bluuebunny/crossref_metadata_2025_split huggingface dataset:
May the brief physical activity assessment tool accurately measure physical activity in patients with resistant hypertension?
Authors: Lopes S , Mesquita-Bastos J , Garcia C , Figueiredo D , Carvalho P , Oliveira J , Polonia J , Alves AJ , Ribeiro F 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): FEDER Funds through the Operational Competitiveness Factors Program—COMPETE National Funds through the Portuguese Foundation for Science and Technology (FCT) “PTDC/DTP-DES/1725/2014”. SL is a PhD fellow supported by the FCT (Grant Ref: SFRH/BD/129454/2017).

Introduction
Resistant hypertension is a major health problem due to the increased risk of cardiovascular events and mortality. Physical activity and exercise reduces blood pressure in resistant hypertension and is associated with lower cardiovascular risk and mortality. It is presently recommended that physical activity assessment should be a priority in all visits to health settings

Purpose
This study aims to determine if the Brief Physical Activity Assessment Tool (BPAAT), a 2-question tool to assess physical activity, is a valid instrument to detect inactive patients with resistant hypertension.

Methods
Sixty patients with a diagnosis of resistant hypertension were recruited. Outcome measures included clinical data, blood pressure and daily physical activity. Physical activity was objectively measured over a 7-day period with an accelerometer and subjectively assessed (self-assessment) by the BPAAT. The association between the BPAAT and accelerometry, according to the BPAAT scoring categories, was assessed bythe percentage of agreement, Cohen’s Kappa and sensitivity and specificity.

Results
Patients (33 were male) had a mean age of 59.4 ± 9.1years, were on average overweight (BMI 29.5 ± 4.5 kg/m2) and on an average of 4.5 ± 0.7 antihypertensive medications. Forty-two patients (70%) were classified as insufficiently active by the BPAAT compared to the 38 (63.3%) insufficiently active patients identified by the accelerometry data. Regarding the questionnaire’s specificity and sensitivity, the BPAAT correctly identified 32 [84.2 (73.1 – 95.3) %] of the 38 ‘insufficiently active’ patients and 12 [54.5 (34.3 – 74.7) %] of the 22 ‘sufficiently active’ patients identified by accelerometry. The agreement between BPAAT and accelerometry to identify sufficiently/insufficiently active patients, according to the BPAAT’s cut-off values was fair to moderate (Kappa = 0.403 (0.162 – 0.674), with a percentage of agreement of 73.3%.

Conclusion
The BPAAT, a 2-question tool to assess physical activity, seems to be a valid and fast solution to identify insufficiently active adults with resistant hypertension during routine clinical visits.
Clinical characteristics and outcomes of patients with heart failure admitted to the intensive care unit with coronavirus disease 2019 (COVID19): a multicenter cohort study
Authors: Badreldin H , Hafidh DR , Bin Saleh DR , Al Sulaiman DR , Al Juhani DR , Alharbi DR , Alanazi DR , Almujarri MS , Alobathani MS , Al Harbi MR , Al Harbi DR 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Patients with heart failure in the setting of COVID-19 requiring admission to the intensive care unit may present a set of unique challenges. There is limited data to describe the clinical characteristics and outcomes in this subset of the patient population.

Purpose
The study"s purpose was to extensively describe the characteristics and outcomes of heart failure patients admitted to the intensive care unit with COVID-19 compared to non-heart failure patients .

Methods
We conducted a multicenter, prospective analysis for all adult critically ill patients with heart failure admitted to intensive care units (ICUs) between March 1 to August 31, 2020, with an objectively confirmed diagnosis of COVID-19.

Results
A total of 723 critically ill patients with COVID-19 had been admitted in ICUs, 59 patients with heart failure, and 664 patients with no heart failure before ICU admission. Heart failure patients had significantly more comorbid conditions such as diabetes mellitus, hypertension, dyslipidemia, atrial fibrillation, and acute coronary syndrome. Higher baseline severity scores (APACHE II & SOFA score) and nutritional risk (NUTRIC Score) were observed in heart failure patients. Also, heart failure patients had more acute kidney injury during ICU admission and required more mechanical ventilation within 24 hours of ICU admission. Patients with heart failure had a similar incidence of thrombosis compared to patients with no heart failure. Critically ill patients with COVID-19 and heart failure had similar ICU length of stay (LOS), mechanical ventilation duration, and hospital LOS compared to patients with no heart failure. During ICU stay, patients with heart failure had more in-hospital and ICU deaths in comparison to the non-heart failure group (64.3% vs. 44.6%, P-value &lt;0.01) and (54.5% vs. 39%, P-value = 0.02) respectively.

Conclusion
In this observational study evaluating the clinical characteristics and outcomes of critically ill COVID-19 patients with heart failure, patients with COVID-19 and heart failure had similar ICU LOS, duration of MV and hospital LOS, thrombosis rate compared to patients with no heart failure. However, during ICU stay, patients with heart failure had more in-hospital and ICU deaths than the non-heart failure group.
Emergency Department chest pain patient experience time (PET): the impact of ANP cardiology autonomy from triage to diagnosis
Authors: Ingram S 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Chest pain accounts for 8% of local Emergency Department (ED) presentations. Patient experience time (PET) is the entire time each patient spends in ED and the national ED PET goal is 6 - 9 hours. The Cardiology Advanced Nurse Practitioner (ANP) consult service reduced PET for patients with chest pain from 17 hours, however the average PET for patients presenting with chest pain remains high at 10 hours in 2019.

Aim
To assess the impact on of ANP Cardiology autonomy on the PET of chest pain patients who present to a busy ED.

Method
Building on 6 years of ANP chest pain consultations in the ED, cardiology ANPs expanded their caseload to fully manage chest pain patients directly from the waiting room as named clinicians, instead of an ED doctor. The ANP managed the patient completely from triage to diagnosis, resulting in discharge or admission. Enablers included ANP referral for ionising radiation and medicinal prescribing, with buy in from ED Consultants and Cardiology clinical lead. All patients managed directly by the ANP from 2017-2019 were included in the data analysis. The ED symphony system was used as a clinical and audit tool. ANP chest pain PET was compared to ED Doctor chest pain PET. This service evaluation was approved by the hospital audit committee.

Results
197 patients who presented with chest pain were autonomously managed by one ANP as a named clinician over 3 years. Sixty-four percent were managed completely autonomously. Eighty per cent were discharged from ED. ANP decision time from initial assessment to admit or discharge was 2.6 hours. The ANP average chest pain PET time was 7.5 hours compared to average ED doctor chest pain PET of 9.5 hours.

Conclusions
As social distancing now impacts more than ever on usual ED pressures, caseload expansion by the Cardiology ANPs evidences further PET reductions for patients who present with chest pain in line with targets. As only one ANP is on the floor and not every shift, many hours of the PET occurred in the ED prior to the ANP ‘clicking’ on as a named clinician. Professional courage to completely manage this potentially high risk cohort autonomously has been welcomed patients and ED staff. PET of the chest pain patient has the potential to reduce further with more ANPs proficient in chest pain assessment within the emergency department setting.
Post cardiac surgery Mediastinitis : Risk factors and therapeutic management
Authors: Mleyhi S , Miri R , Messai M , Ellouze H , Tesnim B , Ben Omrane S , Denguir R 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background : Despite the progress in therapy and patient management in cardiac surgery, postoperative mediastinitis remains an serious complication. Our study aims to study the incidence of mediastinitis after cardiac surgery and to identify the risk factors.

Methods
We conducted a retrospective, descriptive study including patients who had undergone cardiac surgery by sternotomy during a period of 5 years ( 2015 – 2019)and who meet the definition of mediastinitis proposed by the "Centers of disease control and disease". We collected the demographic characteristics of the patients and operative operative data of the first intervention as well as those relating to mediastinitis.

Results
25 patients ( 2.93%) among 1042 patients operated for cardiac surgery during the cited period presented mediastinitis. The main clinical signs were : surgical wound infection (80%), fever (40%) and sternal instability (30%). Biological tests showed : hyperleukocytosis and high C-Reactive Protein in 22.7 % and 58.1 % of cases respectively. Gram-positive cocci are largely predominant and one case of Candida mediastinitis was found. type 1 diabetes and coronary artery bypass grafting were significantly associated with the occurrence of mediastinitis with P &lt;0.01. The mean duration of intra venous antibiotic therapy was 21 days.
92 % of patients operated on for mediastinitis are cured, 4 % had a recurrence of infection and 4 % died.

CONCLUSION
Mediastinitis after heart surgery is rare but serious. The main risk factors are insulin-dependent diabetes and coronary bypass surgery. The curative treatment is heavy and it is based on a rigorous and long medico-surgical care.
Aortic Coarctation of the newborn and infant: predictors of morbidity and mortality
Authors: Mleyhi S , Miri R , Khadhar Y , Tesnim B , Ghedira F , Ben Omrane S , Ben Mrad M , Denguir R 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Aortic coarctation represents 8% of all congenital heart disease. Whether isolated or associated with an intra or extra cardiac anomaly, newborns or infants coarctation could lead to early heart failure. this specific form can be associated with peri-operative difficulties and subsequent complications especially recoarctation and late hypertension.
Objective : our objective is to determine the predictive factors of morbi-motality in this disease.

Methods
It’s a monocentric and restrospcetive study of 34 newborns and infants operated on for aortic coarctation between January 2010 and december 2019. Clinical, paraclinical and therapeutic data have been collected.

Results
Our study include 23 newborns and 11 infants, with sex ratio of 2,4. The diagnosis was retained at an average age of 2 months and 2/3 of which before the age of 1 month. The main clinical signs were an abnormality of the femoral pulses in 92% of cases (abolished in 15 babies), tachycardia with polypnea in 68% of cases and hypertension in 48% of patients. Other signs are less common, such as hepatomegaly (44%), left side-sternal murmur (38%) and hypotrophy (20.6%). The mean gradient in blood pressure between the upper and lower limbs was 22 mm Hg [17-38mmHg]. Eight patients required mechanical ventilation. Biological examinations showed metabolic acidosis in 8 patients hepatic failure and renal failure in five patients each one. On the chest x-ray, 60% had cardiomegaly and 42% had pulmonary edema. The trans-thoracic echocardiography detect coarctation in all cases which was preductal in 70.6% of cases. The averge of trans-isthmic gradient was 37mmHg. The main associated cardiac abnormalities were: IVC in 7 patients and aortic bicuspid in 6. However, persistent ductus arteriosus was in 27 cases (79.4%). Cardiac catheterization was used in 5 babies aged between 4 and 9 months with a mean trans-isthmic hemodynamic gradient of 65 mmHg [45-100] and MRI and Ct scann was done in 3 patients each one.
The average weight at the time of the operation was 4.780 kg [2.4-9.8]. 3 newborns were operated between the 9th and 20th days of life. The first approach was a posterolateral thoracotomy in the left 4th intercostal space in 33 patients and a vertical midline sternotomy in a single infant with a total abnormal pulmonary venous return. The modified Crafoord technique (extended-anastomosis) was performed in the majority of cases (97.05%) and 4 patients with unrestricted IVC required also pulmonary artery banding. The overall mortality rate was 29.4%. Prematurity, a birth weight &lt;2.5 kg, an operative age &lt;120 days and complex heart disease were significantly associated with mortality (P&lt; 0.05).

Conclusion
Coarctation of the aorta in newborns and infants is a surgical emergency in some cases, with still high mortality despite the surgical and anesthetic progress.
The impact of COVID-19 on recovery after heart surgery: preliminary findings from the CardiacCovid Study
Authors: Bueser T , Clayton T , Dodd M , Beaumont E , Owens G , Murray S , Sepehripour A , Oo A , Sanders J 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background/Introduction
The COVID-19 pandemic has had far-reaching effects on everyday life leading to stress and anxiety, which may be heightened in those undergoing cardiac surgery. Health impacts following a traumatic event may be apparent at one month but can also present after many months.

Purpose
The aim of the CardiacCovid study was to explore the effect of the pandemic on recovery from cardiac surgery. We report the preliminary results from a single centre study in the UK during the early phase of the COVID-19 pandemic.

Methods
Patients &gt;18 years old undergoing any form of cardiac surgery between 23rd March 2020 (UK lockdown) to 4th July 2020 (lifting of most restrictions) were recruited to this prospective observational study. Those too unwell or unable to give consent/complete study questionnaires were excluded. Participants completed a Quality of Life (QoL) (EQ-5D), impact of event (IES-R), depression (CES-D) and health service use questionnaire at baseline, 1 week after hospital discharge, and 6 weeks after surgery. Questionnaires were completed electronically on the Amplitude platform or via post. Ethics approval (20/YH/0132) was obtained and the study was registered (Clinicaltrials.gov:NCT04366167).

Results
A total of 395 patients had surgery of which 298 (91.7%) were screened and 203 (68.1%) were enrolled to the study. Participants were mostly male (74.6%), with a mean age of 63 years, undergoing urgent/emergency (57.9%) CABG +/-valve (70.1%). Mean inpatient stay was 8.6 days and in-hospital mortality was 0.5%. No patients had Covid-19. The initial findings suggest a deterioration of QoL at 1 week post discharge with near restoration to baseline level at 6 weeks post-surgery. Mean scores for CES-D and IES-R remained within subclinical levels at all available time points. However, at 6 weeks, a proportion of patients reached levels for depression on the CES-D and had high IES-R scores indicating possible post-traumatic stress.

Conclusion
We believe that this is the largest/only study exploring the impact of the pandemic on cardiac surgery recovery, including QoL, spanning the immediate recovery phase but will continue until 1 year. The findings so far show that recovery from cardiac surgery during the Covid-19 pandemic is similar to that reported prior to the pandemic (Cromhout et al 2018) and reinforces the need for psychosocial assessments to identify patients who may require additional support during the immediate recovery phase.
Dietary intake of plant sterols in cardiovascular diseases: a population-based study of Polish adults
Authors: Witkowska AM , Waskiewicz A , Zujko ME , Szczesniewska D , Drygas W 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute of Cardiology, Warsaw, Poland
Introduction. Cardiovascular diseases (CVD) are a major cause of premature mortality and disability in developed countries. Among various risk factors, disorders of lipid metabolism are prevalent. Scientific evidence shows that plant sterols have a positive effect on dyslipidemia. The primary mechanism of hypolipemic effect of plant sterols is inhibition of cholesterol absorption in the small intestine, and this effect depends on the dose.
Purpose. The aim of the study was to determine the intake of plant sterols, which was never studied in the Polish population.
Methods. In total, 5690 participants of the population-based cross-sectional Polish National Multicenter Health Examination Survey WOBASZ II (2013-2014), aged 20+, were evaluated in the study (1). Nutritional data were collected using a single 24-hour dietary recall method. A dietary plant sterol database was compiled from available experimental data including total and individual plant sterols such as β-sitosterol, campesterol and stigmasterol. Plant sterol intakes were calculated taking into account plant sterol contents in individual food products and the volume of food consumption. Statistical calculations were performed using Statistical Analysis System (SAS), version 9.4 (SAS Institute Inc., Cary, NC, USA).
Results. The dietary plant sterol intake (DPSI) for the general population, 283 mg/day, was dependent on the age and gender. The intake of sterols among people over 65 years of age (264 mg/day in men and 208 mg/day in women) was lower than in younger age groups (20-44 years) of participants (343 mg/day in men and 259 mg/day in women). The main dietary plant sterol for both genders was β-sitosterol (∼62% of intake), followed by campesterol (∼21%) and stigmasterol (∼9%). Overall, men and women with cardiovascular disease had significantly lower DPSI (p &gt; 0.002) than men and women without cardiovascular disease, 298.6 and 237.8 vs. 326.1 and 255.9 mg/d, respectively, and men but not women with diabetes had significantly (p &gt; 0.04) lower DPSI than men without diabetes, 301.7 vs. 323.3, respectively.
Conclusions. In the view of current recommendations to lower cholesterol, this research confirms findings for other populations, that the dietary intake of plant sterols in the Polish population is insufficient to beneficially modulate lipid metabolism, especially in CVD and diabetic patients.
Multidisciplinary program based in physiotherapy and nutrition in coronary artery disease patients: randomized controlled trial
Authors: Munoz Gomez E , Sempere-Rubio N , Blesa J , Iglesias P , Mico L , Sanchez-Torrijos J , Girbes V , Soriano JM , Espi-Lopez GV , Mesa-Rico R , Timonet-Andreu E , Canca-Sanchez JC , Senra S , Fernandez-Oliver AL , Marques-Sule E 
Published: July 2021

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 with PCI.
Methods. A prospective, randomized controlled trial with blinded outcome assessment was developed. The study was developed at a University research laboratory. 44 participants diagnosed with CAD, aged between 40 and 72 years, were randomly allocated to two treatment groups: HIIT group (HIITG, n = 22) and dietary intervention and HIIT group (DEHIITG, n = 22). The assessment consisted of applying a Food Frequency Questionnaires (FFQ) at baseline and post-intervention. DEHIITG performed a 3-month dietary intervention program combined with 24 HIIT sessions at 85-95% of peak heart rate, whilst HIITG performed a 3-month HIIT sessions at 85-95% of peak heart rate. This study did not receive any funding. No conflict of interest is declared.
Results. At the end of the program, when comparing between groups, statistically significant changes were noted. DEHIITG consumed more olive oil (p = 0.021), chicken or turkey (p = 0.039), stir-fried with vegetables (p = 0.033), vegetables (p = 0.003), fish and seafood (p = 0.039), and quantity of commercial juices (p = 0.042), sweets and snacks (p = 0.033). HIITG showed more improvements than DEHIITG in soups and creams consumption (p = 0.042). No adverse events were reported.
Conclusions. A dietary intervention with HIIT protocol yields better benefits than only HIIT on eating habits in CAD patients with PCI. Thus, our combined program could be considered a suitable treatment option among these patients.
Identify the patients perceived learning needs after myocardial infarction
Authors: Chi SY , Soh KL , Hasina AH , Noraini A , Mazrianna M 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Cardiovascular disease is the major trait to public health and the leading cause of death worldwide. There are over 1 million new and recurrent myocardial infarctions (MI) occur each year and 12,000 of these individuals are still living. Patients surviving from MI have to adapt to live with the heart disease and restore their quality of life. Hence health education for patients to combat the disease as secondary prevention has become very important. Health care professionals must understand the information needs of patients so that effective health education could be taken place consistently with patients’ needs, to optimize outcome of risk factor modification and lifestyle changes.

Purpose
This study aims to identify post MI patients" perceived learning needs and the demographic factors that influence the needs.

Methods
Cross-sectional design and convenience sampling method were used for this study. A questionnaire adapted from Cardiac Patient Learning Needs Inventory (CPLNI) was completed by 56 patients who were recruited from a tertiary hospital during inpatient hospitalization in Malaysia. Data from the questionnaires were analyzed using SPSS version 24.

Results
It was shown that patients’ perceived learning needs were highly important in all eight domains. All domains range from mean 3.52-3.66. Information in the domains of other pertinent information (sign and symptom of MI), medication as well as anatomy and physiology were highly needed by post MI patients, with mean 3.66, 3.65 and 3.64 respectively. Age was significantly related to the patients’ learning need in the domain of anatomy and physiology.

Conclusion
MI patients need abundant cardiac related information prior discharge, to regain and improve their life. This need should be met by delivering appropriate health education before discharge or during follow-up by health care professionals. There is a necessity to integrate this study finding into the cardiac rehabilitation content to benefit post MI patients.