Депрессия и тревожность у пациентов с инфекцией Clostridioides difficile

Rezumat Este binecunoscut faptul că există o corelație între tulburările funcționale intestinale, bolile intestinale organice și starea psihoemoțională a pacienților. Dar starea psiho-emoțională a pacienților cu infecție determinată de Clostridioides difficile (ICD), în special în cazurile de reconvalescență după infecția Covid-19, nu este studiată suficient. Scopul studiului a fost evaluarea anxietății și depresiei la bolnavii cu ICD în perioada de recuperare după Covid-19. În studiul nostru au fost incluși 28 de pacienți cu ICD confirmată prin analiza enzimatică la glutamat dehidrogenaza și toxinele A și B din masele fecale a pacienților cu diaree nosocomială. Depresia a fost evaluată prin scala Hamilton (17 itemi), iar anxietatea a fost diagnosticată prin scala Spielberger (40 itemi) care include analiza anxietății reactive (AR) și anxietății de personalitate (AP). Rezultatele studiului arată că doar în 14,29% nu este depresie. Depresie ușoară a fost determinată în 75% cazuri, preponderent în rândul femeilor. Depresie moderată a fost determinată la 10.71% dintre pacienți. S-a determinat afectarea mai frecventă pacienții de vârsta medie aceasta fiind de 57±10,1 ani. AR a fost diagnosticată în 42,7% cazuri: AR majorată în 28,5% și AR foarte exprimată în 14,2% cazuri. Toți participanții din studiu posedă AP: 57,1% posedă AP majorată și 42,3% - PA foarte exprimată. Rezultatele studiului confirmă prezența anxietății și a depresiei la un număr extrem de mare de pacienți cu ICD după infectarea cu COVID-19. Acești pacienți trebuie monitorizați pentru diagnosticarea precoce a depresiei și anxietății.Summary. The correlation between functional bowel disorders, some organic intestinal disease and psychiatric implication is well known. However, the psycho-emotional state of patients with Clostridioides difficile infection (CDI), particularly in the cases after Covid-19 is not studied enough. The aim of the study was to evaluate depression and anxiety in patients with CDI during the recovery period after Covid-19. Our study included 28 patients with CDI confirmed by enzymatic analysis of glutamate dehydrogenase and toxins A and B in the faeces of patients with nosocomial diarrhea. Depression was assessed on the Hamilton scale (17 points), and anxiety was diagnosed on the Spielberger scale (40 points), including the analysis of reactive anxiety (RA) and personal anxiety (PA). The results of the study show that only 14.3% did not have depression. Mild depression was determined in 75% cases and was significantly more frequent among women. Moderate depression was determined in 10.7% of patients. The most frequent impairment was observed in relatively young people, with a mean age of 57 ± 10.1 years. RA was diagnosed in 42,7% of cases: increased RA - in 28.5%, and highly expressed RA - in 14.2% cases. All patients from the study group had PA: 57.1% had increased PA, and 42.3% - highly expressed PA. Study results confirm the presence of anxiety and depression in an extremely large number of patients with CDI after COVID-19 infection. Such patients should be monitored for early diagnosis of depression and anxiety.Резюме. Корреляция между функциональными расстройствами кишечника, некоторыми органическими заболеваниями ЖКТ и психиатрическими расстройствами хорошо известна. Однако психоэмоциональное состояние пациентов с инфекцией Clostridioides difficile (CD), особенно в случаях после Covid-19, изучено недостаточно. Целью исследования было оценить степень депрессии и тревожности у пациентов с инфекцией CD в период выздоровления после Covid-19. В наше исследование были включены 28 пациентов с инфекцией CD, подтвержденной иммуноферментным анализом глутаматдегидрогеназы и токсинов А и В в фекалиях больных с внутрибольничной диареей. Депрессия оценивалась по шкале Гамильтона (17 баллов), а тревожность диагностировалась по шкале Спилбергера (40 баллов), включая анализ реактивной тревожности (РТ) и личностной тревожности (ЛТ). Результаты исследования показывают, что только у 14,3% не было депрессии. Легкая депрессия определялась в 75% случаев и достоверно чаще встречалась у женщин. Умеренная депрессия определялась у 10,7% больных. Наиболее часто нарушения наблюдались у относительно молодых людей, средний возраст 57 ± 10,1 года. РТ диагностирована в 42,7% случаев: умеренная РТ - в 28,5%, выраженная РТ - в 14,2% случаев. Все пациенты основной группы имели ЛТ: 57,1% - повышенная ЛТ, 42,3% - выраженная ЛТ. Результаты исследования подтверждают наличие тревожности и депрессии у чрезвычайно большого числа пациентов с инфекцией CD после COVID-19. Такие пациенты должны находиться под наблюдением для ранней диагностики депрессии и тревожности

On the generalized Freedman-Townsend model

Consistent interactions that can be added to a free, Abelian gauge theory comprising a finite collection of BF models and a finite set of two-form gauge fields (with the Lagrangian action written in first-order form as a sum of Abelian Freedman-Townsend models) are constructed from the deformation of the solution to the master equation based on specific cohomological techniques. Under the hypotheses of smoothness in the coupling constant, locality, Lorentz covariance, and Poincare invariance of the interactions, supplemented with the requirement on the preservation of the number of derivatives on each field with respect to the free theory, we obtain that the deformation procedure modifies the Lagrangian action, the gauge transformations as well as the accompanying algebra. The interacting Lagrangian action contains a generalized version of non-Abelian Freedman-Townsend model. The consistency of interactions to all orders in the coupling constant unfolds certain equations, which are shown to have solutions.Comment: LaTeX, 62 page

Assessment of the Anthropogenic Impact and Distribution of Potentially Toxic and Rare Earth Elements in Lake Sediments from North-Eastern Romania

Chemical analysis was performed on sediment samples collected in two sampling sessions (July and October) from Podu Iloaiei Dam Lake, one of the most important water resources used for aquaculture in north-eastern Romania. The concentration of 15 trace elements (TEs), 8 refractory elements (REs), and 15 rare earth elements (REEs)—determined using inductively coupled plasma mass spectrometry—showed variability largely dependent of the sampling points and collection time. Manganese was the most abundant TE, V and Cr were the most abundant REs, while Ce was one of the most abundant REEs. The cerium negative anomaly and Gd positive anomaly were observed in the Chondrite-normalized distributions. In October, the Ce anomaly showed significant negative correlation with Mn, emphasizing the water body oxidation potential. The identified positive Gd anomaly was most likely associated with the use of Gd-chelating agents in magnetic resonance imaging in Iasi, the largest medical hub in north-eastern Romania. Principal component analysis extracted three factors explaining 96.0% of the observed variance, i.e., rock weathering, leaching from soil surface, contributions from urban stormwater and atmospheric deposition (50.9%), pedological contributions (23.7%), and mixed anthropogenic sources (e.g., traffic, waste discharge, agricultural activities; 21.4%). The evaluation of pollution indices highlighted low and moderate degrees of contamination for most of the elements and a considerable degree of contamination for Cd. Assigned Cd sources included fertilizers and pesticides used in the near agricultural areas or the high traffic road located near the lake. Since contamination of aquatic ecosystems with harmful elements is a human health concern, further monitoring of specific vectors in the food chain of the investigated dam lake will be of the utmost importance

Assessment of Surface Water Quality in the Podu Iloaiei Dam Lake (North-Eastern Romania): Potential Implications for Aquaculture Activities in the Area

The Podu Iloaiei Dam Lake located on the Bahluet River from Bahlui hydrographic basin, north-eastern Romania, is one of the most important water resources used for aquaculture activities in the region of interest. In the present study, the chemical composition related to water-soluble ions and elements was assessed in both water and sediment samples collected from the area of interest during July 2017 and October 2017, representative months for warm and cold seasons, respectively. Water-soluble ions (H3C2O2−, HCO2−, C2O42−, F−, Cl−, NO2−, Br−, NO3−, SO42−, Li+, Na+, NH4+, K+, and Ca2+) were analyzed by ion chromatography, while inductively coupled plasma mass spectrometry was used to quantify water-soluble fractions of elements (Be, B, Mg, Al, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Ga, Ge, Rb, Sr, Mo, Ru, Pd, Ag, Cd, Sn, Sb, Te, Ba, Ir, Tl, Pb, Bi, and U). Evidence was obtained on the contributions of both anthropogenic and natural (pedologic) related sources in controlling the chemical composition of the water and sediment samples in the area. Analysis of Piper diagrams revealed the existence of CO32−/HCO3− and Ca2+/Mg2+ as dominant species for the sediment samples. The interest water pool was found to be oligotrophic over the warm period and eutrophic over the cold period. Overall, abundances and the association of chemical species in the area seemed to be controlled by a complex interplay between the water body’s main characteristics, meteorological factors, and anthropogenic activities. Moreover, the present results suggest that precautions should be taken for physicochemical parameter monitoring and prevention acts for surface water quality assurance in order to control the potential negative influence of some chemical parameters on fish productivity. Reported data also have a high potential to be used by experts in the field of developing lake water management policies for a sustainable exploitation of various aquatic systems