1,721,023 research outputs found
Cardiologia riabilitativa e prevenzione secondaria durante la pandemia COVID-19: stato dell'arte e prospettive
No full text
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Clustering of Lifestyle Risk Factors in Acute Coronary Syndrome: Prevalence and Change after the First Event
No full textBackground: Healthy lifestyles are modifiable risk factors for acute coronary syndrome (ACS) onset and recurrence. While unhealthy lifestyles tend to cluster together within the general healthy population, little is known about the prevalence and clustering of these behaviours in people with ACS before and after the first acute event. The aim of this study was to identify lifestyle profiles of patients with ACS and to explore their change after their first coronary event. Methods: Three hundred and fifty-six patients completed self-report measures of healthy habits at the beginning of cardiac rehabilitation and 6 months later. By adopting a person-oriented approach, we analysed lifestyle clustering and its change over time. Differences in depression, anxiety, and negative illness perception among lifestyle profiles were assessed. Results: We identified seven profiles, ranging from more maladaptive to healthier clusters. Findings showed a strong interrelation among unhealthy habits in patients. We highlighted a moderate individual and group stability of cluster membership over time. Moreover, unhealthier lifestyle profiles were associated with higher levels of depression, anxiety, and negative illness perception. Conclusion: These results may have implications for the development and implementation of multimodal interventions addressing wider-ranging improvement in lifestyles by targeting multiple unhealthy behaviours in patients with ACS
Clinical characteristics and course of patients entering cardiac rehabilitation withchronic kidney disease: data from the Italian Survey on Cardiac Rehabilitation(ISYDE)
No full textPurpose: Data from the Italian SurveY on carDiac rEhabilitation (ISYDE-2008) provide
insight into the characteristics and clinical course of patients with chronic kidney disease
(CKD) admitted to Cardiac Rehabilitation (CR) programs.
Methods: Data from 165 CR units were collected online from January 28th to February 10th,
2008.
Results: The study cohort consisted of 2281 patients (66.911.8 yrs); 200 (71.312.2 yrs,
66% male) CKD patients and 2081 (66.311.6 yrs, 74% male) non-CKD patients. Compared
to non-CKD, CKD patients were older and their admission diagnosis of acute myocardial
infarction, myocardial revascularization or heart failure was more frequent. They also showed
more cardiac and non cardiac comorbidities, mostly diabetes, chronic obstructive lung disease
and cognitive impairment. During the course of CR, CKD patients had reduced access to
exercise functional evaluation, more complications (particularly atrial fibrillation, worsening
of chronic kidney disease and anaemia) requiring more intense medical treatment, and longer
length of in-hospital stay. CKD patients were less likely discharged at home (88% versus 91%,
p1⁄40.05), were more likely transferred to the intensive care units (8% versus 4%, p1⁄40.005),
and had higher death rate during CR programs (2.0% versus 0.5%, p1⁄40.02). After adjusting
for age, ejection fraction, comorbidities (acute myocardial infarction, percutaneous coronary
intervention, cardiac surgery, carotid artery critical lesions, peripheral artery disease, respiratory
insufficiency, heart failure, diabetes, stroke and cognitive impairment), and complications
during CR program (atrial fibrillation and severe ventricular arrhythmias), multivariate logistic
analysis showed that heart failure (OR 1.6, 95% CI, 1.1 to 2.4, p1⁄40.04), respiratory
insufficiency (OR 2.4, 95% CI, 1.4 to 4.0, p1⁄40.0007), and cognitive impairment (OR 4.5,
95% CI, 2.5 to 8.1, p < 0.0001) were significant predictors of death during the CR program in
CKD patients.
Conclusions: This subanalysis of the ISYDE-2008 survey provided a detailed snapshot of the
clinical characteristics, complexity and more severe clinical course of patients admitted to CR
presenting with CKD
Prescribing, dosing and titrating exercise in patients with hypertrophic cardiomyopathy for prevention of comorbidities: Ready for prime time
No full textThe benefits of physical activity are well established, leading to both cardiovascular and non-cardiovascular benefits, improving quality of life and reducing mortality. Despite such striking body of evidence, patients with hypertrophic cardiomyopathy are often discouraged by health professionals to practice physical activity and personalised exercise prescription is an exception rather than the rule. As a result, hypertrophic cardiomyopathy patients are on average less active and spend significantly less time at work or recreational physical activity than the general population. Exercise restriction derives from the evidence that vigorous exercise may occasionally trigger life-threatening arrhythmias and sudden cardiac death. However, while participation in competitive sports should be prudentially denied, hypertrophic cardiomyopathy patients can benefit from the positive effects of regular physical activity, aimed to reduce the risk of comorbidities and improve the quality of life. Based on this rationale, exercise should be prescribed and titrated just like a drug in hypertrophic cardiomyopathy patients, considering individual characteristics, symptoms, past medical history, objective individual response to exercise, previous training experience and stage of disease. Type, frequency, duration, and intensity should be defined on a personal basis. Yet exercise prescription in hypertrophic cardiomyopathy and its long-term effects represent major gaps in our current knowledge and require extensive research. We here review existing evidence regarding benefits and hazards of physical activity, with specific focus on viable modalities for tailored and safe exercise prescription in these patients, highlighting future developments and relevant research targets. © The European Society of Cardiology 2020
Cardiac rehabilitation in chronic heart failure: data from the Italian SurveY on carDiac rEhabilitation (ISYDE-2008).
No full textBACKGROUND:
Using data from the Italian SurveY on carDiac rEhabilitation (ISYDE-2008), this study provides insight into the level of implementation of cardiac rehabilitation in patients with chronic heart failure (CHF).
METHODS:
Data from 165 Italian cardiac rehabilitation units were collected online from 28 January to 10 February 2008.
RESULTS:
The study cohort consisted of 2281 patients (66.9 ± 11.8 years): 285 (71.3 ± 12.2 years, 66% male) CHF patients and 1996 (66.3 ± 11.6 years, 74% male) non-CHF patients. Compared with non-CHF, CHF patients were older, showed more comorbidity, had lower left ventricular (LV) ejection fraction and reduced access to functional evaluation, underwent more complications during cardiac rehabilitation, and had longer length of in-hospital stay. CHF patients were also more likely to be transferred to ICU (9 versus 3%, P < 0.0001), and less likely to be discharged home (85 versus 92%, respectively, P < 0.0001). Also, discharge prescriptions were significantly different from those of non-CHF patients. Finally, CHF patients had higher mortality during cardiac rehabilitation (1.7 versus 0.5%, P = 0.01). After adjusting for age, ejection fraction, comorbidity, previous interventions and complications during cardiac rehabilitation, multivariate logistic analysis showed that not performing any of the physical performance tests [odds ratio (OR) = 7.0, 95% confidence interval (CI), 1.9-25.8, P = 0.003], acute respiratory failure (OR = 2.3, 95% CI, 1.3-4.1, P = 0.002), acute kidney insufficiency or worsening of chronic kidney disease (OR = 2.9, 95% CI, 1.5-5.6, P = 0.001) and worsening of cognitive impairment (OR = 3.7, 95% CI, 2.0-6.7, P < 0.001) were significant predictors of death in CHF patients.
CONCLUSION:
The ISYDE-2008 survey provided a detailed snapshot of cardiac rehabilitation in CHF patients, and confirmed the complexity and the more severe clinical course of these patients during cardiac rehabilitation
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