Familial hypercholesterolemia in cardiac rehabilitation: a new field of interest

Familial hypercholesterolemia (FH) is a frequently undiagnosed genetic disease characterized by substantial elevations of low-density lipoprotein cholesterol (LDL-C). The prevalence of heterozygous FH (HeFH) in the general population is 1:500 inhabitants, while the prevalence of homozygous FH (HoFH) is 1:1,000,000. If FH is not identified and aggressively treated at an early age, affected individuals have a 20-fold increased lifetime risk of coronary heart disease compared with the general population. This narrative review provide a concise overview of recommendations for diagnosis and treatment of adults and children with FH, and discuss the utility of considering FH as a comorbidity at the entry of cardiac rehabilitation programme

Apparent digestibility of insect protein meals for rainbow trout

Insect meals are considered to be promising future ingredients for aquaculture feeds. In past feeding trials in rainbow trout, insect meals were included in diets only on the basis of their nutrients content and energy density without taking into account their biological availability due to the lack of their digestible values. Apparent digestibility (ADC) provides good indication of the bioavailability of nutrients and energy thus providing rational basis for the correct inclusion of feedstuffs. The aim of this research was to assess, in an in vivo trial on rainbow trout, the ADC of five full fat insect meals: one Tenebrio molitor (TM), two Hermetia illucens obtained through two different process (HI1 and HI2), one Musca domestica (MD), and one Alphitobius diaperinus (AD). Fish were fed a high-quality reference diet (R) and test diets obtained mixing the R diet with each of the test ingredients at a ratio of 70:30. Diets contained 1% celite as inert marker. Fish were fed to visual satiety twice a day and faecal samples collected using a continuous automatic device. Faeces were freeze dried and frozen (-20 \ub0C) until analyses. The ADC of dry matter, crude protein and ether extract of each insect meal diet were calculated. ADC for dry matter varied between 70.07 (HI1) and 80.85 (TM). ADC for protein was above 84% in all treatments and resulted the highest in MD, TM and AD treatments. Ether extract apparent digestibility significantly differed among diets with the highest value reported for TM treatment. All treatments reported values higher than 96%. Observed differences could be due to the insect species and meal treatment but in general, tested insect meals were highly digestible for rainbow trout. The results from this research could be useful to optimize the diet formulation

Iron deficiency from the standpoint of cardiac rehabilitation : Novel therapeutic opportunities

Anemia is one of the most frequent comorbidities found in patients with coronary artery disease and chronic heart failure (CHF) who are being followed in cardiac rehabilitation facilities. The more frequent type of anemia is that caused by iron deficiency (IDA, iron-deficiency anemia): this review summarizes the state of the art of this topic. First of all, the mechanisms of IDA will be analyzed. Subsequently, a description of the main conditions where IDA can unfavorably affect the clinical course, and of its more frequent complications, will be presented (percutaneous interventions, heart surgery, CHF). Special attention will be paid in the description of anemia in the setting of CHF. To this regard, in recent years a relevant amount of research has been carried out, to determine whether treating anemia (either by directly stimulating erythropoiesis or by correcting iron deficiency by oral or intravenous route) is of any clinical and prognostic relevance in patients with CHF. The results of this research will therefore be summarized and critically discussed. Finally, we will outline the n-commer promising role of cardiac rehabilitation facilities and of its network of experts in the diagnosis, prognostic stratification and treatment of anemia and iron deficiency. o

Abnormal ECG Findings in Athletes: Clinical Evaluation and Considerations.

PURPOSE OF REVIEW: Pre-participation cardiovascular evaluation with electrocardiography is normal practice for most sporting bodies. Awareness about sudden cardiac death in athletes and recognizing how screening can help identify vulnerable athletes have empowered different sporting disciplines to invest in the wellbeing of their athletes. RECENT FINDINGS: Discerning physiological electrical alterations due to athletic training from those representing cardiac pathology may be challenging. The mode of investigation of affected athletes is dependent on the electrical anomaly and the disease(s) in question. This review will highlight specific pathological ECG patterns that warrant assessment and surveillance, together with an in-depth review of the recommended algorithm for evaluation