Particularities of traditional and novel atherosclerotic risk factors in women with peripheral arterial disease in a Romanian Rehabilitation Hospital

Introduction. The increasing prevalence of peripheral arterial disease (PAD) among women is becoming a general healthcare issue, as this populational group is still underrepresented in clinical trials and registries addressing this disease. The aim of this research is to determine women peculiarities in both classical and novel atherosclerosis risk factors in patients admitted in a Romanian Rehabilitation Hospital. Material and methods. 83 consecutive female patients with a mean age of 68.48±10.39 years, symptomatic PAD and a pathological ankle-brachial index were included in the analysis. Data regarding the traditional and novel cardiovascular risk factors, both clinical, biological and paraclinical parameters were all registered. A subgroup of 40 subjects had novel inflammatory markers (hs-CRP, IL-6 and TNF-α) measured, which were compared in a case-control manner to those of 17 agematched healthy controls. Results. Traditional risk factors most prevalent in our overall cohort were hypertension (85%), smoking (44.57%) and diabetes mellitus (45.7%). Mean ankle-brachial index was 0.47±0.17. Novel inflammatory markers were significantly higher in women with symptomatic PAD compared to healthy controls: hs-CRP (p<0.0001), IL-6 (p=0.0053 and TNF-α (p=0.005). Multivariate statistical analysis found ankle-brachial index (ABI)- (p<0.0001), diastolic blood pressure (p=0.0272), obesity (p=0.0445), LDL-cholesterol (p=0.0018), HDL-cholesterol (p=0.0092) and serum creatinine (p<0.0001) to be independent predictors for a more advanced PAD. 59% of the patients exhibited critical limb ischemia on admission, while 60.24% had at least one major arterial occlusion on angiography. Percutaneous revascularization was the most employed treatment method, with 42% of subjects receiving PTA compared to 21.7% in the surgical arm. Conclusion. Women with PAD have specific clinical and biological characteristics that ultimately affect treatment modality, prescription of a rehabilitation program and outcome

Inflammation and fibrosis in patients with atrial fibrillation and heart failure: is there a need for rehabilitation?

Background: Atrial fibrillation (AF) is increasingly prevalent among the general population as well as in those exhibiting heart failure (HF), and the symptomatology progressively worsens when both conditions are met. The aim of this study was to analyse the role of inflammation and fibrosis biomarkers in patients with AF and HF. Methods: 108 subjects with heart failure were enrolled in the study. All patients were evaluated clinically, biologically and echocardiographically. Plasma values of NT-proBNP, Gal-3 and sST2 were determined. Results: Out of all patients, 64.8% experienced at least one AF event. There were no differences in the mean left ventricular ejection fraction between the groups, which was 39.4 ± 11.2%. In terms of left atrium dimensions, the values in the AF group were significantly higher ( 51.19 ± 7.3 vs. 44.68 ± 7.16 mm, p<0.001). AF history was associated with a trend of decreased eGFR - 59,22±24,1 ml/min/1.73m3 vs 75,95±29,1 ml/min/1.73m3 (p=0.006). There was no statistically significant difference in the level of HF biomarkers (sST2, Galectin-3 and NT-pro BNP) between individuals with or without AF. Conclusion: Patients with HF are at greater risk to develop AF. HF biomarkers (sST2, Galectin-3 and NT-pro BNP) are not influenced by the presence of AF

Cardiac rehabilitation after catheter ablation of atrial fibrilation

Atrial fibrillation is the most common arrhythmia worldwide. Besides antiarrhythmic drugs and electrical cardioversion, atrial fibrillation can be treated with a newer technique called catheter ablation. Patients suffering a catheter ablation can benefit from an integrated rehabilitation programme like all other patients suffering a cardiac surgery. Physical training and psycho-educative consultations are specific after catheter ablation and integrated rehabilitation can improve mental health, physical capacity and permits return to sports activities

Periodontitis and Heart Disease: Current Perspectives on the Associative Relationships and Preventive Impact

Due to the important advancement and the accumulation of new evidence on the periodontitis-cardiovascular disease (CVD) relationship as well as the major medical, economic and social burden caused by both diseases this chapter aims to review existing epidemiological and pathogenetic links related to this topic. Also, this chapter aims to highlight the impact of the periodontitis-CVD relationships on clinical practice and on the preventive approaches targeting to decrease the impact of periodontitis on CVD. Periodontitis is an infectious disease eliciting local and general inflammation, which leads to periodontal destruction and systemic involvement. Several pathways could explain the link between periodontitis and CVD such as bacteraemia, chronic persistent systemic inflammation and oxidative stress. The first step in the treatment of periodontitis addresses the elimination of microbial components, which lead to a decrease in local and systemic inflammation. Periodontal therapy seems to positively impact CVD. Specialists should inform patients with CVD on the negative impact of periodontitis on their systemic status and refer patients to the periodontist for an extensive examination as routine management of CVD. Some possible risks of periodontal therapy should be considered in patients undergoing antithrombotic medication

STRESS AND MODAL ANALISYS REPORT FOR AVERT PROGRAM

This report presents a modal and a static analysis of the assembly wing-flap ,using the finite element software’s ANSYS 11 PATRAN-NASTRAN 2007. The geometry was created in Catia V5 R18and imported. The results from the modal analysis refer to the natural frequencies and represent the displacement vector sum for each frequency. For the static analysis, 17 zones of pressure were chosen. For each zone the pressures values were calculated using the pressure distribution resulted from the INCAS subsonic wind tunnel experiments. For this analysis the results consist in the displacement vector sum and the Von Mises equivalent stress

The role of cardiopulmonary exercise testing in the initial evaluation of patients wearing intracardiac devices submitted to cardiac rehabilitation

Cardiopulmonary exercise testing(CPET) can be used to determine the maximum exercise capacity, to identify the factors that cause a limitation of the patient’s functional capacity, to evaluate symptoms triggered by physical exercise and to reveal specific complications related to intracardiac devices that might occur during the physical rehabilitation program. The rehabilitation of a patient that is wearing an intracardiac device raises some particular issues besides the ones that we meet in a conventionally treated cardiovascular patient. Several clinical studies have shown that the programming mode of the cardiac pacemakers can have a significant influence on the patients exercise capacity, a crucial element of any physical rehabilitation program. CPET is one of the most accurate and comprehensive methods for the evaluation of the pacemaker-wearing patients, being able to optimize their functional capacity and, therefore, should be recommended in all patients before inclusion in cardiac exercise rehabilitation programs

Incidental Discovery of a Cardiac Thrombus Mimicking a Right Atrial Myxoma in a Young Female Patient – A Case Report

Cardiac masses are at the attention of health specialists since the development of echocardiography. Even though imaging is an excellent tool for diagnosis, the clinical presentation, risk factors, and hemodynamic status of the patients are important in establishing the diagnosis and subsequent management. The purpose of this presentation is to assess the difficulty of diagnosis in the case of an intracardiac mass and its therapeutic management

The role of cardiovascular rehabilitation in women with ischemic heart disease and rhythm disorders

The incidence and prevalence of cardiovascular disease among women has increased significantly over the last 50 years. However, women diagnosed with ischemic cardiopathy benefit to a much lesser extent from both pharmacological or interventional treatment and inclusion in cardiovascular rehabilitation programs. Cardiovascular rehabilitation programs in women should be individualized, taking into account the particularities of cardiovascular risk factors, effort, aritmogenic risk, socio-economic status. Women's cardiovascular rehabilitation programs need to be diversified and deployed in smaller groups of female patiens. These programs should include, besides physical recovery, emotional, social and psychological support. The purpose of this article is to synthesize some of the particularities of cardiovascular rehabilitation in women with ischemic heart disease and rhythm disorders

Cardiac rehabilitation in patients with heart failure and diabetes mellitus

Over the past decades, cardiac rehabilitation has had a spectacular evolution, from the mere monitoring of the patients’ return to physical activity to a multidisciplinary approach focused on patient education, individualized physical exercise, changes in cardiovascular risk factors and, not least, an improvement in patient quality of life. Heart failure represents an important public health problem, and the association of this disease with diabetes mellitus significantly reduces prognosis in these patients, the two disorders potentiating each other. Recent data demonstrate a significant benefit of cardiac rehabilitation in patients with diabetes mellitus and heart failure, with important effects in reducing mortality, increasing exercise capacity and improving symptoms. Unfortunately, cardiac rehabilitation is generally underused, most probably due to the lack of awareness and low adherence of patients, as well as due to insufficiently developed programs at national level

DESIGN & ANALYSIS TOOLS AND TECHNIQUES FOR AEROSPACE STRUCTURES IN A 3D VISUAL ENVIRONMENT

The main objective of this project is to develop a set of tools and to integrate techniques in a software package which is build on structure analysis applications based on Romanian engineers experience in designing and analysing aerospace structures, consolidated with the most recent methods and techniques. The applications automates the structure’s design and analysis processes and facilitate the exchange of technical information between the partners involved in a complex aerospace project without limiting the domain