Associations between Toxoplasma gondii seropositivity and psychopathological manifestations in schizophrenic patients: A single-center study from Ecuador.

BACKGROUND: Schizophrenia, a complex neuropsychiatric disorder, is believed to be influenced by various factors including environmental exposures. A potential environmental factor is the infection by the obligate intracellular parasitic protozoan, Toxoplasma gondii which affects neurotransmitter levels, which could potentially exacerbate, trigger symptoms of schizophrenia or make them worst. OBJECTIVE: To investigate the association between Toxoplasma gondii seropositivity and psychopathological presentation in persons with schizophrenia in Ecuador. METHODS: This study was conducted at the Neuroscience Institute of Guayaquil, Ecuador. Among 368 inpatients, 104 were selected based on specific inclusion and exclusion criteria. Descriptive statistics captured patient characteristics and mental health outcomes. Logistic regression models estimated the effect of toxoplasmosis on various mental health outcomes, controlling for demographic and health-related variables. RESULTS: 86.5% of participants were seropositive for toxoplasmosis. Toxoplasma-seropositive schizophrenic patients had a lower risk of depression but a significantly higher risk of disorientation. The most prevalent mental health outcomes were Language Impairments (70.2%) and Bizarre Behavior (76.0%). CONCLUSION: Our findings suggest that Toxoplasma gondii seropositivity may have specific effects on mental functions in schizophrenic patients, particularly reducing the risk of depression but increasing the risk of disorientation. Further studies are required to clarify these associations and the potential underlying mechanisms.

Small airway disease in post-acute COVID-19 syndrome, a non-conventional approach in three years follow-up of a patient with long COVID: a case report.

BACKGROUND: Small airways disease (SAD), a novel finding described in post-acute COVID-19 patients, should be suspected when respiratory symptoms continue, air trapping persists on expiratory CT scans, and imaging findings fail to improve despite objectively better conventional pulmonary function test (PFT) parameters. The forced oscillation technique (FOT) and Multiple breathing washout (MBW) are both very sensitive methods for detecting anomalies in the peripheral airways. CASE PRESENTATION: We discuss the case of a 60-year-old Hispanic patient who had severe COVID-19 pneumonia and developed dyspnea, fatigue, and limited daily activity a year later. The PFTs revealed restrictive lung disease, as seen by significant diffusing capacity of the lungs for carbon monoxide (DLCO) decrease, severe desaturation, and poor 6-min walk test (6MWT) performance. The patient was treated with lowering corticosteroids as well as pulmonary rehabilitation (PR). During the 24-month follow-up, the dyspnea and fatigue persisted. On PFTs, 6MWT performance and restricted pattern improved slightly, but MBW discovered significant ventilatory inhomogeneity. FOT revealed substantial peripheral airway obstructive abnormalities. On CT scans, air trapping and ground-glass opacities (GGO) improved somewhat. The patient used a bronchodilator twice a day and low-dose inhaled corticosteroids (160 µg of budesonide and 4.5 µg of formoterol fumarate dihydrate) for nine months. PR sessions were resuming. The restricting parameters were stabilized and the DLCO had normalized after 36 months, with a 6MWT performance of 87% but significant desaturation. The CT scan revealed traction bronchiectasis, low GGO, and persistent air trapping. Without normalization, FOT and MBW scores improved, indicating small airway disease. CONCLUSIONS: The necessity of integrating these tests when detecting SAD is emphasized in our paper. This article lays the foundation for future research into the best ways to manage and monitor SAD in post-acute COVID-19 patients.

Anaphylaxis after prick-to-prick skin test to seafood allergy: A rare adverse event.

Allergies to seafood are common all over the world. The prick-to-pricktest is used to diagnose allergic reactions. In this article, a femalepatient suffered an anaphylactic reaction 5 minutes following a Prick-to-Prick skin test. Therefore, it is important to stratify, recognize and treatthe anaphylactic reaction promptly.

18FDG-PET/CT assessing the absence of cell viability and excluding metastatic disease in a case of necrotic choroidal melanoma.

PURPOSE: To report a case of choroidal melanoma in which the absence of 18FDG-positron emission tomography (PET)/computed tomography (CT) uptake in the whole body scan excluded the presence of any foci of metastases. Additionally, the PET/CT study correctly diagnosed the necrotic character of the lesion. METHODS: A 76-year-old woman with neovascular glaucoma, and without vitreous or retina visualization, was studied by our ophthalmology service. RESULTS: Ocular ultrasound showed an 18 × 16 mm vitreous exophytic image compatible with choroidal melanoma; magnetic resonance gave a 17 × 15 mm exophytic image, highly intense at T1 and hypointense at T2, with cystic and necrotic images after a contrast injection. An 18FDG-PET/CT study revealed a clearly hypometabolic lesion, representing absence of cell viability and excluding active melanoma cells. No other uptake lesions were detected at the whole-body PET/CT scan, assuming the absence of extraocular metastases. The eye was enucleated, and the pathology study showed a 16 × 15 mm necrotic choroidal melanoma. CONCLUSIONS: The 18FDG-PET/CT study correctly depicted the necrotic character of the choroidal melanoma and was able to exclude other foci of metastases.

Assessment of rhabdoid brain tumor by F-18 FDG PET, C-11 methionine PET and MRI.

A 28-year-old man with headache, nausea, and decreased vision had a left parieto-occipital tumor demonstrated by MRI. Postradical resection and histology showed a solid mass containing rhabdoid cells, 10% positive for Ki-67. After completing chemotherapy and radiotherapy treatment, follow-up MRI revealed possible tumoral recurrence. Cerebral F-18 FDG PET revealed no pathologic uptake, and C-11 methionine PET showed a pathologic low uptake. These findings suggested recurrence of a mild-grade aggressiveness tumor, which was confirmed by a second neurosurgical resection.

Influenza-like infection can result in diffuse fluordeoxyglucose uptake in the lungs.

A 32-year-old man underwent an F-18 fluordeoxyglucose positron emission tomography (FDG-PET/CT) scan for response assessment of mediastinal bulky non-Hodgkin lymphoma after completion of a CHOP therapy regimen. The F-18 FDG-PET/CT scan showed complete response regarding the mediastinal lesion. However, an unexpected pattern of prominent lung and abdominal muscular uptake was detected. The patient's clinical history was reassessed for differential diagnosis purposes. The medical records confirmed an episode of self-resolved influenza-like infection 4 days before the PET scan.This case underlines the importance of careful history taking before interpretation of PET scans. Viral infections should be included in the differential diagnosis of pulmonary diffuse F-18 FDG uptake.