Aims: To evaluate the effectiveness of a hybrid cardiac telerehabilitation (HCTR) program after acute coronary syndrome (ACS) on patient quality of life (QoL) and physical activity indices throughout phases 2-3 and establish predictors for hybrid program self-selection. Methodology: This single-centre longitudinal retrospective study included patients who attended a cardiac rehabilitation program (CRP) between 2018-2021. Patients self-selected between two groups: Group 1 – conventional CRP (CCRP); Group 2 – HCTR. Baseline characteristics were registered. EuroQol-5D (EQ-5D) and International Physical Activity Questionnaire (IPAQ) were applied at three times: T0 – phase 2 onset; T1 – phase 3 onset; T2 – 3 months after T1. Results: 59 patients participated (Group 1 – 27; Group 2 – 32). We found significant between-group differences regarding occupation (p=0.003). Diabetic patients were less likely to self-select into HCTR (OR=0.21; p<0.05). EQ-5D visual analogue scale and IPAQ result significantly improved between T0-T2 only for HCTR (p=0.001; p=0.021). Conclusions: HCTR was superior to CCRP on physical activity indices and QoL of ACS patients.
Aggressive lipid lowering has been shown to be a crucial part of secondary prevention after acute coronary syndrome (ACS). The selection of the best lipid-lowering agents is controversial, with some trials showing rosuvastatin as more efficacious in improving lipid profile compared to atorvastatin, others showing no difference. Another concern is the impact of statin therapy on the reduction of muscle oxidative capacity, and, consequently, on functional capacity. This study aimed to analyse the differences in lipid profile and physical capacity in post-ACS patients undergoing a cardiac rehabilitation program (CPR), medicated with rosuvastatin versus atorvastatin. A retrospective analysis of patients in phase 2 of CRP between 2017 and 2020 was performed. Two groups were created: group 1 for patients under atorvastatin 40 mg and group 2 under rosuvastatin 20 mg. Variables were analysed at the beginning and the end of phase 2, 12 weeks later. A P-value < 0.05 is statistically significant. A total of 98 patients completed phase 2 of CRP, of which 14 are part of group 1, 67 of group 2, and 17 users of other lipid-lowering drugs. Table 1 shows the main characteristics. Univariate (table 2) and multivariate analyses show no differences regarding lipid profile or functional activity between groups. In conclusion, in this group of patients, high-intensity rosuvastatin and atorvastatin in secondary prevention post-ACS had a comparable impact on lipidic profile, without a significant difference in functional activity, independently of age, sex or comorbidities. Larger randomized prospective trials, including phase 3 of CRP, are needed to confirm these results.
Ankle tuberculosis is a relatively rare condition and may develop after hematogenous dissemination from the pulmonary origin, particularly in cases of immunosuppression. Both pregnancy and delivery are relatively immunosuppressive states, and immune modulations during these periods can contribute to the pathogenesis of disseminated tuberculosis. A 26-year-old mother presented with severe, continuous, and debilitating pain in the left ankle, lasting for three months after delivery and associated with fever. Inspection demonstrated ankle swelling and redness, with a cold and cyanotic forefoot. Ankle radiograph and musculoskeletal ultrasound evaluation were obtained. Tibiotalar joint arthrocentesis revealed purulent liquid suggestive of septic arthritis and an emergent arthroscopic washout of the ankle was performed. The synovial mycobacterial culture was posteriorly positive and the diagnosis established was both pulmonary and osteoarticular tuberculosis. A comprehensive rehabilitation program was then implemented to achieve maximum functional gains. This report presents a rare case of ankle tuberculosis diagnosed in the postpartum period. Early evaluation, treatment, and adequate rehabilitation interventions can be crucial to promote functionality and enhance the quality of life.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.