Evaluation of a surveillance system for Clostridioides difficile infections for Swiss hospitals.

AIMS: This study evaluated an approach to establishing a comprehensive nationwide surveillance system for Clostridioides difficile infection in Switzerland. We report the results of patient-related surveillance and calculate the incidence rate of C. difficile infection in Switzerland in 2022. METHODS: Initiated in 2017 by the National Centre for Infection Prevention (Swissnoso), in collaboration with the Swiss Centre for Antibiotic Resistance (ANRESIS), laboratory surveillance enables the automatic import of C. difficile infection laboratory data and is fully operational. However, the very limited number of participating laboratories impedes the generation of representative results. To address this gap, Swissnoso introduced patient-related surveillance, with a questionnaire-based survey used across Swiss acute care hospitals. RESULTS: This survey revealed an incidence of 3.8 (Poisson 95% CI: 3.2-4.5) C. difficile infection episodes per 10,000 patient-days, just above the mean rate reported by the European Centre for Disease Prevention and Control (ECDC). Additionally, we report substantial heterogeneity in laboratory tests, diagnostic criteria and infection control practices among Swiss hospitals. CONCLUSION: This study underscores the importance of a joint effort towards standardized surveillance practices in providing comprehensive insights into C. difficile infection epidemiology and effective prevention strategies in Swiss healthcare settings. The patient-related approach remains the gold standard for C. difficile infection surveillance, although it demands substantial resources and provides results only annually. The proposed implementation of nationwide automated laboratory-based surveillance would be pragmatic and efficient, empowering authorities and hospitals to detect outbreaks promptly and to correlate infection rates with antibiotic consumption.

A Reanalysis of Historical Figures With Depression and Dropsy.

OBJECTIVES: Recent studies suggest a link between chronic kidney disease and brain dysfunctions such as depression and cognitive problems. A review of medieval and early-modern historical figures with aspects of both kidney disease (gout and edema [dropsy]) and depression (melancholia) shows that these conditions were observed together in the past. MATERIALS AND METHODS: References to the diseases of gout, dropsy, and melancholia were compared in literature on historical subjects. Case studies are reported to detail a previously unremarked com-bination of current kidney disease and depression comorbidity in historical writings. RESULTS: The poet Boccaccio had gout and melancholia, and some descendants of the Portuguese Avis and Spanish Trastàmara dynasties, known for melancholia and madness, also had gout and dropsy. Historical case series of causes of death for sultans of the Ottoman Empire suggest an association among dropsy, gout, and melancholia. CONCLUSIONS: In this article, we reviewed the medical research on the comorbidity of kidney disease and depression and shared case studies of historical figures with these conditions and posit not previously noted data supporting comorbidity observations in historical writings.

Anxiety as a neurodevelopmental disorder in a neuronal subpopulation: Evidence from gene expression data.

The relationship between genes and anxious behavior, is nor linear nor monotonic. To address this problem, we analyzed with a meta-analytic method the literature data of the behavior of knockout mice, retrieving 33 genes whose deletion was accompanied by increased anxious behavior, 34 genes related to decreased anxious behavior and 48 genes not involved in anxiety. We correlated the anxious behavior resulting from the deletion of these genes to their brain expression, using the Allen Brain Atlas and Gene Expression Omnibus (GEO) database. The main finding is that the genes accompanied, after deletion, by a modification of the anxious behavior, have lower expression in the cerebral cortex, the amygdala and the ventral striatum. The lower expression level was putatively due to their selective presence in a neuronal subpopulation. This difference was replicated also using a database of human gene expression, further showing that the differential expression pertained, in humans, a temporal window of young postnatal age (4 months up to 4 years) but was not evident at fetal or adult human stages. Finally, using gene enrichment analysis we also show that presynaptic genes are involved in the emergence of anxiety and postsynaptic genes in the reduction of anxiety after gene deletion.

Freely dissolved concentrations of anionic surfactants in seawater solutions: optimization of the non-depletive solid-phase microextraction method and application to linear alkylbenzene sulfonates.

A solid-phase microextraction method (SPME) has been optimized for the analysis of freely dissolved anionic surfactants, namely linear alkylbenzene sulfonates (LAS), in seawater. An effect of the thermal conditioning treatment on the polyacrylate fiber coating was demonstrated for both uptake kinetics and sorption isotherm linearity. Thermal conditioning at 120 degrees C yielded linear sorption isotherms and reproducible SPME measurements for several individual LAS compounds, with detection limits at the low microgram per liter range. Sorption of LAS to the conditioned SPME fiber was independent of LAS co-solutes in mixtures. The method has been applied to study the precipitation of LAS in seawater, and solubility data for a wide range of individual LAS constituents is presented for the first time. Hence, the developed SPME method for the anionic LAS has shown to be a useful tool in complex matrices. The advantage of the SPME analyses in complex matrices is, besides its simplicity, that it also leads to clean extracts for chromatographic analyses.

Fast immobilization of probe beads by dielectrophoresis-controlled adhesion in a versatile microfluidic platform for affinity assay.

The use of probe beads for lab-on-chip affinity assays is very interesting from a practical point of view. It is easier to handle and trap beads than molecules in microfluidic systems. We present a method for the immobilization of probe beads at defined areas on a chip using dielectrophoresis (DEP)-controlled adhesion. The method is fast, i.e., it takes between 10 and 120 s--depending on the protocol--to functionalize a chip surface at defined areas. The method is versatile, i.e., it works for beads with different types of probe molecule coatings. The immobilization is irreversible, i.e., the retained beads are able to withstand high flow velocities in a flow-through device even after the DEP voltage is turned off, thus allowing the use of conventional high-conductivity analyte buffers in the following assay procedure. We demonstrate the on-chip immobilization of fluorescent beads coated with biotin, protein A, and goat-antimouse immunoglobulin G (IgG). The number of immobilized beads at an electrode array can be determined from their fluorescence signal. Further, we use this method to demonstrate the detection of streptavidin and mouse IgG. Finally, we demonstrate the feasibility of the parallel detection of different analyte molecules on the same chip.

Black bile and psychomotor retardation: shades of melancholia in Dante's Inferno.

The history of melancholy depression is rich with images of movement retardation and mental dysfunction. The recent restoration of psychomotor symptoms to the diagnostic terminology of affective disorder is not novel to the students of medieval melancholia. The move back to the biology of this psychomotor dysfunction with the technical advances in brain imaging in recent years only echoes centuries-old writings on the centrality of movement changes in the depressive condition. The Inferno, the first cantica of Dante Alighieri's Commedia, has a wonderful abundance of allusions to the importance of psychomotor symptoms in describing the depressed individual. Slowed steps, garbled speech, frozen tears, these and many other images keep the physical manifestations of psychomotor suffering in the forefront of the reader's mind. Considering Medieval and Renaissance writings on melancholy suffering, it is fitting that Dante shows a bodily illness reflected in the hellish torments visited on the damned. From the souls of the sullen to those of the violent, the panorama of psychomotor symptoms plays a prominent role in the poem as well as in the medical and literary prose of succeeding centuries.