- Burden and Patterns of Multi-morbidity: Impact on Disablement in Older Adults. [Journal Article]Am J Phys Med Rehabil 2020AJ
- CONCLUSIONS: Multi-morbidity counts may be an excellent tool for risk stratification and identification of persons in need of rehabilitation.
- Transient Cerebral Ischemia at High Altitude and Hyper-Responsiveness to Hypoxia. [Journal Article]High Alt Med Biol 2020HA
- A 36-year-old woman with no medical history participated in a trekking in Ladakh up to 5300 m of altitude. She was well acclimatized and presented no previous sign of acute mountain sickness, high altitude pulmonary edema or high altitude cerebral edema. After an intense effort to catch up with her group, she became breathless and complained of visual disturbances, fatigue, dizziness, and confusi…
A 36-year-old woman with no medical history participated in a trekking in Ladakh up to 5300 m of altitude. She was well acclimatized and presented no previous sign of acute mountain sickness, high altitude pulmonary edema or high altitude cerebral edema. After an intense effort to catch up with her group, she became breathless and complained of visual disturbances, fatigue, dizziness, and confusion. During her descent to a lower altitude (4800 m), with the help of companions, she lost consciousness several times. After a 14-hour sleep, she recovered and all symptoms disappeared so that she was able to walk along with the group for 20 km. On returning home, she went through a battery of examinations that were all normal: cerebral magnetic resonance imaging, Doppler of supra-aortic arteries, 24 hours Holter, and cardiac transthoracic and transesophageal echography. A hypoxia exercise test revealed a hyper-response to hypoxia with severe hypocapnia. The etiology of this neurological episode is discussed (transient embolic ischemic attack, migraine, cerebral edema, and global amnesia). The patchy distribution of neurological symptoms is not in favor of a thrombotic event. The most probable diagnosis proposed is a transient cerebral ischemia due to local cerebral vasoconstriction related to hyperventilation-induced hypocapnia in a context of acute severe exercise. Special attention should be given to subjects who show a hyper-responsiveness to hypoxia before a sojourn at high altitude: they should avoid unnecessary hyperventilation due to any kind of stress, emotion, or exhaustive exercise.
- Vigorous cool room treadmill training to improve walking ability in people with multiple sclerosis who use ambulatory assistive devices: a feasibility study. [Journal Article]BMC Neurol 2020; 20(1):33BN
- CONCLUSIONS: Vigorous cool room training is feasible and can potentially improve walking, fatigue, fitness, and quality-of-life among people with moderate to severe MS-related disability.
- A tRial Evaluating Mid Cut-Off Value Membrane Clearance of Albumin and Light Chains in HemoDialysis Patients: A Safety Device Study. [Journal Article]Blood Purif 2020; :1-11BP
- CONCLUSIONS: Regular HD using the MCO dialyzer did not result in a significant fall in serum albumin. There were no effects on quality of life, functional status or nutrition.
- Patient functionality and walking speed after discharge from the intensive care unit. [Journal Article]Rev Bras Ter Intensiva 2019 Oct-Dec; 31(4):529-535RB
- CONCLUSIONS: There was significant improvement in walking speed at the time of hospital discharge when compared to the walking speed at the time of intensive care unit discharge.
- Effects Of Cardiovascular Conditioning Exercises On Quality Of Life In Patients With Dilated Ardiomyopathy In Pakistan. [Journal Article]J Ayub Med Coll Abbottabad 2019 Oct-Dec; 31(Suppl 1)(4):S651-S655JA
- CONCLUSIONS: Supervised cardiac conditioning program significantly improves Quality of life and NYHA functional class in dilated cardiomyopathy.
- Safety and efficacy of baroreflex activation therapy for heart failure with reduced ejection fraction: a rapid systematic review. [Review]ESC Heart Fail 2020EH
- To retrieve and assess the available data in the literature about the safety and efficacy of baroreflex activation therapy (BAT) in heart failure with reduced ejection fraction (HFrEF) patients, through a rapid systematic review of clinical studies. Rapid systematic review of literature. Searched electronic databases included PubMed, EMBASE, CENTRAL, Scopus, and Web of Science using Mesh and free…
To retrieve and assess the available data in the literature about the safety and efficacy of baroreflex activation therapy (BAT) in heart failure with reduced ejection fraction (HFrEF) patients, through a rapid systematic review of clinical studies. Rapid systematic review of literature. Searched electronic databases included PubMed, EMBASE, CENTRAL, Scopus, and Web of Science using Mesh and free terms for heart failure and BAT. No language restriction was used for the searches. We included full peer reviewed publications of clinical studies (randomized or not), including patients with HFrEF undergoing BAT, with or without control group, assessing safety and efficacy outcomes. One reviewer conducted the analysis of the selected abstracts and the full-text articles, performed data extraction, and evaluated the methodological quality of the selected articles. The methodological quality was assessed according to the Cochrane Collaboration instruments. A descriptive summary of the results is provided. Of the 441 citations screened, 10 publications were included (three were only conference abstracts), reporting data from three studies. Only one study was a randomized clinical trial. Two studies reported a 6 month following, and the other study analysed outcomes up to 41 months. The procedure seems to be safe when performed by a well-trained multi-professional team. An 86% rate of system and procedure-related complication-free was reported, with no cranial nerve injuries. Improvements in New York Heart Association class of heart failure, quality of life, 6 min walk test, and hospitalization rates, as well as in muscle sympathetic nerve activity. No meta-analysis was conducted because of the lack of homogeneity across studies; the results from each study are reported individually. BAT procedure seems to be safe if appropriate training is provided. Improvements in clinical outcomes were described in all included studies. However, several limitations do not allow us to make conclusive statements on the efficacy of BAT for HFrEF. New well-designed trials are still needed.
- Biopsychosocial correlates of physical activity and sedentary time in adults with severe obesity. [Journal Article]Clin Obes 2020; :e12355CO
- Adults with severe obesity have poorer health, are less active and spend more time sedentary compared to people with a lower body mass index (BMI). There is a pressing need to understand the factors associated with low physical activity (PA) and excessive sedentary time to develop more effective behaviour change interventions for this population. The purpose of this study was to identify biopsych…
Adults with severe obesity have poorer health, are less active and spend more time sedentary compared to people with a lower body mass index (BMI). There is a pressing need to understand the factors associated with low physical activity (PA) and excessive sedentary time to develop more effective behaviour change interventions for this population. The purpose of this study was to identify biopsychosocial correlates of PA and sedentary time in adults living with severe obesity. Forty-four adults living with severe obesity (age = 50.5 ± 13.3 years; BMI = 44.3 ± 7.8 kg/m2) completed a survey including questions on sociodemographic characteristics, comorbidities, psychosocial factors (eg, social physique anxiety [SPA], social support for PA, PA level self-perception), quality of life, daily pain and self-reported moderate-to-vigorous intensity PA (MVPA). Participants also completed the 6-minute walk test (6MWT) to assess physical fitness and wore an accelerometer to assess objective PA and sedentary time. In stepwise linear multivariate analyses, higher objective MVPA was associated with higher 6MWT distance, being single and lower SPA (R2 = 0.46, P < .001), whereas higher self-reported MVPA was associated with greater PA level self-perceptions (R2 = 0.47, P < .001). Greater objective light intensity PA was associated with greater quality of life and self-efficacy for PA (R2 = 0.26, P = .001). Greater sedentary time was associated with having more comorbidities (R2 = 0.25, P < .001). This study shows that adults living with severe obesity who have more comorbidities, poorer quality of life and/or lower self-efficacy perception for PA are more likely to be sedentary and to practice less light intensity PA. Additionally, those who were in a relationship, had higher SPA and/or had lower physical fitness practiced less MVPA. Future research is needed to determine causal effects.
- Deficits in muscle strength and physical performance in sarcopenic children after liver transplantation influences physical activity. [Journal Article]Liver Transpl 2020LT
- CONCLUSIONS: Sarcopenia is highly prevalent in children after LTx and is related to lower moderate and vigorous physical activity. Development of effective rehabilitation strategies to treat sarcopenia are needed in post-LTx children.
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- Six-minute walk test does not affect blood pressure in healthy dogs at high altitude. [Journal Article]J Pharmacol Toxicol Methods 2019 Sep - Oct; 99:106595JP