Prevention of congenital toxoplasmosis in Slovenia by serological screening of pregnant women

A programme for the prevention of congenital toxoplasmosis in Slovenia involving the screening of pregnant women for Toxoplasma infection is presented. Of 21,270 pregnant women screened for toxoplasmosis between, 1996 and the end of 1999, 13,987 (66%) were seronegative, 7,151 (34%) seropositive and 132 had primary infection; approximately 9/1,000 women were at risk of acquiring the primary infection. One hundred live-born infants of primary infected women were available for follow-up. Nine infected but asymptomatic children were born to mothers who were screened and treated in time and two congenitally infected babies were born to mothers in whom infection was detected too late in pregnancy and who therefore received no adequate treatment. It is suggested that the results obtained in this study outweigh the cost of screening for toxoplasmosis in pregnancy. Pregnant women should always be tested at the beginning of pregnancy and, in cases of seronegativity, should be re-tested in the second and third trimesters of the pregnancy. Toxoplasma primary infected pregnant women and neonates should be treated as soon as possible. However, long-term follow-up of children born to primary infected women would be necessary for an accurate evaluation of the effectiveness of the screening because of the possibility of late onset of symptoms.     

Analysis of Surface State after Turning of High Tempered Bearing Steel

This paper investigates surface state after turning of the high tempered bearing steel 100Cr6 with a hardness of 40 HRC. White layer (WL) thickness and its microhardness, as well as surface roughness, are investigated as a function of tool flank wear VB as well as cutting speed v_c. The mechanical and thermal load of the machined surface were analysed in order to provide a deeper insight into their superimposing contribution. Cutting energy expressed in terms of cutting force was analyses as that consumed for chip formation F_γ and consumed in the flank wear land F_α. It was found that the mechanical energy expressed in terms of the shear components of the F_α grows with VB, converts to the heat and strongly affects the thickness of the re-hardened layer. Furthermore, the superimposing contribution of the heat generation and its duration in the VB region should also be taken into account. It was also found that the influence of VB predominates over the variable cutting speed.     

Yoga Exercise Intervention Improves Balance Control and Prevents Falls in Seniors Aged 65+

IntroductionBody balance control represents a key factor preventing falls and subsequent injuries in seniors aged 65+. Intervention based on yoga exercises seem to be effective in improving balance.ObjectiveThe objective is to analyse and compare changes in static, dynamic, and total balance scores, changes in body composition and social indices as effects of yoga-based intervention.MethodsA total of 500 participants (234 men aged 74.5 SD±7.74 and 266 women aged 76.9 SD±7.23) were assessed using the Tinetti Balance Assessment Tool, the InBody 230 bioimpedance body composition analyser, and the SF-36 Health Survey, applied to pre and post-testing. The experimental group (n=262; 122 males; 140 females) underwent a four-week yoga-based intervention, 30 minutes daily, while the control group (n=238; 112 males; 126 females) underwent its usual daily programme at senior homes or centres. The ANOVA model, consisting of the Group, Stage, Subject and Group × Stage interaction factors, was used for data evaluation.ResultsIntervention led to improvements in the static, dynamic and total balance scores in the experimental group compared to the control group. The results of SF-36 showed positive changes in the psychosocial aspects of health, such as promoting of calmness and happiness in male seniors and reducing fatigue, nervousness and depression in female seniors. The post-intervention decrease in body fat percentage and increase in muscle mass in seniors is discussed.ConclusionsThe four-week yoga-based intervention had positive effects on the static, dynamic and total balance scores, body composition and social status.     

Long-Term Antibody Response and Vaccination Efficacy in Patients with COVID-19: A Single Center One-Year Prospective Study from the Czech Republic

Background: The diagnosis of SARS-CoV-2 is almost exclusively performed by PCR or antigen detection. The detection of specific antibodies has not yet been considered in official diagnostic guidelines as major laboratory evidence for a case definition. The aim the present study is to analyze antibody responses in outpatient and inpatient cohorts of COVID-19 patients in the Czech Republic over a 12-month period, and assess the potential of antibodies as a diagnostic tool. Methods: A total of 644 patients was enrolled in the prospective study. IgA, IgM and IgG antibody levels, as well as virus neutralization titers, were analyzed over a 12-month period. Results: Our study showed low antibody positivity levels at the admission. However, at 2 weeks after infection, 98.75% and 95.00% of hospitalized patients were IgA and IgG positive, respectively. Even in the outpatient cohort characterized by milder disease courses, the IgG antibody response was still sustained at 9 and 12 months. The data show a high correlation between the IgG levels and virus neutralization titers (VNTs). Samples from later time-points showed positive antibody responses after vaccination in both cohorts characterized by high IgG levels and VNT over 1:640. The samples from unvaccinated persons indicated a relatively high level of reinfection at 6.87%. Conclusions: Our results show that the detection of antibodies against the SARS-CoV-2 shows an increasing sensitivity from week 2 after infection and remains highly positive over the 12-month period. The levels of IgG antibodies correlate significantly with the VNTs. This suggests that the serological data may be a valuable tool in the diagnosis of SARS-CoV-2 infection.     

HHV-6 DNA throughout the tissues of two stem cell transplant patients with chromosomally integrated HHV-6 and fatal CMV pneumonitis

Two patients with the characteristic high human herpesvirus 6 (HHV-6) DNA loads in peripheral blood caused by chromosomally integrated (CI) virus received a haematopoietic stem cell transplant (HSCT) from a donor without CI HHV-6. Both patients died in consequence of cytomegalovirus (CMV) pneumonitis. At autopsy, high amounts of CMV DNA were detected in lungs but at much lower levels in other organs. In contrast HHV-6 DNA was detected at high levels throughout the organs with the exception of donor-derived haematopoietic tissue. In individuals with chromosomal integration, HHV-6 DNA is found in every tissue of recipient origin indicating inheritance through the germ line.     

Antiphospholipid syndrome and central nervous system

Classification criteria, etiology, pathogenesis, major central nervous system (CNS) manifestations of the antiphospholipid syndrome (APS), as well as diagnostic and therapeutic approach are discussed in the article, supported by several MRI findings to illustrate differential complexity of selected topics. Close interplay of inflammation, autoimmunity, coagulation cascade, vasculature bed, neuron physiology and demyelinization in APS is elaborated. Cerebrovascular disease, multiple sclerosis-like syndrome, seizures, cognitive disfunction, headache and migraine, chorea and catastrophic antiphospholipid syndrome (CAPS) are discussed as the most prominent CNS manifestations of the APS.     

ORIGINAL RESEARCH–INTERSEX AND GENDER IDENTITY DISORDERS: Metoidioplasty as a Single Stage Sex Reassignment Surgery in Female Transsexuals: Belgrade Experience

IntroductionMetoidioplasty represents one of the variants of phalloplasty in female transsexuals. Its main characteristic is that it is a one-stage procedure. It involves lengthening and straightening of hypertrophied clitoris to create a neophallus, urethral lengthening to enable voiding while standing, and scrotal reconstruction with insertion of testicle prostheses.AimOur aim is to describe our technique and highlight its advantages.MethodsBetween September 2002 and April 2007, 82 female transsexuals, aged 18–54 years (mean age 31) underwent one-stage metoidioplasty. Clitoris is lengthened and straightened by division of clitoral ligaments and short urethral plate. Urethroplasty is done with combined buccal mucosa graft and genital skin flaps. Scrotum is created from labia majora in which two testicle prostheses are inserted. Simultaneously, female genitalia are removed.Main Outcome MeasuresPatients' personal satisfaction about sensitivity and length of neophallus, possibility to void in standing position, real length of reconstructed urethra as well as complication rate comparing to other published data.ResultsThe median follow-up was 32 months (range 14–69). The mean neophallic length was 5.7 cm (range 4–10). Voiding in standing position was reported in all patients, while dribbling and spraying were noticed in 23 cases and solved spontaneously. There were two urethral strictures and seven fistulas that required secondary minor revision. All patients reported preserved sensation and normal postoperative erection. Testicle prostheses rejection was not observed in any of the patients.ConclusionsMetoidioplasty is a single-stage and time-saving procedure. It could be an alternative to total phalloplasty in female transsexuals who do not wish to have sexual intercourse. Also, it represents a first step in cases where additional augmentation phalloplasty is required. Djordjevic ML, Stanojevic D, Bizic M, Kojovic V, Majstorovic M, Vujovic S, Milosevic A, Korac G, and Perovic SV. Metoidioplasty as a single stage sex reassignment surgery in female transsexuals: Belgrade experience. J Sex Med 2009;6:1306–1313.