Immune persistence following intradermal vaccination with fractional dose of diphtheria-tetanus-acellular component pertussis and Sabin-derived inactivated poliovirus vaccine / 中国生物制品学杂志

Objective@#To evaluate the immune persistence following intradermal(ID) vaccination with diphtheria-tetanusacellular component pertussis and Sabin-derived inactivated poliovirus vaccine(DTacP-sIPV).@*Methods@#40 wistar rats were randomly assigned into four groups.Two test groups were injected intradermally with fractional-doses(1/5 and 1/10dose) of DTacP-sIPV(1/5D ID and 1/10D ID group);The positive control group was intramuscularly injected with full dose of DTacP-sIPV(full-dose IM group);The negative control group was injected with PBS intradermally.Wistar rats were immunized 3 times at 0,1 and 2 months and the blood samples were collected via tail vein 12 months after the last immunization and the serum samples were isolated.The titer of neutralizing antibody against poliovirus was detected by micro-neutralization test,and the titers of IgG antibodies against diphtheria toxin(DT),tetanus toxin(TT),pertussis toxin(PT),filamentous hemagglutinin(FHA) and pertactin(PRN) in rat serum were detected by indirect ELISA.The geometric mean titer(GMT)and positive rate of antibody were calculated.The rats were challenged with aerosolized B.pertussis for 30 min 12 months after the last immunization and determined for the white blood cell(WBC) count and colony-forming unit(CFU) in lung,trachea and nose at day 2,5 and 14 after challenge.@*Results@#Compared with the full-dose IM group,there was no significant difference in the positive rates of poliovirus type Ⅰ,Ⅱ and Ⅲ neutralizing antibodies between 1/5D ID and 1/10D ID groups(each P> 0.05) and the positive rates of all types of antibodies in the control group were 0.The positive rates of IgG antibodies against DT,TT,PT,FHA and PRN in 1/5D ID,1/10D ID and full-dose IM groups were all 100%,and those in control group were all 0.Compared with 2 d after challenge,the WBC counts of rats in control group increased significantly 5 d after aerosol challenge with B.pertussis(F=3.48,P <0.05),and then began to decrease,while those in other groups remained stable with time(F=0.14～1.30,P> 0.05).After aerosol challenge,the CFU in lungs of rats in control group was significantly higher than that in the other three groups(F=19.00～206.00,P<0.05),and B.pertussis was still detected 14 d after challenge;Except for the control group,the bacterial load in lungs of rats in the other three groups reached the peak 5d after challenge,the B.pertussis was basically cleared on the 14d,and there was no significant difference among the groups at each time point(F=1.14～1.25,P> 0.05).The bacterial load of trachea and nose in the control group was slightly higher than that in other groups at each time point,but the difference was not significant(F=0.71～3.54,P> 0.05).Except for the control group,the bacterial load in the trachea and nose of the other three groups were similar,and no significant difference was observed(F=0.75～3.41,P>0.05).@*Conclusion@#ID immunization with1/5 dose of DTacP-sIPV induced persistent protective antibodies against various components of the vaccine in rats.This study provided an experimental basis for the formulation of immunization strategy of ID immunization with fractional dose of DTacP-sIPV.

Implante de marcapasos a través de la vena cava superior izquierda persistente por ausencia de vena cava superior derecha. Reporte de un caso / Pacemaker implantation through the persistent left superior vena cava due to the absence of the right superior vena cava. Report of a case / Implante de marcapasso pela veia cava superior esquerda persistente devido à ausência da veia cava superior direita. Relato de um caso

Resumen: Introducción: la persistencia de la vena cava superior izquierda (PVCSI) tiene una prevalencia de 0.21% en la población general. Presentación del caso: masculino de 67 años de edad diagnosticado con bloqueo auriculoventricular (AV) de tercer grado y que requirió colocación de marcapasos; sin embargo, debido a la ausencia de la vena cava superior derecha, corroborado por angiotomografía, se colocó marcapasos definitivo a través de la vena cava superior izquierda persistente. Conclusión: la persistencia de la vena cava superior izquierda (PVCSI) es la anomalía venosa torácica más común. Puede causar una serie de síntomas clínicamente significativos, incluso en un corazón con anatomía normal. La colocación de marcapasos dificulta la fijación del electrodo debido al recorrido tortuoso que genera.

Abstract: Introduction: the persistence of the left superior vena cava (PLSVC) has a prevalence of 0.21% in the general population. Case presentation: 67-year-old male diagnosed with third-degree AV block, requiring pacemaker placement. However, due to the absence of a right superior vena cava, corroborated by CT angiography, a definitive pacemaker was placed through a persistent left superior vena cava. Conclusion: the persistence of the left superior vena cava (PLSVC) is the most common thoracic venous anomaly. It can cause a number of clinically significant symptoms, even in a heart with normal anatomy. Pacemaker placement makes electrode fixation difficult due to tortuous travel.

Resumo: Introdução: a persistência da veia cava superior esquerda (PVCSI) tem uma prevalência de 0.21% na população geral. Apresentação do caso: Homem de 67 anos com diagnóstico de bloqueio AV de terceiro grau, necessitando de colocação de marcapasso. No entanto, devido à ausência da veia cava superior direita, corroborada pela angiotomografia, colocou-se marcapasso definitivo através da veia cava superior esquerda persistente. Conclusão: a persistência da veia cava superior esquerda (PVCSI) é a anomalia venosa torácica mais comum. Pode causar uma série de sintomas clinicamente significativos, mesmo em um coração com anatomia normal. A colocação do marcapasso dificulta a fixação do eletrodo devido ao trajeto tortuoso.

Psychometric properties and measurement invariance of the Rigid and Flexible Persistence Scale in a Brazilian professional sample

Abstract Persistence involves the intention to maintain efforts when faced with obstacles and challenges, in order to achieve a specific goal. The Rigid and Flexible Persistence Scale (RFPS) is a self-report measure that assesses persistence that is theoretically derived from the premises of the Dualistic Model of Passion. The aim of the present research was to adapt the RFPS to Brazilian Portuguese and to estimate its evidence of validity and reliability in the context of work. Participants were 400 professionals, 55.8% women, aged between 18 and 68 years. The results indicate that the RFPS presented validity evidence based on the content. Corresponding to the theoretical expectations, exploratory and confirmatory factor analyses demonstrated adequacy of the structure composed of two factors, explaining 75% of the data variance, with good levels of reliability. The RFPS also revealed strong invariance across gender and work conditions (in-person vs remote). Flexible persistence showed positive association with harmonious passion and occupational self-efficacy. Conversely, rigid persistence showed positive association with obsessive passion. It was observed a mediational role of occupational self-efficacy in the relationship between harmonious passion and flexible persistence. Overall, the findings suggest that the RFPS is an adequate measure of persistence in a Brazilian occupational sample.

Coexistencia de vasculatura fetal persistente y retinoblastoma en el mismo ojo / Coexistence of persistent fetal vasculature and retinoblastoma in the same eye

Resumen Introducción: El retinoblastoma (RB) es el tumor maligno primario intraocular más frecuente en la infancia y debe ser la principal patología a descartar en los pacientes pediátricos con leucocoria. La persistencia de la vasculatura fetal (PVF) está dentro del diagnóstico diferencial de la leucocoria, un trastorno del vítreo que surge de un defecto en la involución de la vasculatura hialoidea en la etapa embrionaria que afecta al desarrollo ocular normal y comúnmente produce microoftalmia asociada. El diagnóstico temprano y tratamiento oportuno son cruciales para un buen pronóstico y mejor esperanza de vida del infante. Caso clínico: Presentamos un caso de coexistencia de retinoblastoma y PVF: paciente de sexo masculino de 2 años y 11 meses sin reflejo rojo y vasculatura y membrana blanco-amarillenta detrás del cristalino en el ojo derecho. La ecografía en modo B con desorganización de la cavidad vítrea con ecos de alta reflectividad sugestivos de calcificación. A la exploración se observó globo ocular agrandado, rubeosis iridis, vasculatura posterior, presión intraocular 28 mmHg. Tomografía computarizada con masa intraocular heterogénea con regiones hiperdensas. Con diagnóstico de probable retinoblastoma, se realizó la enucleación. La histopatología informó el hallazgo de retinoblastoma moderadamente diferenciado coexistente con PVF. Conclusiones: El hallazgo de estos dos diagnósticos en un mismo ojo es muy poco frecuente debido a la diferente fisiopatología.

Abstract Background: As retinoblastoma (RB) is the most frequent primary intraocular malignant tumor in childhood, it should be the main pathology to rule out in pediatric patients with leukocoria. Persistence of fetal vasculature (PFV) is within the differential diagnosis of leukocoria, a vitreous disorder arising from a defect in the involution of the hyaloid vasculature in the embryonic stage, which affects normal ocular development and commonly produces associated microophthalmia. An early diagnosis and timely treatment are crucial for a better prognosis and life expectancy of the child. Case report: We present a case of retinoblastoma and coexisting with PFV: a 2-years-and 11-months-old male with no red reflex, and vasculature and yellowish-white membrane behind the lens of the right eye. B-mode ultrasound with disorganization of the vitreous cavity with high reflectivity echoes suggestive of calcification. On examination we found an enlarged eyeball, rubeosis iridis, posterior vasculature, intraocular pressure 28 mmHg. Computed tomography with heterogeneous intraocular mass with hyperdense regions. With a diagnosis of probable retinoblastoma, enucleation was performed. Histopathology reported moderately differentiated retinoblastoma coexisting with PFV. Conclusions: The finding of these two diagnoses in the same eye is very rare due to the different pathophysiology.

Evidencias complementarias de validez de la Escala Grit-S y adaptación de la Escala para medir la agencia y el empoderamiento en Colombia

Introducción: el constructo grit predice el desempeño en distintos dominios; aunque con resultados variables en la estructura de las pruebas. El objetivo de la investigación es aportar evidencias de validez de la Grit-S, a través de la confirmación de la estructura y la convergencia con la Escala para Medir Agencia Personal y Empoderamiento. Método: en primer lugar, estudiantes universitarios (n = 313) de modalidad virtual respondieron la prueba Grit-S y se efectuó un análisis factorial confirmatorio de la prueba. A continuación, se evaluó la convergencia con la Escala para Medir Agencia Personal y Empoderamiento. Resultados: Los hallazgos sugieren mantener la estructura bifactorial de Grit-S. Por otra parte, se adaptó la escala de agencia y empoderamiento a través de un análisis factorial exploratorio, con una estructura de cuatro factores que explican el 44.6 % de la varianza. A su vez, la correlación de las subdimensiones de Grit-S y la escala de agencia y empoderamiento son positivas. Conclusiones: La prueba Grit-S es válida y sensible a dimensiones de funcionamiento individual, por la convergencia con las subdime0nsiones de agencia y la baja relación con el empoderamiento social.

Introduction: Grit is a construct that can predict performance in different domains. This research aims to provide evidence about the validity of the Grit-S Scale through a factorial structure confirmatory analysis and a convergence study with the Scale to Measure Personal Agency and Empowerment. Method: Firstly, university students from virtual learning programs (n = 313) answered the Grit-S Scale, and a confirmatory analysis was performed. Afterwards, the Scale to measure personal agency and empowerment was used to evaluate the convergence validity of the Grit-S Scale. Results: Findings confirm that the Grit-S scale has a bifactorial structure. On the other hand, the ESAGE Scale was adapted using an Exploratory Factorial Analysis, with four factors that explain 44.6% of the variance. Correlations between Grit-S subdimensions and the ESAGE Scale are positive and statistically significant. Conclusions: The Grit-S scale accurately measures Grit. Besides, it is possible to confirm the relationship between Grit and personality traits considering its convergence with the agency dimension in the Scale to measure personal agency and the low relationship with the social empowerment dimension.

Encefalitis por Virus Herpes Simplex con PCR persistentemente positivo en líquido cefalorraquídeo. A propósito de un caso neonatal

RESUMEN Las infecciones por herpes virus en la etapa neonatal pueden causar una alta morbimortalidad. La persistencia del virus, a pesar del tratamiento de primera línea, puede llevar a consecuencias devastadoras para el paciente. Presentamos el caso de un paciente neonato con persistencia de Virus Herpes Simplex en LCR, en el cual fue necesario iniciar foscarnet para contener la infección.

ABSTRACT Herpes virus infections in the neonatal stage can cause high morbidity and mortality. The persistence of the virus, despite first-line treatment, can lead to devastating consequences for the patient. We present the case of a neonatal patient with persistence of Herpes Simplex Virus in the CSF, in whic foscarnet treatment was required to contain the infection.

Allergic Rhinitis and House Dust Mite Sensitization Determine Persistence of Asthma in Children

Objective To specify clinical and immunological parameters of the mechanisms, which may lead to development of persistent asthma, or regression of the disease symptoms. Methods Eighty children with childhood asthma, diagnosed in the past by using the modifed Asthma Predicted Index (mAPI), were divided into two groups: remission group and persistent group. There were 3 study visits (baseline, at 6 mo, and at 12 mo). Clinical remission of asthma was defned as the absence of asthma symptoms for at least 12 mo without treatment. The patients could switch from one group to another during the 12 mo of follow-up. Clinical, infammatory, and immunoregulatory predictors of asthma remission/persistence were analyzed. Results The presence of mAPI criteria as well as house dust mite (HDM) allergy and allergic rhinitis at 7–10 y, were associated with a reduced prevalence of asthma remission. The increased eosinophil blood count in mAPI criteria was associated with a lower expression of CD25 positive cells. HDM allergy was associated with a higher fractional exhaled nitric oxide (FeNO) level (p=0.0061) and higher expression of CD25CD71 (p=0.0232). Allergic rhinitis was associated with a higher expression of PPAR (p=0.0493) and CD25CD71 (p=0.0198), and lower expression of glycoprotein A repetitions predominant (GARP). Conclusions Persistence of childhood asthma was largely determined by the presence of allergic rhinitis and sensitization to HDM. Additionally, API criteria but not immunoregulation processes, were related to asthma persistence.

Serological follow up of positive SARS-CoV-2 cases / Seguimiento serológico de casos positivos a SARS-CoV-2

Abstract: Objective: To describe the humoral response in a cohort with mild and asymptomatic SARS-CoV-2 infection previously identified in a community-based serological survey. Materials and methods: This study was an observational follow up of 193 subjects previously identified with positive anti-SARS-CoV-2 antibodies invited for a second test 112 days after the first sampling. All completed a standardized electronic questionnaire. IgM/IgG antibodies were determined using a qualitative IgM/IgG chemiluminescent immunoassay. Results: Among the 193 eligible subjects, a total of 174 (90%) attended the follow-up visit, and their serum samples were tested. Of the samples, 171 (98.3%) were still positive, and 3 (1.7%) were negative. Also, the cut-off index (COI) value of the immunoassay significantly increased from the first to the second test (P <0.001). Conclusions: Our findings support a sustained humoral response in individuals with mild and asymptomatic SARS-CoV-2 infection up to 112 days after a positive serologic baseline test, accompanied by increasing antibody titers.

Resumen: Objetivo: Describir la respuesta humoral en una cohorte con una infección leve o asintomática por SARS-CoV-2, previamente identificada en una encuesta serológica comunitaria. Material y métodos: Se realizó un seguimiento observacional de 193 individuos previamente identificados con anticuerpos IgM/IgG anti-SARS-CoV-2 invitados 112 días después de una determinación serológica inicial. Todos los participantes completaron un cuestionario electrónico estandarizado. Se determinaron los anticuerpos IgM/IgG mediante un inmunoensayo quimioluminiscente cualitativo. Resultados: De entre los 193 sujetos elegibles, 174 (90%) acudieron al seguimiento. De las muestras, 171 (98.3%) eran positivas y 3 (1.7%) negativas. Además, el valor de COI del inmunoenasayo se incrementó al comparar la primera y segunda determinación (P <0.001). Conclusiones: Los presentes resultados apoyan una respuesta humoral sostenida en individuos con infección por SARS-CoV-2 con síntomas leves o asintomática hasta 112 días después de una prueba serológica positiva, acompañada de incremento en los títulos de anticuerpos.

Determinants of Observance to Osteoporosis Treatment in Clinical Practice in a Single Center Study

Background: Improve compliance to prescribed medications is common in clinical practice, and it can lead to potentially fatal outcomes. This continues to be a common issue in the treatment of osteoporosis, although the causes of discontinuation and low compliance are complicated and understudied.Material & Methods:A survey was conducted in 101 patients at Narsingdi Sadar Hospital, Narsingdi, Dhaka, Bangladesh for osteoporosis management for a follow-up assessment, one year (July 2020 to June 2021) after having been prescribed a treatment with one of the following drugs: Calcium+vitamin D supplements alone (CaVitD), hormone replacement therapy (HRT), risedronate 5 mg/day (RIS), alendronate (ALN OW), Ibandronic acid monthly and Zolindronic acid I/V inj yearly.Results:Overall, 19.1 % stopped taking their prescribed medication before their bone mass reevaluations, with more than half of them doing so within the first 6 months. The dropout rate differed dramatically between regimens. ALN-OW was by far the least interrupted (6.9 %; p0.001 versus any other treatment). The most common causes for cessation were drug-related side effects, a lack of willingness to continue therapy, and a fear of negative effects. The reasons for discontinuation differed by treatment: safety concerns were very common for HRT, lack of motivation was the most common cause for CaVitD and drug-related side effects were the most common cause for RIS, ALN, Ibandronic acid and Zolindronic acid . Patients having a history of vertebral fractures, densito-metric osteoporosis, or who were using corticosteroid or anti-inflammatory medications had a considerably greater rate of treatment adherence. Patients on benzodiazepine or gastroprotective drugs, as well as those for whom a bone measurement was not easily accessible, had a considerably greater probability of treatment interruption. ALN OW and HRT had the highest compliance to recommended dosing (p0.001 versus any other) and CaVitD had the lowest (p0.01 versus any other). Poor treatment compliance (50 percent medicine taken) was strongly associated with benzodiazepine and gastroprotective usage, whereas significantly higher compliance was associated with established osteoporosis risk factors: early menopause, low bone mass values, and past vertebral fractures. Adherence was lowest when treatments were prescribed by general practitioners (GPs) and orthopaedic surgeons (p0.01 compared to the global mean).Conclusions:According to the conclusions of this large survey of Bangladeshi osteoporotic women, the kind of medicine provided is the most important factor of both persistence

Implicaciones de los virus Zika y Chikungunya en el semen durante la transmisión sexual / Implications of Zika and Chikungunya viruses in semen during sexual transmission

Introducción: Los brotes de enfermedades causados por los virus Zika (VZIK) y Chikungunya (VCHIK) representan un problema de salud pública para muchos países tropicales y subtropicales. Objetivo: Discutir las implicaciones del hallazgo del VZIK y del VCHIK en el semen, y su relación con la transmisión sexual y la fertilidad masculina. Métodos: Se realizó una revisión narrativa de la literatura usando artículos indexados en PubMed (Medline), Embase y Scopus. Información, análisis y síntesis: Si bien los mosquitos del género Aedes son el vector principal y transmiten ambos virus, la transmisión sexual es una vía de infección significativa del VZIK y una posible ruta alterna para el VCHIK. La diseminación de estas arbovirosis vía linfática y sanguínea contribuye a la infección de diversos tejidos, incluyendo el tracto reproductivo masculino, donde el VZIK puede persistir. La infección de los testículos y quizás también de las glándulas accesorias del sistema reproductor masculino, se asocia con síntomas genitourinarios o alteraciones espermáticas, relacionadas con la detección del virus por largos periodos. Aunque no hay evidencia contundente sobre la presencia del VCHIK en el tracto genital masculino, se ha hallado en orina y semen. Además, se ha sugerido una posible persistencia en macrófagos que pueden infiltrar diferentes tejidos periféricos y cumplir una función de reservorio. Conclusiones: Hay presencia y persistencia de los virus Zika y Chikungunya en el tracto reproductor masculino. La infección en el semen se asocia con la transmisión sexual del virus, y con la alteración en la producción y calidad de los espermatozoides, con consecuencias clínicas graves en la salud sexual y reproductiva de los hombres infectados(AU)

Introduction: Disease outbreaks caused by Zika (ZIKV) and Chikungunya (CHIKV) viruses represent a public health problem for many tropical and subtropical countries. Objective: To discuss the implications of finding ZIKV and CHIKV in semen, and their relationship to sexual transmission and male fertility. Methods: A narrative review of the literature was carried out using articles indexed in PubMed (Medline), Embase and Scopus. Information, Analysis and Synthesis: Although Aedes mosquitoes are the primary vector and transmit both viruses, sexual transmission is a significant route of infection for ZIKV and a possible alternate route for CHIKV. Spread of these arboviruses via lymphatic and blood routes contributes to infection of various tissues, including the male reproductive tract, where ZIKV may persist. Infection of the testes and probably of the accessory glands of the male reproductive system is associated with genitourinary symptoms or sperm alterations, related to the detection of the virus for long periods. Although there is no conclusive evidence of the presence of CHIKV in the male genital tract, it has been found in urine and semen. In addition, a possible persistence in macrophages that can infiltrate different peripheral tissues and function as reservoir has been suggested. Conclusions: Zika and Chikungunya viruses can be present and persist in the male reproductive tract. Infection in semen is associated with sexual transmission of the virus and with alterations in the production and quality of spermatozoa, with serious clinical consequences in the sexual and reproductive health of infected men(AU)

Compliance of oral anticoagulant medication and influencing factors among nonvalvular atrial fibrillation patients with new-onset acute ischemic stroke / 中华全科医师杂志

Objective:To investigate the compliance of oral anticoagulant(OAC) medication and influencing factors among nonvalvular atrial fibrillation(NVAF) patients with new-onset acute ischemic stroke (AIS).Methods:A total of 396 NVAF patients, who initiated OAC therapy after a new-onset AIS from August 2011 to December 2020 were enrolled from China Atrial Fibrillation Registry (China-AF). The demographic characteristics, medical history, comorbid diseases and medication of patients were collected before and after the index stroke, and the influencing factors of compliance of OAC medication were analyzed.Results:Patients were followed up for a mean of 26.9 months. Among 396 patients, 228 (57.6%) had continuous anticoagulant medication (persistent OAC group);while 168 (42.4%) discontinued OAC therapy within 2 years after the index stroke (non-persistent OAC group). Patients on persistence OAC had a higher proportion of atrial fibrillation episodes than patients on non-persistent OAC [83.3% (190/228) vs. 73.8% (126/168); χ 2=5.34, P=0.021], while lower proportion of radiofrequency ablation(RFA)[18.9% (43/228) vs. 32.1% (43/228); χ 2=9.22, P=0.002]. Multivariate Cox regression modelshowed that history of RFA ( HR=1.77, 95% CI: 1.25-2.50; P=0.001) was positively associated with non-persistence of OAC. Conclusion:The study indicates that quite large proportion of NVAD patients with a new-onset of AIS discontinued OAC therapy during 2 years of follow up, and a history of RFA procedure might be an independent factor associated with discontinuing of anticoagulant therapy.

Prolonged SARS-CoV-2 RNA shedding in a young man recovering from traumatic pneumothorax

We describe a case of prolonged SARS-CoV-2 RNA shedding in an HIV-negative 21-year-old man recovering from abdominal and thoracic trauma. Nasopharyngeal (NP) swabs collected at 12 time points over a 95-day span all tested positive for SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR). Genotyping revealed canonical beta-variant E484K and N501Y mutations at earlier time points. Human rhinovirus, coronavirus NL63 and respiratory syncytial virus B were detected at different time points by RT-PCR. Full blood analysis at time point 9 (day 82) showed leukopenia with lymphocytosis. The patient's NP swab tested negative for SARS-CoV-2 by RT-PCR 101 days after the first positive test. The prolonged duration of SARS-CoV-2 RNA shedding in the context of trauma presented here is unique and has important implications for COVID-19 diagnosis, management and policy guidelines

El sentido de la vida en los relatos de discontinuidad de la carrera delictiva: análisis cualitativo de dos casos / The meaning of life in the stories of discontinuity of the criminal career: qualitative analysis of two cases / O sentido da vida nas histórias de descontinuidade da carreira riminosa: análise qualitativa de dois casos

Resumen El estudio de la relación entre el sentido de la vida y la persistencia o desistimiento de la carrera delictiva, así como su aplicabilidad en el tratamiento de delincuentes, han recibido escasa atención en el ámbito de la criminología. El objetivo del presente trabajo consistió en explorar la presencia o ausencia del sentido de vida desde el paradigma de la criminología narrativa. Para ello, estudiamos los relatos de dos varones españoles con extensa carrera delictiva: uno que dejó de delinquir hace 21 años y otro que persiste en la actualidad. Se llevó a cabo un análisis cualitativo sobre tres categorías indicadoras del sentido de vida: comprensión de la propia vida, propósito de vida y sentimiento de importancia. Los resultados indicaron que el relato de desistimiento contenía múltiples referencias al hallazgo de un sentido de vida, en tanto que el entrevistado observó que su hallazgo contribuyó a la finalización del comportamiento ilícito. Por el contrario, el relato de persistencia destacó una experiencia de vacío existencial, la cual condicionaba la continuidad delictiva. Los programas de intervención, cuyo propósito es la prevención de la delincuencia o de la reincidencia, podrían beneficiarse de las aportaciones de un modelo centrado en el sentido de la vida que favorezca el desarrollo de nuevas narrativas resilientes.

Abstract The study of the relationship between the meaning of life and the persistence or withdrawal of the criminal career, as well as its applicability in the treatment of offenders, has received little attention in the field of Criminology. The aim of this work was to explore the presence or absence of the meaning of life from the paradigm of narrative criminology. To do this, we studied the stories of two Spanish men with extensive criminal careers: one who stopped committing crimes 21 years ago and another who persists today. A qualitative analysis was carried out on three categories indicating the meaning of life: understanding of one's own life, life purpose and feeling of importance. The results indicated that the withdrawal report contained multiple references to the finding of a sense of life, while the interviewee observed that its finding contributed to the end of the illicit behavior. On the contrary, the story of persistence highlighted an experience of existential emptiness, which conditioned the criminal continuity. Intervention programmes, whose purpose is the prevention of crime or recidivism, could benefit from the contributions of a model focused on the meaning of life that favours the development of new resilient narratives.

Resumo O estudo da relação entre o sentido da vida e a persistência ou retirada da carreira criminosa, bem como sua aplicabilidade no tratamento dos infratores, tem recebido pouca atenção no campo da Criminologia. O objetivo deste trabalho foi explorar a presença ou ausência do sentido da vida a partir do paradigma da criminologia narrativa. Para isso, estudamos as histórias de dois espanhóis com extensas carreiras criminosas: um que parou de cometer crimes há 21 anos e outro que persiste até hoje. Uma análise qualitativa foi realizada em três categorias indicando o sentido da vida: compreensão da própria vida, propósito de vida e sentimento de importância. Os resultados indicaram que o relatório de retirada continha múltiplas referências à constatação de um sentido de vida, enquanto o entrevistado observou que seu achado contribuiu para o fim do comportamento ilícito. Pelo contrário, a história da persistência destacou uma experiência de vazio existencial, que condiz com a continuidade criminal. Os programas de intervenção, cujo objetivo é a prevenção do crime ou da reincidência, poderiam beneficiarse das contribuições de um modelo focado no sentido da vida que favoreça o desenvolvimento de novas narrativas resilientes.

Coronavirus persistence in human respiratory tract and cell culture: An overview

ABSTRACT Emerging human coronaviruses, including the recently identified SARS-CoV-2, are relevant respiratory pathogens due to their potential to cause epidemics with high case fatality rates, although endemic coronaviruses are also important for immunocompromised patients. Long-term coronavirus infections had been described mainly in experimental models, but it is currently evident that SARS-CoV-2 genomic-RNA can persist for many weeks in the respiratory tract of some individuals clinically recovered from coronavirus infectious disease-19 (COVID-19), despite a lack of isolation of infectious virus. It is still not clear whether persistence of such viral RNA may be pathogenic for the host and related to long-term sequelae. In this review, we summarize evidence of SARS-CoV-2 RNA persistence in respiratory samples besides results obtained from cell culture and histopathology describing long-term coronavirus infection. We also comment on potential mechanisms of coronavirus persistence and relevance for pathogenesis.

Análise do sistema toxina-antitoxina HipA/B na indução da persistência bacteriana de cepas de Escherichia coli extraintestinal / The importance of HipA/B Toxin-Antitoxin system in extraintestinal Escherichia Coli persistence

Os sistemas toxina-antitoxinas (TA) compreendem um conjunto de genes que são amplamente difundidos em procariotos. No cromossomo, os sistemas podem estar envolvidos na indução de morte celular em resposta a condições estressantes, indução de persistência, formação de biofilme, colonização de novos nichos, manutenção da mobilidade bacteriana e virulência de bactérias patogênicas. Em E. coli K12, 36 sistemas TA foram descritos, dos quais o do tipo II é o mais abundante e estudado. Dentre as oito toxinas pesquisadas nesse trabalho, o gene da toxina HipA está presente em 76 das 100 cepas de ExPEC estudadas. Apesar da abundância de hipA em ExPEC e em diversos genomas bacterianos, a participação dos sistemas hipA/B na indução da persistência ainda não é clara. Portanto, o sistema hipA/B de duas cepas ExPEC isoladas de infecção sanguínea foi deletado, e estas foram avaliadas quando a indução da persistência bacteriana na presença de antibióticos, formação de biofilme, resistência ao soro e sobrevivência em macrófagos. O sistema TA hipA/B não influenciou no fenótipo de resistência ao soro humano e na sobrevivência intracelular em macrófagos, no entanto, participou da indução da persistência por ciprofloxacino em um isolado (EC182); e da formação de biofilme em superfície de vidro do isolado (EC273)

Toxin-antitoxin (TA) systems comprise a set of genes that are widespread in prokaryotes. On the chromosome, the systems may be involved in the induction of cell death in response to stressful conditions, persistence induction, biofilm formation, colonization of new niches, maintenance of bacterial mobility and virulence. In E. coli K12, 36 TA systems have been described, of which type II is the most abundant. Among the eight toxins searched in this work, hipA is present in 76 bacteria of the 100 ExPEC strains studied. Despite the abundance of hipA in ExPEC and in several bacterial genomes, the participation of hipA/B modules in the persistence is still unclear. Therefore, hipA/B system of two ExPEC strains isolated from blood infection was deleted and consequently evaluated in bacterial persistence induced by antibiotics, serum resistance and macrophage survival. Despite the fact that, the TA hipA/B system did not influence the phenotype of resistance to human serum and intracellular survival in macrophages. Herein, we described that hipA/B was important for persistence induction in one isolate (EC182); and may participate in the biofilm formation on the glass surface in the other studied strain (EC273)

Viral infections and implications for male reproductive health / 亚洲男科学杂志(英文版)

Viral infections have haunted humankind since times immemorial. Overpopulation, globalization, and extensive deforestation have created an ideal environment for a viral spread with unknown and multiple shedding routes. Many viruses can infect the male reproductive tract, with potential adverse consequences to male reproductive health, including infertility and cancer. Moreover, some genital tract viral infections can be sexually transmitted, potentially impacting the resulting offspring's health. We have summarized the evidence concerning the presence and adverse effects of the relevant viruses on the reproductive tract (mumps virus, human immunodeficiency virus, herpes virus, human papillomavirus, hepatitis B and C viruses, Ebola virus, Zika virus, influenza virus, and coronaviruses), their routes of infection, target organs and cells, prevalence and pattern of virus shedding in semen, as well as diagnosis/testing and treatment strategies. The pathophysiological understanding in the male genital tract is essential to assess its clinical impact on male reproductive health and guide future research.

Effects of booster vaccination with tetanus toxoid, reduced diphtheria and acellular pertussis combined vaccine (Tdap) after vaccination of rats with DTacP-sIPV or DTacP-IPV/Hib / 中华微生物学和免疫学杂志

Objective:To evaluate the effects of a booster immunization with a candidate tetanus toxoid, reduced diphtheria toxoid and acellular pertussis combined vaccine (Tdap) in a rat model after primary vaccination with diphtheria, tetanus, acellular pertussis and Sabin strain inactivated poliovirus combined vaccine (DTacP-sIPV) or diphtheria, tetanus, acellular pertussis, inactivated poliovirus and haemophilus type b combined vaccine (DTacP-IPV/Hib) for further preclinical study.Methods:Wistar rats were randomly divided into three groups and respectively immunized with a self-developed DTacP-sIPV, a marketed DTacP-IPV/Hib and normal saline at 0, 1, and 2 months of age. Serum levels of antibody against each component in each group were detected before immunization and after each dose. A booster dose of the candidate Tdap was given 10 months after primary immunization. Serum levels of antibody against each component in each group were detected before, 1 month and 6 months after the booster immunization.Results:One month after three doses of primary immunization, the geometric mean titers (GMT, Log2) of antibodies against diphtheria toxoid (DT), tetanus toxoid (TT), pertussis toxin (PT), filamentous hemagglutinin (FHA) and pertactin (PRN) in the DTacP-sIPV group were 17.41, 18.34, 18.11, 19.93 and 13.91, respectively, and the seroconversion rates of these components all reached 100%. Ten months after primary immunization, the GMTs of antibodies against DT, TT, PT, FHA and PRN decreased to 15.17, 14.26, 13.60, 14.51 and 10.39, respectively, and the seroconversion rates remained above 89%. One month after booster immunization, the GMTs of antibodies against DT, TT, PT and FHA in the DTacP-sIPV and DTacP-IPV/Hib groups were 16.49/17.26, 16.80/17.63, 16.70/17.74 and 18.48/19.26, respectively, and the seroconversion rates of these components all reached 100% with no significant difference between the two groups ( P>0.05). The GMTs of anti-PRN antibody in the DTacP-sIPV and DTacP-IPV/Hib groups were 13.07 and 11.00, and the seroconversion rates were 100% and 88%, which were higher in the DTacP-sIPV group than in the DTacP-IPV/Hib group ( P<0.05). Six months after booster immunization, the GMTs of antibodies against DT, TT, PT, FHA and PRN in the DTacP-sIPV and DTacP-IPV/Hib groups decreased to 15.74/14.87, 15.07/15.14, 14.84/15.73, 16.62/16.37 and 11.44/9.96, respectively, and the seroconversion rates remained above 88%. Conclusions:Booster vaccination with the candidate Tdap vaccine induces humoral immune response following primary immunization with DTacP-sIPV or DTacP-IPV/Hib in the Wistar rat model, while the antibody titer decreases with time.

Prognostic factors of salvage radiotherapy after radical prostatectomy / 中华泌尿外科杂志

Objective:To investigate the prognosis after salvage radiotherapy with or without hormone therapy for prostate cancer.Methods:From May 2014 to December 2020, 248 patients undergoing salvage radiotherapy due to prostate-specific antigen (PSA)persistence or biochemical progression after radical prostatectomy at Sun Yat-sen University Cancer Center (n=157) and West China Hospital, Sichuan University (n=91) were analyzed. Median age was 66 (45-78) years old. Median PSA was 23.50 (0.18-845.00) ng/ml. The number of PSA persistence and biochemical progression were 143 (59%) and 105 (42%). The number of pT 2, pT 3a, pT 3b, pT 4, and unknown T stage was 99, 49, 78, 15 and 7 cases.The number of N 0, N 1 and unknown N stage was 153, 44 and 51 cases. 165 cases had positive surgical margin. Gleason score of 6, 7, 8, >8 score and unknown was in 12, 104, 34, 90 and 8 patients. Early and late salvage radiotherapy was performed in 117 and 131 patients, and 70 patients (28%) were CRPC. Hormone therapy was used combined with radiotherapy in 182 patients (73%). PSA decline after radiotherapy was compared with Chi-squre test. Kaplan-Meier method and log-rank test were used to compare progression free-survival (PFS)after radiotherapy. Univariate and multivariate analyses of PFS were performed using Cox proportional hazards model. Early salvage radiotherapy was defined as PSA≤0.5 ng/ml before radiotherapy, and late salvage radiotherapy was defined as PSA>0.5ng/ml. Results:PSA response (PSA decline ≥50%) rate was 94% (233/248), and 82% (203/248) patients had PSA decline ≥ 90%. Twelve (5%) patients had rising PSA after completing radiotherapy, but only 4 (2%) had real progression. The median PFS was 69 months (95% CI 68-70), and 3-year and 5-year PFS rate were 80% and 67%. PFS of PSA persistence and biochemical progression were similar ( HR =0.71, 95% CI 0.37-1.37, P=0.311). Compared with late salvage radiotherapy, early salvage radiotherapy had better PFS [69 (95% CI 68-70) vs. 59 (95% CI 44-74) months, P<0.001]. Compared with hormone sensitive, castration-resistant was associated with worse PFS (5-year PFS rate 74% vs. 51%, P<0.001). In multivariate analysis, Gleason score>8, castration-resistant and late salvage radiotherapy were unfavorable prognostic factors. Conclusions:In patients receiving salvage radiotherapy with or without hormone therapy for PSA persistence and biochemical progression after radical prostatectomy, high PSA level before radiotherapy and castration resistant is associated with poor prognosis.

Treatment of prostate cancer with biochemical recurrence after radical prostatectomy: a case report / 中华泌尿外科杂志

As a second-generation AR antagonist, enzalutamide has shown good effects in the treatment of castration-resistant prostate cancer, and has also been used in the treatment of hormone-sensitive prostate cancer. In 2018, a patient with prostate cancer was admitted to Hangzhou First People's Hospital. After radical prostatectomy, the patients was in PSA persistence. After 29 months of endocrine therapy, the patient developed drug resistance against bicalutamide, and PSA increased month by month. PSA dropped back to undetectable after changing bicalutamide to enzalutamine.

Persistencia a largo plazo de agentes biológicos en el tratamiento de pacientes con Artritis Reumatoidea: una revisión sistemática de la literatura / Long-term persistence of biological agents in the treatment of patients with Rheumatoid Arthritis: a systematic literature review

La persistencia en el tratamiento es un marcador subrogante de éxito de tratamiento a largo plazo. Objetivo: Evaluar la persistencia de los agentes biológicos utilizados para el tratamiento de pacientes con artritis reumatoidea (AR) a un tiempo de 5 años y determinar las principales causas asociadas a persistencia o discontinuación. Material y métodos: Se realizó una revisión sistemática de la literatura (RSL), según las recomendaciones PRISMA, en las bases de datos Pubmed, Cochrane y Lilacs, y estudios presentados en los congresos ACR, EULAR, PANLAR (2018/2019) hasta Enero 2020. Dos revisoras independientes, evaluaron todas las publicaciones identificadas, por título y abstract y por full text, de acuerdo a la metodología PICO. Los criterios de elegibilidad fueron estudios de pacientes ≥ 18 años con diagnóstico de AR, en tratamiento con agentes biológicos, que midieran persistencia/discontinuación en un período de tiempo igual o superior a 5 años y que estuvieran en idioma inglés o español. En el caso de falta de acuerdo entre las dos revisoras, un tercer revisor fue consultado. La información extraída fue analizada mediante estadística descriptiva, se calculó el porcentaje promedio de persistencia de cada agente biológico a los 5 años. Resultados: Se seleccionaron 56 artículos luego de la remoción de los duplicados y de la exclusión por título/abstract, y por full text. De ellos 13, eran fase de extensión a largo plazo de estudios randomizados controlados, 15 cohortes retrospectivas, 18 cohortes prospectivas y 10 cohortes retro-prospectivas y correspondían a un total de 72177 (rango: 79-10396) pacientes con AR, con una edad media 53.8 años ± 12.1, 78.2% de sexo femenino y un tiempo promedio de evolución de la AR de 9.7 años ± 8.4. En 33.9% de los estudios, la terapia biológica estaba combinada con drogas modificadoras de la AR convencionales (DMARs-c), en 3.6% en monoterapia, 48.2% ambas modalidades y en 14.3% no informaba. Un estudio fue realizado en 1° línea (metotrexato näive), 29 estudios en 2° línea (respuesta inadecuada a MTX y/o DMARs-c), 5 en 3° línea (respuesta inadecuada a DMARs biológicas-b-), 12 en ≥2° línea terapéutica y en 9 no especificaban. En 30 estudios que evaluaron 2° línea terapéutica, la mayor persistencia correspondió a tocilizumab (TCZ) 66.41% (IC95% 57.8-79.94), abatacept (ABA) 57.91% (IC95% 50.96-64.87) y golimumab (GOL) 54.38% (IC95% 48.58-60.19). Y 10 estudios, en los cuales el DMAR-b había sido analizado en 3° línea terapéutica, las mayores tasas de retención correspondieron a rituximab (RTX) 61.19% (IC95% 57.53-66.22) y TCZ 61.1% (IC95% 58.81-63.32). Entre los estudios que evaluaron predictores, los más frecuentemente asociados a mayor sobrevida fueron: tratamiento combinado con DMAR-c, etanercept versus infliximab y adalimumab y 2° línea de tratamiento vs 3° o 4° línea y los asociados a menor sobrevida fueron: mayor uso de esteroides, mayor actividad basal de la enfermedad y sexo femenino. Conclusiones: En esta RSL, la persistencia de los DMAR-b a 5 años en pacientes con respuesta inadecuada a DMARs-c y DMARs-b fue numéricamente mayor para los agentes no TNFi. Y entre los TNFi, GOL presentó mayor retención en 2° línea terapéutica.

Treatment persistence is a surrogate marker for long-term treatment success. Objective: To assess the persistence of the biological agents used for treatment of patients with rheumatoid arthritis (RA) over 5 years period and to determine the main causes associated with persistence or discontinuation. Material and methods: A systematic literature review (SLR) was carried out, according to PRISMA recommendations, including Pubmed, Cochrane and Lilacs databases, and studies presented at the ACR, EULAR, PANLAR congresses (2018/2019) until January 2020. Two independent reviewers evaluated the identified publications, by title and abstract and full text, according to PICO methodology. Eligibility criteria were: studies including RA patients ≥ 18 years, treated with biological agents, which measured persistence/ discontinuation for a period of time equal to or greater than 5 years and who were in English or Spanish language. In the case of lack of agreement between the two reviewers, a third reviewer was consulted. The extracted information was analyzed using descriptive statistics, an average percentage of persistence for each biological agent at 5 years was calculated. Results: 56 articles were selected after removal of duplicates and exclusion by title/abstract, and by full text. Long-term extension phase of randomized controlled studies were 13, another 15 retrospective cohorts, 18 prospective cohorts and 10 retro-prospective cohorts and corresponded to a total of 72177 (range: 79-10396) patients with RA, with a mean age of 53.8 years ± 12.1, 78.2% female and an average RA disease duration of 9.7 years ± 8.4. In 33.9% of the studies, biological therapy was combined with conventional disease modifying anti-rheumatic drugs (c-DMARDs), in 3.6% monotherapy, 48.2% both modalities, and in 14.3% not reported. One study was in the 1st line (methotrexate näive), 29 studies in 2nd line (inadequate response to MTX and/or c-DMARDs), 5 in 3rd line (inadequate response to biological b-DMARDs), 12 in ≥2nd therapeutic line and in 9 studies did not specify this condition. In 30 studies which evaluated the 2nd therapeutic line, the highest persistence corresponded to tocilizumab (TCZ) 66.41% (95% CI 57.8-79.94), abatacept (ABA) 57.91% (95% CI 50.96-64.87) and golimumab (GOL) 54.38% (95% CI 48.58-60.19). In 10 studies, in which b-DMARD had been analyzed in 3rd therapeutic line, highest retention rates corresponded to rituximab (RTX) 61.19% (95% CI 57.53-66.22) and TCZ 61.1% (95% CI 58.81-63.32). Among studies that evaluated predictors, the most frequently associated with higher survival were: combined treatment with c-DMARD, etanercept versus infliximab and adalimumab and 2nd line of treatment vs. 3rd or 4th line whereas those associated with lower survival rates were: greater use of steroids, higher baseline disease activity, and female gender. Conclusions: In this SLR, the 5-year persistence of b-DMARD in patients with inadequate response to DMARs-c and DMARs-b was numerically greater for non-TNFi agents. And among TNFi, GOL presented a higher retention in 2nd therapeutic line.