Successful use of phlebotomy to treat severe secondary polycythemia due to chronic lung disease

Secondary polycythemia (SP) occurs as a result of increase erythropoietin levels most commonly as a result of tissue hypoxia. Symptoms such as erythromelalgia, pruritis, and bleeding, which are frequently seen in polycythemia vera (PV), do not commonly occur in SP. Phlebotomy is considered one of the mainstays of therapy for PV but is rarely used for treatment of SP due to concern about worsening tissue hypoxia. We present the case of a patient with severe SP due to chronic hypoxic lung disease who presented with erythromelalgia, pruritis, and bleeding and was treated successfully with therapeutic phlebotomy. This case illustrates the importance of considering the use of therapeutic phlebotomy in symptomatic patients with severe SP

Neurocysticercosis among patients with first time seizure in Northern Namibia

Introduction: Neurocysticercosis is a common cause of seizures in low resource countries. There is a paucity of data regarding the extent of this infection in Namibia. There are multiple causes of First-time seizure including electrolyte abnormalities, infections, trauma, drugs, alcohol and many times no apparent cause can be found. We sought to describe the burden of Neurocysticercosis among individuals with a first-time seizure in Namibia. Methods: We recruited 221 patients with a First-time seizure who presented to the Intermediate Hospital Oshakati between August 2012 and March 2014. Patients with seizures due to identifiable causes like trauma, electrolytes, intoxications and meningitis were excluded. Brain CT scans were done, blood serological testing of Neurocysticercosis antibodies, Physical examination and demographic variables were collected. Data was entered into Epidata version 3.1 and transferred to stata version for analysis. Results: Ninety-six (96) of the participants had evidence of Neurocysticercosis on Brain CT scan representing a prevalence of 51.41%. Consumption of pork and rearing of pigs in the homestead were significant factors associated with Neurocysticercosis in our study population with odds of 3.48(1.45-8.33) and 2.07(1.11-3.86) respectively.Serological testing for Cyticercosis IgG had a sensitivity of 65.93% and Specificity of 96.51%. The positive and negative predictive values were 95.2% and 72.81% respectively. Conclusion: Neurocysticercosis is a common cause of Index seizures in Northern Namibia, living in a rural area, rearing pigs in homesteads, eating pork and poor sanitary practices are the major risk factors for this illness.Pan African Medical Journal 2016; 2

Estimates of Toxoplasmosis Incidence Based on Healthcare Claims Data, Germany, 2011–2016

Toxoplasmosis is a zoonotic infection contracted through Toxoplasma gondii–contaminated food, soil, or water. Seroprevalence in Germany is high, but estimates of disease incidence are scarce. We investigated incidences for various toxoplasmosis manifestations using anonymized healthcare claims data from Germany for 2011–2016. Patients with a toxoplasmosis diagnosis during the annual observational period were considered incident. The estimated incidence was adjusted to the general population age/sex distribution. We estimated an annual average of 8,047 toxoplasmosis patients in Germany. The average incidence of non–pregnancy-associated toxoplasmosis patients was 9.6/100,000 population. The incidence was highest in 2011, at 10.6 (95% CI 9.4–12.6)/100,000 population, and lowest in 2016, at 8.0 (95% CI 7.0–9.4)/100,000 population. The average incidence of toxoplasmosis during pregnancy was 40.3/100,000 pregnancies. We demonstrate a substantial toxoplasmosis disease burden in Germany. Public health and food safety authorities should implement toxoplasmosis-specific prevention programs.Peer Reviewe

Incidence of type 1 and type 2 diabetes before and during the COVID-19 pandemic in Germany: Analysis of routine data from 2015 to 2021

Background: To date, there is no data available depicting the trend of the incidence of type 1 and type 2 diabetes across all age groups for the COVID-19 pandemic years in Germany. Methods: Based on anonymized routine data from nine million persons covered by statutory health insurance, newly diagnosed diabetes cases (ICD diagnosis E10.- to E14.-) in inpatient or (confirmed in two quarters) outpatient setting were estimated for 2015 to 2021, differentiating between type 1 and type 2 diabetes. The data were linked to the German Index of Socioeconomic Deprivation. The results are age-standardised (population as of 31 Dec. 2021). Results: Between 2015 and 2021, the incidence of type 1 diabetes increased from 9.5 to 11.6 per 100,000 persons (from 7,007 to 8,699 new cases per year). In contrast, the incidence of type 2 diabetes tended to decline between 2015 and 2019. It continued to drop initially in 2020 during the pandemic, and then rose to 740 per 100,000 persons in 2021 (556,318 new cases per year). The diabetes type-specific seasonal pattern of previous years has changed during the pandemic years. The incidence of both type 1 and type 2 diabetes was observed to be higher in regions of high socioeconomic deprivation as compared to regions characterised by low socioeconomic deprivation. Conclusions: The increase in the incidence of type 1 and type 2 diabetes in 2021 may possibly be related to the COVID-19 pandemic. The high incidence and the differences by regional socioeconomic deprivation indicate that there is a need for targeted prevention strategies

Evaluation of Yield and Physicochemical Quality of \u3cem\u3ePentadesma butyracea\u3c/em\u3e Butter Obtained by Different Traditional Extraction Methods in Ghana

Pentadesma butyracea seed butter or fat (PBSB) is a vegetable fat extracted from the seeds of the P. butyracea plant. The butter has potential use in the food, pharmaceutical, and cosmetic industries. The study investigated traditional PBSB processing methods in Ghana and evaluated their effects on yield, physicochemical parameters, and fatty acid composition. Four traditional extraction methods were identified and evaluated, and these methods are direct wet extraction of PBSB from a fresh mixture of the seed paste and water (DEW); wet extraction of PBSB from a 12-hour fermented mixture of the seed paste and water (FWO); direct wet extraction of PBSB from a fresh mixture of the seed paste, salt, and water (DES); and wet extraction of PBSB from a 12-hour fermented mixture of the seed paste, salt, and water (FSO). Results of physicochemical properties of the PBSB samples showed moisture content of 0.06-0.07%, free fatty acid of 1.38-2.43%, iodine value of 56.50-56.85 Wijs, peroxide value of 5.58-8.52 mEq/kg, relative density of 0.91, refractive index of 1.462-1.464, percent impurities of 0.015-0.017%, saponification value of 165.57-178.02 mg KOH/g, and percent unsaponifiable matter of 2.60-3.18%. The PBSB yield varied in the range of 21.68-26.97%, with the highest average butter yield observed for FWO. Seventeen fatty acids were characterized in the PBSB samples, and they included ten saturated fatty acids, five monounsaturated fatty acids, and two polyunsaturated fatty acids. Key fatty acids found in the PBSB samples were oleic acid (51.21-51.31%), stearic acid (43.22-43.33%), palmitic acid (2.91-3.07%), linoleic acid (0.49-0.51%), linolenic acid (0.12-0.20%), and arachidic acid (0.14-0.15%). PBSB samples produced by the various traditional extraction methods in Ghana recorded similar physicochemical characteristics as unrefined shea butter per the Regional Standard for Unrefined Shea Butter (CXS 325R-2017) as well as Cook Brand Margarine, a common commercial baking fat, and thus, their potential food application such as an alternative shortening/ingredient could be explored in a future study

Species delimitation using genomic data to resolve taxonomic uncertainties in a speciation continuum of pelagic seabirds

Speciation is a continuous and complex process shaped by the interaction of numerous evolutionary forces. Despite the continuous nature of the speciation process, the implementation of conservation policies relies on the delimitation of species and evolutionary significant units (ESUs). Puffinus shearwaters are globally distributed and threatened pelagic seabirds. Due to remarkable morphological status the group has been under intense taxonomic debate for the past three decades. Here, we use double digest Restriction-Site Associated DNA sequencing (ddRAD-Seq) to genotype species and subspecies of North Atlantic and Mediterranean Puffinus shearwaters across their entire geographical range. We assess the phylogenetic relationships and population structure among and within the group, evaluate species boundaries, and characterise the genomic landscape of divergence. We find that current taxonomies are not supported by genomic data and propose a more accurate taxonomy by integrating genomic information with other sources of evidence. Our results show that several taxon pairs are at different stages of a speciation continuum. Our study emphasises the potential of genomic data to resolve taxonomic uncertainties, which can help to focus management actions on relevant taxa, even if they do not necessarily coincide with the taxonomic rank of species

Detecting Eating Episodes with an Ear-mounted Sensor

In this paper, we propose Auracle, a wearable earpiece that can automatically recognize eating behavior. More specifically, in free-living conditions, we can recognize when and for how long a person is eating. Using an off-the-shelf contact microphone placed behind the ear, Auracle captures the sound of a person chewing as it passes through the bone and tissue of the head. This audio data is then processed by a custom analog/digital circuit board. To ensure reliable (yet comfortable) contact between microphone and skin, all hardware components are incorporated into a 3D-printed behind-the-head framework. We collected field data with 14 participants for 32 hours in free-living conditions and additional eating data with 10 participants for 2 hours in a laboratory setting. We achieved accuracy exceeding 92.8% and F1 score exceeding 77.5% for eating detection. Moreover, Auracle successfully detected 20-24 eating episodes (depending on the metrics) out of 26 in free-living conditions. We demonstrate that our custom device could sense, process, and classify audio data in real time. Additionally, we estimateAuracle can last 28.1 hours with a 110 mAh battery while communicating its observations of eating behavior to a smartphone over Bluetooth

Incidence of type 1 and type 2 diabetes before and during the COVID-19 pandemic in Germany: analysis of routine data from 2015 to 2021

Background: To date, there is no data available depicting the trend of the incidence of type 1 and type 2 diabetes across all age groups for the COVID-19 pandemic years in Germany. Methods: Based on anonymized routine data from nine million persons covered by statutory health insurance, newly diagnosed diabetes cases (ICD diagnosis E10.- to E14.-) in inpatient or (confirmed in two quarters) outpatient setting were estimated for 2015 to 2021, differentiating between type 1 and type 2 diabetes. The data were linked to the German Index of Socioeconomic Deprivation. The results are age-standardised (population as of 31 Dec. 2021). Results: Between 2015 and 2021, the incidence of type 1 diabetes increased from 9.5 to 11.6 per 100,000 persons (from 7,007 to 8,699 new cases per year). In contrast, the incidence of type 2 diabetes tended to decline between 2015 and 2019. It continued to drop initially in 2020 during the pandemic, and then rose to 740 per 100,000 persons in 2021 (556,318 new cases per year). The diabetes type-specific seasonal pattern of previous years has changed during the pandemic years. The incidence of both type 1 and type 2 diabetes was observed to be higher in regions of high socioeconomic deprivation as compared to regions characterised by low socioeconomic deprivation. Conclusions: The increase in the incidence of type 1 and type 2 diabetes in 2021 may possibly be related to the COVID-19 pandemic. The high incidence and the differences by regional socioeconomic deprivation indicate that there is a need for targeted prevention strategies

Gelingt das Screening von Schwangeren auf HIV, Syphilis und Hepatitis B in Deutschland? Eine Analyse auf Basis von Routinedaten

Hintergrund: Infektionen in der Schwangerschaft sind weltweit eine der führenden Ursachen für erhöhte Morbidität und Mortalität bei Müttern und ihren Neugeborenen. In Deutschland gibt es seit mehr als 50 Jahren eine standardisierte Gesundheitsvorsorge in der Schwangerschaft. Die Mutterschafts-Richtlinien des Gemeinsamen Bundesausschusses bilden hierzu den gesetzlichen Rahmen und umfassen unter anderem das Screening von Schwangeren auf HIV, Syphilis und Hepatitis B. Ziel der Arbeit: Im Rahmen dieser Arbeit soll eruiert werden, wie hoch die Abdeckung des Screenings in der deutschen Bevölkerung ist. Material und Methoden: Mithilfe von anonymisierten Routinedaten von gesetzlich Versicherten, die dem Institut für angewandte Gesundheitsforschung Berlin GmbH (InGef) aus den Jahren 2011 bis 2015 vorliegen, wurde mithilfe von verschiedenen Internationale statistische Klassifikationsziffern der Krankheiten und verwandter Gesundheitsprobleme(ICD-10)- und Einheitlicher Bewertungsmaßstab(EBM)-Ziffern eine Definition für Schwangerschaft entwickelt und eine erste Auswertung zur Inanspruchnahme von Testungen auf Infektionserreger in der Schwangerschaft vorgenommen. Ergebnisse: Der hohe Anteil von Frauen, die im Rahmen der Schwangerschaft auf Syphilis (95,3 %) und Hepatitis B (91,6 %) getestet werden, spricht für eine sehr gute Erreichbarkeit und Inanspruchnahme von vorgeburtlichen Screeningangeboten. Bei HIV ist der Anteil an getesteten Frauen deutlich niedriger (84,9 %). Diskussion: Ob Schwangere einen HIV-Test ablehnen, der Test anderweitig durchgeführt oder nicht durch das ärztliche Personal empfohlen wurde, lässt sich anhand der vorliegenden Datenlage nicht klären. Angesichts der hochwirksamen medizinischen Interventionsmöglichkeiten für Syphilis, HIV und Hepatitis B ist eine möglichst vollständige Testung von Schwangeren in Deutschland anzustreben. Die Gründe für fehlende Screeninguntersuchungen müssen weiter eruiert und Ansatzpunkte für eine Steigerung der Inanspruchnahme identifiziert werden.Peer Reviewe