The Female Sex Confers Different Prognosis in Heart Failure: Same Mortality but More Readmissions
Introduction: Heart failure (HF) is a major cause of morbimortality both in men and women. Differences between sex in etiopathogenesis, response to treatment, and quality of care have been found in patients with HF. Females are usually under-represented in clinical trials and there is no solid evidence demonstrating the influence of sex in the prognostic of chronic HF. The primary objective of this study was to analyse the differences in mortality and probability of hospital readmission between males and females with HF. The secondary objective was to compare mortality and probability of hospital readmission by ejection fraction (reduced vs. preserved).Methods: Patients with decompensated H…
A blended-learning programme regarding professional ethics in physiotherapy students.
Background: In the university context, assessing students’ attitude, knowledge and opinions when applying an innovative methodological approach to teach professional ethics becomes fundamental to know if the used approach is enough motivating for students. Research objective: To assess the effect of a blended-learning model, based on professional ethics and related to clinical practices, on physiotherapy students’ attitude, knowledge and opinions towards learning professional ethics. Research design and participants: A simple-blind clinical trial was performed (NLM identifier NCT03241693) (control group, n = 64; experimental group, n = 65). Both groups followed clinical practices for 8 mont…
Effectiveness of a physiotherapy and nutrition program in patients with coronary artery disease: randomized controlled trial
Abstract Funding Acknowledgements Type of funding sources: None. Introduction. Dietary and exercise interventions are effective strategies for improving physical and nutritional status of patients with coronary artery disease (CAD). However, few studies have applied a combined exercise protocol based on high intensity interval training (HIIT) and dietary education in patients with CAD with percutaneous coronary intervention (PCI). Purpose This study researches the effectiveness of a multidisciplinary program based in HIIT with dietary education (DEHIIT) in comparison with only HIIT, on adherence to Mediterranean diet in CAD patients with PCI. Methods. A prospective, assessor-blinded, parall…
Physiotherapy Students’ Experiences about Ethical Situations Encountered in Clinical Practices
(1) Background: It is important to explore the ethical situations that physiotherapy students encountered in their clinical practices. (2) Methods: Qualitative, explorative, descriptive study. The participants included third-year physiotherapy students. They had to write five narratives about ethical situations encountered in their clinical practices. Krippendorff's method for qualitative content analysis was used to cluster units within the data to identify emergent themes. The study protocol was approved by the authors' University Ethic Committee of Human Research (H1515588244257). (3) Result: 280 narratives were reported by 64 students (23.34 ± 4.20 years, 59% women). Eight categories we…
Estudio descriptivo y comparativo de factores de riesgo cardiovascular y actividad física en pacientes con síndrome coronario agudo
Resumen: Objetivo: Analizar diversos factores de riesgo cardiovascular en función de la actividad física realizada en pacientes con síndrome coronario agudo (SCA). Diseño: Estudio observacional transversal. Emplazamiento: Servicio de prevención cardiovascular hospitalario (Departamento Salud, Valencia, España). Participantes: Un total de 401 sujetos con SCA y alta hospitalaria entre 2 y 3 meses previos a la medición, entre 30 y 80 años; ausencia de contraindicación para realizar actividad física; sin participación previa en programas de rehabilitación cardiaca. Mediciones principales: Se estimó el equivalente metabólico MET (kcal/kg) según el tipo de actividad, frecuencia, duración e intens…
Mechanism of Sinoatrial Node Dysfunction in a RyR 2 R420Q Mouse Model Ofcatecholaminergic Polymorphic Ventricular Tachycardia
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a genetic disease characterized by stress-induced syncope and/or sudden death in young individuals with structurally normal heart. More than 150 mutations located in the cardiac Ca2+ release channel (type-2 ryanodine receptor, RyR2) gene are related to CPVT. Besides ventricular tachycardia (VT) under stress, sinoatrial node (SAN) dysfunction is frequently observed in CPVT patients. However, the cellular mechanisms remain underexplored. We created a KI mice model bearing a mutation in the N-terminal portion of the RyR2 found in a CPVT family, RyR2(R420Q). ECGs were recorded in KI and WT littermates in resting condition and after…
Reduction in Fear of Physical Activity Among Older Persons With Coronary Artery Disease by Physical Therapist–Assisted Exercise: A Randomized Trial
Idarucizumab in High-risk Thoracic Surgery
Direct oral anticoagulants have suggested a favorable profile compared with vitamin K antagonists. However, the lack of treatment to reverse the effect of direct oral anticoagulants has limited its use in some patients who require rapid reversal of anticoagulation, as those included in the transplant waiting list. Idarucizumab is a recently approved drug to reverse the anticoagulant effect of dabigatran. However, the clinical experience when using this drug is scarce. Herein, we present a clinical case on anticoagulation reversal with idarucizumab to perform heart and lung transplantation in a patient with Eisenmenger syndrome.
Frequency of dicentrics and contamination levels in Ukrainian children and adolescents from areas near Chernobyl 20 years after the nuclear plant accident.
International audience; Purpose To survey the possible presence of chromosomal damage and internal contamination in a group of Ukrainian children and adolescents, 20 years after the Chernobyl accident at the Nuclear Power Plant. Materials and methods Cytogenetical procedures were performed according to dicentric assay in 55 Ukrainian children and adolescents (29 boys and 26 girls), living near Chernobyl. In addition, a whole body detector and urinalysis were used to detect internal contamination. Results 36 dicentrics were found in a total of 53,477 metaphases scored in these children, which reflected a frequency of dicentrics below the background level. On the other hand, internal contamin…
Creatinine and NT-ProBNP levels could predict the length of hospital stay of patients with decompensated heart failure.
Heart failure (HF) is a clinical syndrome that causes high morbidity and mortality with a high number of admissions and sometimes prolonged admissions. This study aimed at assessing whether parameters detected during the first 24 h of admission may predict a prolonged hospital stay in patients admitted to hospital for decompensated HF.From January 2016 to December 2019, 2359 admissions of decompensated HF were recorded. In-hospital transfers,Univariate differences were found at admission in NT-ProBNP, creatinine, history of cardiac surgery, smoking and alcoholism, left and right ventricular ejection fraction, systolic blood pressure and heart rate. The ROC analysis showed significant areas …
Pilot randomized controlled trial to assess a physical therapy program on upper extremity function to counteract inactivity in chronic stroke.
In chronic stroke, feasible physical therapy (PT) programs are needed to promote function throughout life.This randomized controlled pilot trial investigated the feasibility and effect of a PT program composed of strengthening exercises with elastic bands and bimanual functional training, with clearly defined doses based on the rate of perceived exertion (Borg scale), to counteract inactivity in chronic stroke.Fifteen subjects 6 month post-stroke were randomized to three-month of UE function training (UE group), or to lower extremity function training (LE group). At baseline (T0), post-intervention (T1) and three-month follow-up (T2) assessment included the Fugl-Meyer Assessment scale (FMA…
Ensayo no aleatorizado de un programa de fisioterapia continuo frente a interválico para pacientes con sobrepeso y síndrome coronario agudo
Resumen: Presentamos un ensayo no aleatorizado de un programa de fisioterapia continuo frente a interválico para pacientes con sobrepeso y síndrome coronario agudo. Objetivo: Detectar diferencias entre un programa de fisioterapia (PF) continuo (CONT) y uno interválico (INT) en pacientes con sobrepeso y síndrome coronario agudo, respecto a parámetros antropométricos, analíticos, frecuencia cardiaca de reposo, adherencia a la intervención, desgaste, seguridad y tolerancia. Diseño: Estudio multicéntrico cuasiexperimental con diseño pre-post, no aleatorizado con muestreo por conveniencia con 2 brazos de tratamiento. Emplazamiento: Centros de prevención cardiaca comunitaria (Departamentos de Sal…
Physical activity in health care professionals as a means of primary prevention of cardiovascular disease: A STROBE compliant cross-sectional study
ABSTRACT: The aim of this study was to assess the physical activity level of health care professionals, as well as the differences by sex, age, academic background, and among different health care professions.This is an cross-sectional study.Health care settings in the Valencian Community, Spain.A total of 647 health care professionals.Physical activity was assessed with the European Health Interview Survey-Physical Activity Questionnaire (EHIS-PAQ) that includes the assessment of work-related physical activity, transport-related physical activity, health-enhancing physical activity, muscle-strengthening physical activity, and total physical activity.93.51% of all health care professionals …
Effects of a non-pharmacological approach for chronic pain management in patients with haemophilia: efficacy of cognitive-behavioural therapy associated with physiotherapy.
INTRODUCTION More than half of adult patients with severe haemophilia (PWH) suffer pain daily, with chronic pain (CP) in more than 15% of cases, thereby reducing their quality of life (QoL). However, there are no evidence-based therapeutic guidelines for pain management. AIM To evaluate the effectiveness of a combined protocol based on psychology and physiotherapy in the improvement of CP self-efficacy in PWH with CP. Secondary outcomes are changes in QoL, emotional status, pain and kinesiophobia. METHODS In this prospective controlled trial study, recruited patients were allocated either to an experimental group (EG, n = 10) or to a control group (CG, n = 9). EG received interventions over…
Elaboración y validación del «Cuestionario de actitudes hacia la ética profesional en Fisioterapia»
Resumen Objetivo En el contexto universitario resulta necesaria la elaboracion y validacion de cuestionarios para ser aplicados en la valoracion de nuevos modelos formativos que garanticen la adquisicion de la competencia etica. El objetivo de este estudio es presentar la elaboracion, evaluacion de la fiabilidad y unidimensionalidad del «Cuestionario de actitudes hacia la etica profesional en Fisioterapia» (CAEPFIS). Material y metodo Se procedio a la elaboracion de un cuestionario que analizara las actitudes hacia la etica profesional en estudiantes de Fisioterapia (CAEPFIS) mediante un estudio piloto con estudiantes de Fisioterapia de ultimo curso (n = 100). Se llevo a cabo un analisis de…
Impaired Binding to Junctophilin-2 and Nanostructural Alteration in CPVT Mutation
Rationale: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare disease, manifested by syncope or sudden death in children or young adults under stress conditions. Mutations in the Ca 2+ release channel/RyR2 (type 2 ryanodine receptor) gene account for about 60% of the identified mutations. Recently, we found and described a mutation in RyR2 N-terminal domain, RyR2 R420Q . Objective: To determine the arrhythmogenic mechanisms of this mutation. Methods and Results: Ventricular tachycardias under stress conditions were observed in both patients with catecholaminergic polymorphic ventricular tachycardia and knock-in mice. During action potential recording (by patch-clamp in …
Attitudes towards learning professional ethics in undergraduate physiotherapy students: A STROBE compliant cross-sectional study.
BACKGROUND: Ethics is a key competence to be acquired by physiotherapy students to ensure quality care. However, students may not be aware of the importance of ethics for the development of their clinical practice, in the same way that their attitudes towards Professional Ethics are unknown within their curriculum. OBJECTIVES: The aim of this study was to identify the attitudes towards learning Professional Ethics among undergraduate students of Physiotherapy Degree and compare the attitude between the educational years. DESIGN: A cross-sectional study was carried out. SETTINGS: Physiotherapy Degree at the University of Valencia, Spain. PARTICIPANTS: In the study 340 physiotherapy students …
High-Intensity Interval and Resistance Training Improve Health Outcomes in Older Adults With Coronary Disease.
Both high-intensity interval training (HIIT) and resistance exercises (R) are used in cardiac rehabilitation in patients with coronary artery disease (CAD). However, the combined effect of an HIIT + R exercise program in older adults with CAD is not well investigated. The study's purpose was to assess the changes in anthropometric parameters, physical activity, functional capacity, physiological parameters, and quality of life (QoL) in this population following a combined HIIT + R program.The study was a 2-group (n = 45 each) randomized controlled single-blinded trial.The study was done at a treatment clinic of a tertiary hospital. The mean age of participants was 69.23 ± 4.9 years. The HII…
Measuring physical activity with activity monitors in patients with heart failure: from literature to practice. A position paper from the Committee on Exercise Physiology and Training of the Heart Failure Association of the European Society of Cardiology
The aims of this paper were to provide an overview of available activity monitors used in research in patients with heart failure and to identify the key criteria in the selection of the most appropriate activity monitor for collecting, reporting, and analysing physical activity in heart failure research. This study was conducted in three parts. First, the literature was systematically reviewed to identify physical activity concepts and activity monitors used in heart failure research. Second, an additional scoping literature search for validation of these activity monitors was conducted. Third, the most appropriate criteria in the selection of activity monitors were identified. Nine activi…
Effectiveness of Nintendo Wii and Physical Therapy in Functionality, Balance, and Daily Activities in Chronic Stroke Patients.
The aim of this study was to assess whether a virtual rehabilitation program using Nintendo Wii added to conventional physical therapy improved functionality, balance, and daily activities in chronic stroke survivors, when compared with conventional physical therapy.We undertook a randomized controlled clinical trial. The participants of this study were randomized to 2 groups: (1) conventional physical therapy (CPTG), which included exercises related to functionality, balance, and activities of daily living; and (2) virtual reality with Nintendo Wii (VRWiiG), which included balance training with the Wii Balance Board and upper limb exercises with the Wii Sports package, added to conventiona…
Abstract 16304: Readiness for Physical Activity in Patients With Heart Failure
Introduction: Little attention has been given to assessing the physical readiness and psychological readiness (motivation & self-efficacy) in patients with heart failure (HF). The aim of this study is to explore the readiness for PA (physical and psychological) in patients with HF and factors related. Method: A cross-sectional study with 163 patients included (mean age 66±16, 50% female, 63% NYHA I, 37% NYHA II) assessing background and clinical data, physical activity (IPAQ-s), depression and anxiety (HADs), quality of life (SF36). Readiness for PA was assessed with physical readiness based on the PA Readiness Questionnaire (PAR-Q) and psychological readiness was measured with the Exe…
Multidisciplinary program based in physiotherapy and nutrition in coronary artery disease patients: randomized controlled trial
Abstract Funding Acknowledgements Type of funding sources: None. Introduction. The interventions on eating habits and exercise in physiotherapy programs are usually recommended in coronary artery disease (CAD), since they are beneficial to improve physical and nutritional status of patient. Despite this, scarce studies are focused on combined protocols based on high intensity interval training (HIIT) and dietary education in CAD patients with percutaneous coronary intervention (PCI). Purpose The main goal of this study was to compare the effectiveness of a multidisciplinary program based in HIIT, with a program based in dietary education and HIIT (DEHIIT), on eating habits in CAD patients w…
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Impact of a program based in eating habits and physiotherapy on anthropometric parameters in patients with coronary artery disease: randomized controlled trial
Abstract Funding Acknowledgements Type of funding sources: None. Introduction. On the one hand, physical training such as High intensity interval training (HIIT) and on the other, eating habits, it is often prescribed to patients with coronary artery disease (CAD). Nevertheless, the combination of HIIT and eating habits in CAD with percutaneous coronary intervention (PCI) there is no consensus on using a combined protocol of both. Purpose. The purpose of this study was to evaluate the impact of an HIIT program with eating habits, with a program based in HIIT, on anthropometric parameters in CAD patients with PCI. Methods. A randomized controlled trial was carried out in a hospital. 44 pati…
Self-care of heart failure patients: practical management recommendations from the Heart Failure Association of the European Society of Cardiology
Self-care is essential in the long-term management of chronic heart failure. Heart failure guidelines stress the importance of patient education on treatment adherence, lifestyle changes, symptom monitoring and adequate response to possible deterioration. Self-care is related to medical and person-centred outcomes in patients with heart failure such as better quality of life as well as lower mortality and readmission rates. Although guidelines give general direction for self-care advice, health care professionals working with patients with heart failure need more specific recommendations. The aim of the management recommendations in this paper is to provide practical advice for health profe…
Evaluating the extent of patient-centred care in a selection of ESC guidelines
AIMS: Patient-centred care (PCC) is the cornerstone for healthcare professionals to promote high quality care for patients with cardiovascular conditions. It is defined as 'Providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions'. PCC can improve patient outcomes and allow patients and healthcare professionals to manage care collaboratively using best available evidence. However, there is no clear understanding how extensively guidelines incorporate PCC recommendations. The aim of the study was to evaluate the incorporation of PCC into a selection of guidelines published by the E…
Efficacy of a proprioceptive exercise program in patients with nonspecific neck pain: a randomized controlled trial.
BACKGROUND Nonspecific neck pain is associated with chronic pain, disability, reduced cervical mobility, postural control disorders and impaired proprioceptive control. AIM The aim of this study was to compare the effectiveness of two therapeutic exercise programs (i.e. cervical proprioception and cervical mobility) in reducing pain and disability in individuals with nonspecific neck pain. We further aimed to compare the effectiveness of the two treatments in improving pressure pain threshold, cervical range of motion and head repositioning accuracy. DESIGN This study was designed as a randomized controlled trial. SETTING This study took place in a private rehabilitation clinic. POPULATION …
Depression mediates physical activity readiness and physical activity in patients with heart failure.
Aims Although physical activity (PA) and exercise are essential for patients with heart failure (HF), adherence to the recommended guidelines is low. Not much is known about the mediating effect of HF patients mental state with their readiness for PA and reported activity levels. The purpose of this study is to investigate the mediatory effect of depression on PA readiness (physical limitation and psychological readiness) and self-reported PA in patients with HF. Methods and results In this cross-sectional study, 163 New York Heart Association Class I and II HF patients, during their clinic visit, reported on their physical limitation (PAR-Q) and psychological readiness [self-efficacy (ESES…