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At the baseline, 587 women reported having experienced socioeconomic hardships due to the recession. During the 20 years' follow-up, 501 women developed cardiovascular disease. After adjustment for age, the risk of cardiovascular disease was 27% higher among women exposed to socioeconomic hardships compared to those who were not (hazard ratio 1.27, 95% confidence interval 1.06-1.53,

=0.012). click here Further adjustments for overall socioeconomic position at baseline, prior cardiovascular health, and lifestyle factors did not attenuate the association (hazard ratio 1.23, 95% confidence interval 1.02-1.5,

=0.029).

The early 1990s economic recession was associated with a subsequently increased risk of cardiovascular disease among Finnish women.

The early 1990s economic recession was associated with a subsequently increased risk of cardiovascular disease among Finnish women.Background. Laparoscopic liver resection (LLR) has emerged as a considerable alternative to conventional liver surgery. However, the increasing complexity of liver resection raises the incidence of postoperative complications. The aim of this study was to identify risk factors for postoperative morbidity in a monocentric cohort of patients undergoing LLR. Methods. All consecutive patients who underwent LLR between 2015 and 2019 at our institution were analyzed for associations between complications with demographics and clinical and operative characteristics by multivariable logistic regression analyses. Results. Our cohort comprised 156 patients who underwent LLR with a mean age of 60.0 ± 14.4 years. General complications and major perioperative morbidity were observed in 19.9% and 9.6% of the patients, respectively. Multivariable analysis identified age>65 years (HR = 2.56; P = .028) and operation time>180 minutes (HR = 4.44; P = .001) as significant predictors of general complications (Clavien ≥1), while albumin less then 4.3 g/dl (HR = 3.66; P = .033) and also operative time (HR = 23.72; P = .003) were identified as predictors of major postoperative morbidity (Clavien ≥3). Conclusion. Surgical morbidity is based on patient- (age and preoperative albumin) and procedure-related (operative time) characteristics. Careful patient selection is key to improve postoperative outcomes after LLR.

Up to 30% of stroke patients initially presenting with non-disabling or mild deficits may experience poor functional outcome. Despite, intravenous thrombolysis remains controversial in this subgroup of stroke patients due to its uncertain risk benefit ratio.

We aimed to analyze the real-world experience with intravenous thrombolysis in stroke patients presenting with very low NIHSS.

Data of stroke patients presenting with mild initial stroke severity (NIHSS 0-5) including vascular risk factors, stroke syndrome and etiology, early neurological deterioration, symptomatic intracerebral haemorrhage (sICH), and functional outcome by modified Rankin Scale were extracted from a large nationwide stroke registry and analysed. Patients were categorized and compared according to admission severity NIHSS 0-1 versus NIHSS 2-5 and intravenous thrombolysis use.

Seven hundred and three (2%) of 35,113 patients presenting with NIHSS 0-1 and 6316 (13.9%) of 45,521 of patients presenting with NIHSS 2-5 underwent intravenous thrombolysis. In the NIHSS 0-1 group, intravenous thrombolysis was associated with early neurological deterioration (adjusted OR 8.84, CI 6.61-11.83), sICH (adjusted OR 9.32, CI 4.53-19.15) and lower rate of excellent outcome (mRS 0-1) at three months (adjusted OR 0.67, CI 0.5-0.9). In stroke patients with NIHSS 2-5, intravenous thrombolysis was associated with early neurological deterioration (adjusted OR 1.7, 1.47-1.98), sICH (adjusted OR 5.75, CI 4.45-7.45), and higher rate of excellent outcome (mRS 0-1) at three months (adjusted OR 1.21, CI 1.08-1.34).

Among patients with NIHSS 0-1, intravenous thrombolysis did not increase the likelihood of excellent outcome. Moreover, potential signals of harm were observed. Further research seems to be warranted.

Among patients with NIHSS 0-1, intravenous thrombolysis did not increase the likelihood of excellent outcome. Moreover, potential signals of harm were observed. Further research seems to be warranted.

People with stroke experience falls at more than twice the rate of the general older population resulting in high fall-related injuries. However, there are currently no effective interventions that prevent falls after stroke.

To determine the effect and cost-benefit of an innovative, home-based, tailored intervention to reduce falls after stroke.

A total of 370 participants will be recruited in order to be able to detect a clinically important between-group difference of a 30% lower rate of falls with 80% power at a two-tailed significance level of 0.05.

alls

fter

troke

rial (FAST) is a multistate, Phase III randomized trial with concealed allocation, blinded assessment, and intention-to-treat analysis. Ambulatory stroke survivors within five years of stroke who have been discharged from formal rehabilitation to the community and who have no significant language impairment will be randomly allocated to receive habit-forming exercise, home safety, and community mobility training or usual care.

The primary outcome is the rate of falls over the previous 12 months. Secondary outcomes are the risk of falling (proportion of fallers), community participation, self-efficacy, balance, mobility, physical activity, depression, and health-related quality of life. Health care utilization will be collected retrospectively at baseline and prospectively to 6 and 12 months.

The results of FAST are anticipated to directly influence intervention for stroke survivors in the community.

ANZCTR 12619001114134.

The results of FAST are anticipated to directly influence intervention for stroke survivors in the community.Trial Registration ANZCTR 12619001114134.Objective. The surgical treatment of complex anal fistulae is very challenging because of the incidence of incontinence after traditional approaches. There are no studies on the role of video-assisted anal fistula treatment (VAAFT) combined with anal fistula plug (AFP) in the complex anal fistulae. The aim of this study was to demonstrate the efficacy of treating complex anal fistulae using VAAFT combined with AFP. Method. This was a retrospective, nonrandomized observational study. 57 consecutive patients with complex anal fistulae who had undergone the VAAFT with AFP in our hospital between April 2016 and December 2019 were included. The primary outcomes were the cure rate, recurrence rate, and Wexner incontinence scores; the secondary outcomes were surgery time, blood loss, wound healing time postoperatively, pain, and patient satisfaction. Results. All 57 patients completed the surgery and follow-up, with an average follow-up time of 28 months; 6 patients suffered with recurrence (recurrence rate 10.5%). The average surgery time was 57.9 minutes, and the average wound healing time was 46 days. There were no severe postoperative complications, and anal sphincter function was protected in all patients. Conclusions. The treatment of complex anal fistula by VAAFT combined with AFP is safe and effective, has a high healing rate and few postoperative complications, and is a promising surgery that can effectively protect the patient's anal sphincter function.A 4-mo-old northern red-shouldered macaw (Diopsittaca nobilis) was admitted to the veterinary hospital of the Arruda Câmara Zoo, in the State of Paraiba, Brazil, for investigation of an orbital mass. Given rapid progression and lack of response to treatment, the bird was euthanized, and an autopsy was performed. Histologically, the mass consisted of a retrobulbar invasive tumor characterized by tubular and rosette-like structures, with interspersed heteroplastic tissues, such as aggregates of neuroglial cells and islands of hyaline cartilage. The tumor was immunopositive for pancytokeratin, GFAP, NSE, and S100. These findings were compatible with an ocular teratoid medulloepithelioma, a neoplasm best described in humans but also reported rarely in young cockatiels and African Grey parrots.Adolescent aggression is a global public health with long-lasting and costly emotional, social, and economic consequences, and it is of vital importance to identify those variables that can reduce these behaviors in this population. Therefore, there is a need to establish the protective factors of aggressive behavior in adolescence. While some research has demonstrated the relationship between emotional intelligence (EI) and various aggressive responses in adolescence, indicating that EI-or the ability to perceive, use, understand, and regulate emotions-could be considered a protective factor for the development of aggressive behavior in adolescence, the strength of this effect is not clear. The aim of the present study was to conduct a systematic review of the literature concerning the relationship between aggressive behavior and EI in adolescents and provide a reliable estimate of the relationship between both constructs through a meta-analysis. For this purpose, we searched for relevant articles in English and Spanish in Medline, PsycINFO, and Scopus, obtaining 17 selectable articles based on the search terms used in research in the adolescent population. These studies provide scientific evidence of the relationship between the level of EI assessed from the three theoretical models of EI (performance-based ability model, self-report ability model, and self-report mixed model) and various aggressive responses, showing that adolescents with higher levels of EI show less aggressive behavior. Implications for interventions and guidelines for future research are discussed.The first family medicine training programme for medical students in India began at Christian Medical College (CMC), Vellore in 2005 as a two-week programme. Currently, it includes two mandatory and one elective programme along with one to two weeks during the internship. In this study, the authors examined the impact of the mandatory programmes in family medicine through the feedback of medical students and the faculty experience. The aim of the authors was to examine the impact on medical students based on their feedback and the experience of faculty in teaching family medicine.This paper reports a retrospective evaluation based on the feedback of third-year medical students after their mandatory programmes in 2018. The authors collected students' feedback using questionnaires and recorded the faculty experience through a focus-group discussion (FGD) and in-depth interview. Overall attendance of students was 50-60%. About 75% of students who filled in the questionnaire felt the programme to be relevant to their future role as 'Physicians of First Contact'. Faculty felt challenged to balance their role as academics in addition to their clinical responsibilities. However, introducing family medicine principles in the medical curriculum was sensed by the faculty to equip students to manage common clinical conditions effectively. In conclusion students' understanding of the unique status of family medicine to accommodate patients of all ages and problems within a single umbrella health-care system was well discerned by the authors in this study.