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Efficacy and tolerance of a neurological restoration program in stroke patients.

The present paper shows the result of an open prospective study performed to evaluate the tolerance and efficacy of a program for neurological restoration (PRN) in stroke patients. The PRN is organized 4 weeks cycles - 39 hours per week - and applied by a team of physical, occupational, and speech therapists, physiatrists, psychologists, clinicians and nurses; directed by a neurologist. The first phase of treatment aims to increase the physical capacity and tolerance to exercise. The second phase trains specific abilities (balance, posture, gait and handling). Drugs were only used to modulate

Chronic Thromboembolic Pulmonary Hypertension Incidence, Post-pulmonary Embolism Syndrome and Possible Role of Transcatheter Therapy in Prevention.

Pulmonary embolism (PE) presents both acute and chronic complications that significantly affect patient outcomes. Acute complications include syncope or sudden death, often resulting from severe hypoxaemia or right ventricular failure; and early recurrence of the embolic event. Chronic complications, which can develop over time, are often grouped under post-embolic syndrome (PES), a condition affecting more than half of PE survivors. Symptoms of PES include persistent dyspnoea and reduced exercise tolerance. PES is associated with several serious conditions, such as chronic thromboembolic pulm…

Отслеживание Раша: диафрагматическая парализа вслед за герпесом Церкви.

80-летний мужчина представил двухдневную историю анорексии и сокращения ежедневной активности. Физический осмотр показал, что вдоль дерматома C3-C5 происходит эритематический, корчатый, сосудистый извержение. Рентген грудной клетки и вычисленная томография во время вдохновения и истечения срока действия продемонстрировали высоту левой гемидиафрагмы, практически без движения левой диафрагмы во время дыхания. Эти данные соответствуют левому диафрагмическому параличу, вызванному герпесом шейки матки. Как редкий тип сегментального моторного пареза, герпес шейки матки может вызвать паралич френичес

Совпадение в аннотации оригинала
An 80-year-old man presented with a two-day history of anorexia and decreased daily activity. A physical examination revealed an erythematou … C5 roots. Diaphragmatic paralysis results in diminished vital capacity and can lead to a decline in exercise tolerance or daily activity, especially in elderly patients.

[Cardiovascular management of patients undergoing noncardiac surgery].

The risk assessment of patients with cardiovascular diseases before noncardiac surgery (NCS) is particularly relevant in cardiology because of the frequency and the involvement of different disciplines. The risk is determined by the operation itself and the disease or risk profile, including the patient's age. Specialist preoperative consultation can therefore remain limited if the surgery-related risk is low. The subjective symptoms (exercise tolerance) and also the determination of the cardiac biomarkers N‑terminal pro-brain natriuretic peptide (NT-proBNP) and troponin are particularly relev…

Post-Acute Sequelae of COVID-19 and Cardiovascular Autonomic Dysfunction: What Do We Know?

Post-acute sequelae of SARS-CoV-2 (PASC), or long COVID syndrome, is emerging as a major health issue in patients with previous SARS-CoV-2 infection. Symptoms commonly experienced by patients include fatigue, palpitations, chest pain, dyspnea, reduced exercise tolerance, and "brain fog". Additionally, symptoms of orthostatic intolerance and syncope suggest the involvement of the autonomic nervous system. Signs of cardiovascular autonomic dysfunction appear to be common in PASC and are similar to those observed in postural orthostatic tachycardia syndrome and inappropriate sinus tachycardia. In…

Beyond COVID-19: Evidence-Based Consensus Statement on the Role of Physiotherapy in Pulmonary Rehabilitation in the Indian Context.

Post COVID-19 sequelae includes breathlessness, weakness, fatigue, decreased exercise tolerance and impaired quality of life. Physiotherapy based rehabilitation program is an essential component for post COVID-19 patients in facilitating maximum functional recovery. Expert consensus statements are available from the developed countries. There is a need for a guidelines to manage post COVID-19 sequelae in Indian context. The objective of this consensus statement is to provide evidence informed guidelines for post COVID-19 physiotherapy management as a component of pulmonary rehabilitation. This…

[Surgical treatment of paroxysmal ventricular tachycardia (personal observations)].

Five patients with recurrent VT/VF resistant to medical treatment were successfully treated surgically. In 3 patients excision of the altere … ic cardioverter-defibrillator (AICD). No patient had VT and/or VF during the 14-35 month follow-up. Exercise tolerance improved in all patients. Good short- and longterm results of surgical treatment show that these methods can be effective in treating patients with life-threatening arrhythmias resistant to pharmacological therapy.

Orthoterminal correction of coexisting d-transposition of the great arteries, subpulmonary stenosis, and a complete form of atrioventricular canal.

This report outlines orthoterminal correction in an 8-year-old boy with coexisting d-transposition of the great arteries (d-TGA), subpulmonary stenosis, and a complete form of atrioventricular canal (CAVC). The repair consisted of covering the tricuspid valve and atrial part of the atrioventricular canal with a Dacron patch and inserting a valve-containing conduit between the then isolated right atrium and the pulmonary artery to create a venous outlet. The patient's exercise tolerance has improved remarkably. The arterial oxygen saturation has risen from 86 to 90 per cent. A plea is made to e…

Multidimensional improvement in connective tissue disease-associated interstitial lung disease: Two courses of pulse dose methylprednisolone followed by low-dose prednisone and tacrolimus.

BACKGROUND AND OBJECTIVE: Corticosteroids and immunosuppressive agents are considered mainstays of therapy for connective tissue disease-related interstitial lung disease (CTD-ILD); however, tacrolimus with corticosteroid therapy has not been fully investigated. Our objectives were to examine the multidimensional therapeutic benefit and tolerability of the combined therapy for the initial treatment of patients with CTD-ILD. METHODS: In this retrospective case series, we identified consecutive CTD-ILD patients treated with tacrolimus plus intravenous (i.v.) methylprednisolone (1000 mg i.v. 3 d

ATF6β is not essential for the development of physiological cardiac hypertrophy.

Physiological cardiac hypertrophy is a compensatory remodeling of the heart in response to stimuli such as exercise training or pregnancy that is reversible and well-tolerated. We previously described how the activating transcription factor 6 (ATF6) proteins, ATF6α and ATF6β, were required for pathological hypertrophy in response to hemodynamic stress. Here, we examine the functional roles of both ATF6 proteins in the context of exercise-induced physiological hypertrophy. After 20 days of swim training, we found differential roles: whole body gene-deleted mice lacking ATF6α had an attenuated h

Update on the clinical utility of sildenafil in the treatment of pulmonary arterial hypertension.

Sildenafil is an orally administered phosphodiesterase type 5 inhibitor that is approved for the treatment of pulmonary arterial hypertension (PAH). The hemodynamic effects of sildenafil are mitigated primarily via potentiating the effects of endogenous nitric oxide, leading to smooth muscle cell relaxation and reductions in pulmonary arterial pressures and pulmonary vascular resistance. When added to standard background therapy in patients with idiopathic or associated PAH from congenital heart disease, anorexigen use, or connective tissue disease, sildenafil treatment results in improved exe

Sitaxsentan sodium for pulmonary hypertension.

Sitaxsentan is the first oral endothelin receptor antagonist (ETRA) with high selectivity for the endothelin-A (ET(A)) receptor to be approved for clinical use by regulatory agencies in Europe for the treatment of pulmonary arterial hypertension (PAH). Clinical trials have shown it to be well tolerated and to improve exercise tolerance, functional class and pulmonary hemodynamics in PAH, results which appear to be at least as good as those for the mixed ETRA bosentan. Importantly, compared to bosentan, sitaxsentan has a lower incidence of liver toxicity and no interaction with sildenafil, a dr…

Pilot and Feasibility Study of an Individualized Telehealth Exercise Program for People with Cystic Fibrosis.

Background: The Cystic Fibrosis Foundation (CFF) recognizes exercise as a critical part of managing cystic fibrosis (CF). This becomes even more important in the era of highly effective modulator therapy (HEMT) due to many people with cystic fibrosis (pwCF) having decreased symptom burden and a newfound ability to tolerate exercise better. Our single-center pilot study was designed to assess the implementation of a remotely delivered, individualized, and comprehensive exercise program for pwCF. We aimed to determine the feasibility, safety and acceptance of this intervention. Methods: PwCF ≥ 1

Effects of Combined Music and Exercise Therapy on Depression: A Systematic Review and Meta-Analysis.

BACKGROUND: Depression is a common psychiatric disorder that impacts millions globally. Non-pharmacological treatments, such as combining music and exercise therapy, have shown potential as alternatives to medication. This meta-analysis evaluates the impact of integrating music with exercise on depressive symptoms. METHODS: A comprehensive literature search was conducted across multiple databases. Randomized controlled trials of combined music and exercise therapy for patients with mild, moderate, or severe depression were included. Interventions included any exercise paired with music therap

Increased muscle satellite cell content and preserved telomere length in response to combined exercise training in patients with FSHD.

Facioscapulohumeral muscular dystrophy (FSHD) is an inherited muscle disease characterized by weakness and muscle wasting. In the absence of available treatments, exercise training has emerged as a potential strategy to attenuate muscle tissue deterioration. However, little is known about the impact of chronic exercise on degenerative events and regenerative capacity in FSHD muscle. Muscle biopsies were obtained from 16 FSHD patients before and after a 24 week training program combining aerobic-, strength- and high-intensity exercise (Control; n = 8, Training; n = 8). Histochemical and immunoh

Feasibility and Effectiveness of a 12-Week Concurrent Exercise Training on Physical Performance, Muscular Strength, and Myokines in Frail Individuals Living in Nursing Homes: A Cluster Randomized Crossover Trial.

OBJECTIVE: To examine the feasibility and effects of a 12-week exercise intervention on physical performance, muscular strength, and circulating myokines in frail individuals living in nursing homes. DESIGN: A cluster randomized, 2-period, 2-intervention crossover trial. SETTING AND PARTICIPANTS: Frail residents of 9 nursing homes were randomly assigned to either 12 weeks of concurrent exercise training (n = 5, 29 participants) or usual care (n = 4, 17 participants). The concurrent exercise training consisted of resistance and aerobic exercises (3 days/week). The usual care consisted of ever

Health-related quality of life in elderly cardiac patients undergoing cardiac rehabilitation and the association with exercise capacity: the EU-CaRE study.

AIMS: The ability to be physically active is pivotal to the quality of life in elderly patients. This study aims to describe the association between exercise capacity and health-related quality of life (HRQoL), anxiety, and depression following an exercise-based cardiac rehabilitation (CR) programme in elderly cardiac patients. METHODS AND RESULTS: Patients aged ≥65 years with acute and chronic coronary syndrome or heart valve surgery were consecutively included from eight CR centres in seven European countries. Exercise capacity [VO2peak(mL/kg/min)] was assessed with a cardiopulmonary exerci

Biventricular responses to exercise and their relation to cardiorespiratory fitness in pediatric pulmonary hypertension.

Despite exercise intolerance being predictive of outcomes in pulmonary arterial hypertension (PAH), its underlying cardiac mechanisms are not well described. The aim of the study was to explore the biventricular response to exercise and its associations with cardiorespiratory fitness in children with PAH. Participants underwent incremental cardiopulmonary exercise testing and simultaneous exercise echocardiography on a recumbent cycle ergometer. Linear mixed models were used to assess cardiac function variance and associations between cardiac and metabolic parameters during exercise. Eleven pa

Prehabilitation in patients awaiting elective coronary artery bypass graft surgery - effects on functional capacity and quality of life: a randomized controlled trial.

OBJECTIVE: To determine the impact of an exercise-based prehabilitation (EBPrehab) program on pre- and postoperative exercise capacity, functional capacity (FC) and quality of life (QoL) in patients awaiting elective coronary artery bypass graft surgery (CABG). DESIGN: A two-group randomized controlled trail. SETTING: Ambulatory prehabilitation. SUBJECTS: Overall 230 preoperative elective CABG-surgery patients were randomly assigned to an intervention (IG, n = 88; n = 27 withdrew after randomization) or control group (CG, n = 115). INTERVENTION: IG: two-week EBPrehab including supervised a

Effect of carvedilol on heart rate response to cardiopulmonary exercise up to the anaerobic threshold in patients with subacute myocardial infarction.

Resting heart rate (HR) plus 20 or 30 beats per minute (bpm), i.e., a simplified substitute for HR at the anaerobic threshold (AT), is used as a tool for exercise prescription without cardiopulmonary exercise testing data. While resting HR plus 20 bpm is recommended for patients undergoing beta-blocker therapy, the effects of specific beta blockers on HR response to exercise up to the AT (ΔAT HR) in patients with subacute myocardial infarction (MI) are unclear. This study examined whether carvedilol treatment affects ΔAT HR in subacute MI patients. MI patients were divided into two age- and se