Toxoplasma gondii infection and insomnia: A case control seroprevalence study.

We determined the association between Toxoplasma gondii (T. gondii) infection and insomnia. Through an age-and gender-matched case-control study, 577 people with insomnia (cases) and 577 people without insomnia (controls) were tested for anti-T. gondii IgG and IgM antibodies using commercially available enzyme-immunoassays. Anti-T. gondii IgG antibodies were found in 71 (12.3%) of 577 individuals with insomnia and in 46 (8.0%) of 577 controls (OR = 1.62; 95% CI: 1.09-2.39; P = 0.01). Men with insomnia had a higher (16/73: 21.9%) seroprevalence of T. gondii infection than men without insomnia (5/73: 6.8%) (OR: 3.81; 95% CI: 1.31-11.06; P = 0.009). The rate of high (>150 IU/ml) anti-T. gondii IgG antibody levels in cases was higher than the one in controls (OR = 2.21; 95% CI: 1.13-4.31; P = 0.01). Men with insomnia had a higher (8/73: 11.0%) rate of high anti-T. gondii IgG antibody levels than men without insomnia (0/73: 0.0%) (P = 0.006). The rate of high anti-T. gondii IgG antibody levels in cases >50 years old (11/180: 6.1%) was higher than that (3/180: 1.7%) in controls of the same age group (OR: 3.84; 95% CI: 1.05-14.00; P = 0.05). No difference in the rate of IgM seropositivity between cases and controls was found (OR = 1.33; 95% CI: 0.57-3.11; P = 0.50). Results of this seroepidemiology study suggest that infection with T. gondii is associated with insomnia. Men older than 50 years with T. gondii exposure might be prone to insomnia. Further research to confirm the association between seropositivity and serointensity to T. gondii and insomnia is needed.

Clinical value of procalcitonin in critically ill patients infected by SARS-CoV-2.

Background Blood procalcitonin (PCT) levels usually increase during infectious diseases and might be helpful to differentiate bacterial from non-bacterial origin. COVID-19 patients could present co-infections at initial presentation in the Emergency Department and nosocomial infections during stay in the ICU. However, the published literature has not established whether PCT changes could aid in the diagnosis of infectious complication during the COVID-19 pandemic. Methods Retrospective, single-center, cohort study, including COVID-19 patients admitted between March and May 2020. The data were prospectively collected for department purposes; laboratory results were collected automatically at admission and during the whole patient admission. Results 56 patients were analyzed (female 32%, male 68%), 35 were admitted to ICU, and 21 received general ward care. 21 ICU patients underwent mechanical ventilation (88%), and 9 died during admission (26%). Non-survivors had higher initial blood PCT levels than survivors at ICU admission (p.

Patterns of paediatric end-of-life care: a chart review across different care settings in Switzerland.

BACKGROUND: Paediatric end-of-life care is challenging and requires a high level of professional expertise. It is important that healthcare teams have a thorough understanding of paediatric subspecialties and related knowledge of disease-specific aspects of paediatric end-of-life care. The aim of this study was to comprehensively describe, explore and compare current practices in paediatric end-of-life care in four distinct diagnostic groups across healthcare settings including all relevant levels of healthcare providers in Switzerland. METHODS: In this nationwide retrospective chart review study, data from paediatric patients who died in the years 2011 or 2012 due to a cardiac, neurological or oncological condition, or during the neonatal period were collected in 13 hospitals, two long-term institutions and 10 community-based healthcare service providers throughout Switzerland. RESULTS: Ninety-three (62%) of the 149 reviewed patients died in intensive care units, 78 (84%) of them following withdrawal of life-sustaining treatment. Reliance on invasive medical interventions was prevalent, and the use of medication was high, with a median count of 12 different drugs during the last week of life. Patients experienced an average number of 6.42 symptoms. The prevalence of various types of symptoms differed significantly among the four diagnostic groups. Overall, our study patients stayed in the hospital for a median of six days during their last four weeks of life. Seventy-two patients (48%) stayed at home for at least one day and only half of those received community-based healthcare. CONCLUSIONS: The study provides a wide-ranging overview of current end-of-life care practices in a real-life setting of different healthcare providers. The inclusion of patients with all major diagnoses leading to disease- and prematurity-related childhood deaths, as well as comparisons across the diagnostic groups, provides additional insight and understanding for healthcare professionals. The provision of specialised palliative and end-of-life care services in Switzerland, including the capacity of community healthcare services, need to be expanded to meet the specific needs of seriously ill children and their families.

Influence of Toxoplasma Gondii Infection on Symptoms and Signs of Premenstrual Syndrome: A Cross-sectional Study.

Infection with Toxoplasma gondii in brain may cause some symptoms that resemble those in women with premenstrual syndrome. To determine the association of T. gondii infection with symptoms and signs of premenstrual syndrome, we examined 489 women aged 30-40 years old. Sera of participants were analyzed for the presence of anti-Toxoplasma IgG and IgM antibodies using enzyme-linked immunoassays (EIA) and T. gondii DNA by polymerase chain reaction (PCR). Anti-T. gondii IgG antibodies were found in 38 (7.8%) of the women studied. Anti-T. gondii IgM antibodies were found in 13 (34.2%) of the 38 IgG seropositive women. Logistic regression showed two variables associated with seropositivity to T. gondii: presence of diarrhea (odds ratio [OR] = 6.10; 95% confidence interval [CI]: 1.37-27.85; P = 0.01) and weight gain (OR = 2.89; 95% CI: 1.37-6.07; P = 0.005), and two variables associated with high (>150 IU/ml) levels of IgG against T. gondii: presence of diarrhea (OR = 7.40; 95% CI: 1.79-30.46; P = 0.006) and abdominal inflammation (OR = 3.38; 95% CI: 1.13-10.10; P = 0.02). Positivity to EIA IgG and PCR was positively associated with obesity and negatively associated with joint pain by bivariate analysis. Our study for the first time reveals a potential association of T. gondii infection with clinical manifestations of premenstrual syndrome.

Toxoplasma gondii Infection and Premenstrual Dysphoric Disorder: A Cross-Sectional Study.

BACKGROUND: Premenstrual dysphoric disorder is a severe form of premenstrual syndrome. The influence of Toxoplasma gondii (T. gondii) infection on clinical features in women with this disorder has not been studied. Therefore, we determined the association of T. gondii infection with symptoms and signs in women suffering from premenstrual dysphoric disorder. METHODS: We performed a cross-sectional study of 151 women suffering from premenstrual dysphoric disorder. Anti-Toxoplasma IgG and IgM antibodies were detected in sera of the participants using enzyme-linked immunoassays (EIAs). In addition, T. gondii DNA was detected in whole blood of IgG seropositive participants using polymerase chain reaction. We obtained the clinical data of women with the aid of a questionnaire. The association of T. gondii infection with clinical characteristics of women was assessed by bivariate and multivariate analyses. RESULTS: Anti-T. gondii IgG antibodies were found in 10 (6.6%) of the 151 women studied. Of the 10 IgG seropositive women, four (40.0%) were positive for anti-T. gondii IgM antibodies, and one (10.0%) for T. gondii DNA. Mean number (25.8 ± 7.58) of premenstrual clinical characteristics in seropositive women was similar to that (29.22 ± 9.13) found in seronegative women (P = 0.25). Logistic regression showed that seropositivity to T. gondii was negatively associated with difficulty concentrating (OR: 0.18; 95% CI: 0.03 - 0.91; P = 0.03), and positively associated with out of control feeling or overwhelmed (OR: 9.00; 95% CI: 1.32 - 62.00; P = 0.02). CONCLUSIONS: Results of this first study on the association of T. gondii infection and clinical characteristics of premenstrual dysphoric disorder suggest that this infection might be linked to some symptoms of this disorder. We report for the first time the association of T. gondii infection and out of control feeling or overwhelmed. Results warrant for further research on the role of T. gondii in premenstrual dysphoric disorder.

Seroepidemiology of Toxoplasma Gondii Infection in People Applying for Medical Certificates.

Medical certificates are documents that state the health status of a person. This study aimed to determine the seroprevalence and risk factors for Toxoplasma gondii infection in applicants of medical certificates and to investigate seroprevalence association with characteristics of these individuals. We examined 404 applicants in a public health center in Durango City, Mexico for the presence of anti-Toxoplasma IgG and IgM antibodies using enzyme-linked immunoassays. Of the 404 subjects (mean age of 35.94 ± 13.01) studied, 29 (7.2%) were positive for anti-T. gondii IgG antibodies and 9 (31.0%) of them were also positive for anti-T. gondii IgM antibodies. IgG and IgM seropositivities were associated with vision impairment (P = 0.04) and a history of surgery (P = 0.03), respectively. Prevalence of high (>150 IU/ml) IgG antibody levels was associated with hearing impairment (P = 0.03), and histories of lymphadenopathy (P = 0.04) and miscarriages (P = 0.03). Multivariate analysis showed that T. gondii seropositivity was associated with being born out of Durango State (odds ratio [OR] = 4.65; 95% confidence interval [CI]: 1.25-17. 29; P = 0.02) and soil contact (OR = 4.27; 95% CI: 1.71-10.67; P = 0.002) and negatively associated with consumption of sheep meat (OR = 0.12; 95% CI: 0.02-0.65; P = 0.01). These results could be used for the design of optimal preventive measures against toxoplasmosis and its sequelae.

Influence of Toxoplasma Gondii Infection on Symptoms and Signs of Menopause.

Some symptoms of menopause have also been described in patients with toxoplasmosis. Whether Toxoplasma gondii (T. gondii) infection has any influence on clinical manifestations of menopause is yet unknown. We sought to determine whether T. gondii exposure is associated with symptoms and signs of menopause. We performed a cross-sectional study of women attending a public health center in Durango City, Mexico. Participants were examined for the presence of anti-Toxoplasma IgG and IgM antibodies using enzyme-linked immunoassays. A questionnaire including 47 symptoms and signs potentially associated with menopause was applied. Association of seroprevalence for T. gondii with clinical characteristics of women was assessed by bivariate and multivariate analyses. Bivariate analysis showed that bouts of rapid heartbeat, breast pain, electric shock sensation, dizziness, digestive problems, low back pain, and migraine were associated with seropositivity to either IgG anti-T. gondii alone or both IgG and IgM anti-T. gondii. Breast pain was the only variable that was found to be associated with IgG seropositivity to T. gondii by multivariate analysis: (OR = 2.84; 95% CI: 1.35-5.90; P = 0.005). Our results suggest that T. gondii exposure may influence on the clinical manifestations of menopause. Results deserve further research.