Current Issue : July - September Volume : 2019 Issue Number : 3 Articles : 5 Articles
Background: Flight and cabin crew are known to be at increased risk for\natherosclerotic cardiovascular disease (ASCVD). However, ASCVD risks have\nnot yet been compared in flight and cabin crew in low resource settings like\nsub-Saharan Africa. Objectives: To assess absolute ASCVD risk estimate and\nits clinical correlates among flight and cabin crew. Methods: From June 1st\n2015 to December 30th 2015, 379 consecutive aviation navigants (Flight crew:\n62.5%, pilots: 46.2%, women: 29.6%, Caucasians 23.2%) were enrolled in a\ncross-sectional survey of ASCVD risk estimate using the Framingham tools.\nThey underwent a physical examination for either initial or renewal medical\ncertificate Class 1 or 2 including blood chemistry, ECG, and echocardiogram\nas per International Civil Aviation Organization (ICAO) and Civil Aviation\nAuthority (CAA-DRC) medical regulations. We modeled the risk of moderate\nand high ASCVD estimate in a stepwise logistic regression. Results: Low,\nmoderate and high ASCVD risk estimates were observed respectively in 248\n(65.4%), 64 (16.9%), and 67 (17.7%) navigants. Moderate and high ASCVD\nrisk estimates predominated among flight than cabin crew (23.6% vs. 5.6%; p\n< 0.0001 and 28.3% vs. null; p < 0.001), low ASCVD risk estimate among cabin\n than flight crew ...............
Hospitalization in the cardiac care unit can increase anxiety in patients. This study aimed\nto compare hand reflexology versus acupressure on anxiety and vital signs in female patients with\ncoronary artery diseases. This double-blinded randomized placebo-controlled trial with a pre-and\npost-intervention design was conducted on 135 female patients with coronary artery diseases.\nFemale patients hospitalized in a cardiac care unit were randomly divided into three groups of hand\nreflexology, acupressure and placebo (n = 45 patients in each group) using blocking and a table of\nrandom numbers. Data was collected using the Spielberger anxiety inventory. Also, their vital signs\nwere measured before, immediately after and half an hour after the intervention. Data analysis was\nperformed using descriptive and analytical statistics. Before the intervention, there was no\nstatistically significant difference in anxiety levels between the groups (p > 0.05). Also, the effects of\nhand reflexology and acupressure immediately and half an hour later on the reduction of anxiety\nand vital signs were equal (p < 0.05). Implementation of hand reflexology and acupressure can have\npositive effects on anxiety and vital signs in patients with coronary artery diseases. They can reduce\npatientsâ?? anxiety with an equal effectiveness....
Background: Cardiovascular disease (CVD) is the main cause of morbidity and mortality in Sweden. This study aims to\nassess the impact of a CVD intervention implemented in 1993 in northern Sweden on the reduction of premature\nischemic heart disease (IHD) morbidity and mortality in women and men during the period 1987-2013.\nMethods: An ecological controlled interrupted time series design, with pre-intervention period defined as 1987-1993\nand post-intervention period 1994-2013 was carried out. For each year, IHD events, stratified by sex, were retrieved\nfrom national registers.\nResults: Impressive reductions on IHD premature morbidity and mortality were observed to a similar degree in both\nthe intervention county and the other comparison counties across the last 27 years. Significant differences in the\npre-post intervention trends indicating the intervention group had smaller reductions than expected from its preintervention\ntrend and the trend of control counties were found among men for both IHD morbidity and mortality.\nA similar pattern was observed among women but without significant differences.\nConclusions: Taken together, the data do not support that the intervention has contributed to an additional reduction\non IHD morbidity and mortality, above and beyond that which is already seen in neighbouring counties without\nsimilar programs....
Amiodarone is recommended for shock-refractory ventricular arrhythmia during\nresuscitation; however, it is unknown whether amiodarone is effective for preventing ventricular\narrhythmia recurrence in out-of-hospital cardiac arrest (OHCA) survivors treated with targeted\ntemperature management (TTM). We investigated the effectiveness of prophylactic amiodarone\nin preventing ventricular arrhythmia recurrence in OHCA survivors. Data of consecutive adult\nnon-traumatic OHCA survivors treated with TTM between 2010 and 2016 were extracted from\nprospective cardiac arrest registries of four tertiary care hospitals. The prophylactic amiodarone\ngroup was matched in a 1:1 ratio by using propensity scores. The primary outcome was\nventricular arrhythmia recurrence requiring defibrillation during TTM. Among 295 patients with an\ninitially shockable rhythm and 149 patients with initially non-shockable-turned-shockable rhythm,\n124 patients (27.9%) received prophylactic amiodarone infusion. The incidence of ventricular\narrhythmia recurrence was 11.26% (50/444). Multivariate analysis showed prophylactic amiodarone\ntherapy to be the independent factor associated with ventricular arrhythmia recurrence (odds ratio\n1.95, 95% CI 1.04-3.65, p = 0.04), however, no such association was observed (odds ratio 1.32,\n95% CI 0.57-3.04, p = 0.51) after propensity score matching. In this propensity-score-matched study,\nprophylactic amiodarone infusion had no effect on preventing ventricular arrhythmia recurrence in\nOHCA survivors with shockable cardiac arrest. Prophylactic amiodarone administration must be\nconsidered carefully....
Background: The aims of this study were to determine the geographic and time variation of social determinants of\nhealth (SDH) and cardiovascular disease (CVD) mortality in Panama from 2012 to 2016, and to identify which of the\nSDH has the strongest correlation with a socioeconomic index (SEI).\nMethods: We conducted an ecological study obtaining mortality from the National Mortality Register and\nsocioeconomic variables derived from the National Household Survey (NHS). The International Classification of\nDiseases 10th revision codes I20-I25 and I60-I69 were used for ischemic heart disease (IHD) and stroke, respectively.\nStandardized age-adjusted mortality rates were calculated by direct method. Mortality rates and socioeconomic\nvariables were evaluated together in a panel data model. A SEI was developed from factorial analysis by principal\ncomponents with a polychoric correlation matrix. Provinces and regions were categorized in tertiles according to\nmedian value of the SEI score. Results: The NHS evaluated an average of 15,919 households per year. The mean of age throughout the study\nperiod was 41 years. The average monthly income increased, from US$ (SD) 331.94 (5.38) in 2012, to 406.24 (5.81) in\n2016, whereas the social security health coverage remained in a range of 57-58%. The mean number of school\nyears was twelve. Significant geographical and temporal variations in social determinants and mortality rates were\nobserved throughout the country. Colon, categorized in the middle tertile according to the SEI, presented higher\nIHD mortality rates. Darién (in the lowest SEI tertile) Colón and Herrera had higher stroke mortality rates. The SEI\ncategorized indigenous territories in the lowest tertile. Total years of education was the strongest correlated\nvariable with the SEI, when we excluded the population living in indigenous territories. However, when this\npopulation was included, social security coverage had the strongest correlation with the SEI.\nConclusion: We observed geographical and temporal disparities in SDH and CVD mortality rates. Further epidemiological\nstudies are warranted in the provinces of Colón, Darien, Herrera and Los Santos to explore in-depth the higher CVD\nmortality rates observed in these provinces....
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