Predictive comorbidities of hospital admission in 1,571 SARS- CoV-2 positive patients: analysis of administrative data from an Italian Local Health Autority.

Purpose: Globally, age and some comorbidities have been associ-ated with the risk of more severe outcomes of COVID-19. The purpose of this research is to calculate the hospitalization rate of SARS-CoV-2 positive patients in an Italian Local health Authority (LHA) and to examine whether medical comorbidities encoded through pharmaceutical administrative data are predictors of hospital admission in patients with a positive SARS-CoV-2 naso-pharyngeal swab. Methods: This retrospective observational study was conducted in a LHA of Pescara. Comorbidities were coded through the consumption of drugs, using the WHO's Anatomical Therapeutic Chemical (ATC) classification System. The admission was ascertained by checking the hospital discharge records where generated. Results: During the study period, 1571 patients were tested positive for SARS-CoV-2 oro-and-nasopharyngeal swab. Multivariable logistic analisys showed as predictors of admission an age ≥65 in the total sample (aOR 10.91; 95%CI 6.86-17.36) as well as in the male (aOR 12.64;95%CI 6.42-24.87) and female. (aOR 9.27; 95%CI 4.87-17.66) in SARS-CoV-2 positive patients. Comorbidities assiociated with admission were (GERD) in overall (AdjOR 1.58; 95% CI 1.06-2.34) and male (AdjOR 2.30; 95%CI 1.12-4.72) samples and anticoagulants drugs use in male (AdjOR 3.90; 95% 1.11-13.65) sample, the presence of congestive heart failure (CHF) in female (AdjOR 0.47;95%CI 0.27-0.83) sample results as protective factor. Conclusion: In conclusion, increasing age, male gender and PPI use are positively associated while female gender and CHF-related drug use are negatively associated with hospitalization in SARS-CoV-2 positive patients.

Development of in-house lattice-Boltzmann simulator of bioreactors for wastewater treatment: basic concepts and initial results.

While computational modelling has increasingly supported wastewater bioreactor engineering, novel numerical techniques have been developed such as the lattice-Boltzmann method (LBM). With vinasse treatment as case study, this work is a first step towards a comprehensive LBM simulator of a continuous-flow anaerobic packed-bed reactor. Extensions from typical models comprise one-dimensional (besides time) dependence, species transport via convection and diffusion, and imposition of either Dirichlet or Danckwerts condition at inlet. The LBM simulator proved to be operational when simulating the bioreactor at different hydraulic retention times (HRTs). Simulated profiles show that stepwise feeding concentrations are smoothed as they are transported towards the bioreactor exit while concentrations increase or decrease in response to generation or degradation kinetics. Good fitting was observed for concentrations of acetic acid (2.1 kg-COD/m3 for HRT = 24 h) and butyric acid (1.3 kg-COD/m3 for HRT = 16 h) at the exit whereas other concentrations were numerically simulated at proper order of magnitude.

Efeitos da acupuntura nos acupontos Shenmen (C-7) e Neiguan (PC-6) sobre a frequência cardíaca, a variabilidade da frequência cardíaca e o ritmo cardíaco em cães saudáveis / Effects of acupuncture at Shenmen (C-7) and Neiguan (PC-6) acupoints on the heart hate, heart rate variability and cardiac rhythm in healthy dogs

Acupuncture derives from traditional Chinese medicine, which aims to restore homeostasis. The action mechanism of this technique involves stimulation of certain points on the skin by inserting a needle. The aim of this study was to evaluate the influence of stimulation of acupoints C7 and PC6 on the heart rate variability, heart rate and heart rhythm in healthy dogs. 30 male and female adult dogs were used, with no breed restriction. The animals were analyzed at two different times in weekly intervals. Firstly were applied needles in the true acupoints, and on the second time we applied needles in false acupoints. Previously to the acupuncture an ECG with 2 minutes of recorder was performed, and after an insertion of needles the electrocardiographic recording was maintained during the 30 minutes of acupuncture. Results showed no significant difference between the HR when comparing true and false acupoints (p = 0.890). For heart rate variability a small difference was observed between the groups (p = 0.0051), however, when comparing the baseline with 15 and 25 minutes of monitoring in the false acupoint group, no significant results were found when compared with true acupoint. In conclusion, it is suggested that the stimulation of acupoints C-7 and PC-6 in healthy dogs does not promote change in sympathovagal balance, specifically on the heart rate variability, heart rate and heart rhythm on healthy dogs.(AU)

Rapidly controlled outbreak of Serratia marcescens infection/colonisations in a neonatal intensive care unit, Pescara General Hospital, Pescara, Italy, April 2011.

In April 2011, an outbreak of Serratia marcescens infection/ colonisations occurred in the neonatal intensive care unit of Pescara General Hospital. Rapid microbiological investigations lead to identification of five cases of likely cross-transmission from a neonate hospitalised for S. marcescens sepsis: four infections and one neonate colonised post-mortem. Two low birth weight neonates died. The environmental investigation detected S. marcescens from two soap dispensers. Strict hygiene measures lead to early interruption of the outbreak, without recurrences to date.

Nursing informatics needs assessment. Are distance programs needed?

Nursing informatics is a small but growing specialty area in nursing. The authors describe the results of a needs assessment designed to determine interest in a distance-based master's degree and certificate program in nursing informatics. Information was also collected on computer and Internet proficiency for a large sample of BSN graduates. Results suggest that there is an interest in informatics, although somewhat less than was found previously. Respondents indicated that a knowledge of nursing informatics could provide additional career opportunities and that there was a general lack of programs available.

A comparison of cardiopulmonary adaptations to exercise in pregnancy at sea level and altitude.

OBJECTIVE: The purpose of this study was to compare maternal cardiopulmonary and fetal responses of lowlander pregnant women in the third trimester to exercise at sea level and at an altitude of 6000 feet. STUDY DESIGN: Seven women at 33.86 +/- 1 weeks' gestation performed a symptom-limited maximal exercise test and a submaximal cardiac output exercise test at sea level at an altitude of 6000 feet. Cardiopulmonary and metabolic variables were measured and compared at sea level and altitude. RESULTS: Maximal oxygen consumption and work levels were limited by short-term altitude exposure. Ventilatory variables were not significantly influenced by altitude exposure. During submaximal exercise no alteration in exercise efficiency or response was seen for most of the variables when altitude and sea level data were compared. Both cardiac output and stroke volume were elevated at altitude at rest but not during exercise, suggesting a lower reserve for both variables at altitude. Level of plasma glucose, lactate, norepinephrine, and epinephrine were not significantly influenced by altitude exposure. Fetal heart rate responses did not differ between the sea level and altitude conditions. CONDITIONS: Lowlander pregnant women in the third trimester have some limitations to maximal aerobic capacity but not submaximal exercise on short-term altitude exposure. No ominous fetal responses have been observed during this study. The results suggest that pregnant women may engage in at least brief moderate exercise bouts at moderate altitude without adverse consequences.

Etiologic study of urinary tract infection in dogs

Foram estudados 51 casos de infecçäo urinária, considerando-se diversos fatores, tais como: agente etiológico, localizaçäo da infecäo, fatores predisponentes, sexo, idade e raça. O diagnóstico da infecçäo do trato urinário (ITU) foi baseado no exame bacteriológico, sendo considerado positivo quando a amostra de urina, colhida com auxílio de cateter, apresentava acima de 10 elevado à quinta potência bactérias/ml. Dos animais examinados, quatro cäes apresentaram infecçäo mista, totalizando 55 microorganismos isolados. Escherichia coli foi a mais frequentemente isolada (35,3 por cento), seguida de Staphylococcus sp (23,5 por cento), Proteus mirabilis (15,7 por cento), Streptococcus sp (13,7 por cento), Klebsiella sp (9,8 por cento), Pseudomonas aeruginosa (3,9 por cento), Enterobacter cloacae (2,0 por cento), Citrobacter freundii (2,0 por cento) e Providencia rettgeri (2,0 por cento). Quanto à sensibilidade dos germes isolados frente a diversos agentes antimicrobianos, a norfloxacina e a gentamicina mostraram-se eficazes no tratamento de microorganismos Gram-negativos, enquanto a cefalotina e a nitrofurantoina foram mais eficazes contra bactérias Gram-positivas. Os animais que apresentaram maior frequência de ITU pertenciam às raças Cocker Spaniel e Pastor Alemäo, envolvendo mais machos do que fêmeas com predominância de pielonefrites. Embora as infecçöes urinárias tivessem sido observadas em todas as idades, houve um predomínio nos cäes de média idade. Observou-se ainda que a urolitíase foi um fator pré-disponente ou adjacente de ITU, envolvendo germes como Staphylococcus sp e Proteus mirabilis naqueles casos com pH urinário alcalino

[Treatment of refractory hypertension with combined minoxidil and captopril in low doses]. / Trattamento dell'ipertensione refrattaria con l'associazione di minoxidil e captopril a basse dosi.

Twelve patients with severe hypertension of different causes, resistant to conventional antihypertensive agents and also to maximum doses of either minoxidil or captopril added to other combinations, were effectively controlled with the association of small doses of minoxidil and captopril plus a diuretic and a beta-blocker. The untoward effects which were previously present in all the patients with maximum doses of minoxidil and in one of the patients treated with captopril disappeared or greatly diminished shortly after this association was started. The different mechanisms of action and opposite side effects of minoxidil and captopril provide the rationale for a combined treatment with the two drugs.

Evaluation of blocking mechanisms against immunological responses in patients with laryngeal carcinoma.

The specific tumor-induced leukocyte inhibition factor (LIF) production in laryngeal cancer patients has been investigated before and after the removal of adherent cells in order to evaluate the existence of a suppressor activity; 20 patients served as subject. The LIF production, after challenging the lymphocytes with 3MKC1 autologous tumor extracts, was significant in 12 patients and showed a further significant increase after the removal of adherent cells. In 3 patients with no previous significant LIF production, there was a conversion to significance when the adherent cells were removed. The other patients did not show any significant variation. These data seem to suggest the existence of a suppressor activity exerted by adherent cells in laryngeal cancer patients on LIF production.

Natural killer-mediated cytotoxicity in patients with laryngeal carcinoma.

Natural killer (NK)-mediated cytotoxicity against the K562 cell line was evaluated in normal subjects and in patients with laryngeal cancer. Results showed reduced lymphocyte cytotoxicity in patients with neoplastic disease and further reduction in NK activity following postoperative radiation therapy. The authors discuss the possibility of using this test in the immunological monitoring of patients with laryngeal carcinoma.

Specific LIF production in laryngeal cancer patients: evidence of suppressor activity exerted by adherent cells.

The specific tumor-induced LIF production in 30 laryngeal cancer patients has been investigated before and after the removal of adherent cells to evaluate the existence of a suppressor activity. LIF production, after challenging lymphocytes with 3 M KCI autologous tumor extracts, was significant in 16 patients and showed a further significant increase after removal of adherent cells. A conversion to significance when the adherent cells were removed was shown in 6 patients, with no previous significant LIF production. These data suggest the existence of a suppressor activity exerted by adherent cells on LIF production in laryngeal cancer patients.

Evaluation of the immune responsiveness in laryngeal cancer patients with specific and aspecific tests: first results of follow-up in 80 cases.

We have evaluated in 80 patients suffering with laryngeal carcinoma their specific and aspecific immune responsiveness. We used the E rosette-test, the PHA-induced in vitro stimulation and the in vitro specific LIF production. We chose to use the LIF production test both for its marked sensitivity and because the lymphokines--which are soluble mediators--act as a "bridge" between the different fields of the immune response. Furthermore in our previous research, we observed that the specific LIF production was influenced in a negative way by adherent cells of the peripheral blood that could behave as blocking factors. For what attains the autologous LIF production, before and after the removal of adherent cells, our results show that the patients suffering with a cancer staged as T3T4N1N2N3 exhibit much more marked blocking phenomena than the patients with a cancer staged as T1T2T3N0. In fact the results demonstrate that in this second group only 62% of the cases, after the removal of the adherent cells, showed an increase of LIF production, while this percentage rose to 83% for the patients with a more advanced disease. A similar pattern was found in those patients who showed a recurrence two of three years after the primary disease.

Production of leukocyte migration inhibition factor by lymphocytes of larynx cancer patients stimulated by laryngeal carcinoma solubilized membrane antigens.

The production of leukocyte migration inhibition factor (LIF) from lymphocytes after stimulation with 3 M KCl soluble tumor and normal mucosa extracts was investigated in 30 patients with laryngeal carcinoma at different development stages and in 30 normal donors. The experiments were performed in heterologous and autologous systems. In heterologous systems 3 M KCl tumor extracts induced LIF production by heterologous lymphocytes from patients in 91% of the cases, and normal mucosa extracts induced LIF production by heterologous lymphocytes from patients in 73% of the cases and from normal donors in 90% of the cases. In autologous systems 3 M KCl tumor extracts induced LIF production by autologous lymphocytes from the same patients in 65% of the cases, whereas the normal laryngeal mucosa extracts induced LIF production by the same autologous lymphocytes in the 6% of the cases. The high positivity percentage of the test in heterologous systems could be related to differences in the major histocompatibility complex. The 65% test positivity in autologous systems using tumor extracts could be related to the presence of tumor associated antigens.

Evidence of suppressor activity mediated by concanavalin-A stimulated cells towards aspecific LIF production.

Since the T-suppressor subpopulation is known to have a peculiar sensitivity to the mitogenic activity of Concanavalin-A we decided to verify whether in normal subjects it was possible to induce, by using the Con-A as a mitogenic factor, the proliferation of cells--possibly T-suppressor--which: a) had the property of adherence and b) show inhibitory activity toward LIF production. The statistical analysis of the results of our experimental patterns show that even if a difference between the suppression exerted on LIF production by Con-A stimulated versus not stimulated cells is present at any dilution, the level of significance rises from P less than 0.005 to P less than 0.0001 for the range of dilution 1:1/4 to 1:132, thus revealing that these experimental conditions are optimal for eliciting the blocking effect. The researches that are currently in progress in our laboratory seem to suggest that this experimental approach is of some value in characterizing the immunity pattern of laryngeal cancer patients and its evolution through the course of disease.

[T-lymphocyte subpopulations in old age]. / Studio della sottopopolazine linfocitaria T nell'anziano.

The subpopulation of lymphocytes were studied in 25 subjects old age and in 20 adult subjects as control. The results demonstrate an appreciable difference in the percentage of rosettes values at +4 degrees C for 18 hours between the old age subjects (mean value 83,5%) and the control subjects (mean value 66,2%). It is difficult to interpret these variations but it is possible that there is a different distribution on the cell membrane of lymphocyte T for the receptors for SRBC. The probable relation ship with variations of the citoskeleton and more specifically the distribution of the "Tubuline".

Effect of the cryopreservation on the production of leukocyte migration inhibition factor (LIF) by lymphocytes from normal volunteers and patients with laryngeal carcinomas.

The present paper reports the results of an investigation on the influence of cryopreservation methods of human lymphocytes on the leukocyte migration inhibition factor (LIF) production following PHA stimulation. The optimal freezing and thawing procedures, fetal calf serum and dimethyl sulphoxide concentrations are reported.