Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Knowledge about dietary fibre and its health benefits: A cross-sectional survey of 2536 residents from across Croatia

This cross-sectional study is aimed at identifying the level of understanding of the health benefits of dietary fibre in the prevention of disease, as well as the association between that understanding and fibre consumption in the Croatian population. We believe that nutritional knowledge is important for the consumption of healthy food which includes also a positive reflection on food habits and health. Only well-informed consumers can shop effectively for food rich in dietary fibre and thereby derive the health benefits that fibre can offer. We suppose the association between that understanding and fibre consumption in the Croatian population. However, this knowledge is not the only important determinant; food purchases are influenced by socioeconomic and demographic factors. Our hypothesis is that the level of knowledge about fibre and fibre consumption varies with age, gender, education level and urban or rural environment. It is our assumption that life styles, environmental conditions and education can affect the level of knowledge and perception about healthy eating habits. If this assumption is accurate, targeted education campaigns to educate and sensitise the population about fibre-rich foods and the health benefits of fibre is a priority. Public health programmes are urgently needed, particularly in rural areas, to sensitise the population to fulfill the recommended fibre intake, high-fibre food sources and the mechanisms by which fibre can help prevent disease.info:eu-repo/semantics/publishedVersio

Role of Calcium and Low-Fat Dairy Foods in Weight-Loss Outcomes Revisited: Results from the Randomized Trial of Effects on Bone and Body Composition in Overweight/Obese Postmenopausal Women

Several studies have investigated the possibility of dairy foods and calcium (Ca) mediating weight and body composition, but a consensus has not been reached. We aimed to investigate weight-loss-related outcomes during intervention with low-fat dairy foods or Ca + vitamin D supplements, both as complements to hypocaloric diets. Overweight/obese Caucasian, early-postmenopausal women (n = 135) were recruited for a 6 month energy-restricted weight loss study complemented with either low-fat dairy foods (D; 4&#8722;5 servings/day), or Ca + vitamin D supplements (S); both to amount a total of ~1500 mg/day and 600 IU/day of Ca and vitamin D, respectively, or placebo pills (C). Bone mineral density (BMD) and lean and fat tissue were measured by Lunar iDXA. Serum and urinary markers of bone turnover were analyzed. Diet and physical activity were assessed with 3-day records. Participants on average lost ~4%, ~3%, and ~2% of body weight, fat, and lean tissue, respectively. The significantly better outcomes were noticed in participants in the D group regarding body composition (fat loss/lean tissue preservation) and in participants in the S group regarding the BMD outcomes, compared to those in the C group. Therefore, increasing low-fat dairy foods to 4&#8722;5 servings/day and/or increasing Ca &amp; vitamin D intake by supplements (in those who are at the borderline dietary intake) may be beneficial for weight loss/maintenance and may lead to more favorable bone and body composition outcomes in postmenopausal women during moderate weight loss

Benefits of dietary fibre to human health: study from a multi-country platform

Purpose: Because dietary fibre has been recognized as a major ally to the maintenance of a healthy body as well as to help against the development of some chronic diseases, this work aimed at studying the level of knowledge of a relatively wide range of people about the health effects related to the ingestion of dietary fibre in appropriate dosages. Methodology: A descriptive cross-sectional study was undertaken on a non-probabilistic sample of 6010 participants. The data were collected from 10 countries in 3 different continents (Europe, Africa and America) and measured the level of knowledge regarding different health benefits from dietary fibre. The questionnaires were applied by direct interview after verbal informed consent. Findings: The results obtained considering the general level of knowledge revealed a considerable degree of information about the benefits of fibre (average score of 3.54±0.5, on a scale from 1 to 5). There were significant differences between genders (p<0.001), with higher average score for women, and also for level of education (p<0.001), with higher score for university level. The living environment also showed significant differences (p<0.001), with people living in urban areas showing a higher degree of knowledge. Also for countries the differences were significant (p<0.001), with the highest score obtained for Portugal (3.7), and the lowest for Croatia, Italy, Latvia, Macedonia and Romania (3.5). However, despite these differences, the results showed that for all the countries the degree of knowledge was good (above 3.5), corresponding to a minimum level of knowledge of 70%. Originality/Value: This work is considered important due to the wide coverage, including so many countries inclusive with different social and cultural settings. The study allowed concluding that, in general, the participants in the study were quite well informed about the benefits of dietary fibre for the improvement of human health, regardless of gender, level of education, living environment or country. This finding is very relevant considering the diversity of people that composed the sample and reinforces the necessity of continuing with educational policies aimed at providing the general population with the knowledge that might help them make appropriate food choices.info:eu-repo/semantics/publishedVersio

Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p &lt; 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures

International Impact of COVID-19 on the Diagnosis of Heart Disease

Background: The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. Objectives: The study sought to assess COVID-19's impact on global cardiovascular diagnostic procedural volumes and safety practices. Methods: The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. Results: Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoracic echocardiography decreased by 59%, transesophageal echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p &lt; 0.001 for each procedure). In multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower–middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and telehealth. Conclusions: COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19–related changes in care delivery is warranted