Vol 3-3 Original Research Article

Utility of A Cardiorenal Monographic Consultation to Reduce The Cardiovascular Mortality of The Renal Transplant Patient

Juan de Dios Arjona-Barrionuevo1, Manuel Gonzales Vargas-Machuca2, Francisco José Guerrero-Márquez3*, Luis Gil-Sacaluga4, Miguel Ángel Gentil-Govantes4

1Department of Cardiology, Hospital University Virgen del Rocio, Seville, Spain

2Departament of Cardiology, Hospital San Juan de Dios del Aljarafe, Bormujos (Seville), Spain

3Department of Cardiology, Hospital de la Serrania Ronda, Spain

4Department of Nephrology, Hospital University Virgen del Rocio, Seville, Spain

Introduction and objectives: WHO recognizes chronic kidney disease as a serious health problem with increasing incidence and prevalence. In our midst, the first cause of death in renal replacement therapy is cardiovascular disease (CVD), especially ischemic. We studied and follow-up of candidates for renal transplantation and subsequently transplanted, With the objective of knowing the ischemic load and reducing the mortality of the transplant.

Methods: In November 2005, we began a cardiorenal monographic consultation for the study of all patients with chronic renal disease with a high cardiovascular risk who were candidates for renal transplantation who underwent coronary angiography, according to the protocol prior to transplantation, were studied.

Results: From November 2005 to December 2013, 313 patients were studied, 64% males, 56.7 ± 11 years old. The Prevalence of significant coronary lesions: 39.3%, 54.4, % of more than one vessel. Silent: 32.4%, 47.6% more than one glass. Total mortality of candidates: 10.2%. Cardiovascular: 4.8%. Total transplant mortality: 5.3%, cardiovascular: 2.1%. Cardiovascular mortality of the revascularized transplant patient: 0%.

Conclusions: Screening and intervention on CVD, leven preventive, reduce total and cardiovascular mortality of the transplant, extending this benefit to those remaining on dialysis. In our hospital, CVD is no longer the leading cause of death in renal replacement therapy.

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Vol 3-3 Mini Review

The Effect of eHealth Interventions on Physical Activity in Patients with Chronic Obstructive Pulmonary Disease: A Mini Review

Yoshiki Tsuchida1#, Sigrid N.W. Vorrink2,3*

1Department of Physical Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan

2Utrecht University of Applied Sciences, Research Group Technology for Healthcare Innovations, Utrecht, Netherlands

3JointResearch, Department of Orthopaedic Surgery, OLVG Amsterdam, Netherlands

Physical activity (PA) is important for patients with chronic obstructive pulmonary disease (COPD). eHealth interventions may have the possibility to increase and maintain PA. The objective of this mini review is to provide an overview of research published from 2016 to 2018 about the effect of eHealth on PA in patients with COPD.

Recent studies used phone calls, websites combined with monitoring devices and smartphone applications as eHealth interventions. These studies showed both positive and no effects of eHealth interventions on PA in patients with COPD. The effects seem to depend on the type of eHealth intervention. A multicomponent eHealth intervention including reinforcement, self-management, monitoring and exercise with phone calls, websites and pedometers may be useful for stimulating PA for short-term periods.

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Vol 3-3 Case Report

A Pericardial Cyst Causing Obstructive Shock

Mit Patel*, Injoon Lee, Neel Parikh, David Sane, Thomas Bishop

Virginia Tech Carilion School of Medicine, USA

Pericardial cysts are rare anomalies that are usually benign and asymptomatic. A prompt intervention is necessary when patients present with concerning clinical features. We report a case of pericardial cyst causing obstructive shock in a patient that underwent bowel resection after small bowel obstruction. Our patient underwent emergent cyst aspiration which alleviated the shock.

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Vol 3-3 Commentary

Commentary: Teaching Games of Understanding (TGfU) coaching effects on Heart Rate among Malaysian and Indian Junior Hockey Players

Sanmuga Nathan*

Sultan Idris Education University, Malaysia

Teaching Games for Understanding (TGfU) offers tactical-technical instruction is gaining international recognition for its ability to produce intelligent players via a problem-solving approach in game play such as hockey. However the effect of TGfU pedagogical approach through small side game play (SSG) towards physiology components of Heart Rate (HR) still takes a backseat compared to research on tactical decision making and skill execution that has been studied widely. SSG proposed in TGfU approach dwells around duration of game play (load), how fast the SSG game manouvers (intensity) and players cardiovascular fitness can be detected by HR tool and therefore HR crucial to be investigated. This quasi-experimental study investigated the effect of TGfU compared to skill mastery instruction, termed as Skill Drill Technical (SDT), among Malaysian and Indian elite junior hockey players in terms of SSG game play intensity via heart rate (HR) measurement at different points of game play. A total of n = 60 players with an average age of 15 ± 1.03 were selected via simple random technique from both countries involved in this study and assigned equally into groups, with 15 players per group for TGfU and for SDT across Malaysia and India. Gathered data were analysed using the ANOVA and ANCOVA techniques. There was significant higher warm-up HR bpm among players via TGfU compated to SDT across the two countries. Whereas HR bpm immediately after the 5 vs. 5 game play intervention and HR bpm after three minutes’ recovery, Indian players with TGfU recorded a higher and significant difference compared to SDT. However, in contrast, findings indicated no significant difference between these two instruction models among Malaysian player. Therefore, overall findings reiterated that TGfU is a useful approach for game play to enhance intensity and cardiac output through HR bpm measurement. In conclusion, future research can employ together HR and RPM (Borg Scale) or electronic device for more accurate reading coupled 6 sec and 15 sec HR readings. Future study, should too address the effect of TGfU on different variation of small sided game play intensity along skill execution and tactical decision making.

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Vol 3-4 Original Research Article

Long Term Health Outcomes Following Coronary Artery Bypass Grafting: A Different Journey for Men and Women

G.M. Lindsay*, P.R. Ponaiah, I. Nomani, S.M. Lamadah, N.A. Tayyib and A. Johargy

College of Nursing, Umm Al-Qura University, Taif Road, Makkah, Saudi Arabia

Background: The applicability of the Short Form (SF36) questionnaire to disparate populations led us to use this tool to investigate how health-related quality-of-life (HRQoL) for patients who underwent coronary artery bypass grafting (CABG) is related to gender, age and survival.

Method: SF36 data and the presence of cardiac symptoms were collected from 44 women and 166 men prior to surgery and from consenting survivors at one and eight-year follow-ups. Survival data were collected from government records for 18 years post operation. Paired t-tests, Pearson correlation coefficients, chi-squared tests and the log-rank test were used to investigate connections between HRQoL and age, presence of angina/breathlessness and survival within and across genders.

Results: HRQoL improved significantly for males and females in almost all health domains at the one year follow-up. At the eight year follow-up most female domain scores showed further improvement whereas the majority of male domain scores declined. Cardiac symptoms were present in 75.8% of women and 68.3% of men (χ2=0.7120, p=0.3988) at the one-year follow-up, and 84.2% of women and 70.2% of men at the eight-year follow-up. Male long term survival (53.6% after 18 years) depended significantly on retaining post-operative improvements in HRQoL to the medium term (p<0.002 in 4 of 8 domains). Female long term survival (40.9%) was significantly less than male survival (p=0.0108) and depended on maintaining a steady upward trend in HRQoL over the medium term. Age was not a determinant in HRQoL following CABG. Long term male and female survival was not significantly different and approached those of age and gender matched samples from the general population.

Conclusion: Strategies to improve HRQoL in women may support improved survival by reducing excess short term female mortality, but the effectiveness of the same strategy for men is less apparent.

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