The Canadian journal of cardiology
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Randomized Controlled Trial Comparative Study
Early exercise-based rehabilitation improves health-related quality of life and functional capacity after acute myocardial infarction: a randomized controlled trial.
The purpose of this study was to evaluate the influence of an early cardiac rehabilitation (CR) program on health-related quality of life (HRQL) and functional capacity in patients who recently experienced an acute myocardial infarction (AMI). This program was initiated in the inpatient setting and was followed by an unsupervised outpatient intervention. ⋯ A CR program based on early progressive exercises, initiated by supervised inpatient training and followed by an unsupervised outpatient program, improved HRQL and functional capacity in patients at low cardiovascular risk who recently experienced an AMI.
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Case Reports
How long should resuscitative efforts be continued in adult out-of-hospital cardiac arrest?
The neurological prognosis of out-of-hospital cardiac arrest (OHCA) is extremely poor, particularly in patients who require prolonged cardiopulmonary resuscitation (CPR). However, the upper limit of CPR duration is unclear. ⋯ There are some patients for whom CPR duration might not be associated with prognosis. To determine when to terminate resuscitative efforts or whether more lifesaving medical resources should be provided, a prognostic indicator other than CPR duration is needed.
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Severe obesity is associated with increased morbidity and mortality and represents a major health care problem with increasing incidence worldwide. Bariatric surgery, through its efficacy and improved safety, is emerging as an important available treatment for patients with severe obesity. Classically, bariatric surgery has been described as either a restrictive or a hybrid surgery, which is a combination of restriction and malabsorption. ⋯ Studies on postoperative outcomes, investigations on weight loss physiology, and mechanism of action after bariatric surgery provide a better understanding of the bariatric surgery metabolic benefits. In this article, we present an overview of bariatric procedures with their effects, including risks and benefits, on the severely obese patients' health. It provides evidence to support surgical treatment of severe obesity to achieve cardiovascular disease risk reduction in severely obese patients.
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Obesity has reached epidemic proportions in the general population and is associated with an increased risk for the development of new-onset heart failure (HF). However, in acute and chronic HF, overweight and mild to moderate obesity is associated with substantially improved survival compared with normal weight. ⋯ Newer studies have explored the use of other measures of body fat and body composition, including waist circumference, waist-to-hip ratio, skinfold thickness, and bioelectrical impedance analysis of body composition. The relationship between the obesity paradox and cardiorespiratory fitness in HF is also discussed in this review, and we explore the various potential explanations for the obesity paradox and summarize the current evidence and guidelines for intentional weight loss treatments for HF in the obese population.
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Overweight/obesity has been associated with increased risk for several conditions, including hypertension, hypercholesterolemia, diabetes mellitus, heart disease, and stroke. The morbidity associated with overweight and obesity translates into excess mortality risk, which is observed even when increased weight is not associated with metabolic abnormalities. The achievement of moderate weight loss, regardless of the treatment strategy, is associated with favorable clinical outcomes, including significant reduction in the incidence of type 2 diabetes and blood pressure levels. These data suggest that weight loss might be a useful therapeutic objective in the prevention and management of comorbidities associated with overweight/obesity.