The Association between Suicide Attempts and Toxoplasma gondii Infection

OBJECTIVE: Chronic ‘latent’ infection by Toxoplasma gondii is common and most of the hosts have minimal symptoms or they are even asymptomatic. However, there are possible mechanisms by which T. gondii may affect human behavior and it may also cause humans to attempt suicide. This article aimed to investigate the potential pathophysiological relationship between suicide attempts and T. gondii infection in Korea. METHODS: One hundred fifty-five psychiatric patients with a history of suicide attempt and 135 healthy control individuals were examined with enzyme-linked immunoassays and fluorescent antibody technique for T. gondii seropositivity and antibody titers. The group of suicide attempters was interviewed regarding the history of suicide attempt during lifetime and evaluated using 17-item Korean version of Hamilton Depression Scale (HAMD), Columbia Suicide Severity Rating Scale (C-SSRS), State-Trait Anxiety Inventory (STAI) and Korean-Barratt Impulsiveness Scale (BIS). RESULTS: Immunoglobulin G antibodies were found in 21 of the 155 suicide attempters and in 8 of the 135 controls (p=0.011). The Toxoplasma-seropositive suicide attempters had a higher HAMD score on the depressed mood and feeling of guilt subscales and a higher total score than the seronegative suicide attempters. T. gondii seropositive status was associated with higher C-SSRS in the severity and lethality subscales. T. gondii IgG seropositivity was significantly associated with higher STAI-X1 scores in the suicide attempters group. CONCLUSION: Suicide attempters showed higher seroprevalence of T. gondii than healthy controls. Among the suicide attempters, the T. gondii seropositive and seronegative groups showed several differences in the aspects of suicide. These results suggested a significant association between T. gondii infection and psychiatric problems in suicidality.

A Case of Nocardia farcinica Pneumonia and Mediastinitis in an Immunocompetent Patient / 결핵및호흡기질환

Nocardia species are aerobic, gram-positive pathogens found worldwide in soil. Nocardia is considered an opportunistic pathogen, and its infection mostly occurs in immunocompromised patients. We report a case of Nocardia farcinica induced mediastinitis and pneumonia that occurred in a 64-year-old male patient who had no significant medical history except for hypertension. He visited another hospital with a complaint of dyspnea and left chest wall pain. The symptoms arose 7 days ago without any trauma and they worsened. A mediastinal mass was found on computed tomography scan. After being transferred to our hospital for further evaluation, he was diagnosed with mediastinitis and pneumonia. As N. farcinica was found to be the causative organism by 16S rRNA sequencing, proper antibiotic therapy including trimethoprim/sulfamethoxazole was initiated immediately. After this, the patient improved and he was discharged. If an infection has a disseminating course, nocardiosis cannot be excluded even in immunocompetent patients. Once the diagnosis is established, prompt antibiotic therapy should be performed based on the severity.

Nutritional Status and Energy Expenditure in the Elderly in a Rural Community / 대한지역사회영양학회지

In this study, nutrient intake status and energy expenditure were examined to investigate the nutritional status of the elderly in a rural community. The results obtained by questionaries, the 24 hour recall method, and time-diary were as follows: The elderly men surveyed were 73.8 years old, on the average. The elderly women surveyed were 73.5 years old, on the average. The proportion of the elderly with diseases was 51.9%. Most of the subjects (86.1%) had a regular meal pattern of consuming three meals a day. The average daily energy intake of the rural elderly was much lower than the Korean RDA. The dietary assessment data showed that each energy intake of the males and the females was 79.5% and 84.3% of the RDA, respectively. The dietary intake of Ca, Fe, niacin, thiamin, and riboflavin was lower than the Korean RDA, and that of P and Vitamin C was adequate. The Fe intake was significantly different with respect to age and sex (p < 0.05). Although, in both elderly men and elderly women it decreased with age, the elderly men's intake was lower than the elderly women's. The heights of the elderly men and the elderly women was 159.7 cm and 147.5 cm, respectively, and the weights were 60.0 kg and 52.2 kg, respectively, and the BMI was in the moderate range. Heights significantly decreased with age (p < 0.05). According to daily living schedules, leisure time (11.0 hour) was the longest, physiological time (9.6 hours) was next, and work time (3.4 hours) was the shortest. Energy expenditure significantly decreased with age (p < 0.01). Energy intake also decreased with aging. Energy balance (energy expenditure/ energy intake) was 93.4% in elderly men and 104.0% in elderly women. Especially, in elderly men in the 65 to 74 age range, the energy balance was the lowest, and the nutrient intake was also much lower than that of elderly women.