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Sociodemographic and environmental factors are associated with incidence, severity, and mortality of COVID-19. However, little is known about the role of such factors in persisting symptoms among recovering patients. We designed a cohort study of hospitalized COVID-19 survivors to describe persistent symptoms and identify factors associated with post-COVID-19 syndrome.We included patients hospitalized between March to August 2020 who were alive six months after hospitalization. We collected individual and clinical characteristics during hospitalization and at follow-up assessed ten symptoms with standardized scales, 19 yes/no symptoms, a functional status and a quality-of-life scale and performed four clinical tests. We examined individual exposure to greenspace and air pollution and considered neighbourhood´s population density and socioeconomic conditions as contextual factors in multilevel regression analysis.We included 749 patients with a median follow-up of 200 (IQR = 185-235) days, and 618 (83%) had at least one of the ten symptoms measured with scales. Pain (41%), fatigue (38%) and posttraumatic stress disorder (35%) were the most frequent. COVID-19 severity, comorbidities, BMI, female sex, younger age, and low socioeconomic position were associated with different symptoms. Exposure to ambient air pollution was associated with higher dyspnoea and fatigue scores and lower functional status.We identified a high frequency of persistent symptoms among COVID-19 survivors that were associated with clinical, sociodemographic, and environmental variables. These findings indicate that most patients recovering from COVID-19 will need post-discharge care, and an additional burden to health care systems, especially in LMICs, should be expected.

Individuals with obsessive-compulsive disorder (OCD) more often think about, attempt, and die by suicide than individuals from the general population. Sexual and religious obsessions (i.e., taboo obsessions) have been linked to increased risk of suicidality, but it is unclear if they explain additional risk over and above other risk factors. We refined the recently proposed multidimensional hierarchical model of OCD and explored how each symptom dimension in the model was associated with suicidality in a random half (n = 500) of a well-characterized cohort of patients with OCD. Symptom dimensions and other risk factors significantly associated with suicidality were included in a confirmatory multivariable model conducted with the other half of the sample (n = 501). The predictive confirmatory model accounted for 19% of the variance in suicidality. Taboo obsessions, the general OCD factor (i.e., having many different OCD symptoms at the same time), lifetime major depression, and lifetime substance use disorders significantly predicted suicidality in this model. Lifetime major depression explained most unique variance in suicidality (5.6%) followed by taboo obsessions and the general OCD factor (1.9% each). Taboo obsessions explain a small but significant proportion of variance in suicidality and should be considered an independent risk factor for suicidality in patients with OCD.

Este escrito es el intento de de compartir una experiencia de trabajo en un Hospital de Día situado en la ciudad de Buenos Aires – Argentina. Surge del trabajo realizado a partir de repensar conceptos clásicos relacionados al dispositivo, como por ejemplo: resocialización, rehabilitación, “espacio de ficción” entre otros; a partir de los interrogantes surgidos desde la clínica. Esto nos llevó a abrir espacios de talleres a la comunidad y de este modo propiciar el encuentro con otros.

Rickettsia conorii is responsible for the Mediterranean Spotted Fever. Recently, new rickettsial species have been recognized in Europe and implicated in human diseases. Clinical features often differ greatly from each other, but non-severe liver involvement is frequently observed during any rickettsial infection.We describe the unique case of a patient presented with significant high aminotransferase levels due to the first human R. aeschlimannii infection ever detected in Italy. The hypothesis of rickettsiosis was made on the basis of a comprehensive medical history and was confirmed by serological tests. Molecular analyses made on a sample of hepatic tissue revealed the presence of a rickettsial species never found before in human liver.A brief review of the literature is reported to highlight how relevant this case is and to remind that rickettsioses should be in the differential diagnoses of acute hepatitis, considering mostly the recent spread of new rickettsial species.

Background Studies on “Spirituality, religion and health” (R/S) have been increasing worldwide, including in Brazil. Mapping this production can help researchers to understand this field and also to identify gaps in the Brazilian R/S studies. Objective To analyze the Brazilian scientific articles on “Religion, Spirituality and Health” available on the main electronic databases using a bibliometric approach. Methods A comprehensive review of four major databases (PubMed, Scopus, BVS and Web of Science) was conducted. Three reviewers performed the data analysis. Off-topic articles, articles from Portugal, books and thesis were excluded. Articles were then classified by: Publication year, journal, Central focus in R/S, Academic Area, Main topic and Study Type. Results From 3,963 articles found, 686 studies were included in the final analysis (320 had central focus on R/S). There was an increase of articles in the last decade (most observational), with predominance of mental health issues, and from journals in the field of psychiatry, public health and nursing. Discussion This study enabled us to widen our understanding about how the field of “spirituality, religion and health” has been established and how this field is increasing in Brazil. These findings can help in the development of future Brazilian studies.

The aim of the present study was to evaluate the in vitro contractile response of rat aorta in mild and severe type I diabetes and the effect of melatonin on it. Aortic rings were obtained from male Wistar rats injected with streptozotocin 8-12 wks earlier. Rats were divided into three groups: non-diabetic rats (NDR), mildly diabetic rats (MDR) and severely diabetic rats (SDR). Dose-response curves for acetylcholine-induced, endothelium-related relaxation of aortic rings (after previous exposure to phenylephrine) and for serotonin-induced vasoconstriction were conducted in the presence or absence of 10 -5 mol/L melatonin. This protocol was repeated with rings preincubated in a high glucose solution (44 mmol/L). The contractile response to phenylephrine decreased in SDR, an effect counteracted by preincubation with high glucose. Melatonin decreased phenylephrine-induced vasoconstriction in MDR and counteracted the effect of high glucose in SDR. Acetylcholine-evoked relaxation decreased significantly after exposure to a high glucose in SDR, this effect being counteracted by melatonin. Serotonin-induced vasoconstriction decreased in SDR and augmented in MDR, but only after exposure to high glucose. Melatonin reduced the maximal tension of aortic contraction after serotonin in MDR, both under basal conditions and after preincubation in a high glucose solution. The results support the existence of differences in vasomotor responses as a function of the diabetes state and of an improvement of contractile performance in diabetic rats after exposure to melatonin at a pharmacological concentration (in terms of circulating melatonin levels but not necessarily for some other fluids or tissues).

A fructose-enriched diet induces an increase in blood pressure associated with metabolic alterations in rats. Our hypothesis was that an increase in protein kinase C (PKC) activation, reported in the acute period of fructose overload, and an impaired vessel's response to vasoactive substances contribute to maintain elevated blood pressure levels in the chronic period. The aims of this study were to investigate in this animal model of hypertension: (1) if the increase in PKC activation was also found in the chronic stage; (2) the involvement of nitric oxide and insulin in the vessel's response; and plasma atrial natriuretic factor and nitrites/nitrates (nitric oxide metabolites) behavior. We evaluated the effects of: PKC-stimulator 12,13-phorbol dibutyrate, phenylephrine, insulin, nitric oxide synthase-inhibitor NG-nitro-L-arginine methyl esther (L-NAME) and PKC-inhibitor Calphostin C on aortic rings responses of Sprague-Dawley rats: fructose-fed and control. The fructose-fed group showed higher contractility to 12,13-phorbol dibutyrate than the control group in aortic rings pre-incubated with insulin, and this difference disappeared with L-NAME. The response to phenylephrine in rings pre-incubated with Calphostin C was decreased in the fructose-fed group and increased with Calphostin C plus L-NAME. Fructose-fed rats showed higher levels of plasma atrial natriuretic factor and nitrites/nitrates than controls. In conclusion, chronic fructose feeding seems to develop an impaired response to insulin, dependent on nitric oxide, suggesting a PKC alteration. Vasorelaxant agents, such as atrial natriuretic factor and nitric oxide, would behave as compensatory mechanisms in response to high blood pressure.

Nitric oxide (NO) has been identified as an effective vascular relaxant. This study analyses the contribution of the precursor L-arginine (L-arg) by oral administration in two kidney-two clip hypertension in the rat (2K-2C). Two groups were studied: sham (SH, n=21) and hypertensive (HT, n=15). After 4 weeks of surgery, a group of rats remained as controls (SHc and HTc, respectively), while others were supplemented with L-arg (1.25 g/L) in drinking water (SHa and HTa) for 3 weeks. Blood pressure was significantly increased in 2K-2C rats but remained unchanged after L-arg treatment. Plasma nitrite/nitrate concentrations were not different among groups. The contractile response of aorta to KCl, serotonin and the protein kinase C (PKC) stimulant, phorbol 12,13-dibutyrate (PDBu) was also evaluated. Higher contractile responses to PDBu (p

Abstract —A fructose-enriched diet promotes hypertension in rats. We thought that an enhancement of the glycolytic and/or lipid disorder (s) that raise blood pressure could be the cause. Therefore, we studied 4 groups of Sprague-Dawley rats (±200 g): (1) control rats received a standard diet and tap water; (2) the glycerol group of rats received a standard diet and 0.54 mol/L glycerol in tap water; (3) the fructose group was given a fructose-enhanced diet (chow had 55% fructose instead of dextrin) and tap water; and (4) the fructose-glycerol group was given the fructose-enhanced diet and 0.54 mol/L glycerol in drinking water. At the end of the second week, the findings were as follows. Blood pressure was 149±2 mm Hg in the fructose-glycerol group versus 129±2 ( P P P P P P P P P 50 to 12,13-phorbol dibutyrate in the fructose-glycerol group than in the control ( P P P

It is known that several factors influence the ability of calcium to catalyse the steam-activated gasification of chars derived from low rank coals. One of the most important is that calcium which is ion exchanged on to the parent coal is more likely to become catalytically active in the char than calcium which is present in the coal in inorganic crystalline form. The findings reported here show that a great deal of catalytic activity is realised when only a small fraction of the available ion exchangable sites in the coal contain calcium and that further addition leads to comparatively small rate increases. It is also found that the calcium influences the product gas mixture through driving the water gas shift reaction toward equilibrium. In order to do this, it is necessary for the initial products of gasification to remain near the char surface for some time. When the initial products are rapidly swept away from the surface, the ability of calcium to influence product gas distribution is severely inhibited.

An HIV-positive woman receiving antiretroviral therapy developed an opportunistic toxoplasma infection, detected by morphological examination of bone marrow aspirate in the absence of serological positivity. The intracellular presence of Toxoplasma gondii was confirmed by indirect immunofluorescence microscopy, using a polyclonal antitoxoplasma antiserum on marrow smears. This case report confirms the utility of morphological bone marrow examination for the diagnosis of parasitic infections in patients with impaired host defenses.

Previous studies from our own laboratory have shown that abdominal aorta rings from two kidney - two clip hypertensive rats (HT) develop hypersensitivity to serotonin (SER) which is related to a decreased nitric oxide (NO) availability and enhanced thromboxane A2 production. In the present study we investigated whether calcium and prostanoid-NO interactions are involved in these findings. To this purpose, the aortic responses to SER were analyzed in calcium-free medium and in calcium-depleted aorta placed in normal medium. Moreover, effects of ridogrel (RID, an antagonist of TxA 2/PGH2 receptors and inhibitor of thromboxane synthetase) were analysed by cumulative dose-response curves to SER in the presence and in the absence of the NO synthase inhibitor N(omega)-nitro-L-arginine (NOLA). Vascular responses to SER in vessels from HT rats were associated with increased intracellular calcium mobilization. In addition, hypersensitivity to SER in HT group respect to sham group (SH) disappeared in the presence of RID, NOLA and RID plus NOLA. RID decreases the maximum tension to SER and this effect was prevented by NOLA. This inhibition was of a greater magnitude in rings from sham rats (SH): 34 +/- 6% than in HT rats: 15 +/- 6% (p < 0.05). Besides, RID decreased the sensibility to SER in the presence of NOLA only in the HT group. In conclusion, the present study suggests that SER hypersensitivity observed in HT rats is related to a facilitated intracellular calcium mobilization and enhanced TxA2-endoperoxide response. Changes in membrane SER-gated calcium channels opening are observed only during the early hypertensive period. Besides, the lower depressor effect of RID on the maximal tension to SER in aorta rings from HT rats are related with a decreased NO availability in this model of renovascular hypertension.

The authors present the observation of a case of lipoma of the transverse colon. They review the latest literature confirming the rarity of this case and its clinical importance for diagnostic and therapeutic problems that it could give.

Findings from a seroepidemiological survey of Leishmania infantum (LI) infection are presented. Among residents in the province of Rome, 2.7% (4.4% in the city of Rome and 1% in the suburbs) of 374 adults were positive for specific LI antibodies in indirect haemoagglutination studies. Among 217 adult residents of Caltanissetta province (Sicily), 4.1% were positive for LI antibodies (4.2% in Caltanissetta city and 4% in the suburbs). Serological tests for LI antibodies were also carried out on stray dogs captured in Rome. 5% of them resulted positive. Our findings show that LI infection is moderately present in both Rome and Caltanissetta, the latter being an area of known endemicity. According to our data, LI infections are usually asymptomatic: none of the positive subjects had a history of visceral leishmaniasis, and none of the seropositive dogs showed any sign or symptom correlated to leishmaniasis.

C. Faith and J. Cozzens have shown that a ring, whose right proper cyclic modules are injective, is either semisimple or a simple, right semihereditary, right Ore V-domain. They have posed a question as to whether such a ring is right noetherian. In this paper, an affirmative answer is given to that question. Moreover, necessary and sufficient conditions are given as to when a right PCI ring is left PCI. In [1], Faith and Cozzens proved that a ring R whose proper right cyclic modules are injective must be either semisimple or a simple, right semihereditary, right Ore V-domain. They noted that all the known examples of such rings are right noetherian and posed the question whether every ring with this property is noetherian. We will answer this question in the affirmative. More clearly, we will show: THEOREM 1. Let R be a right PCI ring, then either (a) R is semisimple, or (b) R is a simple right noetherian, right hereditary, right Ore V-domain. By using Boyle's theorem [1, Theorem 6.26] and Theorem 1, we get the following immediately: COROLLARY. R is a PCI ring, that is a right and left PCI ring, if and only if R is either semisimple or a simple noetherian hereditary Ore V-domain. C1 PROOF OF THEOREM. Faith and Cozzens have shown that a PCI ring R must be either semisimple or a simple, right semihereditary, right Ore V-domain [1, Theorems 6.13, 6.17]. Thus, we may assume R is a simple, right semihereditary, right Ore V-domain that is not semisimple. Furthermore it is known that such a ring has the property that every proper finitely presented cyclic module has a von Neumann regular endomorphism ring [1, Proposition 6.20]. Suppose that the endomorphism ring of every proper finitely presented cyclic module is semisimple. Then, every proper finitely presented cyclic module has an indecomposable decomposition. It is clear from the properties of R that the only indecomposable injective modules are the simple modules and E(RR). Thus, it follows that every proper finitely presented cyclic module is a direct sum of a semisimple module and a finite number of isomorphic copies of E(RR). Received by the editors October 5, 1978 and, in revised form, January 22, 1979. AMS (MOS) subject classifications (1970). Primary 16A48. ? 1979 American Mathematical Society 0002-9939f79f0000-0452/$02.00 This content downloaded from 207.46.13.184 on Fri, 29 Jul 2016 05:57:32 UTC All use subject to http://about.jstor.org/terms

modules RR and RR are coflat. The structure of these rings is examined with emphasis on the categorical dualities that arise. Finally, with respect to FC rings, categorial equivalence is discussed. O* Background and notation* Throughout this paper R denotes an associative ring with identity 1. We denote the Jacobson radical of R by J(R) and the right (left) socle of R by Soc (RR) (Soc (RR)). The pxq matrix ring over R is denoted by M.B,tpxq (R). Every right (left) ϋJ-module is assumed to be unitary. We denote the endomorphism ring of a right (left) .ff-module, MR (BM) by End(MR) (End(RM)). The category of right (left) i2-modules is denoted by CMR (RCM) and its class of objects by ^£R (R^). A submodule N ^ M is said to be essential, denoted N^2M, if N n L Φ 0 f or all 0 Φ L ^ M. A submodule N ^ M is said to be superfluous, denoted by N < M, if K + N = M implies K = M for all K ^ M. We say

The genus Streptomyces produces about two-thirds of naturally occurring antibiotics and many other biologically active secondary metabolites. The genetic manipulation of Streptomycetes is often labor and time intensive due to their large genome and complex development. Much progress has been made to develop gene transfer methods useful to construct antibiotic-producing strains with improved properties. The φC31 Att/Int system is an integration system that has been widely used to produce stable recombinants in Actinomycetes and its integration site is an attB site located in a pirin-like gene (pirA) of the bacterial chromosome. In this study we demonstrate that the integration of φC31 DNA in Streptomyces ambofaciens ATCC 23877 chromosome results in a significantly reduced spiramycin production and causes some phenotypic changes. With the aim to get insight into the molecular mechanisms underlying these effects we have analyzed the transcriptome and proteome of the wild type strain and a derivative strain harboring pTYM-18 vector plasmid integrated into the pirA gene. Evidence is provided that inactivation of the pirA gene by plasmid integration leads to dramatic gene expression changes with marked effects on central carbon and energy metabolism, high sensitivity to oxidative injury and repression of polyketide antibiotic production.

BACKGROUND: Basophils, eosinophils and monocytes may be involved in BCG-induced immune responses and be associated with outcomes of bladder cancer patients receiving intravesical BCG. Our objective was to explore the association of baseline counts of basophils, eosinophils and monocytes with outcomes of patients with high-grade T1 bladder cancer receiving a standard course of intravesical BCG. METHODS: We retrospectively reviewed medical records of patients with primary T1 HG/G3 bladder cancer. After re-TURBT, patients were treated with a 6-week course of intravesical BCG induction followed by intravesical BCG every week for 3 weeks given at 3, 6, 12, 18, 24, 30 and 36 months from initiation of therapy The analysis of potential risk factors for recurrence, muscle invasion and cancer-specific and overall survival was performed using univariable Cox regression models. Those factors that presented, at univariate analysis, an association with the event at a liberal p