<i>Toxoplasma gondii</i> seroprevalence among two selected groups of women

Toxoplasma gondii is an intracellular parasite able to cross the placental barrier and known to infect the foetal tissues leading to abortions and congenital deformities. This was a case control study conducted between April 2009 and 2010 that compared the seroprevalence of T. gondii and the frequency of association to known risk factors for infection between 100 healthy pregnant women within 28 weeks of pregnancy having no medical complications and 100 women having undergone a spontaneous miscarriage in the past 6 months attending the Antenatal and  Gynaecology clinics of the Professorial Obstetrics &amp; Gynaecology Unit of the De Soyza Maternity Hospital for Women in Colombo. Two milliliters of venous blood was collected and tested for T. gondii antibodies at the Department of Parasitology, Faculty of Medicine, Colombo, using OnSite Toxo IgG/IgM Rapid Test-Dip Strip®. Personal details and data regarding the known risk factors for the infection were obtained using an interviewer administered questionnaire. The participants were aged between 15 and 46 years (median 29); 38% of women in each group were primigravidae. All participants were sero-negative for anti-T. gondii IgM antibodies. However, 22.5% (n=45) of all study subjects were sero-positive for anti-T. gondii IgG antibodies, which included 62.2% (n=28) from the healthy group and 37.8% (n=17) from those with a recent past history of a spontaneous miscarriage. The difference in seropositivity for Toxoplasma gondii between the two selected groups was not statistically significant (X2=3.47; p=0.063). There were no significant associations between sero-positivity and known risk factors either (p&gt;0.05). Although our study did not reveal any evidence for association between exposure to Toxoplasma gondii infection and spontaneous miscarriage, the presence of more than 75% non-immune women of child bearing age is a cause for concern considering the potential risks posed by this parasite, emphasizing the importance of an organized educational programme targeting this high risk group to prevent infection during pregnancy.DOI: http://dx.doi.org/10.4038/sljid.v1i1.3091 Sri Lankan Journal of Infectious Diseases Vol.1(1) 2011: 9-17</p

What do we know about micronutrients in critically ill patients? A narrative review.

Micronutrient (MN) status alterations (both depletion and deficiency) are associated with several complications and worse outcomes in critically ill patients. On the other side of the spectrum, improving MN status has been shown to be a potential co-adjuvant therapy. This review aims to collect existing data to better guide research in the critical care setting. This narrative review was conducted by the European Society of Intensive Care Medicine Feeding, Rehabilitation, Endocrinology, and Metabolism MN group. The primary objective was to identify studies focusing on individual MNs in critically ill patients, selecting the MNs that appear to be most relevant and most frequently investigated in the last decade: A, B &lt;sub&gt;1&lt;/sub&gt; , B &lt;sub&gt;2&lt;/sub&gt; , B &lt;sub&gt;3&lt;/sub&gt; , B &lt;sub&gt;6&lt;/sub&gt; , folate, C, D, E, copper, iron, selenium, zinc, and carnitine. Given the limited number of interventional studies for most MNs, observational studies were included. For each selected MN, the review summarizes the main form and functions, special needs and risk factors, optimal treatment strategies, pharmacological dosing, and clinical implications all specific to critically ill patients. A rigorous rebalancing of research strategies and priorities is needed to improve clinical practice. An important finding is that high-dose monotherapy of MNs is not recommended. Basal daily needs must be provided, with higher doses in diseases with known higher needs, and identified deficiencies treated. Finally, the review provides a list of ongoing trials on MNs in critically ill patients and identifies a priority list of future research topics