Objective This study evaluated the effectiveness, feasibility, and safety of early rehabilitation for patients after coronary artery bypass graft (CABG) surgery. Methods In a three-arm randomized controlled trial, patients who underwent CABG from January 2018 to June 2018 were randomly assigned to one of three groups: (i) usual care (UC group); (ii) UC + single general ward rehabilitation (SGR group); and (iii) UC + general ward rehabilitation and intensive care unit (ICU) rehabilitation (IGR group). The primary outcome was the Barthel Index scores. Results The Barthel Index score for UC (75.3 ± 12.1) was significantly lower than that of both SGR (86.2 ± 14.1) and IGR (89.1 ± 15.5). There was no significant difference in the Barthel Index scores between the SGR and IGR groups. Statistically significant differences were found in the length of ICU stay and post-operative hospital stay but not in post-operative pulmonary complications (PPC) or atrial fibrillation between the three groups. Conclusion Early rehabilitation implemented during ICU stay and on the general ward resulted in significant improvements in functional independence and could be a safe part of routine care post-CABG.
Objectives The purpose of this study was to investigate the relationship between speech-frequency hearing loss (SFHL), high-frequency hearing loss (HFHL), and cognitive impairment (CI). Then to determine whether there are any differences in gender among older community dwellers in China. Methods This study involved 1,012 adults aged ≥ 60 years (428 male; average age, 72.61 ± 5.51 years). The participants had their hearing and cognition measured using pure tone audiometry and Mini Mental State Examination (MMSE), respectively. We used the audiometric definition of hearing loss (HL) adopted by the World Health Organization (WHO). Speech-frequencies were measured as 0.5 kHz, 1 kHz, 2 kHz, and 4 kHz; high-frequencies were measured as 4 kHz and 8 kHz. Pure tone average (PTA) was measured as hearing sensitivity. Results Our studies demonstrated a 37.6% prevalence of HL in males and a 36.0% prevalence of HL in females. Adjusted for confounding variables, the results from a multivariate analysis showed that SFHL was associated with CI in females (OR = 2.400, 95% Confidence Interval = 1.313–4.385) and males (OR = 2.189, 95% Confidence Interval = 0.599–2.944). However, HFHL was associated with CI only in females (OR = 2.943, 95% Confidence Interval = 1.505–5.754). HL was associated with poorer cognitive scores (P < 0.05). “Registration” (P < 0.05) in MMSE was associated with speech- and high-frequency hearing sensitivity. Conclusion The associations between HL and CI varied according to gender in older community-dwellers, suggesting that different mechanisms are involved in the etiology of HL. Moreover, hearing sensitivity was negatively associated with cognition scores; therefore, early screening for HL and CI among older community-dwelling adults is advised.
Objective. There can be extreme variability between individual responses to exercise training, and the identification of genetic variants associated with individual variabilities in exercise-related traits could guide individualized exercise programs. We aimed to screen the exercise-related gene sensitivity of patients with acute myocardial infarction after PCI by establishing the gene spectrum of aerobic exercise and cardiopulmonary function sensitivity, test the effect of individualized precision exercise therapy, and provide evidence for the establishment of a precision medicine program for clinical research. Methods. Aerobic exercise- and cardiopulmonary function-related genes and single-nucleotide polymorphisms (SNPs) were obtained by data mining utilizing a major publicly available biomedical repository, the NCBI PubMed database. Biological samples from all participants underwent DNA testing. We performed SNP detection using Samtools. A total of 122 patients who underwent PCI were enrolled in the study. We screened the first 24 cases with a high mutation frequency for aerobic exercise- and cardiopulmonary function-related genes and the last 24 cases with a low mutation frequency and separated them into two groups for the exercise intervention experiment. Results. In both the low mutation frequency group and the high mutation frequency group, after 8 weeks of exercise intervention, 6 MWT distance, 6 MWT%, VO2/kg at peak, and VO2/kg at AT were significantly improved, and the effect in the high mutation frequency group was significantly higher than that in the low mutation frequency group (6 MWT distance: 468 vs. 439, P = 0.003 ; 6 MWT%: 85 vs. 77, P = 0.002 , VO2/kg at peak: 14.7 vs. 13.3, P = 0.002 ; VO2/kg at AT: 11.9 vs. 13.3, P = 0.003 ). Conclusions. There is extreme variability between individual responses to exercise training. The identification of genetic variants associated with individual variabilities in exercise-related traits could guide individualized exercise programs. We found that the subjects with a high mutation frequency in aerobic exercise and cardiopulmonary function-related genes achieved more cardiorespiratory fitness benefits in the aerobic exercise rehabilitation program and provided evidence for the establishment of a precision medicine program for clinical research.
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