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Pubblicazioni recenti - cardiac rehabilitation
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Peripheral Vascular Disease in Women: Therapeutic Options in 2019.
Curr Treat Options Cardiovasc Med2019 Nov;21(11):68. doi: 10.1007/s11936-019-0769-5.
Saati Ammar, AlHajri Noora, Ya'qoub Lina, Ahmed Waqar, Alasnag Mirvat,
Abstract
PURPOSE OF REVIEW:
In recent years, there have been advances in the prevention, management, and control of peripheral vascular disease (PVD). There is a trend towards aggressive risk factor modification, noninvasive screening, and endovascular revascularization with surgical approaches reserved only for select cases. This article reviews the different management strategies ranging from pharmacotherapy, revascularization, and rehabilitation with an emphasis on the response of women to these therapies.
RECENT FINDINGS:
Overall, the representation of women in the majority of the published data in this arena remains poor. Studies examining medical therapy and endovascular and surgical revascularization were not designed to address sex disparities. Nevertheless, we dissect these therapies and their relevant randomized trials. The paucity of data investigating the response of women to the different management options makes it difficult to make any evidence-based recommendations. This not only applies to the type of intervention, but also the appropriate timing and risks entailed.
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To what extent is multi-morbidity associated with new onset depression in patients attending cardiac rehabilitation?
BMC Cardiovasc Disord2019 Nov;19(1):256. doi: 10.1186/s12872-019-1245-6.
Sever Serdar, Doherty Patrick, Harrison Alexander Stephen, Golder Su,
Abstract
BACKGROUND:
Depression is associated with increased mortality and poor prognosis in patients with cardiovascular disease (CVD). However, little is known about the patient characteristics associated with new onset post heart event depressive symptoms, specifically medical comorbidities, among cardiac rehabilitation (CR) participants. Therefore, this paper examines the comorbidity profile and characteristics associated with new onset depressive symptoms in patients attending CR.
METHODS:
An observational study using the routine practice data of British Heart Foundation National Audit of Cardiac Rehabilitation (NACR) from the last six years between April 2012 and March 2018. Patients with new onset post heart event depression and no previous documented history of depression were selected as the study population. An independent samples t-test and chi square tests were used to compare the association between new onset depressive symptoms and patient variables including demographics, clinical measures and comorbidities. A binary logistic regression was conducted to investigate the predictors of new onset depressive symptoms employing log-likelihood ratio statistic.
RESULTS:
The analyses included 109,055 CR patients with new onset depression measured by Hospital Anxiety and Depression Scale (HADS). At baseline assessment, comorbidity measures associated with new onset depressive symptoms were increased total number of comorbidities and a range of comorbidities - including diabetes, angina, arthritis, chronic back problems, asthma, stroke, anxiety, rheumatism, claudication, osteoporosis, chronic bronchitis and emphysema. After multivariate adjustments were done, at the start of CR, the significant predictors of new onset depressive symptoms were physical inactivity, high HADS anxiety score measurement, increased weight, total number of comorbidities, diabetes, stroke, chronic back problems, being from areas with higher levels of social deprivation, being single, and male.
CONCLUSION:
The research findings establish new insights into the association between patient demographic and clinical variables across a range of comorbidities in patients with new onset post heart event depressive symptoms. At the start of CR, patients with new onset depressive symptoms need to be assessed skilfully as they tend to have a complex multi-morbid presentation linked to psychosocial risk factors known to hinder CR engagement.
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The Timed Up and Go test and the ageing heart: findings from a national health screening of 1,084,875 community-dwelling older adults.
Eur J Prev Cardiol -
Critical Illness Neuromyopathy Complicating Cardiac Surgery.
Acute Crit Care2018 Feb;33(1):51-56. doi: 10.4266/acc.2016.00255.
Baek Wan Ki, Kim Young Sam, Kim Joung Taek, Yoon Byoung-Nam,
Abstract
Critical illness neuromyopathy (CINM) is a sporadically reported disease in the setting of an intensive care unit developing in the process of managing a critical illness. The disease primarily affects the motor and sensory axons and results in severe limb weakness rendering ventilator weaning extremely difficult. We report a case of CINM after cardiac valve surgery. Quadriplegia developed after the operation and resolved slowly over the following 2 months. The patient was discharged home free of neurologic symptoms.
Copyright © 2018 The Korean Society of Critical Care Medicine.
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Effect of congenital toxoplasmosis on the encoding of speech in infants.
Int J Pediatr Otorhinolaryngol2019 Nov;129():109767. doi: S0165-5876(19)30520-8.
Ferreira Laís, Valadão Maria Clara da Silva, Skarzynski Piotr H, Sanfins Milaine Dominici, Biaggio Eliara Pinto Vieira,
Abstract
OBJECTIVE:
To investigate the effect of congenital toxoplasmosis (CTP) on the Frequency-Following Response (FFR) in infants.
STUDY DESIGN:
11 infants diagnosed with CTP and 12 healthy infants with no risk indicators for hearing impairment, aged 29-90 days old. All infants underwent an FFR neurophysiological assessment. The test stimulus was the syllable [da], 40?ms in duration, which was monaurally presented to the right ear at an intensity of 80 dBnHL. Absolute latencies and amplitudes of the V, A, C, D, E, F, and O waves, the slope (?V/ms) and measure between onset (A) and offset (O), were compared between the two groups.
RESULTS:
Infants with CTP had increased latency of FFR waves V, A, E, F, and O, and decreased amplitude for waves A and F. They also showed a reduction in A-O slope and a higher latency difference between onset (A) and offset (O).
CONCLUSION:
The neurophysiological responses of Frequency-Following Response can be influenced by congenital toxoplasmosis. Since, the CTP showed prolongation of the V, A, E, F and O waves and decrease of the amplitude for waves A and F.
Copyright © 2019 Elsevier B.V. All rights reserved.
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Renal dysfunction can occur in advanced stage Duchenne muscular dystrophy.
Muscle Nerve2019 Nov;():. doi: 10.1002/mus.26757.
Motoki Takahiro, Shimizu-Motohashi Yuko, Saito Isao, Komaki Hirofumi, Ishiyama Akihiko, Aibara Kaori, Jogamoto Toshihiro, Tezuka Yuko, Kawabe Mika, Makino Kei, Nagatani Koji, Tatara Katsunori, Kuwabara Kozue, Kikuchi Chiya, Fukuda Mitsumasa, Ishii Eiichi, Eguchi Mariko,
Abstract
INTRODUCTION:
With improved treatments, patients with Duchenne muscular dystrophy (DMD) can survive far beyond adolescence. However, advanced stage DMD patients are at risk of developing renal dysfunction. In this study, long-term renal function outcomes and associated risk factors in advanced stage DMD were analyzed.
METHODS:
Fifty-one patients were classified into 3 different age groups (<20, 20-29, and ?30?years old), and cystatin C (CysC) levels were compared among groups.
RESULTS:
Median serum CysC levels were 0.74 mg/L, 0.63 mg/L, and 0.76 mg/L in the <20, 20-29, and ?30?years old groups, respectively (p = 0.003). Five of the 9 patients in the ?30 year age group showed elevated serum CysC and decreased cardiac function compared with the other 4 (p = 0.014).
DISCUSSION:
Our results indicate an association between cardiac and renal dysfunction in patients with advanced stage DMD. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
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Effect of endostatin overexpression on angiotensin II-induced cardiac hypertrophy in rats.
Chin Med J (Engl)2019 Nov;():. doi: 10.1097/CM9.0000000000000513.
Dai You-Jin, Gong Jue-Xiao, Bian Rong,
Abstract
BACKGROUND:
Endostatin, a biologically active fragment of collagen XVIII, has been observed in patients with ischemic heart disease. The aim of the present study was to investigate whether endostatin overexpression could attenuate cardiac hypertrophy by inhibiting the cyclic adenosine monophosphate-protein kinase A (cAMP-PKA) signaling pathway.
METHODS:
This study was examined in vivo in rats and in vitro in primary neonatal rat cardiomyocytes treated with angiotensin (Ang) II to model cardiac hypertrophy. Twenty-four male Sprague-Dawley rats were randomized into adenovirus (Ad)-green fluorescent protein, Ang II, Ad-endostatin, and Ang II + Ad-endostatin groups (n?=?6 in each group). Four weeks later, all the rats were weighed and sacrificed after transthoracic echocardiography. Cardiac function was evaluated by transthoracic echocardiography, cardiomyocyte size was evaluated by hematoxylin-eosin staining. Levels of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) were evaluated by quantitative reverse-transcription polymerase chain reaction or Western blotting, PKA level was evaluated by Western blotting, and cAMP level was evaluated by enzyme-linked immunosorbent assay. Statistical significance among multiple groups was evaluated by one-way analysis of variance.
RESULTS:
Endostatin overexpression reduced the increases in left ventricle (LV) mass (P?=?0.0063), LV mass/body weight (BW) (P?=?0.0013), interventricular septal thickness (IVS) in diastole (P?=?0.0013), IVS in systole (P?=?0.0056), left ventricular posterior wall thickness (LVPW) in diastole (P?=?0.0291), LVPW in systole (P?=?0.0080), heart weight (HW) (P?=?0.0138), HW/BW (P?=?0.0001), and HW/tibial length (P?=?0.0372) in Ang II-treated rats. In addition, endostatin overexpression reduced cardiomyocyte cross-sectional area expansion, and reduced the levels of ANP and BNP in Ang II-treated rats (P?=?0.0251 and 0.0477 for messenger RNA [mRNA]), and primary neonatal rat cardiomyocytes (P?=?0.0188 and P?=?0.0024 for mRNA; P?=?0.0023 and 0.0013 for protein, respectively). Additionally, endostatin overexpression reduced the increase of cAMP (P?=?0.0054) and PKA (P?=?0.0328) levels in cardiomyocytes treated with Ang II. Treatment with cAMP reversed the effects of endostatin overexpression on ANP (P?=?0.0263) and BNP (P?=?0.0322) levels in cardiomyocytes induced by Ang II.
CONCLUSION:
Endostatin overexpression could alleviate cardiac hypertrophy by inhibiting the cAMP-PKA signaling pathway.
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Quality of life after coronary artery bypass graft surgery - results of cardiac rehabilitation programme.
J Exerc Rehabil2019 Oct;15(5):715-722. doi: 10.12965/jer.1938444.222.
Moreira José Manuel Afonso, Grilo Eugénia Nunes,
Abstract
Accountability, involvement, empowerment of the patients and families/caregiver, as well as the incentive for health behaviors based on physical exercise and healthy living habits with the support of health professionals, are fundamental in meeting the demands of the current society. The main objective of this report is to describe the process of developing skills in rehabilitation nursing that was possible in the context of the final stage in which an intervention program in the area of cardiac rehabilitation was designed, implemented and evaluated. In this quantitative study with exploratory characteristics, it was used the collection of observable and quantifiable data, from patients submitted to coronary artery bypass grafting. During the study, the Kolmogorov-Smirnov test was applied-being verified the normal distribution-and Student -test, which aimed at comparing outcomes at the beginning and end of the program. When 6-min walk test was applied, there was an optimization of functional capacity (=0.05), can be proved by the fact that all the patients had statistically significant improvements in the time-walk relationship. Furthermore, the quality of life in those who participated in the program was moderate in the preoperative period with 53.09%, and at the end a significant improvement was observed with 75.02%. Cardiac rehabilitation is fundamental in the patient submitted to coronary artery bypass grafting, taking into account the educational, physical exercise, and quality of life dimensions. Given the prevalence of risk factors associated with cardiovascular disease, differentiated intervention in rehabilitation nursing becomes essential in the training of patients for self-care.
Copyright © 2019 Korean Society of Exercise Rehabilitation.
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Clinical aspects of congenital microcephaly syndrome by Zika virus in a rehabilitation center for patients with microcephaly.
Rev Assoc Med Bras (1992)2019 ;65(10):1249-1253. doi: S0104-42302019001001249.
Almeida Kelson James, Martins Augusto César Beserra, Almendra Isadora Costa Coelho Gayoso E, Meneses Gabriel Medina Sobreira de, Sampaio Thales Daniel de Oliveira, Campêlo José da Cruz Moura, Bor-Seng-Shu Edson,
Abstract
OBJECTIVE:
In this study, we intend to identify the prevalence of clinical variables in children with microcephaly.
METHODS:
This is a cross-sectional and observational study with data collected from medical records of patients admitted to the microcephaly outpatient clinic of a referral center in Teresina-PI. Demographic (gender and age) and clinical data (presence of epilepsy, dysphagia, irritability, and associated comorbidities) were collected. The frequency of Zika virus as a probable etiology was determined from computed tomography patterns and the exclusion of other etiologies by serological tests.
RESULTS:
A total of 67 patient records were evaluated, of which 31 were male and 36 were female, with a mean age of 1 year and 10 months. The most prevalent clinical variables were epilepsy, present in 47 children (70.2%), and irritability in 37 (55.2%). Also with a high frequency, 22 had dysphagia (32.8%), and 13 had musculoskeletal comorbidities (19.4%). Only three patients in the sample had cardiac abnormalities (4.5%), and no endocrine comorbidity was found. A total of 38 children in the sample (56.7%) presented ZIKV as a probable etiology and, in these cases, there was a higher frequency of epilepsy and dysphagia compared to other etiologies, although not statistically significant.
CONCLUSION:
Epilepsy, irritability, dysphagia, and musculoskeletal comorbidities were the most frequent clinical variables in children with microcephaly. There was a high prevalence of congenital ZIKV microcephaly syndrome in this sample.
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Pedometer Feedback Interventions Increase Daily Physical Activity in Phase III Cardiac Rehabilitation Participants.
J Cardiopulm Rehabil Prev2019 Nov;():. doi: 10.1097/HCR.0000000000000472.
Ozemek Cemal, Strath Scott J, Riggin Katrina, Harber Matthew P, Imboden Mary T, Kaminsky Leonard A,
Abstract
PURPOSE:
To determine the effects of individually tailored interventions designed to increase physical activity (PA) in cardiac patients.
METHODS:
A total of 99 (77 men and 22 women, 61.5 ± 10.7 yr) patients entering a phase III cardiac rehabilitation program completed a 12-wk PA intervention. Patients were randomized to usual care (UC, time-based recommendation), pedometer feedback (PF), newsletter-based motivational messaging (MM), or PF + MM. Both PF groups were given a goal of increasing steps/d by 10% of individual baseline value each week. If the goal for the week was not reached, the same goal was used for the next week. Physical activity was assessed for 7 d before beginning and after completing the program. The change in steps/d, moderate to vigorous intensity PA minutes, and sedentary time were compared among intervention groups.
RESULTS:
Average change in steps/d was found to be significantly greater (P < .01) in the PF (2957 ± 3185) and the PF + MM (3150 ± 3007) compared with UC (264 ± 2065) and MM (718 ± 2415) groups. No group experienced changes in moderate to vigorous intensity PA time and only the PF intervention group decreased sedentary time (baseline 470.2 ± 77.1 to postintervention 447.8 ± 74.9 min/d, P = .01).
CONCLUSION:
The findings from this study demonstrate that using PF was superior to the usual time-based PA recommendations and to newsletter-based MM in patients starting a phase III CR program. Cardiac rehabilitation programs are encouraged to implement PA feedback with individualized PA goals in order to support the increase in PA.
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The Effect and Safety of Aerobic Interval Training According to Exercise Intensity in Acute Coronary Syndrome.
J Cardiopulm Rehabil Prev2019 Nov;():. doi: 10.1097/HCR.0000000000000455.
Kim Chul, Choi Hee Eun,
Abstract
PURPOSE:
To evaluate the effect of increasing the maximal oxygen uptake (VO2max) and the safety of maximal-intensity aerobic interval training (MAIT) compared with high-intensity aerobic interval training (HAIT).
METHODS:
Forty-seven patients with first-ever acute coronary syndrome were assigned to MAIT or HAIT. Subjects underwent adaptation period during the first 2 wk of cardiac rehabilitation and then MAIT at 95-100% of the heart rate reserve or HAIT at 85% of the heart rate reserve, 3 d/wk for 4 wk. The primary outcome was VO2max. The secondary outcomes were major cardiovascular complications, hemodynamic responses, myocardial oxygen demand, cardiometabolic health, and echocardiographic findings.
RESULTS:
A total of 670.5 hr of MAIT and HAIT were completed. After 6 wk of aerobic interval training, VO2max was significantly increased in both groups. However, the increment of VO2max was significantly greater in the MAIT group than in the HAIT group (P < .05). The percentage increases for MAIT and HAIT were 31% and 17%, respectively. No major cardiovascular or musculoskeletal complications were noted.
CONCLUSIONS:
The results of this study indicate that 6 wk of MAIT resulted in statistically significantly better improvement in VO2max than 6 wk of HAIT at a similar total work in patients with acute coronary syndrome. Moreover, both MAIT and HAIT may be safe to use in the cardiac rehabilitation setting.
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Type 2 Diabetes Mellitus, Glycated Hemoglobin Levels, and Cardiopulmonary Exercise Capacity in Patients With Ischemic Heart Disease.
J Cardiopulm Rehabil Prev2019 Nov;():. doi: 10.1097/HCR.0000000000000451.
Uribe-Heredia Giovanna, Arroyo-Espliguero Ramón, Viana-Llamas María Carmen, Piccone-Saponara Luis Guillermo, Álvaro-Fernández Henar, García-Magallón Belén, Torán-Martínez Claudio, Silva-Obregón Alberto, Izquierdo-Alonso José Luis,
Abstract
PURPOSE:
Diabetes mellitus (DM) is associated with long-term cardiovascular complications, including ischemic heart disease (IHD). Nonetheless, DM may directly impair myocardial and lung structure and function. The aim of this study was to assess the impact of type 2 DM (T2DM) and glycemic control on cardiopulmonary exercise capacity in patients with IHD.
METHODS:
The study involved a cross-sectional analysis of 91 consecutive patients (57 ± 10 yr, 90% men) who underwent a cardiopulmonary exercise test at the beginning of an exercise-based standard phase-II cardiac rehabilitation program, 2 to 3 mo after an acute coronary syndrome. Association of T2DM with cardiopulmonary exercise test parameters was assessed using multiple linear regression analysis controlling for prespecified potential confounders.
RESULTS:
There were 26 (29%) diabetic subjects among IHD patients included in the study. After adjustment, T2DM was an independent predictor of a reduced peak oxygen uptake (VO2peak) (P = .005), a reduced pulse O2 trajectory (P = .001), a steeper minute ventilation to carbon dioxide output (VE/VCO2) slope (P = .046), and an increased dead space-to-tidal volume ratio (VD/VT) at peak exercise (P = .049). Glycated hemoglobin (HbA1c) levels were significantly associated with a reduced forced expiratory volume in the first second of expiration (FEV1) (P = .013), VE (P = .001), and VT (P = .007). VO2peak (P trend < .001), VO2 at anaerobic threshold (P trend < .001), and pulse O2 trajectory (P trend < .001) decreased among HbA1c tertiles.
CONCLUSIONS:
Patients with IHD and a previous diagnosis of T2DM had a reduced aerobic capacity and a ventilation-perfusion mismatch compared with nondiabetic patients. Poor glycemic control in men further deteriorates aerobic capacity probably due to ventilatory inefficiency.
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Effect of Home-Based Cardiac Rehabilitation in a Lower-Middle Income Country: RESULTS FROM A CONTROLLED TRIAL.
J Cardiopulm Rehabil Prev2019 Nov;():. doi: 10.1097/HCR.0000000000000471.
Uddin Jamal, Joshi Vicky L, Moniruzzaman Mohammad, Karim Rezaul, Uddin Jalal, Siraj Masoom, Rashid Mohammad Abdur, Rossau Henriette Knold, Taylor Rod S, Zwisler Ann-Dorthe,
Abstract
PURPOSE:
Cardiovascular disease is the leading cause of mortality and morbidity in lower-middle income countries (LMICs), including Bangladesh. Cardiac rehabilitation (CR) as part of secondary prevention of cardiovascular disease has been shown to reduce mortality and morbidity and improve quality of life and exercise capacity. However, to date, very few controlled trials of CR have been conducted in LMICs.
METHODS:
A quasi-randomized controlled trial comparing home-based CR plus usual care with usual care alone was undertaken with patients following coronary artery bypass graft surgery. Participants in the CR group received an in-hospital CR class and were introduced to a locally developed educational booklet with details of a home-based exercise program and then received monthly telephone calls for 12 mo. Primary outcomes were coronary heart disease (CHD) risk factors, health-related quality of life (HRQOL), and mental well-being. Maximal oxygen uptake as a measure of exercise capacity was a secondary outcome.
RESULTS:
In total, 142 of 148 eligible participants took part in the trial (96%); 71 in each group. At 12-mo follow-up, 61 patients (86%) in the CR group and 40 (56%) in the usual care group provided complete outcome data. Greater reductions in CHD risk factors and improvements in HRQOL, mental well-being, and exercise capacity were seen for the CR group compared with the usual care group.
CONCLUSIONS:
In the context of a single-center LMIC setting, this study demonstrated the feasibility of home-based CR programs and offers a model of service delivery that could be replicated on a larger scale.
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Role of Left Ventricle Function in Cardiac Rehabilitation Outcomes in Stage B Heart Failure Patients.
J Cardiopulm Rehabil Prev2019 Nov;():. doi: 10.1097/HCR.0000000000000461.
Braga Marta, Nascimento Helena, Nunes Alzira, Araújo Paulo, Pinto Roberto, Rodrigues Joana, Araújo Vítor, Parada-Pereira Fernando, Maciel Maria Júlia, Rocha Afonso,
Abstract
PURPOSE:
To study the role of left ventricle systolic function in cardiac rehabilitation program (CRP) response in stage B heart failure patients.
METHODS:
A retrospective analysis was completed of 691 patients with previous myocardial infarction that underwent a CRP, classified in 3 groups: preserved ejection fraction (pEF), mid-range ejection fraction (mrEF), and reduced ejection fraction (rEF). We compared the response to CRP analyzing the relative changes of estimated cardiorespiratory fitness (CRFe), resting heart rate (HR), and chronotropic index (CI).
RESULTS:
After exercise training (median [interquartile range]) mrEF (23.9% [9.7, 40.8]) and rEF (23.9% [9.7, 41.2]) groups had a better CRFe response to CRP than pEF groups (17.6% [0.0, 35.9]), P = .009. CI increased similarly in all groups. We found a small effect of CRP on resting HR.
CONCLUSION:
Exercise-based CRP yields notable benefits to mrEF and rEF groups and the magnitude of its benefits is, at least, similar to that found in pEF patients.
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Long-term outcome of vein of Galen malformation.
Dev Med Child Neurol2019 Nov;():. doi: 10.1111/dmcn.14392.
Taffin Hélène, Maurey Hélène, Ozanne Augustin, Durand Philippe, Husson Béatrice, Knebel Jean-François, Adamsbaum Catherine, Deiva Kumaran, Saliou Guillaume,
Abstract
AIM:
To describe the long-term outcomes of children by the time they reached school age with vein of Galen aneurysmal malformation (VGAM).
METHOD:
This was a retrospective observational study on a consecutive cohort of patients with VGAM. We included patients with at least one Francophone parent, aged between 6 and 11 years at the time of long-term evaluation. The neurological outcome was assessed with the King's Outcome Scale for Childhood Injury score and eight neurological and behavioural items from the Rivermead Postconcussion Symptoms questionnaire.
RESULTS:
All 52 patients (17 females, 32 males [data missing for n=3]) with at least one Francophone parent (5 fetuses and 47 children) were included. At the long-term evaluation time-point, 33 patients were alive and 19 patients had died. Risk of postnatal death was associated with severe neonatal cardiac failure (p=0.007) or isosystemic or suprasystemic pulmonary hypertension (p=0.014). Among survivors, 19 had a good outcome with normal schooling and 14 had a poor outcome. Moreover, among the good outcome patients, a large proportion had neurodevelopmental alterations.
INTERPRETATION:
Long-term outcome of patients with VGAM appears to be less favourable than outcome described at the short- and medium-term, even in the absence of encephalomalacia at birth. Even patients with good outcome often have neuropsychological disorders that may have repercussions on learning and requiring appropriate rehabilitation or medical management.
WHAT THIS PAPER ADDS:
Long-term outcome appears to be less favourable than described at short- and medium-term follow-up. Even patients with good outcome at these time-points often have minor neuropsychological disorders.
© 2019 Mac Keith Press.
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Knowledge of cardiopulmonary resuscitation among Greek physiotherapists.
Monaldi Arch Chest Dis2019 Nov;89(3):. doi: 10.4081/monaldi.2019.1124.
Pepera Garyfallia, Xanthos ?fstratios, Lilios Andreas, Xanthos Theodoros,
Abstract
High quality cardiopulmonary resuscitation (CPR) is crucial for influencing survival from cardiac arrest. Healthcare professionals are expected to know how to perform CPR as they may encounter emergency situations during their work. Physiotherapists, who use exercise as a therapeutic approach, should have good knowledge and skills in CPR not only to cope with possible adverse cardiac events during exercise but also because a widespread CPR application and early defibrillation can greatly reduce mortality due to heart attack. The aim of this study is to investigate knowledge of Greek physiotherapists in European Resuscitation Council guidelines for resuscitation. A secondary aim of this study was to assess and compare the knowledge score between those with and without previous training and/or lower self-confidence in CPR skills. Three hundred and fifty Greek physiotherapists who were working in hospitals and rehabilitation centres (face-to-face and e-mail contact) were randomly selected to complete an anonymous questionnaire containing demographic questions, CPR experience questions, and ten theoretical knowledge questions, based on European Resuscitation Council guidelines for resuscitation. The response ratio was 63% (n=220 physiotherapists). Respondents' total mean score for the theoretic knowledge questions was 4.1±2 (range 1-10); 21.4% of the respondents had participated in a CPR course, while only 0.9% had previous experience in CPR performance. The group of respondents who had attended a CPR course had a significantly higher score in CPR knowledge questions and higher confidence score (p<0.01). Moreover, the physiotherapists who attended refresher courses in CPR in the workplace scored significantly higher (p<0.01). Our results indicate that Greek physiotherapists have knowledge gaps in the European Resuscitation Council guidelines for resuscitation. The percentage of Greek physiotherapists who had CPR certification and recertification was low, thus the CPR training should be mandatory for all working physiotherapists.
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Standard Cardiac Rehabilitation Program for Heart Failure.
Circ J2019 Nov;():. doi: 10.1253/circj.CJ-19-0670.
Izawa Hideo, Yoshida Toshiko, Ikegame Toshimi, Izawa Kazuhiro P, Ito Yoshihiro, Okamura Hideo, Osada Naohiko, Kinugawa Shintaro, Kubozono Takuro, Kono Yuji, Kobayashi Kiyonori, Nishigaki Kazuhiko, Higo Taiki, Hirashiki Akihiro, Miyazawa Yasushi, Morio Yuji, Yanase Masanobu, Yamada Sumio, Ikeda Hisao, Momomura Shin-Ichi, Kihara Yasuki, Yamamoto Kazuhiro, Goto Yoichi, Makita Shigeru, ,
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Postural control abnormalities related to sleep deprivation in patients with Marfan Syndrome.
J Vestib Res2019 Nov;():. doi: 10.3233/VES-190684.
Micarelli Alessandro, Viziano Andrea, Lanzillotta Alessia, Giorgino Federica Maria, Pisano Calogera, Ruvolo Giovanni, Alessandrini Marco,
Abstract
BACKGROUND:
Marfan syndrome (MFS) is a rare autosomal dominant connective tissue disorder affecting virtually every organ. Sleep disturbances, associated to high collapsibility in upper airways, are common in MFS; daytime sleepiness could lead to reduction in attention and motor coordination, with detrimental effects on balance.
OBJECTIVE:
To evaluate otoneurological function in MFS patients, compared to healthy subjects, and to investigate possible correlations with sleep deprivation extent.
METHODS:
Forty-one MFS patients underwent a thorough otoneurological examination, video Head Impulse Test (vHIT), and static posturography. Sleep parameters were recorded by home monitoring. Daytime sleepiness and dizziness-related handicap were screened by means of Dizziness Handicap Inventory (DHI) and Epworth Sleepiness Scale (ESS). Results were compared with 49 healthy controls (HC).
RESULTS:
DHI and ESS scores were increased in MFS patients (p?
CONCLUSIONS:
An impaired postural control, related to the extent of sleep deprivation, was found in MFS patients. Such results could advocate for screening and treating sleep deprivation and balance dysfunctions in MFS patients.
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Giant right atrium: case report of a rare congenital disease in adulthood.
J Echocardiogr2019 Nov;():. doi: 10.1007/s12574-019-00452-x.
Soleimani Azam, Dehghan Houman, Soleimani Maryam,
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Appropriate coronary revascularization can be accomplished if myocardial perfusion is quantified by positron emission tomography prior to treatment decision.
J Nucl Cardiol2019 Nov;():. doi: 10.1007/s12350-019-01938-y.
Akil Shahnaz, Hedeer Fredrik, Oddstig Jenny, Olsson Thomas, Jögi Jonas, Erlinge David, Carlsson Marcus, Arheden Håkan, Hindorf Cecilia, Engblom Henrik,
Abstract
BACKGROUND:
Many patients undergo percutaneous coronary intervention (PCI) without the use of non-invasive stress testing prior to treatment. The aim of this study was to determine the potential added value of guiding revascularization by quantitative assessment of myocardial perfusion prior to intervention.
METHODS AND RESULTS:
Thirty-three patients (10 females) with suspected or established CAD who had been referred for a clinical coronary angiography (CA) with possibility for PCI were included. Adenosine stress and rest N-NH PET, cardiac magnetic resonance (CMR), and cardiopulmonary exercise test were performed 4?±?3 weeks before and 5?±?1 months after CA. The angiographer was blinded to the PET and CMR results. Myocardial flow reserve (MFR)
CONCLUSION:
Assessment of quantitative myocardial perfusion prior to revascularization could lead to more appropriate use of CA when managing patients with stable CAD.
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