Comparative effectiveness of tele-monitoring of users with pacemakers at 6 months after implant: the nordland study

Comunicación oral presentada en el 3er Congreso Internacional de Comunicación en Salud (3ICHC), celebrado los días 19 y 20 de octubre de 2017 en la Universidad Carlos III de Madrid.The main purpose of the present study was to assess the effectiveness of tele-monitoring (TM) in patients with pacemakers regarding reliability, safety and health-related quality of life, compared to traditional follow-up in outpatient clinic

Remote monitoring of cardiac implantable electronic devices

Seminario desarrollado en la Segunda Conferencia Internacional de Comunicación en Salud, celebrada el 23 de octubre de 2015 en la Universidad Carlos III de MadridCardiac implantable electronic devices (CIEDs) are used with increasing frequency for the diagnosis and treatment of cardiac arrhythmias. In Europe, a total number of 550,000 pacemakers and 180,000 defibrillators were implanted in 2014. Follow-up of these patients is a large challenge to the health system and requires a substantial amount of resources, both with regard to time, travel expenses and access to qualified personel. Remote monitoring through transmission of information from the CIED to a server accessible from the hospital is possible. Such remote monitoring may improve follow-up in a number of ways: Convenience for the patient: The patient can get a reassuring letter or phone call from the hospital and does not have to travel to the out-patient clinic. Cost-saving for the hospital, the society, the patient and for family members: Travel expenses as well as the time for patients, caregivers and hospital staff is reduced. Aid clinical decision making / tailor drug therapy: Remote monitoring can help the physician decide when to start, stop and change doses of antiarrhythmic drugs and anticoagulation. Safety when it comes to battery status, lead integrity etc: The system can alarm hospital personell about technical issues which require reprogramming og replacement. The presentation will give examples of heart conditions requiring a CIED, such as sick sinus node, atrioventricular block and ventricular tachycardia, and give a brief description of the implantation process. Furthermore, the way remote monitoring can be useful for the above mentioned reasons will be illustrated

Correction: Patients' experiences of remote communication after pacemaker implant: The NORDLAND study.

[This corrects the article DOI: 10.1371/journal.pone.0218521.]

Effect of N-3 Polyunsaturated Fatty Acids on Lipid Composition in Familial Hypercholesterolemia : A Randomized Crossover Trial

Individuals with familial hypercholesterolemia (FH) have an increased risk of cardiovascular disease. Treatment is mainly low-density lipoprotein cholesterol (LDL-C) reduction. How omega-3 polyunsaturated fatty acids (n-3 PUFAs) supplements affect lipoproteins in FH subjects is unknown. We hypothesized that a high-dose n-3 PUFA supplement would reduce atherogenic lipoproteins and influence the high-density lipoprotein cholesterol (HDL-C) function. We performed a randomized, double-blinded crossover study with 34 genetically verified FH individuals (18-75 years, clinically stable, statin treatment &amp;gt; 12 months). Treatment was 4 g n-3 PUFAs (1840 mg eicosapentaenoic acid and 1520 mg docosahexaenoic acid daily) or four capsules of olive oil for three months in a crossover design with a washout period of three months. The defined outcomes were changes in triglycerides, lipoproteins, lipoprotein subfractions, apolipoproteins, and HDL-C function. After treatment with n-3 PUFAs, total cholesterol, LDL-C, and triglycerides were reduced compared to placebo (p &amp;lt;= 0.01 for all). Total HDL-C levels were unchanged, but the subfraction of large HDL-C was higher (p &amp;lt;= 0.0001) after n-3 PUFAs than after placebo, and intermediate HDL-C and small HDL-C were reduced after n-3 PUFAs compared to placebo (p = 0.02 and p &amp;lt;= 0.001, respectively). No changes were found in apolipoproteins and HDL-C function. N-3 PUFAs supplements reduced atherogenic lipoproteins in FH subjects, leaving HDL-C function unaffected.Funding Agencies|Northern Norway Regional Health Authority (Helse Nord RHF) [SFP1311-16]; UiT The Arctic University of Norway</p

Bariatric surgery improves lipoprotein profile in morbidly obese patients by reducing LDL cholesterol, apoB, and SAA/PON1 ratio, increasing HDL cholesterol, but has no effect on cholesterol efflux capacity

BACKGROUND: Bariatric surgery has been shown to reduce cardiovascular events and cause specific mortality for coronary artery disease in obese patients. Lipoprotein biomarkers relating to low-density lipoprotein (LDL), high-density lipoprotein (HDL), their subfractions, and macrophage cholesterol efflux have all been hypothesized to be of value in cardiovascular risk assessment. OBJECTIVES: The objective of this study was to examine the effect of a lifestyle intervention followed by bariatric surgery on the lipid profile of morbidly obese patients. METHODS: Thirty-four morbidly obese patients were evaluated before and after lifestyle changes and then 1 year after bariatric surgery. They were compared with 17 lean subjects. Several lipoprotein metrics, serum amyloid A (SAA), serum paraoxonase-1 (PON1), and macrophage cholesterol efflux capacity (CEC) were assessed. RESULTS: Average weight loss after the lifestyle intervention was 10.5% and 1 year after bariatric surgery was 33.9%. The lifestyle intervention significantly decreased triglycerides (TGs; 28.7 mg/dL, P amp;lt; .05), LDL cholesterol (LDL-C; 32.3 mg/dL, P amp;lt; .0001), and apolipoprotein B (apoB; 62.9 mu g/mL, P amp;lt; .001). Bariatric surgery further reduced TGs (-36.7 mg/dL, P amp;lt; .05), increased HDL cholesterol (+12 mg/dL, P amp;lt; .0001), and reductions in LDL-C and apoB were sustained. Bariatric surgery reduced large, buoyant LDL (P amp;lt; .0001), but had no effect on the small, dense LDL.The large HDL subfractions increased (P amp;lt; .0001), but there was no effect on the smaller HDL sub fractions. The ratio for SAA/PON1 was reduced after the lifestyle intervention (P amp;lt; .01) and further reduced after bariatric surgery (P amp;lt; .0001). Neither the lifestyle intervention nor bariatric surgery had any effect on CEC. CONCLUSIONS: Lifestyle intervention followed by bariatric surgery in 34 morbidly obese patients showed favorable effects on TGs, LDL-C, and apoB. HDL cholesterol and apoA1 was increased, apoB/apoA1 ratio as well as SAA/PON1 ratio reduced, but bariatric surgery did not influence CEC. (C) 2017 National Lipid Association. All rights reserved