Asymptomatic and yet C. difficile-toxin positive? Prevalence and risk factors of carriers of toxigenic Clostridium difficile among geriatric in-patients

Abstract Background Clostridium difficile infections (CDI) are the most frequent cause of diarrhoea in hospitals. Geriatric patients are more often affected by the condition, by a relapse and complications. Therefore, a crucial question is how often colonization with toxigenic Clostridium difficile strains occurs in elderly patients without diarrhoea and whether there is a “risk pattern” of colonized patients that can be defined by geriatric assessment. Furthermore, the probability for those asymptomatic carriers to develop a symptomatic infection over time has not been sufficiently explored. Methods We performed a cohort study design to assess the association of clinical variables with Clostridium difficile colonization. The first stool sample of 262 consecutive asymptomatic patients admitted to a geriatric unit was tested for toxigenic Clostridium difficile using PCR (GeneXpert, Cepheid). A comprehensive geriatric assessment (CGA) including Barthel Index, Mini Mental State Examination (MMSE) and hand grip-strength was performed. In addition, Charlson Comorbidity Index, body mass index, number and length of previous hospital stays, previous treatment with antibiotics, institutionalization, primary diagnoses and medication were recorded and evaluated as possible risk factors of colonization by means of binary logistic regression. Secondly, we explored the association of C. difficile colonization with subsequent development of CDI during hospital stay. Results At admission, 43 (16.4%) patients tested positive for toxin B by PCR. Seven (16.3%) of these colonized patients developed clinical CDI during hospital stay, compared to one out of 219 patients with negative or invalid PCR testing (Odds ratio 12,3; Fisher’s exact test: p = 0.000). Overall, 7 out of 8 (87.5%) CDI patients had been colonized at admission. Risk factors of colonization with C. difficile were a history of CDI, previous antibiotic treatment and hospital stays. The parameters of the CGA were not significantly associated with colonization. Conclusion Colonization with toxigenic Clostridium difficile strains occurs frequently in asymptomatic patients admitted to a geriatric unit. Previous CDI, antibiotic exposure and hospital stay, but not clinical variables such as CGA, are the main factors associated with asymptomatic Clostridium difficile carriage. Colonization is a crucial risk factor for subsequent development of symptomatic CDI

Prevalence of metabolic syndrome in patients with schizophrenia, and metabolic changes after 3 months of treatment with antipsychotics - results from a German observational study

<p>Abstract</p> <p>Background</p> <p>This observational study explored the prevalence of metabolic syndrome (MetS) in adult in- and outpatients with untreated or treated schizophrenia at baseline, and month-3 after initiation or switch of antipsychotic treatment.</p> <p>Methods</p> <p>MetS-prevalence (AHA/NHLB-definition) was assessed and Clopper-Pearson 95% confidence intervals (CIs) were calculated. Factors associated with MetS were explored through univariate and multivariate logistic regressions (both visits).</p> <p>Results</p> <p>MetS-prevalence was 44.3% (CI 39.8;48.9) at baseline and 49.6% (CI 45.0;54.2) at month-3. Previously unmedicated patients showed the lowest baseline MetS-prevalence (24.7%, CI 18.3;32.1). MetS-prevalence was not significantly different, regardless if patients previously received typical or atypical antipsychotics. Increased MetS-risk was associated with somatic comorbidity and non-smoking at both visits, and with non-psychiatric co-medication, male sex, and increased C-reactive protein at month-3.</p> <p>Conclusions</p> <p>At baseline, MetS was most prevalent in patients with previous antipsychotic medication. Limited metabolic changes were observed 3 months after switch/initiation of antipsychotic therapy.</p> <p>Trial Registration Number</p> <p>ClinicalTrials.gov Identifier: n.a.</p

Proteine als Bausteine von innovativen Lebensmitteln

Veränderte Lebensgewohnheiten und neue Lebensstile der Konsumentinnen und Konsumenten haben einen immer stärker werdenden Einfluss auf die Lebensmittelindustrie. Die interdisziplinäre Forschung an der HAFL bemüht sich daher, die Bedürfnisse der Verbrauchergemeinschaft zu verstehen und in neue Konzepte zu übersetzen

Pflanzliche Proteine als Fleischersatz: eine Betrachtung für die Schweiz

Soll die Eigenversorgung an pflanzlichem Protein für die menschliche Ernährung ausgebaut werden, bedarf es einer möglichst gesamthaften Betrachtung. In dieser Studie wird die Situation in der Schweiz systemisch analysiert. Es wird aufgezeigt, welche proteinreichen Pflanzen sich besonders für einen nachhaltigen und ökologischen Anbau eignen, welches ernährungsphysiologische Potenzial sie mitbringen und welche Prozessschritte notwendig sind, um sie zu Proteinkonzentraten und -isolaten aufzuarbeiten, die sich wiederum zur Herstellung von Fleischersatzprodukten eignen

Parametric meta-filter modeling from a single example pair

We present a method for learning a meta- �lter from an example pair comprising an original image A and its �ltered version A0 using an unknown image �lter. A meta-�lter is a parametric model, consisting of a spatially varying linear combination of simple basis �lters. We introduce a technique for learning the parameters of the meta-�lter f such that it approximates the e�ects of the unknown �lter, i.e., f(A) approximates A0. The meta-�lter can be transferred to novel input images, and its parametric representation enables intuitive tuning of its parameters to achieve controlled variations. We show that our technique successfully learns and models meta-�lters that approximate a large variety of common image �lters with high accuracy both visually and quantitatively

The dynamics of root cap sloughing in Arabidopsis is regulated by peptide signalling

The root cap protects the stem cell niche of angiosperm roots from damage. In Arabidopsis, lateral root cap (LRC) cells covering the meristematic zone are regularly lost through programmed cell death, while the outermost layer of the root cap covering the tip is repeatedly sloughed. Efficient coordination with stem cells producing new layers is needed to maintain a constant size of the cap. We present a signalling pair, the peptide IDA-LIKE1 (IDL1) and its receptor HAESA-LIKE2 (HSL2), mediating such communication. Live imaging over several days characterized this process from initial fractures in LRC cell files to full separation of a layer. Enhanced expression of IDL1 in the separating root cap layers resulted in increased frequency of sloughing, balanced with generation of new layers in a HSL2-dependent manner. Transcriptome analyses linked IDL1-HSL2 signalling to the transcription factors BEARSKIN1/2 and genes associated with programmed cell death. Mutations in either IDL1 or HSL2 slowed down cell division, maturation and separation. Thus, IDL1-HSL2 signalling potentiates dynamic regulation of the homeostatic balance between stem cell division and sloughing activity