Seroprevalence and risk factors for toxoplasma infection among pregnant women in Aydin province, Turkey

BACKGROUND: The aims of the present study were to determine the prevalence of toxoplasmosis in pregnant women at first trimester of their pregnancy and to follow up the seroconversion for next two trimesters, and to identify the risk factors and possible contamination routes in Aydin province, Turkey. METHOD: The sample size was calculated as 423 on a prevalence of 50%, d=0.05 at a confidence level of 95% with 10% addition. It was a cross-sectional study with multistage sampling. After a questionnaire applied to the pregnant women, anti-Toxoplasma IgG antibodies were studied with ELISA and IFA, values in conflict with DA test, where IgM antibodies were studied with ELISA and for borderline or positive values of IgM avidity test was used. RESULTS: The mean age of 389 (92.9%) of pregnant women in the study was 24.28+/-4.56 years, the seroprevalence of anti-Toxoplasma IgG antibodies for toxoplasmosis was 30.1%. Seroprevalence was increased with age (p=0.001) and with drinking water consumption other than bottled water (p=0.042). No significant relations were observed between anti-Toxoplasma IgG antibodies and education level, being native or migrant, abortion history, consumption of meat, vegetable and milk/milk products, personal or kitchen hygiene habits, cat owning at home of the pregnant women. No IgM antibody was detected. CONCLUSION: One of every three pregnant women in Aydin was at risk of toxoplasmosis at the first trimester of their pregnancy. Increased seroprevalance with age was a predictable result because of increasing time of exposure. Increased seroprevalence with consumption of municipal and uncontrolled water (well/spring water) supplies was similar with latest epidemiological findings

Postresectional lung injury in thoracic surgery pre and intraoperative risk factors: a retrospective clinical study of a hundred forty-three cases

<p>Abstract</p> <p>Introduction</p> <p>Acute respiratory dysfunction syndrome (ARDS), defined as acute hypoxemia accompanied by radiographic pulmonary infiltrates without a clearly identifiable cause, is a major cause of morbidity and mortality after pulmonary resection. The aim of the study was to determine the pre and intraoperative factors associated with ARDS after pulmonary resection retrospectively.</p> <p>Methods</p> <p>Patients undergoing elective pulmonary resection at Adnan Menderes University Medical Faculty Thoracic Surgery Department from January 2005 to February 2010 were included in this retrospective study. The authors collected data on demographics, relevant co-morbidities, the American Society of Anesthesiologists (ASA) Physical Status classification score, pulmonary function tests, type of operation, duration of surgery and intraoperative fluid administration (fluid therapy and blood products). The primary outcome measure was postoperative ARDS, defined as the need for continuation of mechanical ventilation for greater than 48-hours postoperatively or the need for reinstitution of mechanical ventilation after extubation. Statistical analysis was performed with Fisher exact test for categorical variables and logistic regression analysis for continuous variables.</p> <p>Results</p> <p>Of one hundred forty-three pulmonary resection patients, 11 (7.5%) developed postoperative ARDS. Alcohol abuse (p = 0.01, OR = 39.6), ASA score (p = 0.001, OR: 1257.3), resection type (p = 0.032, OR = 28.6) and fresh frozen plasma (FFP)(p = 0.027, OR = 1.4) were the factors found to be statistically significant.</p> <p>Conclusion</p> <p>In the light of the current study, lung injury after lung resection has a high mortality. Preoperative and postoperative risk factor were significant predictors of postoperative lung injury.</p

Lucy's Flat Feet: The Relationship between the Ankle and Rearfoot Arching in Early Hominins

BACKGROUND. In the Plio-Pleistocene, the hominin foot evolved from a grasping appendage to a stiff, propulsive lever. Central to this transition was the development of the longitudinal arch, a structure that helps store elastic energy and stiffen the foot during bipedal locomotion. Direct evidence for arch evolution, however, has been somewhat elusive given the failure of soft-tissue to fossilize. Paleoanthropologists have relied on footprints and bony correlates of arch development, though little consensus has emerged as to when the arch evolved. METHODOLOGY/PRINCIPAL FINDINGS. Here, we present evidence from radiographs of modern humans (n=261) that the set of the distal tibia in the sagittal plane, henceforth referred to as the tibial arch angle, is related to rearfoot arching. Non-human primates have a posteriorly directed tibial arch angle, while most humans have an anteriorly directed tibial arch angle. Those humans with a posteriorly directed tibial arch angle (8%) have significantly lower talocalcaneal and talar declination angles, both measures of an asymptomatic flatfoot. Application of these results to the hominin fossil record reveals that a well developed rearfoot arch had evolved in Australopithecus afarensis. However, as in humans today, Australopithecus populations exhibited individual variation in foot morphology and arch development, and "Lucy" (A.L. 288-1), a 3.18 Myr-old female Australopithecus, likely possessed asymptomatic flat feet. Additional distal tibiae from the Plio-Pleistocene show variation in tibial arch angles, including two early Homo tibiae that also have slightly posteriorly directed tibial arch angles. CONCLUSIONS/SIGNIFICANCE. This study finds that the rearfoot arch was present in the genus Australopithecus. However, the female Australopithecus afarensis "Lucy" has an ankle morphology consistent with non-pathological flat-footedness. This study suggests that, as in humans today, there was variation in arch development in Plio-Pleistocene hominins.Leakey Foundatio

ADHERE: randomized controlled trial comparing renal function in de novo kidney transplant recipients receiving prolonged-release tacrolimus plus mycophenolate mofetil or sirolimus

ADHERE was a randomized, open-label, Phase IV study comparing renal function at Week 52 postkidney transplant, in patients who received prolongedrelease tacrolimus-based immunosuppressive regimens. On Days 0?27, patients received prolonged-release tacrolimus (initially 0.2 mg/kg/day), corticosteroids, and mycophenolate mofetil (MMF). Patients were randomized on Day 28 to receive either prolonged-release tacrolimus plus MMF (Arm 1) or prolongedrelease tacrolimus (?25% dose reduction on Day 42) plus sirolimus (Arm 2). The primary endpoint was glomerular filtration rate by iohexol clearance (mGFR) at Week 52. Secondary endpoints included eGFR, creatinine clearance (CrCl), efficacy failure (patient withdrawal or graft loss), and patient/graft survival. Tolerability was analyzed. The full-analysis set comprised 569 patients (Arm 1: 287; Arm 2: 282). Week 52 mean mGFR was similar in Arm 1 versus Arm 2 (40.73 vs. 41.75 ml/min/1.73 m2; P = 0.405), as were the secondary endpoints, except composite efficacy failure, which was higher in Arm 2 versus 1 (18.2% vs. 11.5%; P = 0.002) owing to a higher postrandomization withdrawal rate due to adverse events (AEs) (14.4% vs. 5.2%). Results from this study show comparable renal function between arms at Week 52, with fewer AEs leading to study discontinuation with prolonged-release tacrolimus plus MMF (Arm 1) versus lower dose prolonged-release tacrolimus plus sirolimus (Arm 2)

Zooarchaeological reconstruction of newly excavated Middle Pleistocene deposits from Elandsfontein, South Africa

The current study provides the first zooarchaeological account of systematically excavated faunal material from Elandsfontein, South Africa (ca. 1.0 – 0.6 Ma). Archaeological assemblages of this age typically lack well-preserved faunal remains recovered in primary association with artifacts, and thus studies have primarily focused on lithic technology. The sizeable faunal sample from Elandsfontein, South Africa is a rare exception and has dramatically influenced the way that we interpret early hominin foraging behavior during this time. Surface collections, starting in the 1950s, recovered ~13,000 mammalian fossils and more than 160 Acheulean artifacts. The Elandsfontein faunal assemblage was interpreted as having accumulated through natural mortality and subsequent scavenging by carnivores and hominins, with hominins playing a very minimal role in carcass modification. Low frequencies of stone tool cutmarks were taken as evidence that Acheulean hominins had limited ability to obtain large carcasses. However, this interpretation contrasts with a growing body of evidence suggesting that many Acheulean hominins across sub-Saharan Africa not only had access to large mammal carcasses but were often the primary agents of accumulation and modification. The majority of the original Elandsfontein faunal material was collected from deflation surfaces and lacks sufficient contextual information. We conducted a detailed zooarchaeological analysis of faunal remains from four recent excavations within the Elandsfontein dune field. Our results differ from those based on surface collections and suggest multiple agents of bone accumulation with varying degrees of hominin and carnivore activity across the paleolandscape. Frequencies of hominininduced butchery are higher (up to 3.6% NISP) than reported for previously collected samples (<1% of limb surfaces) and demonstrate butchery of megafauna on at least two occasions. Our findings indicate that earlier zooarchaeological studies at Elandsfontein underestimate the degree of hominin contribution to the fossil assemblage and do not take into account the complicated taphonomic history across the paleolandscape. The results of this analysis are congruent with recent studies suggesting that Acheulean hominins and their Oldowan producing predecessors had regular access to large carcasses and that megafauna were an essential component of the diet for early Homo

Thyroid abnormalities in lithium treated bipolar patients: a crossectional study with healthy controls

WOS: 00035533810035

Co-occurrence of substance use disorders with anxiety disorders: Epidemiology, psychobiology, clinical features, and treatment

Symptoms of anxiety and anxiety disorders commonly co-occur with substance use disorders (SUDs). The interaction between these disorders is bidirectional: anxiety disorders may contribute to the development of SUDs and modify the presentation and the outcomes of treatment for SUDs; on the other hand, SUDs may modify the manifestation of anxiety disorders. Anxiety symptoms are also accompanied with intoxication or withdrawal symptoms. Studies in clinical samples and community surveys have demonstrated high rates of co-occurrence of anxiety disorders with alcohol and drug use disorders. In National Epidemiologic Survey on Alcohol and Related Conditions, 17.71% of respondents with any 12 month substance use disorder had at least one independent anxiety disorder and 14.96% of respondents with any 12-month anxiety disorder had at least one substance use disorder, during the same 12-month period. Despite the high prevalence rates, anxiety disorders are frequently under-diagnosed in substance abuse settings. However, it is clinically important while the outcome for each type of disorder is worse across clinical and psychosocial domains than for the disorders without comorbidity. Integrated treatment strategies including medications and psychosocial treatment perspectives are needed for co-occurring anxiety and substance disorders to improve outcome. © 2010 Nova Science Publishers, Inc. All rights reserved