The effect of a comprehensive lifestyle intervention on cardiovascular risk factors in pharmacologically treated patients with stable cardiovascular disease compared to usual care: a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>The additional benefit of lifestyle interventions in patients receiving cardioprotective drug treatment to improve cardiovascular risk profile is not fully established.</p> <p>The objective was to evaluate the effectiveness of a target-driven multidisciplinary structured lifestyle intervention programme of 6 months duration aimed at maximum reduction of cardiovascular risk factors in patients with cardiovascular disease (CVD) compared with usual care.</p> <p>Methods</p> <p>A single centre, two arm, parallel group randomised controlled trial was performed. Patients with stable established CVD and at least one lifestyle-related risk factor were recruited from the vascular and cardiology outpatient departments of the university hospital. Blocked randomisation was used to allocate patients to the intervention (n = 71) or control group (n = 75) using an on-site computer system combined with allocations in computer-generated tables of random numbers kept in a locked computer file. The intervention group received the comprehensive lifestyle intervention offered in a specialised outpatient clinic in addition to usual care. The control group continued to receive usual care. Outcome measures were the lifestyle-related cardiovascular risk factors: smoking, physical activity, physical fitness, diet, blood pressure, plasma total/HDL/LDL cholesterol concentrations, BMI, waist circumference, and changes in medication.</p> <p>Results</p> <p>The intervention led to increased physical activity/fitness levels and an improved cardiovascular risk factor profile (reduced BMI and waist circumference). In this setting, cardiovascular risk management for blood pressure and lipid levels by prophylactic treatment for CVD in usual care was already close to optimal as reflected in baseline levels. There was no significant improvement in any other risk factor.</p> <p>Conclusions</p> <p>Even in CVD patients receiving good clinical care and using cardioprotective drug treatment, a comprehensive lifestyle intervention had a beneficial effect on some cardiovascular risk factors. In the present era of cardiovascular therapy and with the increasing numbers of overweight and physically inactive patients, this study confirms the importance of risk factor control through lifestyle modification as a supplement to more intensified drug treatment in patients with CVD.</p> <p>Trial registration</p> <p>ISRCTN69776211 at <url>http://www.controlled-trials.com</url></p

The effect of electroporation pulses on functioning of the heart

Electrochemotherapy is an effective antitumor treatment currently applied to cutaneous and subcutaneous tumors. Electrochemotherapy of tumors located close to the heart could lead to adverse effects, especially if electroporation pulses were delivered within the vulnerable period of the heart or if they coincided with arrhythmias of some types. We examined the influence of electroporation pulses on functioning of the heart of human patients by analyzing the electrocardiogram. We found no pathological morphological changes in the electrocardiogram; however, we demonstrated a transient RR interval decrease after application of electroporation pulses. Although no adverse effects due to electroporation have been reported so far, the probability for complications could increase in treatment of internal tumors, in tumor ablation by irreversible electroporation, and when using pulses of longer durations. We evaluated the performance of our algorithm for synchronization of electroporation pulse delivery with electrocardiogram. The application of this algorithm in clinical electroporation would increase the level of safety for the patient and suitability of electroporation for use in anatomical locations presently not accessible to existing electroporation devices and electrodes

Differential branching fraction and angular analysis of the decay B s0 → φμ + μ -

The determination of the differential branching fraction and the first angular analysis of the decay Bs0 → φμ + μ - are presented using data, corresponding to an integrated luminosity of 1.0 fb-1, collected by the LHCb experiment at √s=7 TeV. The differential branching fraction is determined in bins of q 2, the invariant dimuon mass squared. Integration over the full q 2 range yields a total branching fraction of B (Bs0 → φμ + μ -(7.07 -0.59+0.64± 0.71± 0.71) × 10 -7, where the first uncertainty is statistical, the second systematic, and the third originates from the branching fraction of the normalisation channel. An angular analysis is performed to determine the angular observables F L, S 3, A 6, and A 9. The observables are consistent with Standard Model expectations. [Figure not available: see fulltext.] © 2013 CERN for the benefit of the LHCb collaboration

Updated measurements of exclusive J/ψ and ψ(2S) production cross-sections in pp collisions at √s = 7 TeV

The differential cross-section as a function of rapidity has been measured for the exclusive production of J/ψ and ψ(2S) mesons in proton–proton collisions at √s = 7 TeV, using data collected by the LHCb experiment, corresponding to an integrated luminosity of 930 pb−1. The cross-sections times branching fractions to two muons having pseudorapidities between 2.0 and 4.5 are measured to be where the first uncertainty is statistical and the second is systematic. The measurements agree with next-to-leading order QCD predictions as well as with models that include saturation effects

Measurement of Charged Particle Multiplicities and Densities in pp Collisions at √s = 7 TeV in the Forward Region

Charged particle multiplicities are studied in proton–proton collisions in the forward region at a centre-of-mass energy of √s = 7 TeV with data collected by the LHCb detector. The forward spectrometer allows access to a kinematic range of 2.0 &lt; η &lt; 4.8 in pseudorapidity, momenta greater than 2 GeV/c and transverse momenta greater than 0.2 GeV/c. The measurements are performed using events with at least one charged particle in the kinematic acceptance. The results are presented as functions of pseudorapidity and transverse momentum and are compared to predictions from several Monte Carlo event generators

First evidence for the two-body charmless baryonic decay B0 → pp̄

The results of a search for the rare two-body charmless baryonic decays B0 → pp̄ and B0s → pp̄ are reported. The analysis uses a data sample, corresponding to an integrated luminosity of 0.9 fb-1, of pp collision data collected by the LHCb experiment at a centre-of-mass energy of 7 TeV. An excess of B0 → pp̄ candidates with respect to background expectations is seen with a statistical significance of 3.3 standard deviations. This is the first evidence for a two-body charmless baryonic B0 decay. No significant B0s → pp̄ signal is observed, leading to an improvement of three orders of magnitude over previous bounds. If the excess events are interpreted as signal, the 68.3% confidence level intervals on the branching fractions are (Equation) where the first uncertainty is statistical and the second is systematic

Searches for B(s)0 →J/ψpp‾ B_{(s)}^0\ \to {J \left/ {{\psi p}} \right.}\overline{p} and B + → J/ψ p p‾ \overline{p} π + decays

The results of searches for B0(s)→J/ψ pp¯ and B + → J/ψ p p¯ π+ decays are reported. The analysis is based on a data sample, corresponding to an integrated luminosity of 1.0 fb−1 of pp collisions, collected with the LHCb detector. An excess with 2.8 σ significance is seen for the decay B0s→J/ψ pp¯ and an upper limit on the branching fraction is set at the 90 % confidence level: B(B0s→J/ψ pp¯) &#60; 4.8 × 10−6, which is the first such limit. No significant signals are seen for B 0 → J/ψ p p¯ and B + → J/ψ p p¯ π + decays, for which the corresponding limits are set: B(B0→J/ψ pp¯) &#60; 5.2 × 10−7, which significantly improves the existing limit; and B(B+→J/ψ pp¯π+) &#60; 5.0 × 10−7, which is the first limit on this branching fraction

Studies of beauty baryon decays to D0ph− and Λ+ch− final states

Decays of beauty baryons to the D0ph− and Λ+ch− final states (where h indicates a pion or a kaon) are studied using a data sample of pp collisions, corresponding to an integrated luminosity of 1.0  fb−1, collected by the LHCb detector. The Cabibbo-suppressed decays Λ0b→D0pK− and Λ0b→Λ+cK− are observed, and their branching fractions are measured with respect to the decays Λ0b→D0pπ− and Λ0b→Λ+cπ−. In addition, the first observation is reported of the decay of the neutral beauty-strange baryon Ξ0b to the D0pK− final state, and a measurement of the Ξ0b mass is performed. Evidence of the Ξ0b→Λ+cK− decay is also reported