Main Findings : The results indicate that an intervention involving any human factor principles may nearly double an individual ’s probability of not being readmitted .
Principal Conclusions : Interventions with human factor principles reduce readmissions among HF patients .
Background : Human factors play an important role in health-care outcomes of heart failure ( HF ) patients .
A systematic review and meta- analysis of clinical trial studies on HF hospitalization may yield positive proofs of the beneficial effect of specific care management strategies .
Purpose : To investigate how the 8 guiding principles of choice , rest , environment , activity , trust , interpersonal relationships , outlook , and nutrition reduce HF readmissions .
Long-term effects of dietary sodium intake on cytokines and neurohormonal activation in patients with recently compensated congestive heart failure.
BACKGROUND A growing body of evidence suggests that the fluid accumulation plays a key role in the pathophysiology of heart failure ( HF ) and that the inflammatory and neurohormonal activation contribute strongly to the progression of this disorder . METHODS AND RESULTS The study evaluated the long-term effects of 2 different sodium diets on cytokines neurohormones , body hydration and clinical outcome in compensated HF out patients ( New York Heart Association Class II ) . A total of 173 patients ( 105 males , mean age 72.5+/-7 ) recently hospitalized for worsening advanced HF and discharged in normal hydration and in clinical compensation were r and omized in 2 groups ( double blind ) . In Group 1 , 86 patients received a moderate restriction in sodium ( 120mmol to 2.8g/day ) plus oral furosemide ( 125 to 250 mg bid ) ; in Group 2 , 87 patients : received a low-sodium diet ( 80mmol to 1.8g/day ) plus oral furosemide ( 125 to 250 mg bid ) . Both groups were followed for 12 months and the treatment was associated with a drink intake of 1000mL daily . Neurohormonal ( brain natriuretic peptide , aldosterone , plasma rennin activity ) and cytokines values ( tumor necrosis factor-alpha , interleukin-6 ) were significantly reduced with a significant increase of the anti-inflammatory cytokine interleukin-10 at 12 months in normal , P < .0001 ) than low-sodium group . The low-sodium diet showed a significant activation of neurohormones and cytokines and worsening the body hydration , whereas moderate sodium restriction maintained dry weigh and improved outcome in the long term . CONCLUSIONS Our results appear to suggest a surprising efficacy of a new strategy to improve the chronic diuretic response by increasing Na intake and limiting fluid intake . This counterintuitive approach underlines the need for a better underst and ing of factors that regulate sodium and water h and ling in chronic congestive HF . A larger sample of patients and further studies are required to evaluate whether this is due to the high dose of diuretic used or the low-sodium diet
Main Findings : The results indicate that an intervention involving any human factor principles may nearly double an individual ’s probability of not being readmitted .
Principal Conclusions : Interventions with human factor principles reduce readmissions among HF patients .
Background : Human factors play an important role in health-care outcomes of heart failure ( HF ) patients .
A systematic review and meta- analysis of clinical trial studies on HF hospitalization may yield positive proofs of the beneficial effect of specific care management strategies .
Purpose : To investigate how the 8 guiding principles of choice , rest , environment , activity , trust , interpersonal relationships , outlook , and nutrition reduce HF readmissions .