Tuberculin positivity: A serious problem before transplantation in Turkey.

Chronic renal failure (CRF) patients are at increased risk of tuberculosis. Detecting latent tuberculosis infection is essential before transplantation. The tuberculin skin test is the only validated method for the diagnosis of latent tuberculosis infection and for screening for hypersensitivity. The aim of this study was to assess the tuberculin test status (5 Todd units tuberculin) of 164 asymptomatic transplant candidates and correlate it with anamnestic data and laboratory values of patients awaiting transplantation. Skin test positivity was higher among older age subjects (r = .294, P = .0001). The cumulative prevalence rates of tuberculin positivity and anergy were 42.1% (69 patients) and 43.3% (71 patients), respectively. Only 14.5% of the positive patients had a previous tbc history; 15.9% had a family history of tbc. Among peritoneal dialysis (PD) patients, the rate of anergic skin tests was higher, while positivity was higher among patients who were preparing for preemptive renal transplantation (P = .009). In conclusion, there was a high prevalence of tuberculin positivity and anergy among asymptomatic pretransplant CRF patients. CRF patients who are awaiting transplantation especially should meet evaluations for previous tbc anamnesis and family history. Elderly subjects showed a higher risk for purified protein derivate positivity.

SESy-Europe: a multi-language database dedicated to cancer screening monitoring.

Cancer is the second cause of death in developed countries. Many efforts to educate the public to more tumor free life-style and screening practice have been therefore adopted. Considering the high costs of diagnostic procedures and educational programs a cancer prevention/screening practice monitoring system is required to reduce costs, to assist health making policy decisions, and to tailor more targeted interventions whenever indicated. We, therefore, realized a computerized data-base able to assist medical personnel in health intervention monitoring and making policy at community level with a focus on the European region. An international medical board provided the translation of medical-related contents in English, French, German, Greek, Italian, Rumanian, Spanish and Turkish. The electronic system recognizes and finds relationships between screening events or secondary prevention tests and various causes of medical examinations (symptoms, diseases, professions, presence and type of health insurance, sex, age, medical history, family history, educational level, knowledge about cancer screening and prevention, patient location, type of community, region of provenance, etc). Due to its multi-language standardized characteristics its application may bridge European countries in cancer screening monitoring policy.

[Intrauterine therapy and outcome in four pregnancies of one mother with anti ro-autoantibody positive Sjoegren's syndrome]. / Intrauterine Therapie und kindliche Entwicklung bei vier Schwangerschaften einer Mutter mit Sjögren-Syndrom und Anti-Ro-Autoantikörpern.

Autoantibodies against 52/60kD-Ro proteins, frequently present in patients with Sjoegren's Syndrome or systemic lupus erythematosus, are transmitted to the fetus during pregnancy. These autoantibodies can damage the cardiac conductive system of the fetus and cause a complete atrioventricular block, with a mortality of 30 %. We report the intrauterine therapy during four pregnancies of the same mother with high 52/60kD-Ro autoantibodies and the outcome of her infants. Our patient with primary Sjoegren's Syndrome suffered an early miscarriage during her first pregnancy. During the second pregnancy, a fetal atrioventricular block was observed at 23 weeks of gestation. Although subsequently dexamethasone therapy and daily plasmaphereses were started, a cesarean section was necessary at 26 weeks due to hydrops fetalis. The girl died from the atrioventricular block after two days. During the third and fourth pregnancies, dexamethasone therapy was begun already at 7 weeks, and regular plasmaphereses at 15 weeks. The children were delivered by cesarean section at 32 and 36 weeks because of growth retardation. Both had normal electrocardiograms after birth and after 2 and 4 years. In pregnant women with connective tissue diseases, monitoring of anti Ro-autoantibodies and fetal heart function is important. Intrauterine therapeutic options are dexamethasone therapy to suppress maternal and fetal inflammatory reactions and repeated plasmaphereses to reduce autoantibody levels. Postnatal follow up of the infants for atrioventricular block and rheumatic manifestations is necessary.

A pilot study of measurement of the frequency of sounds emitted by high-speed dental air turbines.

Since the development and use of the high-speed dental air turbine some 45 years ago, concern has been expressed in the literature about a possible cause and effect relationship between use of the drill and hearing loss in dentists. The hearing threshold in humans varies with the frequency of sound. It is well known that dentists experience gradual hearing loss during their working life. The aim of this study was to measure the frequency of sounds emitted by high-speed dental air turbines under different working conditions. Five high-speed dental air turbines were used (2 x Trend TC-80 BC W&H Dentalwerk, Austria, 2 x Black Pearl Eco Bien-air, Switzerland, 1 x Trend TC-80 BC W&H Dentalwerk, Austria. Each turbine was tested under 8 different working conditions: under free working conditions the turbines were tested without burs, with fissure burs, with flare burs, with round burs and with inverted cone burs; under operation they were tested with fissure burs by application to a 3 x 3 x 10 mm amalgam block surface, a 3 x 3 x 10 mm composite block surface, and the occlusal surface of an extracted molar tooth. Forty sound recordings were made in total using a computer with a microphone (Shure 16 LC) located 30 cm away from the samples, at 10-s intervals using a mixer. Frequency analysis was done by a Cool Edit Pro 1.2 computer program. Data were analyzed by multi-variate analysis with the S.P.S.S 9.05 software program. The average measurement was 6860 Hz. According to the statistical analysis there was no significant difference in the frequencies recorded under different working conditions. There was also no significant difference among the different high-speed dental air turbines at alpha = 0,05, P > alpha /2 levels. These results indicate that under any working conditions, high-speed dental air turbines emit frequencies which can cause hearing loss.

[Effect of maternal age on the course of labor--analysis of women over 40 years of age]. / Einfluss des mütterlichen Alters auf den Geburtsverlauf--Analyse bei Frauen über 40 Jahre.

In order to determine the birth risk for pregnant women in the age group > or = 40, the delivery data of 143 pregnant women in this age group were retrospectively evaluated over a 3-year period. Here, 37 of these 143 women (25.9%) were primiparae. The following was examined: The number of prenatal examinations (including ultrasound examinations), the incidence of genetic examinations, the delivery methods with the percentage of surgical deliveries, complications at the time of delivery as well as the fetal outcome with APGAR values, umbilical artery pH, birth weights, neonatal morbidity and mortality. The delivery results were compared with representative populations of women between 20-29 years (n = 2252) and 30-39 years (n = 1980). Pregnancy in older women still ends significantly more often with cesarean section than in younger women. Here, the rate of cesarean sections was 32.7% compared to 21.9% in 30-39-year-olds and 15.8% in 20-29-year-olds. However, parity has an even greater influence on the mode of delivery than age. Only 30.1% of multi-parae over 40 years underwent surgical delivery (vaginal and abdominal) compared to 77.3% of primiparae. It was also found that multiparae more rarely had surgical delivery than younger primiparae (30-39 years 53.3%, 20-29 years 39.3%). Despite the high surgical delivery rate being in the group of primiparae over 40 years, the fetal outcome was comparatively poor, so that the less restrictive indication for surgical delivery seems justified.