Linking soils and human health: geospatial analysis of ground-sampled soil data in relation to community-level podoconiosis data in North West Cameroon.

BACKGROUND: Podoconiosis is a form of leg swelling, which arises when individuals are exposed over time to red clay soil formed from alkaline volcanic rock. The exact causal agent of the disease is unknown. This study investigates associations between podoconiosis disease data and ground-sampled soil data from North West Cameroon. METHODS: The mineralogy and elemental concentrations were measured in the soil samples and the data were spatially interpolated. Mean soil values were calculated from a 3 km buffer region around the prevalence data points to perform statistical analysis. Analysis included Spearman's rho correlation, binary logistic regression and principal component analysis (PCA). RESULTS: Six elements, barium, beryllium, potassium, rubidium, strontium and thallium, as well as two minerals, potassium feldspar and quartz, were identified as statistically related to podoconiosis. PCA did not show distinct separation between the spatial locations with or without recorded cases of podoconiosis, indicating that other factors such as shoe-wearing behaviour and genetics may significantly influence podoconiosis occurrence and prevalence in North West Cameroon. CONCLUSION: Several soil variables were statistically significantly related to podoconiosis. To further the current study, future investigations will look at the inflammatory pathway response of cells after exposure to these variables.

A pilot study of a randomised trial of cognitive analytical therapy vs educational behavioral therapy for adult anorexia nervosa.

The aim of this study was to compare two forms of outpatient treatment, educational behavioural treatment and cognitive analytical therapy for adult anorexia nervosa. Thirty patients were randomly allocated to the two treatments. At one year, the group had gained 6.8 kg, 19/30 (63%) had a good or intermediate recovery in terms of nutritional outcome. The group given cognitive analytical treatment reported significantly greater subjective improvement but there were no differences in other outcome parameters. In conclusion outpatient treatment of adult onset anorexia nervosa leads to an improvement in two thirds of cases. Larger studies will be needed to determine the most effective form of treatment in this group.

[Complications from physiological and rate responsive pacemaker implantations]. / Fiziológiás és frekvenciaválaszos pacemaker implantációk szövödményei.

One hundred eighteen surgical complications of 209 patients underwent 249 physiological and rate responsive pacemaker implantations are discussed. In 27.9% of total complications represented the dislodgement of atrial leads occurred particularly in the early period of the observation time which decreased significantly later in the second period of the survey. This high complication rate of bifocal pacemakers was found due to a high incidence of the generator preerosion beside the dislodgment of the atrial electrodes. Complication rate could be reduced by the improvement of surgical technics, and with the implantations of new types of leads and smaller generators, however the number of complications remained higher compared to the pacemaker systems with one lead. The implantation procedure of ventricular rate responsive pacemakers is simple, and significant improvement in working capacity could be observed by the restoration of the chronotropic capacity during exercise. Physiological and atrial rate responsive pacemakers provide many advantages in the hemodynamic state even at rest which exceed all disadvantage of the expected complications, which might occur.