Cardiac Rehabilitation on Health Behaviors and Clinical Outcomes Among Myocardial Infarction Patients

The lack of adherence to health behaviors in cardiac rehabilitation (CR) is the leading cause of recurrent myocardial infarction (MI) in Indonesia. This randomized control trial (RCT) study was conducted to examine the effect of a family based self-efficacy enhancing cardiac rehabilitation program on self-efficacy in cardiac health behaviors, health behaviors, and clinical outcomes among MI patients in Indonesia. Sixty MI patients who met the inclusion criteria were randomized by the modified stratified-block method and assigned into either the control group or the experimental group. The patients in the experimental group received the program during phase I over two days and continued to phase II of CR with weekly follow-up sessions. Patients were asked to complete the Self-Efficacy in Cardiac Health Behaviors Scale (SECHBS) and the Modified Myocardial Infarction Health Behaviors Questionnaire (Modified MIHBQ). The results revealed that self-efficacy, health behaviors, and clinical outcomes such as fasting blood glucose, total cholesterol, LDL, triglyceride, and BMI of the patients after receiving the intervention were significantly better than before receiving the intervention, except for blood pressure, and HDL levels. Self-efficacy, health behaviors, and clinical outcomes such as total cholesterol, LDL, and triglyceride were significantly better in patients in the experimental group than those in the control group (p < .05), except for blood pressure, HDL, BMI, and blood glucose levels (p > .05). In conclusion, the family based self-efficacy enhancing cardiac rehabilitation program shows evidence of effectiveness in enhancing self-efficacy, health behaviors, and some clinical outcomes in MI patients

Health Behaviors and Clinical Outcomes Among Patients with Myocardial Infarction in Indonesia

Introduction: Health behaviors are necessary for preventing possible cardiac events and maintaining health for MI patients. In addition to health behaviors, measuring clinical outcomes is a critical element for optimizing treatment and monitoring the risk factors of a cardiac event. The aims of this study were to (1) describe health behaviors and clinical outcomes among patients with myocardial infarction (MI) in Indonesia; and (2) investigate the relationship between their health behaviors, clinical outcomes, and other selected variables. Method: Sixty hospitalized MI patients participated in this descriptive correlational study. Data were analyzed using descriptive and correlational statistics. Results: The majority of MI patients in this study had a moderate level of total health behaviors, exercise behaviors, dietary behaviors, and stress management. Interestingly, most of the patients had a high level of medication adherence, and smoking cessation. Also, their blood pressure (BP) and body mass index (BMI) of MI patients were at the normal level. In contrast, more than half the patients had a high level of fasting blood glucose and total cholesterol, and a low level of HDL. Moreover, nearly half of the patients presented a high level of LDL, and triglyceride. Exercise behaviors have a negative relationship with total cholesterol, and LDL. Interestingly, gender showed a positive relationship with total health behaviors, and smoking cessation. In addition, monthly incomes show a positive relationship with exercise behavior, and dietary behaviors. The number of times hospitalized appeared to have a positive relationship with systolic BP. Surprisingly, MI treatments showed a positive relationship with total health behaviors, smoking cessation, and BP. Discussion: In conclusion, cardiac rehabilitation should involve health behaviors and clinical outcomes to prevent recurrent cardiac events and maintain health for MI patients

WT1 gene expression as a prognostic marker in advanced serous epithelial ovarian carcinoma: an immunohistochemical study

BACKGROUND: WT1 is a tumor suppressor gene responsible for Wilms' tumor. WT1 reactivity is limited to ovarian serous carcinomas. Recent studies have shown that WT1 plays an important role in the progression of disease and indicates a poorer prognosis of human malignancies such as acute myeloid leukemia and breast cancer. The aims of this study were to determine the survival and recurrence-free survival of women with advanced serous epithelial ovarian carcinoma in relation to WT1 gene expression. METHODS: The study accrued women over an 18-year period, from 1987–2004. During the study period, 163 patients were diagnosed with advanced serous epithelial ovarian carcinoma and had undergone complete post-operative chemotherapy, but the final study group comprised 99 patients. The records of these women were reviewed and the paraffin-embedded tissue of these women stained with WT1 immunostaining. Survival analysis was performed using Kaplan-Meier and Cox regression methods. RESULTS: Fifty patients showed WT1 staining and forty-nine did not. Five-year survival of non-staining and staining groups were 39.4% and 10.7% (p < 0.00005); five-year recurrence-free survival of these groups were 29.8% and ≤ 7.5% (p < 0.00005), respectively. For survival the HR of WT1 staining, adjusted for residual tumor and chemotherapy response, was 1.98 (95% CI 1.28–3.79), and for recurrence-free survival the HR was 3.36 (95% CI 1.60–7.03). The HR for recurrence-free survival was not confounded by any other variables. CONCLUSION: This study suggests that expression of WT1 gene may be indicative of an unfavorable prognosis in patients with advanced serous epithelial ovarian carcinoma

Aneurysm Growth After Endovascular Sealing of Abdominal Aortic Aneurysms (EVAS) with the Nellix Endoprosthesis.

From PubMed via Jisc Publications RouterHistory: received 2018-11-21, revised 2020-06-17, accepted 2020-07-08Publication status: aheadofprintThe aim of this study was to measure the incidence of post endovascular aneurysm sealing (EVAS) abdominal aortic aneurysm (AAA) growth, and its association with stent migration, in a cohort of patients with differing compliance to old and new Instructions For Use (IFU). A retrospective single centre study was conducted to review the computed tomography (CT) and clinical data of elective, infrarenal EVAS cases, performed as a primary intervention, between December 2013 and March 2018. All included patients had a baseline post-operative CT scan at one month and at least one year follow up. The primary outcome measure was the incidence of AAA growth and its association with stent migration. AAA growth was defined as a ≥5% increase in aortic volume between the lowermost renal artery and the aortic bifurcation post EVAS at any time during follow up, in comparison to the baseline CT scan. Migration was defined according to the ESVS guidelines, as > 10 mm downward movement of either Nellix stent frame in the proximal zone. Seventy-six patients were eligible for inclusion in the study (mean age 76 ± 7.4 years; 58 men). AAA growth was identified in 50 of 76 patients (66%); adherence to IFU did not affect its incidence (mean growth within IFU-2016 compliant cohort vs. non-compliant: 16% vs. 13%, p = .33). Over time, the incidence of AAA growth increased, from 32% at one year to 100% at four years. AAA growth by volume was progressive (p < .001), as its extent increased over time. Migration was detected in 16 patients and there was a statistically significant association with AAA growth (13 patients displayed migration and AAA growth, p = .036). Patients treated with EVAS are prone to AAA growth, irrespective of whether their aortic anatomy is IFU compliant. AAA growth by volume is associated with stent migration. Clinicians should continue close surveillance post EVAS, regardless of whether patients are treated within IFU. [Abstract copyright: Copyright © 2020. Published by Elsevier B.V.