Rehab Centers: Pharmacist Intervention in Cardiac Rehabilitation: A RANDOMIZED CONTROLLED TRIAL.

Pharmacist Intervention in Cardiac Rehabilitation: A RANDOMIZED CONTROLLED TRIAL.

Filed under: Rehab Centers

J Cardiopulm Rehabil Prev. 2012 Nov; 32(6): 394-9
Alsabbagh MW, Lemstra M, Eurich D, Wilson TW, Robertson P, Blackburn DF

: We aimed to determine to what extent a telephone-based pharmacist intervention would (a) be utilized by individuals not attending a traditional cardiac rehabilitation (CR) program and (b) facilitate adherence to cardiovascular medications.: We conducted a randomized, controlled open-label trial among patients eligible for CR in Saskatoon, Canada. Patients were invited to participate in telephone-based CR, regardless of participation in the formal program. Subjects in the intervention group were assessed by the CR pharmacist and received education and counseling on medication adherence. The primary endpoint was adherence to cardiovascular medication assessed by electronic filling records over a minimum of 6 months. Mean adherence was expected to reach 70% during the followup period.: Patient recruitment was halted early because of low enrollment. Of the 95 patients randomized, 90% had also registered in the traditional CR program. During the followup period, 129 telephone interactions were performed (median, 2 calls), with every subject taking part in at least 1 interaction. Over the study period, the mean adherence to all recently initiated cardiovascular medications combined was 88.8% in the intervention group and 89.9% in the usual care group (P = .73).: Participation in traditional CR programs does not appear to be influenced by the availability of telephone-based education and support. Furthermore, the high rate of adherence among the control group may suggest that CR programs are attracting “healthy adherers” who volunteer for such programs, while missing those with the greatest need for health care system resources.
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Differences in hemodynamic parameters and exercise capacity between patients with pulmonary arterial hypertension and chronic heart failure.

Filed under: Rehab Centers

J Cardiopulm Rehabil Prev. 2012 Nov; 32(6): 379-85
Nishio R, Tanaka H, Tsuboi Y, Kinutani H, Taniguchi Y, Shigeru M, Toh R, Miura Y, Sakai Y, Emoto N, Kawai H, Hirata K

: Although pulmonary arterial hypertension (PAH) and chronic heart failure (CHF) lead to exercise limitation, their pathophysiology is different. Our objective was to evaluate, using right heart catheterization and cardiopulmonary exercise testing, the difference in hemodynamic parameters and exercise capacity between PAH and CHF, which have the same subjective symptoms.: We studied 20 PAH (mean pulmonary artery pressure: 36 ± 10 mmHg, all . 25 mmHg) and 20 CHF (ejection fraction: 35 ± 10%, all < 40%) patients who underwent both cardiopulmonary exercise testing and right heart catheterization. All patients were in New York Heart Association functional class II or III.: Peak oxygen uptake (VO2) was lower for PAH patients than for CHF patients (11.7 ± 3.2 mL·kg·min vs 14.5 ± 4.6 mL·kg·min, P = .03), while the slope of ventilation to carbon dioxide production ratio (VE/VCO2) was higher for PAH patients than for CHF patients (41.0 ± 12.7 vs 28.0 ± 9.0, P = .001), despite the similarity in their New York Heart Association functional class. Peak VO2 and VE/VCO2 correlated with cardiac index for both groups. An important finding was that peak VO2 correlated with pulmonary vascular resistance for PAH patients (r = 20.46, P = .04) but not for CHF patients (r = 0.33, P = .15). Furthermore, peak VO2 correlated with pulmonary capillary wedge pressure for CHF patients (r = 20.47, P = .03) but not for PAH patients (r = 0.17, P = .47), while the VE/VCO2 slope correlated with pulmonary capillary wedge pressure (r = 0.67, P = .002) but not with pulmonary vascular resistance (r = 0.12, P = .63) for CHF patients.: Peak VO2 and VE/VCO2 slope were worse for PAH patients than for CHF patients despite the similar subjective symptoms. This difference might be explained by an altered hemodynamic status. HubMed – rehab

Elevated serum levels of high mobility group box protein 1 (HMGB1) in patients with ankylosing spondylitis and its association with disease activity and quality of life.

Filed under: Rehab Centers

Rheumatol Int. 2012 Nov 10;
Oktayoglu P, Em S, Tahtasiz M, Bozkurt M, Ucar D, Yazmalar L, Nas K, Yard?meden I, Cevik F, Celik Y, Mete N

This study was carried out to determine the serum levels of high mobility group box protein 1 (HMGB1) in patients with ankylosing spondylitis (AS) and to evaluate its correlation with disease activity and quality of life. According to our knowledge, it is the first trial evaluating HMGB1 levels in AS. Serum samples of 30 patients (18 males and 12 females) with AS and 29 healthy controls (HC) (15 females and 14 males) were collected. HMGB1 levels were measured by enzyme-linked immunosorbent assay, activity of disease was assessed according to the Bath AS Disease Activity Index (BASDAI), and functional status of patients was evaluated with Bath AS Functional Index (BASFI). Modified Schober, chest expansion values and AS Quality of Life Questionnaire (ASQoL) scores were noted. The serum levels of HMGB1 were obtained significantly increased in AS patients compared to HC (p < 0.05). There was no significant correlation between HMGB1 levels and ESR (p > 0.05), and CRP (p > 0.05) values. BASDAI, BASFI and ASQoL scores were also not correlated with serum levels of HMGB1 (p > 0.05). Our results suggest that HMGB1 might play an important role in the pathogenesis of AS; however, it seems not to be a good candidate for reflecting disease activity, functional abilities and the quality of life in patients with AS; on the other hand, the increased levels of HMGB1 in patients may open a new dimension for targeting this cytokine as a new therapy option in AS.
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