Are infectious agents involved in the pathogenesis of postpartum psychosis?

BACKGROUND: Since postpartum psychosis has been linked to activation of the immune system, it has been hypothesized that infectious agents may be involved in the pathogenesis of this disorder. We therefore investigated whether exposure to pathogens that can infect the central nervous system is increased in patients with postpartum psychosis. METHODS: We measured the prevalence and titers of immunoglobulin G (IgG) and M (IgM) to herpes simplex virus type 1 (HSV-1) and 2 (HSV-2), Epstein-Barr virus (EBV), cytomegalovirus (CMV) and Toxoplasma Gondii (TG) in a cohort of patients with postpartum psychosis (n = 81) and compared these to matched postpartum controls. RESULTS: We did not find significant differences in seroprevalence or antibody titers for any of these pathogens. LIMITATIONS: Limitations of this study include the indirect measurement of infectious disease and the cross-sectional design. CONCLUSION: Our results do not support the hypothesis that exposure to these neurotropic pathogens is involved in postpartum psychosis.

Co-infection with Toxoplasma gondii and Clostridium perfringens in a postpartum woman with uterine gas gangrene: a case report.

Toxoplasmosis is a protozoan infection caused by Toxoplasma gondii. We report a case of Toxoplasma gondii and Clostridium perfringens co-infection complicating uterine gas gangrene following a term pregnancy. The histological examination of the necrotic uterine tissues and uterine swab cultures obtained at laparotomy revealed T. gondii and C. perfringens, respectively. Treatment was administered with bactericidal activity against both pathogens and the patient had an uneventful post-operative recovery. Although there have been some cases that have documented an association between toxoplasmosis and non-uterine C. perfringens infection, such a relationship has not been established. It is of interest to determine if the presence of both organisms can explain the severe myonecrosis that occurs in some cases of uterine gas gangrene.

Penalized likelihood and multi-objective spatial scans for the detection and inference of irregular clusters.

BACKGROUND: Irregularly shaped spatial clusters are difficult to delineate. A cluster found by an algorithm often spreads through large portions of the map, impacting its geographical meaning. Penalized likelihood methods for Kulldorff's spatial scan statistics have been used to control the excessive freedom of the shape of clusters. Penalty functions based on cluster geometry and non-connectivity have been proposed recently. Another approach involves the use of a multi-objective algorithm to maximize two objectives: the spatial scan statistics and the geometric penalty function. RESULTS & DISCUSSION: We present a novel scan statistic algorithm employing a function based on the graph topology to penalize the presence of under-populated disconnection nodes in candidate clusters, the disconnection nodes cohesion function. A disconnection node is defined as a region within a cluster, such that its removal disconnects the cluster. By applying this function, the most geographically meaningful clusters are sifted through the immense set of possible irregularly shaped candidate cluster solutions. To evaluate the statistical significance of solutions for multi-objective scans, a statistical approach based on the concept of attainment function is used. In this paper we compared different penalized likelihoods employing the geometric and non-connectivity regularity functions and the novel disconnection nodes cohesion function. We also build multi-objective scans using those three functions and compare them with the previous penalized likelihood scans. An application is presented using comprehensive state-wide data for Chagas' disease in puerperal women in Minas Gerais state, Brazil. CONCLUSIONS: We show that, compared to the other single-objective algorithms, multi-objective scans present better performance, regarding power, sensitivity and positive predicted value. The multi-objective non-connectivity scan is faster and better suited for the detection of moderately irregularly shaped clusters. The multi-objective cohesion scan is most effective for the detection of highly irregularly shaped clusters.

Peri-parturient rise in faecal strongyle egg counts of different genotypes of sheep in North Sumatra, Indonesia.

Faecal strongyle egg counts were monitored in peri-parturient ewes and dry ewes grazing in a rubber plantation in North Sumatra, Indonesia. A significant rise in faecal egg counts was observed during the post-parturient period. Haemonchus contortus was the dominant species in the faecal cultures of the lactating ewes. The intensity of the peri-parturient rise was affected by the genotype of the sheep, which were the local Sumatra and its F1 crosses with St. Croix, Barbados Blackbelly and Java Fat-tail. The peri-parturient rise in egg counts was highest in Sumatra and lowest in the Barbados Blackbelly x Sumatra cross. A significant effect of litter size on the peri-parturient rise was also demonstrated. These findings are discussed in relation to the epidemiology and control of gastrointestinal nematodes in the humid tropics.

Identification of Entamoeba histolytica antigens recognized by IgA class human antibodies in sera and colostra of puerperal women using immunoblotting techniques.

Immunodetection of total antigens of Entamoeba histolytica trophozoites transferred to nitrocellulose paper was realized with IgA antibodies present in colostra and sera samples of 28 puerperal women and in 24 sera samples of patients with a diagnosis of amebic hepatic abscess. The most frequently recognized antigens by colostra antibodies were those which correspond to 1290, 82.79, 52.14, 40.91, 37.75, 35.08, 33.52, 28.53, 27.53 and 25.32 KDa of molecular weight, in the case of puerperal sera those of 82.79, 52.14, 40.91, 37.75, 35.08, 33.52, 28.53, 27.53, and 25.32 KDa, whereas the sera of patients with amebic hepatic abscess those of molecular weight of 719, 118.45, 88.45, 69.45, 55.26, 52.14, 49.38, 42.72, 36.81, 35.08, 33.52, 25.32, 23.82, 23.47, 20.52 and 20.03 KDa. The putative adhesins were recognized infrequently by Iga of puerperal colostra and sera while the IgA of sera of patients with amebic hepatic abscess recognized those of 118.45 KDa (112 KDa in other studies) in 83.33% of the cases.

Amebic abscess of the liver and spleen in pregnancy and the puerperium.

Two patients who developed hepatic and splenic amebic abscesses during pregnancy are reported. The frequency of incorrect diagnosis in patients with these conditions is stressed. Factors that influence the course and outcome of amebiasis in pregnancy are discussed.