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Introduction: There is currently no strategy for identifying chronic obstructive pulmonary disease (COPD) patients whose pulmonary function could benefit from inhaled corticosteroids. We investigated whether a 28-day regime of inhaled corticosteroids improved pulmonary function test results among COPD patients with a fractional exhaled nitric oxide concentration > 35 parts per billion. Methods: This single-centre one-arm pre–post trial included COPD patients with a fractional exhaled nitric oxide concentration > 35 parts per billion treated at our institution from September 2018 to August 2019. Patients were administered budesonide (200 μg, 8 puffs daily) for 28 days. The primary outcome measure was the difference between the forced expiratory volume in 1 s (FEV1) at baseline and after 28 days of inhaled corticosteroid treatment. Secondary outcomes included differences in COPD Assessment Test scores, %FEV1, and that between the percent forced vital capacity (%FVC) at baseline and after 28 days of treatment. Results: Twenty patients completed the 28-day inhaled corticosteroid regime. The mean difference in FEV1 between day 1 and day 28 was 340 mL (95% confidence interval: −100 to 770 mL; p = 0.122). The mean differences in secondary outcomes were: %FVC, −0.16% (95% confidence interval [CI]: −2.84 to 2.53%; p = 0.905); %FEV1, 1.63% (95%CI: −4.56 to 7.81%; p = 0.589); COPD Assessment Test score, −2.50 (95%CI: −5.72 to 0.72; p = 0.121). Conclusion: The 28-day course of inhaled corticosteroids yielded no significant difference in FEV1 for COPD patients with a fractional exhaled nitric oxide concentration > 35 parts per billion. Trial registration: University Hospital Medical Information Network Center, UMIN000034005. Registered 3 September 2018. https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000038557

To investigate the variables correlation analysis research method for assessing the caregivers’ perceptions in two groups including dependent and independent variables to correlate the measuring of early childhoods. Typically, in correlated data, for jointly normally distributed data with relevant outliers that can use a correlation as a measure of a monotonic association. Designing the 65-paired samples for the Thai Model of early detection and intervention of children as the health care system guidelines from 26-CUPs have compared. Using the DSPM divided into 65-appropriate and 65-inappropriate development early childhoods for every 13 CUPS that depends on talented children. Selecting the Receptive Language (RL) skills identified in contributing growth relative factors with four research instruments: the EPRLS, PRLF, CNRLF, and CMRLF are valid and reliable significantly. Comparisons of the appropriate and inappropriate early childhoods are differences ( < .05), the intercorrelation circumflex nature analysis (p < .05), positively. The R2 values show that 26% and 55% of the variance in training caregivers’ factor skills on the PRLF, CNRLF, and CMRLF to the EPRLS in inappropriate and appropriate early childhoods, respectively. Developmentally Appropriate Practice is a perspective in a child’s development: social, emotional, physical, and cognitive-based on the child’s cultural background: community, family history, and family structure.

Central venous catheter fracture and migration are rare complications in patients receiving long-term infusions or chemotherapy. We present a rare case of a chest port catheter fracture that migrated into the coronary sinus. This case is likely the fourth report of a port catheter fracture with migration to the coronary sinus. Because of the difficult-to-retrieve location, multiple attempts were unsuccessful with traditional techniques using a loop snare. Finally, the fractured portion was disengaged from the coronary sinus using a navigational electrophysiology catheter guided by intracardiac echocardiography; the dislodged end was snared and eventually removed by the femoral route. This case of a chest port catheter fracture is unique because of the unusual migration to the coronary sinus and the use of a navigational electrophysiology catheter as a novel retrieval technique.

This article contains modern data on the etiology, clinical presentation and treatment as well as the differential diagnosis of a rare dermatosis, Sneddon-Wilkinson disease.Clinical observation of subcorneal pustular dermatosis in a 68-year-old woman is reported. Histopathological examination played a key role in making the correct diagnosis. Treatment consisted of a physiotherapeutic approach (311 nm UVB phototherapy) in combination with systemic glucocorticosteroids (dexamethasone). This therapeutic approach (instead of dapsone therapy) can be used due to its relatively good safety profile.

According to the Food and Agriculture Organization [1], it’s possible to conceptualize food security from four dimensions: physical availability of food, economic and physical access to  food, food utilization and stability of the other three dimensions over time. A situation of food security is found in  these four dimensions are fulfilled simultaneously.

Purpose: The time course of muscle stiffness of muscles around the shoulder joint and the scapula was investigated according to the degree of muscle weakness. This study was conducted to clarify the recovery process of muscle hardness of the muscles surrounding the shoulder joint and the scapula after the shoulder internal and external rotational exercises. Methods: Participants were 7 healthy men (23.6 ± 1.4 yr), repeated internal and external rotations of the shoulder joint until the mean work of three internal and external rotations each was less than 90%, 80%, or 70% of the standard. Muscle hardness of the supraspinatus muscle, the infraspinatus muscle, and the rhomboideus muscle was measured before, immediately after, and 1to 72 hr after each bout of exercise. Muscle hardness was measured as Strain ratio using an ultrasound real-time tissue elastography. In addition, the rates of change were calculated using muscle hardness before exercise as the standard, to compare differences in the rate of change after exercise between conditions. Results: The rates of change of the Strain ratio between measurements taken before and after exercise were compared among conditions for the infraspinatus muscle. Results were -7.1 ± 5.3, -15.2 ± 10.3, and -25.0 ± 8.8, respectively, at 90%, 80%, and 70%, with a significant difference between a decrease to 90% and to 70% (p < 0.05). Significant difference was found in the change over time for the infraspinatus muscle only between values obtained immediately after exercise and after 72 hr at a decrease to 70% (p < 0.05). Conclusion: Those results described above demonstrated that the infraspinatus muscle and the supraspinatus muscle were harder immediately after exercise when the shoulder joint was at a higher degree of muscle weakness, and demonstrated that the change was likely to be recovered after 72 hr.

Dynamic Knee Valgus (DKV) is correlated with both, Anterior Cruciate Ligament (ACL) injury and hip and ankle disorders in female athletes and has a more significant prevalence compared with male athletes because of numerous factors. The aim of this study is to determine if the connexion between DKV, landing errors, and non-contact ACL injury and re-injury in high-performance, adult, female team sport athletes can be eliminated by changing the frontal plane movement pattern and the landing errors during the rehabilitation process (RHB), a process which was focussed on dynamic knee stability with multidimensional single-leg jump landing training, on 3D knee balance improvement and multistimulus perturbation challenges and tasks,+ eccentric & concentric exercise, strength & conditioning, aerobic training that lasted from 26 - 44 weeks.Assessing and eliminating-reducing DKV during the RHB is mandatory in lowering the re-rupture rates in female professional athletes after ACL surgery and in preventing opposite knee trauma.

Summary: Myelodysplastic Syndrome (MDS) is a heterogeneous group of clonal hematopoietic malignancies characterized by progressive cytopenias, ineffective hematopoiesis, bone marrow hypercellularity and transformation to acute myeloid leukemia (AML). Objectives: Identify plasma proteins from MDS patients and from two healthy controls groups (young and elderly) by SDS-Page. Methods: Plasma from 08 healthy young, 08 healthy elderly and 08 MDS patients were used for this study. Proteins were fractionated, precipitated, used for SDS-PAGE gel analysis, stained with comassie brilliant blue, scanned and bands were analyzed. Results: It was possible to identify in both, 20% fraction and supernatant, proteins that were differentially expressed in each group. The ones that have showed some clinical relevance. Fibronectin was highly expressed only in the young control group. α2-Macroglobulin was also expressed in both control groups, but it was not expressed in the MDS group. Haptoglobin was highly expressed only in the elderly control and SMD groups. Conclusion: Protein expression in plasma can be a biomarker for MDS, and may play a key role in the process of aging and hematologic malignancies development.

Background: With the advancement of cell therapy research, there is an increasing need for healthy volunteers (HV) to donate small volumes (30 ml) of human bone marrow (BM). The BM procedure required to procure small volumes is invasive, although short-lived (25 seconds), is not without risk. To ensure a sustainable supply of BM for research and cell therapy, greater information of the risks and factors that motivate HV to donate small volumes of BM will help optimize the procedure and HV enrolment, ensuring donors are fully informed of the potential risks. Objective: To identify the adverse events (AE) experienced by HV during and after small volume BM procedure and understand the motivating factors that influence HV to donate BM for research. Method: HV (n = 55) who donated BM (30 ml) for scientific research and provided informed consent were administered a questionnaire to identify the type, duration and severity of AE experienced during and post-BM aspiration; and to determine the motivating factors that influenced their willingness to donate BM. Results: Pain was experienced by 89% of participants during the BM procedure with moderate grade reported by 40%. One/more of the following AE were experienced by 73% of the volunteers post-BM procedure: pain, fatigue, site reaction, nausea and transient hypotension. AE resolved within an average of three days. The reported motivational factors ranked in the following order: first, to advance research for the benefit of future patients; compensation for participation; free medical check-up; lastly, the research question was interesting. Conclusion: Young HV, motivated primarily by altruism and financial compensation, risk the occurrence of transient AE following donation of small-volume BM for research.

Introduction: Sepsis remains a major cause of death in neonatal period. Although significant advances in diagnosis, therapeutic and prevention strategies have been noted, sepsis remains a common concern in clinical practice especially in low-resource countries. The aim of this study was to determine the predictors of mortality in neonatal sepsis in Lubumbashi city (Democratic Republic of Congo). Methods: The records of newborns with sepsis managed in Neonatal Intensive Care Units in two University Hospitals between November 2019 and October 2020 were studied. Binary and multiple logistic regressions have been used to observe the association between independent variables and dependent variable. Results: A total of 162 cases of neonatal sepsis were reviewed. The mortality rate of neonatal sepsis was 21% of babies admitted. Very low birth weight (< 1500 grams) and primiparity were significantly associated with mortality in neonatal sepsis (AOR = 12.66; 95% CI 2.40 to 66.86; p = 0.003 and AOR = 3.35; 95% Cl 1.31 to 8.59; p = 0.012, respectively). Conclusion: The mortality rate of neonatal sepsis was 21%. Very low birth weight and primiparity were significantly associated with mortality in neonatal sepsis.