Seroprevalence and Associated Risk Factors of Toxoplasma gondii in Patients Diagnosed with Schizophrenia: A Case-Control Cross Sectional Study.

The protozoan parasite, Toxoplasma gondii, has been linked to several psychiatric disorders, including schizophrenia. The aim of this study was to assess the prevalence of T. gondii IgG antibodies and risk factors associated with seroprevalence in patients diagnosed with schizophrenia. This seroepidemiological study assessed 196 participants, divided into two groups. The study group consisted of 98 schizophrenic patients and was matched with 98 healthy blood donors. A questionnaire was used to gather information regarding potential risk factors associated with T. gondii seroprevalence. Results revealed a higher seroprevalence of T. gondii IgG antibodies in schizophrenic patients (69.39%, 68/98) when compared to healthy controls (51.02%, 50/98) (OR: 2.18; 95% CI: 1.21-3.9; p = 0.01). Patients with schizophrenia who consumed raw or undercooked meat (80.65%, 25/31) (OR: 3.75; 95% CI: 1.25-11.21, p = 0.02) and those with a lower educational level (77.59%, 45/58) (OR: 3.5; 95% CI: 1.59-7.54, p = 0.002) presented increased T. gondii seropositivity rates versus their control counterparts. Our findings indicate a high T. gondii IgG seroprevalence in patients diagnosed with schizophrenia compared to healthy blood donors. Factors associated with T. gondii seroprevalence were consumption of raw or uncooked meat and a lower educational attainment. This study provided the first data regarding the potential risk factors for toxoplasmosis in Romanian patients diagnosed with schizophrenia and may serve as a foundation for future research and the development of preventive strategies.

Dynamic shifts in lung cytokine patterns in post-COVID-19 interstitial lung disease patients: a pilot study.

Introduction: The pathogenesis of post-COVID interstitial lung disease, marked by lung tissue scarring and functional decline, remains largely unknown. Objectives: We aimed to elucidate the temporal cytokine/chemokine changes in bronchoalveolar lavage (BAL) from patients with post-COVID interstitial lung disease to uncover potential immune drivers of pulmonary complications. Design: We evaluated 16 females diagnosed with post-COVID interstitial lung disease, originating from moderate to severe cases during the second epidemic wave in the Autumn of 2020, treated at the Pneumology Department of the Arad County Clinical Hospital, Romania. Their inflammatory response over time was compared to a control group. Methods: A total of 48 BAL samples were collected over three intervals (1, 3, and 6 months) and underwent cytology, gene, and protein expression analyses for pro/anti-inflammatory lung cytokines and chemokines using reverse transcription polymerase chain reaction and enzyme-linked immunosorbent assay. Results: One month after infection, there were significant increases in the levels of IL-6 and IL-8. These levels decreased gradually over the course of 6 months but were still higher than those seen in control. Interferon-gamma and tumor necrosis factor alpha exhibited similar patterns. Persistent elevations were found in IL-10, IL-13, and pro-fibrotic M2 macrophages' chemokines (CCL13 and CCL18) for 6 months. Furthermore, pronounced neutrophilia was observed at 1 month post-COVID, highlighting persistent inflammation and lung damage. Neutrophil efferocytosis, aiding inflammation resolution and tissue repair, was evident at the 1-month time interval. A notable time-dependent reduction in CD28 was also noticed. Conclusion: Our research provides insight into the immunological processes that may lead to the fibrotic changes noted in the lungs following COVID-19.

BACKGROUND: Post-COVID lung disease represents a significant health concern that demands comprehensive research. The pathogenesis of post-COVID interstitial lung disease, marked by lung tissue scarring and functional decline, remains largely unknown. METHODS: We evaluated 16 females diagnosed with post-COVID interstitial lung disease, originating from moderate to severe cases during the second epidemic wave in the Autumn 2020, treated at the Pneumology Department of the Arad County Clinical Hospital, Romania. Their inflammatory response over time was compared to a control group. A total of 48 BAL samples were collected over three intervals (1, 3, and 6 months) and underwent cytology, gene, and protein expression analyses for pro/anti-inflammatory lung cytokines and chemokines using RT-PCR and ELISA The interrelationships between the expression levels of various pro-inflammatory and anti-inflammatory cytokines and chemokines by Pearson's correlations was investigated. RESULTS: One month after infection, there were significant increases in the levels of IL-6 and IL-8. These levels decreased gradually over the course of six months but were still higher than those seen in control. IFN-γ and TNF-α exhibited similar patterns. Persistent elevations were found in IL-10, IL-13, and pro-fibrotic M2 macrophages' chemokines (CCL13 and CCL18) for six months. Pronounced neutrophilia was observed at 1 month post-COVID, highlighting persistent inflammation and lung damage. Neutrophils efferocytosis, aiding inflammation resolution and tissue repair, was evident at the 1-month time-interval. A notable time-dependent reduction in CD28 was also noticed. CONCLUSIONS: Our research provides insight into the immunological processes that may lead to the fibrotic changes noted in the lungs following COVID-19.

Dynamic shifts in lung cytokine patterns in post-COVID-19 interstitial lung disease patients: a pilot study The objective of this pilot study was to investigate changes in lung cytokine pro- and anti-inflammatory profiles among patients with interstitial lung disease after COVID-19 infection.

Retrospective Analysis of Vitamin D Deficiency in an Adult Population of Arad County, Western Romania (2019-2022).

Vitamin D, a steroid hormone synthesized primarily in the skin upon exposure to ultraviolet light, is widely deficient across global populations. This study aimed to fill the data gap in Western Romania by measuring 25-hydroxy-vitamin D levels in a cohort of 7141 from Arad County. It was observed that women, younger adults (18-29 years), and older adults (70-79 years) had notably lower vitamin D levels compared to the average population. Additionally, there was a rise in vitamin D levels over the four-year span of 2018-2022, coinciding with the COVID-19 pandemic. Our research provides fresh data on those most susceptible to vitamin D deficiency and lays the groundwork for educational campaigns on vitamin D supplementation benefits.

Prevalence of Toxoplasma gondii IgG Antibodies and Associated Risk Factors in Psychiatric Patients from Western Romania: A Cross-Sectional Study.

Infection with the coccidian parasite Toxoplasma gondii was associated with an increased risk of several mental disorders. We conducted a case-control study of 464 consecutive psychiatric patients and assessed the prevalence of IgG antibodies against T. gondii and the potential risk factors associated with infection. T. gondii-specific antibodies were determined using a chemiluminescence assay. A questionnaire was utilized to assess the potential correlation between risk factors and Toxoplasma gondii seropositivity. IgG antibodies were found in 325 (70.04%) of the patients. We observed a higher likelihood of positive IgG antibodies against Toxoplasma gondii in older individuals, patients residing in rural areas, and females. We also noted associations between Toxoplasma gondii infection and certain risk factors, like activities that involve contact with soil, low-income levels, and limited educational attainment. Our findings indicate a high prevalence of T. gondii infection among psychiatric patients from Western Romania and provide new information regarding the potential risk factors associated with T. gondii in this population group. This study may serve as a foundation for future research and the development of preventive strategies.

Cystic Echinococcosis in Hospitalized Adult Patients from Western Romania: 2007-2022.

Cystic echinococcosis (CE) is a neglected parasitic disease caused by the tapeworm Echinococcus granulosus. The aim of this study was to assess the epidemiological features of human cystic echinococcosis in patients from Western Romania. We retrospectively investigated the medical records of patients hospitalized with CE between 1 January 2007 and 1 September 2022. A total of 366 patients (range 18-90 years) were recorded. The number of hospitalized individuals was higher in patients aged 50-59 years (83/366, 22.7%), in females (194/366, 53%), and in residents of rural areas (225/366, 61.5%). The liver was the most common localization of the cysts (302/366, 82.5%). Ninety-eight patients (26.8%) presented complications, including biliary fistula, allergies, and infection of the cyst. Patients with complications had a longer mean hospital stay (15.7 ± 8.3 days) compared to patients without complications (11.5 ± 7.3 days) (p < 0.001). The results of this study revealed that patients diagnosed with CE required hospitalization and extended medical care, indicating that this zoonotic disease remains a significant public health problem in Western Romania. Public health authorities should enhance CE surveillance by implementing control programs and mandatory notification of new cases.

COVID-19 association with multidrug-resistant bacteria superinfections: Lessons for future challenges.

The future waves of COVID 19 infections will continue to raise serious problems in patients with severe forms of the disease. Bacterial infections associated with SARS-CoV-2 disease may complicate the progress of hospitalized patients with COVID-19. The present study aimed to evaluate the etiological spectrum of superinfection in adult patients with COVID-19 and to investigate the correlation between superinfection with multidrug-resistant (MDR) bacteria and serum procalcitonin (PCT). A total of 82 COVID-19 hospitalized patients with COVID-19 and bacterial superinfection were included. The superinfections were classified into early infections (3-7 days from admission) and late infections (>7 days from admission). Bacterial superinfection etiological spectrum, MDR bacteria profile and levels of serum PCT were studied. The most frequently isolated bacteria were Klebsiella pneumoniae, Acinetobacter baumannii and Enterococcus spp. MDR bacteria were involved in 73.17% of COVID-19 patients with bacterial superinfections. Most MDR bacteria superinfections (73.52%) occurred in the late infection period. Klebsiella pneumoniae, Enterococcus spp. and Methicillin-resistant Staphylococcus aureus were the most common MDR bacteria identified in late infections after hospitalization in 20.43, 4.30 and 4.30% of all infections, respectively. Serum PCT values were significantly higher in patients with MDR bacteria superinfection compared with patients with sensitive bacteria superinfection (P=0.009). The principal findings of the present study were the high prevalence of superinfection with MDR bacteria among the COVID-19 patients with bacterial superinfections and the presence of a statistically significant association between serum PCT levels and the presence of superinfection with MDR bacteria. The most effective way to fight against microbial resistance to antibiotics, whether it occurs independently or overlaps with viral infections, is to pursue a national policy for the rational use of antibiotics.

First Case of Raoultella planticola Urinary Tract Infection Reported in Western Romania.

Raoultella planticola is a Gram-negative bacterium rarely involved in urinary tract infections. The patient was an 80-year-old woman with several associated diseases who presented to the hospital with fever and dysuria. Raoultella planticola was identified to be the causative agent of the urinary tract infection. Antibacterial treatment led to a full recovery within 7 days. This report highlights the presence of a rare pathogen as a causative agent in the case of a urinary tract infection and also the importance of using multiple methods in order to identify bacteria and to establish the diagnosis.

Screening for the Detection of Toxoplasma gondii IgG, IgM and IgA in Females of Reproductive Age from Western Romania.

Toxoplasma gondii, a zoonotic protozoan parasite, has the capacity to infect the fetus if the pregnant woman primarily acquires the infection during pregnancy. We evaluated the prevalence of T. gondii IgG, IgM and IgA antibodies in women of reproductive age residing in Western Romania. We also assessed the value of adding a T. gondii IgA test to the serologic panel for the diagnosis of toxoplasmosis, including the detection of a recently acquired infection. Serologic testing to demonstrate the presence of T. gondii IgG antibodies was conducted in 1317 females aged 15−45 years. T. gondii IgM and IgA antibody tests were performed in those with detectable IgG antibodies and IgG avidity test was performed if IgM and/or IgA screening test results were positive. T. gondii IgG were detected in 607 (46.09%; 95%CI: 43.41−48.79) of 1317 study participants and IgG seroprevalence tended to increase with age from 35.44% (95%CI: 29.89−41.30) in age group 15−24 years to 62.85% (95%CI: 56.57−68.82) in age group 35−45 years, showing a significant age-associated increase (p < 0.001). Of the 607 persons with detectable T. gondii IgG antibodies, T. gondii IgM antibodies were demonstrated in 8.90% (95%CI: 6.88−11.43), T. gondii IgA in 1.65% (95%CI: 0.90−3.01) and both T. gondii IgM and IgA in 0.99% (95%CI: 0.45−2.14). The prevalence of IgA antibodies tended to decrease with increasing avidity, from 75% (95%CI: 19.41−99.37) in samples with low avidity to 11.76% (95%CI: 4.44−23.87) in those with high avidity (p = 0.01). Of the study participants who were positive for both T. gondii IgM and IgA antibodies, 66.67% had low or equivocal IgG avidity test results compared to 6.25% who tested positive for IgM, were negative for IgA and in whom low or equivocal IgG avidity test results were noted (p = 0.001). This study indicates that in Western Romania, T. gondii IgG seroprevalence is high in females of reproductive age and T. gondii IgA antibodies may be rarely detected during a serologic screening. However, in individuals with demonstrable T. gondii IgG and IgM antibodies, testing for T. gondii IgA may improve the rate for the detection of a recently acquired toxoplasmosis.

Cellular and Molecular Mechanism of Pulmonary Fibrosis Post-COVID-19: Focus on Galectin-1, -3, -8, -9.

Pulmonary fibrosis is a consequence of the pathological accumulation of extracellular matrix (ECM), which finally leads to lung scarring. Although the pulmonary fibrogenesis is almost known, the last two years of the COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its post effects added new particularities which need to be explored. Many questions remain about how pulmonary fibrotic changes occur within the lungs of COVID-19 patients, and whether the changes will persist long term or are capable of resolving. This review brings together existing knowledge on both COVID-19 and pulmonary fibrosis, starting with the main key players in promoting pulmonary fibrosis, such as alveolar and endothelial cells, fibroblasts, lipofibroblasts, and macrophages. Further, we provide an overview of the main molecular mechanisms driving the fibrotic process in connection with Galactin-1, -3, -8, and -9, together with the currently approved and newly proposed clinical therapeutic solutions given for the treatment of fibrosis, based on their inhibition. The work underlines the particular pathways and processes that may be implicated in pulmonary fibrosis pathogenesis post-SARS-CoV-2 viral infection. The recent data suggest that galectin-1, -3, -8, and -9 could become valuable biomarkers for the diagnosis and prognosis of lung fibrosis post-COVID-19 and promising molecular targets for the development of new and original therapeutic tools to treat the disease.

Seroepidemiology of Toxoplasma gondii Infection in Blood Donors from Western Romania.

Background: Toxoplasma gondii is estimated to infect 33% of blood donors worldwide, and seroprevalence varies widely between countries. We aimed to evaluate, for the first time, the seroprevalence and risk factors associated with T. gondii in blood donors from Western Romania. Methods: Serologic testing to demonstrate the presence of T. gondii antibodies was conducted in 1347 healthy blood donors. Risk factors for T. gondii infection were assessed through an epidemiological questionnaire. Results: The overall prevalence of T. gondii antibodies was 45.9%, with a significant age-associated increase (p < 0.001) from 32.6% in age group 18−25 years to 67.6% in age group 56−63 years. T. gondii seroprevalence decreased with increasing level of education, from 64.3% in individuals who graduated from elementary/middle school to 40.4% in those who graduated from University (p < 0.001). The multiple logistic regression analysis revealed that age, level of education and having pets (cats and/or dogs) were significantly associated with T. gondii infection. Conclusions: This study brings new and valuable data regarding the seroepidemiology of T. gondii infection in Romania. Our findings indicate a high prevalence of T. gondii antibodies in blood donors and may serve as a starting point for further epidemiological studies that should lead to implementation of prevention programs for toxoplasmosis.

Toxoplasma gondii Infection in Patients with Psychiatric Disorders from Western Romania.

Background and Objectives: High rates of infection with Toxoplasma gondii were found in psychiatric patients globally. In this study, we assessed for the first time the prevalence of T. gondii infection in psychiatric patients and healthy individuals with no known psychiatric disorders in Western Romania. Materials and Methods: The presence of specific IgG anti-T. gondii antibodies was evaluated in 308 psychiatric patients and 296 control subjects using a chemiluminescence assay. Results: Overall, the seroprevalence of IgG antibodies was higher in psychiatric patients (67.86%; 209/308), compared with the control group (54.05%; 160/296) (p < 0.001). Our results revealed a significantly higher prevalence of T. gondii antibodies among patients with schizophrenia (69.77%), organic (personality and behaviour) disorders (76.74%), and mental disorders concerning alcohol abuse (84.62%), compared with the control group (p = 0.009, p = 0.005, p = 0.043, respectively). Conclusions: This study provides new and important information on the seroprevalence of T. gondii in Romanian psychiatric patients and may serve for further scientific research regarding the status of T. gondii infection in patients with psychiatric disorders.

Seroprevalence of Toxoplasma gondii in Females Aged 15-45 Years from Bihor County, Western Romania.

Toxoplasma gondii is a protozoan parasite that causes an important worldwide zoonosis called toxoplasmosis. This infection is often asymptomatic in immunocompetent people. If the infection occurs in pregnant women, it poses great risks to the infant due to its clinical manifestations as mental retardation, seizures, or chorioretinitis. In this study, we evaluated the seroprevalence of IgG antibodies against T. gondii in females aged 15-45 years in Bihor County, Romania. Serum samples drawn from 1935 females aged 15-45 years were screened for IgG antibodies against T. gondii. T. gondii antibodies were found in 706 females (36.48%) and the proportion of IgG positive females tended to increase with age. The seroprevalence was higher in females residing in rural areas (47.79%) compared with those from urban areas (30.95%). This is the first study on the seroprevalence of toxoplasmosis in females aged 15-45 years from Bihor County, Romania. Our survey brings new and important data regarding the seroepidemiology of T. gondii and provides an insight into the demographic risk factors as a basis for a future prevention program for toxoplasmosis.

Seroprevalence of Toxoplasma gondii infection among women of childbearing age in an endemic region of Romania, 2016-2018.

Toxoplasmosis is an important worldwide zoonosis caused by the protozoan parasite Toxoplasma gondii. This parasitic infection is often asymptomatic in immunocompetent people. However, if the infection occurs in pregnant women, it can have serious consequences for the foetus. In this study, we evaluated the seroprevalence of T. gondii in women of childbearing age in Arad County, Western Romania. Serum samples from 2626 women were analysed using a Siemens ADVIA Centaur XP Immunoassay System. Toxoplasma gondii IgG antibodies were demonstrated in 1081 women (41%) and prevalence tended to increase with age, from 32% in women aged 15-19 years to 62% in women aged 40-45 years. There was a higher prevalence in rural areas (46%) than in urban areas (36%). This study provides new data on T. gondii seroprevalence in women of childbearing age from Western Romania.

TITLE: Séroprévalence de l'infection à Toxoplasma gondii chez les femmes en âge de procréer dans une région endémique de la Roumanie, 2016-2018. ABSTRACT: La toxoplasmose est une zoonose mondiale importante causée par le parasite protozoaire Toxoplasma gondii. Cette infection parasitaire est souvent asymptomatique chez les sujets immunocompétents. Cependant, si l'infection survient chez la femme enceinte, elle peut avoir de graves conséquences pour le fœtus. Dans cette étude, nous avons évalué la séroprévalence de T. gondii chez les femmes en âge de procréer dans le comté d'Arad, dans l'ouest de la Roumanie. Des échantillons de sérum de 2626 femmes ont été analysés avec le Siemens ADVIA Centaur XP. Des anticorps IgG contre T. gondii ont été mis en évidence chez 1081 femmes (41 %) et la prévalence avait tendance à augmenter avec l'âge, passant de 32 % chez les femmes âgées de 15 à 19 ans à 62 % chez les femmes âgées de 40 à 45 ans. La prévalence était plus élevée dans les zones rurales (46 %) que dans les zones urbaines (36 %). Cette étude fournit de nouvelles données sur la séroprévalence de T. gondii chez les femmes en âge de procréer de l'ouest de la Roumanie.