Ideal Family Size and Fertility in Egypt: An Overview of Recent Trends

Egypt is already the most populous Arab country in the world with 93 million citizens in 2016 which may grow to about 120 million by 2030 if the same level of fertility continues. This paper aims to offer an overview of the evolution over time of the ideal number of children in Egypt, assessing previous researches and giving a particular emphasis on most recent data on such topic. In a context of raising fertility, whose causes are still unknown, we test the persistence of a high ideal number of children among younger cohorts

Advances in exercise rehabilitation for patients with Lower Extremity Peripheral Artery Disease

Patients with Lower Extremity Peripheral Artery Disease (LEPAD) have been recently identified as target groups for structured Cardiac Prevention and Rehabilitation (CPR) programs, whose core components and intervention goals are now well recognized. Historically, exercise training (ET) programs have been employed for the treatment of LEPAD with typical intermittent claudication, and several meta-analysis documented improvements in walking distances of enrolled patients. Both in American and European guidelines, a frequency of at least 3 sessions per week and program duration of 12 weeks were judged as optimal, while recommended sessions lengths were 30-45 minutes and 30-60 minutes respectively. Among emerging aspects in the field of LEPAD rehabilitation, 1) the extended role of CPR programs in stages other than that of intermittent claudication, 2) an updated identification of predictors of poor outcome after ET, 3) the attributable effect of exercise on global cardio-respiratory fitness in LEPAD, 4) the combination of ET and invasive measures for advanced stages of LEPAD, and 5) the role of community walking programs have been discussed

Metabolic syndrome and related dietary intervention among patients with coronary and peripheral arterial disease attending cardiovascular rehabilitation programs

Aim of the study: To provide estimates of the prevalence of metabolic syndrome (MS) among patients with coronary artery disease (CAD) or peripheral arterial obstructive disease (PAOD) attending cardiac rehabilitation (CR) programs, as well as related dietary needs targeted on the single core components of the syndrome. Methods: Observational study enrolling 209 patients (males 75%, mean age 65±8 yrs.) referred to a CR facility because of silent ischemia (11%), chronic stable angina (28%), acute coronary syndrome (41%), or peripheral arterial disease (20%). The MS was diagnosed according to the 2005-modified NCEP ATP III criteria. Dietary regimens were classified into four areas of intervention (weight control, lipid control, glycaemic control, and blood pressure control) and compared in patients with and without MS. Results: MS accounted for 26% of all patients, with the highest prevalence (31%) among those admitted after acute coronary syndromes. All four dietary regimens were significantly more prescribed (p< 0.001) among patients with MS as compared to controls, with low sodium (95%) and low fat (90%) diets as the most represented patterns. All patients with MS were prescribed multiple dietary patterns, with adoption of a comprehensive low energy, low fat, and low glucose diet in up to one fifth of cases. Conclusion: Patients with CAD or PAOD referred to CR programs often display an high cardiometabolic risk and need a broad regimen of dietary modification

The GICR polls: a new instrument for Cardiovascular Prevention and Rehabilitation in Italy

During the year 2015 GICR-IACPR, a scientific society for Cardiovascular Prevention and Rehabilitation (CRP) in Italy, carried out several "Polls" based on its website, in order to know current attitudes of health operators involved in the management and care of cardiac patients. The Poll #1 focused on post revascularization residual myocardial ischemia, familial dyslipidemia, erectile dysfunction, sleep apnoea, and hyperuricaemia, all conditions being paradigmatic of well known situations of high cardiovascular risk and disability in the CRP setting. In the present report feasibility and results of the GICR Poll #1 are discussed

Obesity and cardiovascular risk. Systematic intervention is the key for prevention

Obesity is a serious public health issue and associated with an increased risk of cardiovascular disease events and mortality. The risk of cardiovascular complications is directly related to excess body fat mass and ectopic fat deposition, but also other obesity-related complications such as pre-type 2 diabetes, obstructive sleep apnoea, and non-alcoholic fatty liver diseases. Body mass index and waist circumference are used to classify a patient as overweight or obese and to stratify cardiovascular risk. Physical activity and diet, despite being key points in preventing adverse events and reducing cardiovascular risk, are not always successful strategies. Pharmacological treatments for weight reduction are promising strategies, but are restricted by possible safety issues and cost. Nonetheless, these treatments are associated with improvements in cardiovascular risk factors, and studies are ongoing to better evaluate cardiovascular outcomes. Bariatric surgery is effective in reducing the incidence of death and cardiovascular events such as myocardial infarction and stroke. Cardiac rehabilitation programs in obese patients improve cardiovascular disease risk factors, quality of life, and exercise capacity. The aim of this review was to critically analyze the current role and future aspects of lifestyle changes, medical and surgical treatments, and cardiac rehabilitation in obese patients, to reduce cardiovascular disease risk and mortality, and to highlight the need for a multidisciplinary approach to improving cardiovascular outcomes

Clinical Characteristics and Course of Patients Entering Cardiac Rehabilitation with Chronic Kidney Disease: Data from the Italian Survey on Cardiac Rehabilitation

This survey shows the clinical risk profile, resource utilization, pharmacologic treatment, and course of cardiac rehabilitation (CR) programs in patients with chronic kidney disease (CKD). Data from 165 CR units in Italy were collected online from January 28 to February 10, 2008. The study cohort consisted of 2281 patients: 200 CKD patients and 2081 non-CKD patients. CKD patients were older and showed more comorbidity and complications during CR, a more complex clinical course and interventions with less functional evaluation, and a different pattern of drug therapy at hospital discharge. CKD patients had higher mortality during CR programs due to heart failure, respiratory insufficiency, and cognitive impairment. These findings suggest that patients with CKD should not be denied access to CR, provided careful attention to clinical status, possible complications, optimization of drug therapy, and close followup

Clinical Characteristics and Course of Patients Entering Cardiac Rehabilitation with Chronic Kidney Disease: Data from the Italian Survey on Cardiac Rehabilitation

This survey shows the clinical risk profile, resource utilization, pharmacologic treatment, and course of cardiac rehabilitation (CR) programs in patients with chronic kidney disease (CKD). Data from 165 CR units in Italy were collected online from January 28 to February 10, 2008. The study cohort consisted of 2281 patients: 200 CKD patients and 2081 non-CKD patients. CKD patients were older and showed more comorbidity and complications during CR, a more complex clinical course and interventions with less functional evaluation, and a different pattern of drug therapy at hospital discharge. CKD patients had higher mortality during CR programs due to heart failure, respiratory insufficiency, and cognitive impairment. These findings suggest that patients with CKD should not be denied access to CR, provided careful attention to clinical status, possible complications, optimization of drug therapy, and close followup

Physico-Chemical Features of Undoped and Fe/Cu-Doped Na0.67MnO2-Layered Cathodes for Sodium Batteries

Na0.67MnO2 (NMO) stands out among the layered cathode materials used for sodium batteries due to its high-capacity values, low cost, and environmental friendliness. Unfortunately, many drawbacks arise during cycling, but nanostructure tailoring and doping can help to mitigate them. Our aim was to synthesize undoped and Cu- or Fe-doped NMO samples via the sol-gel route, with a different cooling step to room temperature, i.e., in a natural way or via quenching. The formation of a mixture of polymorphs was observed, as well as differences in the external morphology of the powders' grains. The use of spectroscopic techniques, Mössbauer spectroscopy for the Fe-doped samples and Electron paramagnetic resonance, allowed us to gain insights into the oxidation states of transition metals and to make suggestions about the magnetic ordering, as well as on the possible presence of magnetic impurities. Cyclic voltammetry and galvanostatic cycling results were interpreted on the basis of the spectroscopic data: the introduction of substituents, in general, worsens the capacity values, due to the decrease in the P2 amount and the introduction of structural distortions. The structural stability of the samples in air as a function of time was also analyzed via X-ray diffraction, demonstrating the positive effect of Cu presence