Systematic Review and Meta-Analysis of Randomized Clinical Trials in the Treatment of Human Brucellosis

BACKGROUND: Brucellosis is a persistent health problem in many developing countries throughout the world, and the search for simple and effective treatment continues to be of great importance. METHODS AND FINDINGS: A search was conducted in MEDLINE and in the Cochrane Central Register of Controlled Trials (CENTRAL). Clinical trials published from 1985 to present that assess different antimicrobial regimens in cases of documented acute uncomplicated human brucellosis were included. The primary outcomes were relapse, therapeutic failure, combined variable of relapse and therapeutic failure, and adverse effect rates. A meta-analysis with a fixed effect model was performed and odds ratio with 95% confidence intervals were calculated. A random effect model was used when significant heterogeneity between studies was verified. Comparison of combined doxycycline and rifampicin with a combination of doxycycline and streptomycin favors the latter regimen (OR = 3.17; CI95% = 2.05-4.91). There were no significant differences between combined doxycycline-streptomycin and combined doxycycline-gentamicin (OR = 1.89; CI95% = 0.81-4.39). Treatment with rifampicin and quinolones was similar to combined doxycycline-rifampicin (OR = 1.23; CI95% = 0.63-2.40). Only one study assessed triple therapy with aminoglycoside-doxycycline-rifampicin and only included patients with uncomplicated brucellosis. Thus this approach cannot be considered the therapy of choice until further studies have been performed. Combined doxycycline/co-trimoxazole or doxycycline monotherapy could represent a cost-effective alternative in certain patient groups, and further studies are needed in the future. CONCLUSIONS: Although the preferred treatment in uncomplicated human brucellosis is doxycycline-aminoglycoside combination, other treatments based on oral regimens or monotherapy should not be rejected until they are better studied. Triple therapy should not be considered the current treatment of choice

Validity and reliability of the Turkish Occupational Balance Questionnaire (OBQ11-T)

Background: Occupational balance (OB) is an important concept in occupational therapy and is considered as an essential component of health and well-being. Aim: The aim of this study was to investigate the validity and reliability of the Turkish version of the Occupational Balance Questionnaire-11 (OBQ11-T). Materials and methods: The OBQ11-T was administered to 116 individuals for construct validity analysis and to 58 individuals for reliability analysis. Validity was determined using explanatory and confirmatory factor analysis. In confirmatory factor analysis, RMSEA (root mean square error of approximation) value, comparative fit index (CFI), and Chi-square to degrees of freedom ratio (CMIN/DF) were analysed. The test–retest method and Cronbach’s alpha coefficient were used to assess the reliability and internal consistency of the OBQ11-T, respectively. Results: The model fit the data according to the indices of relative fit (RMSEA = 0.076, CMIN/DF = 1.661, and CFI = 0.875). The correlation coefficient between test and retest OBQ11-T total scores was 0.922. Total scores showed a significant statistical relationship (p < 0.01), indicating good reliability. Cronbach’s alpha for OBQ11-T total score was 0.785, indicating acceptable internal consistency. Conclusions and significance: The current study demonstrates that the OBQ11-T is a valid and reliable tool for measuring the self-rated OB of healthy individuals. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group

Validity and reliability of the Turkish Occupational Balance Questionnaire (OBQ11-T)

Background: Occupational balance (OB) is an important concept in occupational therapy and is considered as an essential component of health and well-being. Aim: The aim of this study was to investigate the validity and reliability of the Turkish version of the Occupational Balance Questionnaire-11 (OBQ11-T). Materials and methods: The OBQ11-T was administered to 116 individuals for construct validity analysis and to 58 individuals for reliability analysis. Validity was determined using explanatory and confirmatory factor analysis. In confirmatory factor analysis, RMSEA (root mean square error of approximation) value, comparative fit index (CFI), and Chi-square to degrees of freedom ratio (CMIN/DF) were analysed. The test–retest method and Cronbach’s alpha coefficient were used to assess the reliability and internal consistency of the OBQ11-T, respectively. Results: The model fit the data according to the indices of relative fit (RMSEA = 0.076, CMIN/DF = 1.661, and CFI = 0.875). The correlation coefficient between test and retest OBQ11-T total scores was 0.922. Total scores showed a significant statistical relationship (p 0.01), indicating good reliability. Cronbach’s alpha for OBQ11-T total score was 0.785, indicating acceptable internal consistency. Conclusions and significance: The current study demonstrates that the OBQ11-T is a valid and reliable tool for measuring the self-rated OB of healthy individuals. © 2019, © 2019 Informa UK Limited, trading as Taylor ; Francis Group

First-trimester thyroid hormone reference data in a Turkish pregnant women population living in middle Blacksea Region [Orta karadeni·iz bölgesi·inde yaşayan türk gebe kadin popülasyonunda bi·iri·inci·i tri·imester ti·iroi·id hormon referans degerleri·i]

Objective: No reference values for thyroid hormones have been established for Turkish pregnant women yet in the first trimester of pregnancy. The aim of the present study was to determine first trimester reference values for thyroid hormones in pregnant women living in middle Black Sea region of Turkey and getting service from our institution's laboratory. Material and Method: 1144 pregnant women admitted to Gaziosmanpaşa University Faculty of Medicine hospital between January 2005 and January 2009 for first trimester visit were enrolled retrospectively. Maternal thyroid hormones measured as a part of laboratory examination were analyzed. Results: Anti-TPO and anti-TG antibodies were measured in 250 of the total 1144 women. 166 of these had antibody levels within the normal ranges. The 2.5th and 97.5th percentiles of these 166 antibody negative women were as follows: for TSH (µIU/mL): 0.043-3.968, for fT4 (ng/dL): 0.840-1.638 and for fT3 (pg/mL): 2.059-4.386. The 2.5th and 97.5th percentiles of the remaining 894 antibody status unknown women were as follows: for TSH (µIU/mL): 0.059-4.196, for fT4 (ng/dL): 0.634-1.527 and for fT3 (pg/mL): 2.340-4.143.Conclusion: For diagnosis of thyroid abnormalities; population, laboratory and even method based reference values should be established. This is a preliminary data from Turkish pregnant women

Repair of aortic coarctation and aneurysm of ductus arteriosus in the presence of right-sided arch and descending aorta

PubMedID: 17803589Association of right aortic arch and coarctation of the aorta is rare. A patient with aortic coarctation was presented to our clinic. Detailed radiological work-up revealed aortic coarctation, aneurysm of ductus arteriosus, mirror image brachiocephalic vessels, right-sided arch, and right-sided descending aorta. The patient underwent successful operative repair through a right thoracotomy. She is normotensive and doing well two years postoperatively. © 2007 by Blackwell Futura Publishing, Inc

Role of first trimester total testosterone in prediction of subsequent gestational diabetes mellitus

PubMedID: 25256364Aim To assess the role of first trimester maternal testosterone and dehydroepiandrosterone sulfate (DHEA-S) levels in prediction of development of gestational diabetes mellitus (GDM). Methods Four hundred and fifty pregnant women were included in this prospective cohort study. All pregnant women with a singleton pregnancy who were not diabetic, had no family history of diabetes, had no history of previous GDM, were of white race and non-smokers were enrolled. Total testosterone and DHEA-S were measured at 11-14 weeks of gestation. The patients were called for routine pregnancy visits and followed accordingly. Forty-two patients did not come to their visits and were excluded. During gestational weeks 24-28, the remaining 408 patients were screened for GDM. The total testosterone and DHEA-S levels were compared between patients with and without GDM. Regression and receiver-operator curve analysis were performed. Results GDM developed in 22 women (5.7%). Compared with women without GDM, first trimester total testosterone levels were higher among women in whom GDM subsequently developed. The DHEA-S level did not differ. Age, total testosterone and body mass index were found to be independent predictors of GDM development. A total testosterone value of 0.45 ng/mL was found to predict development of GDM with a sensitivity of 63.6% and a specificity of 62.7%. Conclusion First trimester total testosterone has a low testing power for GDM screening with low sensitivity and specificity values and cannot be used as a marker alone. It may have a role in combination with other markers. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology

Immediate-type hypersensitivity reactions to proton pump inhibitors: usefulness of skin tests in the diagnosis and assessment of cross-reactivity

Background: Data are limited about the value of skin tests in the diagnosis of proton pump inhibitor (PPI)-induced hypersensitivity reactions and the cross-reactivity between PPIs. We aimed to assess the role of skin testing in the diagnosis of PPI-related immediate hypersensitivity reactions and the cross-reactivity patterns among PPIs