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In addition to the financial burden, acute exacerbation of chronic obstructive pulmonary disease (AECOPD) also has a negative impact on health status and disease progression for patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate the effect of affiliation to a cross-sectorial lung team (CLT) on hospitalization and length of hospital stay for patients with COPD and ≥ one severe or two moderate AECOPD events within a year. We conducted a randomized clinical trial between 2017 and 2020. Participants were randomly assigned 11 for one year to CLT or usual care (UC). The CLT was available for telephone calls and home visits day and night on the request from patients, and the CLT could initiate home treatment. In total, 56 patients were affiliated to the CLT (Mean age 71.6 years, FEV1 37.1%) and 57 patients received UC (Mean age 71.5 years, FEV1; 33.6%). Patients affiliated to the CLT had on average fewer hospitalizations due to AECOPD than patients receiving UC (CLT 0.59 (95% CI 0.35; 0.83 - UC 1.86 (95% CI 1.12; 2.20; p = 0.002). Patients affiliated to the CLT also had shorter hospital stay on average due to AECOPD (CLT 3.27(95% CI 2.39; 4.15 - UC 4.47 (95% CI 3.70; 5.24; (p = 0.045). No significant difference in number of severe adverse events, including death, was observed between groups. Affiliation to the CLT seemed safe and reduced both hospitalizations and length of hospital stay related to AECOPD compared to UC.Children with recurrent or persistent pneumonia often have underlying chronic cardiopulmonary disease, but few reports on this subject have been published. Children with isolated common cardiac diseases, uncomplicated bronchial asthma or with incomplete records were excluded. see more Of 4361 children followed during a five-year period, 107 were included in our study. Underlying causes were identified in 99.0% immunodeficiency disorders (20.2%), cardiothoracic malformations (18.3%), syndromic conditions (14.4%), infections (10.6%) bronchiectasis (10.6%), gastro-oesophageal reflux disease (6.6%), interstitial lung disease (3.8%) and other miscellaneous conditions (15.4%). Thus, children with recurrent or persistent pneumonia should be carefully evaluated for an underlying aetiology, as early diagnosis and appropriate management will decrease morbidity and mortality in most of these children.Affectionate touch is an important behavior in close relationships throughout the lifespan. Research has investigated the relational and individual psychological and physical benefits of affectionate touch, but the situational factors that give rise to it have been overlooked. Theorizing from the interpersonal process model of intimacy, the current studies tested whether perceived partner responsiveness forecasts affectionate touch in romantic couples. Following a preliminary integrative data analysis (N = 842), three prospective studies use ecologically valid behavioral (Studies 1 and 2) and daily (Studies 2 and 3) data, showing a positive association between perceived partner responsiveness and affectionate touch. Furthermore, in Study 3, we tested a theoretical extension of the interpersonal process of intimacy, finding that affectionate touch forecasts the partner's perception of the touch-giver's responsiveness the next day. Findings suggest affectionate touch may be an untested mechanism at the heart of the interpersonal process of intimacy.The increasing prevalence of periodontal and cardiovascular diseases is the result of a sedentary lifestyle associated with poor diet, obesity, hypercholesterolaemia, smoking habits, alcohol consumption and stress. The present study aims to uncover molecular associations between periodontitis and coronary heart disease using an unbiased strategy of automatic text mining traditionally applied to bibliometric studies. A total of 1590 articles on these diseases were retrieved from the Web of knowledge database and searched using the VOS viewer to create a network of keywords associated with both diseases. These data were supplemented with data from DisGeNET, which stores known associations to either periodontitis or coronary heart disease. Overall, the automated text mining approach presented here highlighted inflammatory molecules as common associations between periodontitis and coronary heart disease. Specifically, this study showed that molecules such as C-reactive protein, interleukins 6 and 1-β, myeloperoxidase, and matrix metalloproteinase 9 are simultaneously associated with periodontitis and coronary artery disease by both text mining and DisGeNET analyses. This association validates the multiplex assessment of salivary inflammatory markers as a tool to assess cardiovascular disease risk and could become an important tool to identify common molecular targets to monitor both diseases simultaneously. In addition, the text mining protocol and subsequent data processing and methods using bioinformatics tools could be useful to uncover links between other diseases.

Early mobilization is believed to be helpful for patients with acute ischemic stroke. This study aimed to compare the difference between starting rehabilitation between 24 and 48 h and 72 and 96 h following the onset of ischemic stroke.

This was a single-center, single-blind, randomized controlled trial. The early rehabilitation (ER) group started exercising between 24 and 48 h after stroke onset, which the standard rehabilitation (SR) group started exercising between 72 and 96 h. The two groups received sitting, standing, and repetitive body strength training respectively.

In this study, 110 patients were analyzed. Patients in the early rehabilitation group had more favorable outcomes (The modified Rankin scale score 0-2, ER group = 32 versus SR group = 20, adjusted odds ratio 2.27, 95% CI 1.05-4.87;

 = 0.036) at 3-month follow-up. The simplified Fugl-Meyer assessment (FMA) scores for the lower extremity were influenced by the interaction effect (

 = 7.24,

 = 0.01). The post-hoc analysis revealed sequent rehabilitation process, the upper extremity function should be paid more attention.

Antiphospholipid antibodies (aPL) have been extensively reported in children, but investigations into thrombotic risks associated with aPL positivity in pediatric patients is scarce. Positive aPL are not uncommon in pediatric connective tissue diseases (CTD), but identification and management of these patients is challenging due to lack of validated criteria and a paucity of data. In this study, we identify potential additional risk factors for thrombosis in a unique cohort of pediatric aPL positive carriers.

Retrospective chart review was performed on 491 pediatric patients with CTD seen in our institution from 2001 to 2019. Patients without persistently moderate to high titer aPL at least 12 weeks apart were excluded. Univariate analysis was performed to evaluate correlation between different risk factors and thrombotic events.

Seventy-one aPL positive children with underlying CTD are included in this cohort. The majority (87%) are female and of Hispanic ethnicity (56%). Mean age of the cohort at the are needed to help guide clinicians in caring for these challenging patients.

Data from our cohort suggest that Raynaud's phenomenon is a potential predictor of arterial thrombosis while the presence of hypertension or anti-hypertensive medication use is a potential predictor of venous thrombosis in aPL positive pediatric carriers. Further studies investigating pediatric aPL profiles and risk factors for development of thrombosis are needed to help guide clinicians in caring for these challenging patients.High rates of divorce seem related to low marital satisfaction levels; however, there is still a lack of a model that can help understand the couple's resilience and fragility throughout the life cycle. This research explores the role of communication patterns, their own and partner's motivation for conjugality, cohesion and flexibility within a couple, and several sociodemographic characteristics (e.g., stage of the family life cycle) that can explain marital satisfaction. A sample of 331 Portuguese in a marital relationship completed a sociodemographic questionnaire and marital satisfaction measures, communication and conflict management competencies, cohesion and flexibility, and motivation. Adequate statistical analysis was performed using descriptive statistics and structural equation modeling. Both measurement and structural model performed in the study presented a good fit, with five significant predictors of marital satisfaction (that accounted for 85% of the variability) intrinsic motivation (β = .64), communication (β = .31), families with young children (β = -.08), families with teenagers (β = -.07) and professional/academic status (β = .06). By identifying a model for marital satisfaction, this research provides clues regarding which aspects might need to be considered in couples' clinical work to promote healthier relationships.Introduction Bronchiectasis is a chronic endobronchial suppurative disease characterized by irreversibly dilated bronchi damaged by repeated polymicrobial infections and predominantly, neutrophilic airway inflammation. Some consider bronchiectasis a syndromic consequence of several different causes whilst others view it as an individual disease entity. In most patients, identifying an underlying cause remains challenging. The acquisition and colonization of affected airways by Pseudomonas aeruginosa represent a critical and adverse clinical consequence for its progression and management.Areas covered In this review, we outline clinical and pre-clinical peer-reviewed research published in the last 5 years, focusing on the pathogenesis of bronchiectasis and the role of P. aeruginosa and its virulence in shaping host inflammatory and immune responses in the airway. We further detail its role in airway infection, the lung microbiome, and address therapeutic options in bronchiectasis.Expert opinion P. aeruginosa represents a key pulmonary pathogen in bronchiectasis that causes acute and/or chronic airway infection. Eradication can prevent adverse clinical consequence and/or disease progression. Novel therapeutic strategies are emerging and include combination-based approaches. Addressing airway infection caused by P. aeruginosa in bronchiectasis is necessary to prevent airway damage, loss of lung function and exacerbations, all of which contribute to adverse clinical outcome.The aim of this research was to conduct a risk assessment and management of psychological, structural, social and economic determinants (PSSED) in a suicide attempt. The sample consisted of 353 individuals who had a recorded history of suicidal attempt; and 20 professional individuals by purposive sampling method within a descriptive cross-sectional design. Worksheets for RAM and AHP were used for data collection in this study. The rate of suicide attempt was 7.21 per 100,000 population in this study. Analysis showed that depression and mental disorders; personality disorders; family problems; socio-cultural and economic problems; lack of awareness; and low level of education have a high level of risk for suicide attempts. Psychiatric and psychological services; awareness and knowledge of life skills; medical services to dysfunctional families; development of community-based planning for PSSED of suicide; and employment and entrepreneurship services may lower suicide attempt risk.

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