complex is an exceptionally reliable method for preliminary reporting of cording-positive cases; however, for cording-negative cases. preliminary reports based solely on cord formation Lire not reliable. It was also observed that the length of the incubation period has a significant effect on cord formation. Incubation periods of 4 days or less are not sufficient to determine noncording in smears prepared from positive BACTEC vials

Comparison of colistin-carbapenem, colistin-sulbactam, and colistin plus other antibacterial agents for the treatment of extremely drug-resistant Acinetobacter baumannii bloodstream infections

The purpose of this investigation was to compare the efficacy of colistin-based therapies in extremely drug-resistant Acinetobacter spp. bloodstream infections (XDR-ABSI). A retrospective study was conducted in 27 tertiary-care centers from January 2009 to August 2012. The primary end-point was 14-day survival, and the secondary end-points were clinical and microbiological outcomes. Thirty-six and 214 patients [102 (47.7 %): colistin-carbapenem (CC), 69 (32.2 %): colistin-sulbactam (CS), and 43 (20.1 %: tigecycline): colistin with other agent (CO)] received colistin monotherapy and colistin-based combinations, respectively. Rates of complete response/cure and 14-day survival were relatively higher, and microbiological eradication was significantly higher in the combination group. Also, the in-hospital mortality rate was significantly lower in the combination group. No significant difference was found in the clinical (p = 0.97) and microbiological (p = 0.92) outcomes and 14-day survival rates (p = 0.79) between the three combination groups. Neither the timing of initial effective treatment nor the presence of any concomitant infection was significant between the three groups (p > 0.05) and also for 14-day survival (p > 0.05). Higher Pitt bacteremia score (PBS), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Charlson comorbidity index (CCI), and prolonged hospital and intensive care unit (ICU) stay before XDR-ABSI were significant risk factors for 14-day mortality (p = 0.02, p = 0.0001, p = 0.0001, p = 0.02, and p = 0.01, respectively). In the multivariable analysis, PBS, age, and duration of ICU stay were independent risk factors for 14-day mortality (p < 0.0001, p < 0.0001, and p = 0.001, respectively). Colistin-based combination therapy resulted in significantly higher microbiological eradication rates, relatively higher cure and 14-day survival rates, and lower in-hospital mortality compared to colistin monotherapy. CC, CS, and CO combinations for XDR-ABSI did not reveal significant differences with respect to 14-day survival and clinical or microbiological outcome before and after propensity score matching (PSM). PBS, age, and length of ICU stay were independent risk factors for 14-day mortality

The importance of biostatistics and scientific research in evidence- based medicine

ÖZETKanıta Dayalı Tıp terimi 1990’ların başında ilk kez Guyatt ve arkadaşlarının çalışmasında yayınlanmıştır. Daha sonra ise Kanada Ontorio McMaster Üniversitesinden Sackett ve arkadaşları yeni bilgiye ulaşmak için klinik deneyim ve hastaya ait tercihlerin önemini vurgulamıştır.Kanıta Dayalı Tıp, sistematik araştırmalardan elde edilen klinik dışı kanıtların, klinik tecrübe, mesleksel deneyim ve olgunun özellikleri ile birleştirilmesi ve bunun tıp etiği çerçevesinde yapılmasıdır. Hekimlerin hastaların tedavi sürecinde en iyi kararı vermesi için kanıtların dikkatli, açık ve akıllıca kullanılması gerekir. Bireysel klinik deneyime dayanan karar verme yaklaşımının yaratmış olduğu değişkenlikler ve tutarsızlıklar ile sağlık alanında sürekli olarak yeni kanıtların ortaya çıkması ve büyüyen literatürü takip etmenin zorlaşması ile klinik uygulama ve tıbbi araştırmalar arasında kopukluğun artmasından dolayı Kanıta Dayalı Tıp yaklaşımı önemli hale gelmiştir. Kanıta dayalı tıp yaklaşımında en iyi kanıtı belirlemek epidemiyolojik ve biyoistatistiksel düşünme yollarını kullanmak anlamına gelir. Bununla birlikte elde edilen kanıtların geçerliliği ve güvenilirliği test edilir. Randomize kontrollü çalışmalar, sistematik derleme ve meta analizler en iyi araştırma kanıtlarıdır. Yine biyoistatistiksel yöntemlerden tanı testleri, çok değişkenli modeller ve uzunlamasına modeller ile en iyi tanı yöntemleri, ilgili araştırmadaki risk faktörleri ve yapılan müdahalelerin uzun dönem etkileri elde edilir.Sağlık alanında tanı ve tedavinin gelişmesi insan sağlığı açısından çok önemlidir. Bunun için yapılan çalışmalarda da bir biyoistatistik uzmanı ile çalışmak ve biyoistatistiksel yöntemlerin kullanılması hem çalışmanın geçerlilik ve güvenirliğini arttıracaktır hem de zaman açısından önemli kazançlar sağlayacaktır.Anahtar Kelimeler: Kanıta Dayalı Tıp, Biyoistatistik, Bilimsel Araştırma

A study on awareness and attitude of teachers on epilepsy in Istanbul

Epilepsy is a disease frequently seen among school children. Children having seizures may bother their teachers, who do not receive specific training about epilepsy during their education. Moreover, teachers feet desperate not knowing how to handle the situation. In a series of seminars it was our aim both to investigate and to improve the present awareness, knowledge, and attitude of elementary school teachers about epilepsy in Istanbul. In the pre- and post-seminar tests teachers who attended the seminar on a voluntary basis, were asked 29 questions. There were 346 male and female participants aged (mean +/- S.D.) 32.19 +/- 7.25. 69.3% of the participating teachers had either read or heard about epilepsy, while 71.9% had seen someone having a seizure and 59.4% knew someone with epilepsy. Although they had some prior misconceptions, like considering epilepsy a contagious (2.3%) or a psychological disease (17.8%), the teachers' knowledge and awareness improved after the seminar due to their special interest in the subject. Consequently, their negative attitude toward the participation of people with epilepsy in sports and social activities diminished post seminar. However, it should be noted that further education not only of teachers but also of family members is always required. (C) 2004 BEA Trading Ltd. Published by Elsevier Ltd. All rights reserved

Proximity to crops and residential exposure to agricultural herbicides in Iowa

Rural residents can be exposed to agricultural pesticides through the proximity of their homes to crop fields. Previously, we developed a method to create historical crop maps using a geographic information system. The aim of the present study was to determine whether crop maps are useful for Predicting levels of crop herbicides in carpet dust samples from residences. From homes of participants in a case-control study of non-Hodgkin lymphoma in Iowa (1998-2000), we collected vacuum cleaner dust and measured 14 herbicides with high use on corn and soybeans in Iowa. Of 112 homes, 58% of residences had crops within 500 m of their home, an intermediate distance for primary drift from aerial and ground applications. Detection rates for herbicides ranged from 0% for metribuzin and cyanazine to 95% for 2,4-dichlorophenoxyacetic acid. Six herbicides used almost exclusively in agriculture were detected in 28% of homes. Detections and concentrations were highest in homes with an active farmer. Increasing acreage of corn and soybean fields within 750 m of homes was associated with significantly elevated odds of detecting agricultural herbicides compared with homes with no crops within 750 m (adjusted odds ratio per 10 acres = 1.06; 95% confidence interval, 1.02-1.11). Herbicide concentrations also increased significantly with increasing acreage within 750 m. We evaluated the distance of crop fields from the home at < 100, 101-250, 251-500, and 501-750 m. Including the crop buffer distance parameters in the model did not significantly improve the fit compared with a model with total acres within 750 m. Our results indicate that crop maps may be a useful method for estimating levels of herbicides in homes from nearby crop fields

Screening athletes with Down syndrome for ocular disease

Background: Persons with Down syndrome are well known to have a high prevalence of vision and eye health problems, many of which are undetected or untreated primarily because of infrequent ocular examinations. Public screening programs, directed toward the pediatric population, have become more popular and commonly use letter or symbol charts. This study compares 2 vision screening methods, the Lea Symbol chart and a newly developed interactive computer program, the Vimetrics Central Vision Analyzer (CVA), in their ability to identify ocular disease in the Down syndrome population. Methods: Athletes with Down syndrome participating in the European Special Olympics underwent an ocular screening including history, auto-refraction, colour vision assessment, stereopsis assessment, motility assessment, pupil reactivity, and tonometry testing, as well as anterior segment and fundus examinations to evaluate for ocular disease. Visual acuity was tested with the Lea chart and CVA to evaluate these as screening tests for detecting ocular disease as well as significant, uncorrected refractive errors. Results: Among the 91 athletes that presented to the screening, 79 (158 eyes) were sufficiently cooperative for the examination to be completed. Mean age was 26 years ±10.8 SD. Significant, uncorrected refractive errors (≥1.00 spherical equivalent) were detected in 28 (18%) eyes and ocular pathology in 51 (32%) eyes. The Lea chart sensitivity and specificity were 43% and 74%, respectively, for detecting ocular pathology and 58% and 100% for detecting uncorrected refractive errors. The CVA sensitivity and specificity were 70% and 86% for detecting pathology and 71% and 100% for detecting uncorrected refractive errors. Conclusion: This study confirmed the findings of prior studies in identifying a significant presence of uncorrected refractive errors and ocular pathology in the Down syndrome population. Screening with the Lea symbol chart found borderline sufficient sensitivity and specificity for the test to be used for screening in this population. The better sensitivity and specificity of the CVA, if adjusted normative values are utilized, appear to make this test sufficient for testing Down syndrome children for identifying both refractive errors and ocular pathology. © 2010 American Optometric Association

An Alternative to ROC Analysis: LOWESS

Objective: Receiver operating characteristic (ROC) analysis is commonly preferred for the dichotomous classification of a continuous random variable in the process of determination of the optimum cut-off point. The optimum cut-off point can be detected using ROC curve, which is a graphic presentation of the relationship between sensitivity and specificity. In the circumstances where the optimum cut-off point cannot be determined properly using ROC curves, the importance of smoothing is emphasized. In this study, it is proposed to use as an alternative locally weighted scatterplot smoothing (LOWESS) instead of ROC curves with Kernel smoothing. Methods: In our study, determination of the accurate and clear cut-off point obtained using the curves belonging to ROC and LOWESS techniques was discussed by means of an application. Excessive fluid administration during lung resection is a risk for pulmonary injury. The significant risk factors for the presence of postoperative pulmonary complications are the infusion rate of intraoperative fluids, acute respiratory distress syndrome, acute lung injury, pneumonia, atelectasis, need for toilet bronchoscopy, prolonged air leak, and failure to expand were used in the application. Results: According to the ROC analysis, the cut-off point should have been between 5.5-6mL/kg/h, but according to the LOWESS method, it was determined to be 6.125mL/kg/h. Conclusion: For the dichotomous classification, to interpret curves and to determine cut-off points perfectly, LOWESS smoothing non parametric method is strongly recommended instead of the non-parametric ROC curve

Ta grade 3/high grade non-invasive bladder cancer: Should we perform a second TUR?

Purpose To evaluate the effect of second transurethral resection (TUR) on oncological outcomes, according to the presence or absence of detrusor muscle in the initial TUR of patients with pTa Grade 3/high grade (G3/HG) tumours, who received at least 1 year of maintenance Bacillus Calmette-Guerin (BCG) therapy. Patients and methods In this retrospective study, we evaluated the effect of second TUR on oncological outcomes of 93 patients with pTa G3/HG tumours, according to the presence or absence of muscle in the initial TUR. All patients received maintenance BCG therapy according to the SWOG protocol. Results Median follow-up was 36 months. If muscle is present in the initial TUR, a second TUR significantly increased median time to first recurrence, compared to those without a second TUR (77.6 vs 36.9 mos, P = .0086). If muscle is missing in the initial TUR, a second TUR significantly decreased recurrence rate (20% vs 66.7%, P = .002), increased median time to first recurrence (78.9 vs 42.7 mos, P = .0001) and median time to progression (22 vs 7 mos, P = .05), compared to those without a second TUR. Conclusion In patients with pTa G3/HG tumours, if the muscle is missing in the initial TUR, a second TUR should be performed in order to attain lower recurrence rates and longer median time to recurrence and progression. If the muscle is present in the initial TUR, a second TUR will only increase median time to first recurrence