At least one in five people who recovered from acute COVID-19 have persistent clinical symptoms, however little is known about the impact on quality-of-life (QOL), socio-economic characteristics, ...fatigue, work and productivity. We present a cross-sectional descriptive characterization of the clinical symptoms, QOL, socioeconomic characteristics, fatigue, work and productivity of a cohort of patients enrolled in the MedStar COVID Recovery Program (MSCRP). Our participants include people with mental and physical symptoms following recovery from acute COVID-19 and enrolled in MSCRP, which is designed to provide comprehensive multidisciplinary care and aid in recovery. Participants completed medical questionnaires and the PROMIS-29, Fatigue Severity Scale, Work and Productivity Impairment Questionnaire, and Social Determinants of Health surveys. Participants (n = 267, mean age 47.6 years, 23.2% hospitalized for COVID-19) showed impaired QOL across all domains assessed with greatest impairment in physical functioning (mean 39.1 ± 7.4) and fatigue (mean 60.6 ±. 9.7). Housing or "the basics" were not afforded by 19% and food insecurity was reported in 14% of the cohort. Participants reported elevated fatigue (mean 4.7 ± 1.1) and impairment with activity, work productivity, and on the job effectiveness was reported in 63%, 61%, and 56% of participants, respectively. Patients with persistent mental and physical symptoms following initial illness report impairment in QOL, socioeconomic hardships, increased fatigue and decreased work and productivity. Our cohort highlights that even those who are not hospitalized and recover from less severe COVID-19 can have long-term impairment, therefore designing, implementing, and scaling programs to focus on mitigating impairment and restoring function are greatly needed.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
BACKGROUND—Although the prevalence of hypertension (HTN) continues to increase in developing countries including China, recent data are lacking. A national wide survey was conducted from October 2012 ...to December 2015 to assess the prevalence of HTN in China.
METHODS—A stratified multistage random sampling method was used to obtain a nationally representative sample of 451,755 residents aged ≥18 years from 31 provinces in mainland China from October 2012 to December 2015. Blood pressure (BP) was measured after resting for 5 minutes by trained staff, using a validated oscillometric BP monitor. HTN was defined as systolic BP (SBP) ≥140 mmHg and/or /diastolic BP (DBP) ≥90 mmHg and/or use of antihypertensive medication within two weeks. Pre-HTN was defined as SBP 120-139 mmHg and DBP 80-89 mmHg without antihypertensive medication. HTN control was defined as SBP <140 mmHg and DBP<90 mm Hg. In addition, the prevalence of HTN (SBP≥130 or DBP≥80 mmHg) and control rate (SBP<130 and DBP<80 mmHg) of HTN were also estimated according to the 2017 American College of Cardiology (ACC) /American Heart Association (AHA) High Blood Pressure Guideline.
RESULTS—Overall, 23.2% (estimated 244.5 million) of the Chinese adult population aged ≥18 years had HTN, and another 41.3% (estimated 435.3 million) had pre-HTN according to the Chinese guideline. There were no significant differences of HTN prevalence between urban and rural residents (23.4% vs. 23.1%, P=0.819). Among individuals with HTN, 46.9% were aware of their condition, 40.7% were taking prescribed antihypertensive medications, and 15.3% had controlled HTN. Calcium channel blockers were the most commonly used antihypertensive medication (46.5%) as monotherapy; and 31.7% of treated hypertensive patients used two or more medications. The prevalence of HTN based on the 2017 ACC/AHA guideline was twice as high as that based on 2010 Chinese guideline (46.4%), while the control rate fell to 3.0%.
CONCLUSIONS—In China, there is a high prevalence of HTN and pre-HTN; awareness, treatment and control of HTN were low. Management of medical therapy for HTN needs to improve.
The Pathophysiology and Burden of Restenosis Weintraub, William S., MD
The American journal of cardiology,
09/2007, Letnik:
100, Številka:
5
Journal Article, Conference Proceeding
Recenzirano
The introduction of percutaneous transluminal coronary angioplasty (PTCA) revolutionized the surgical treatment of coronary artery disease. However, despite increased surgical experience and ...technical breakthroughs, restenosis occurs in 30%–50% of patients undergoing simple balloon angioplasty and in 10%–30% of patients who receive an intravascular stent. Animal and human data indicate that restenosis is a response to injury incurred during PTCA. The need for reintervention in a high percentage of patients due to restenosis remains an important limitation to the long-term success of PTCA. Stenting reduces initial elastic recoil and limits negative arterial remodeling; however, bare-metal stents may promote intimal hyperplasia by eliciting an immune and proliferative response. Consistent with these data, clinical studies suggest that drug-eluting stents, coated with anti-inflammatory or antiproliferative agents, reduce the risk for restenosis. Stenting represents a considerable cost burden. Treatment strategy should focus on selective use of expensive drug-eluting stents in populations where they have been found to be more clinically effective than bare-metal stents—patients who are at high risk for restenosis or who develop restenosis with bare-metal stents. Recent studies suggest that the pharmacologic management of restenosis is now feasible. Together, the judicious use of stents and oral pharmacotherapy promise to reduce the risk for restenosis, even among high-risk patients.
Dietary sodium and health: more than just blood pressure Farquhar, William B; Edwards, David G; Jurkovitz, Claudine T ...
Journal of the American College of Cardiology,
2015-Mar-17, 20150317, Letnik:
65, Številka:
10
Journal Article
Recenzirano
Sodium is essential for cellular homeostasis and physiological function. Excess dietary sodium has been linked to elevations in blood pressure (BP). Salt sensitivity of BP varies widely, but certain ...subgroups tend to be more salt sensitive. The mechanisms underlying sodium-induced increases in BP are not completely understood but may involve alterations in renal function, fluid volume, fluid-regulatory hormones, the vasculature, cardiac function, and the autonomic nervous system. Recent pre-clinical and clinical data support that even in the absence of an increase in BP, excess dietary sodium can adversely affect target organs, including the blood vessels, heart, kidneys, and brain. In this review, the investigators review these issues and the epidemiological research relating dietary sodium to BP and cardiovascular health outcomes, addressing recent controversies. They also provide information and strategies for reducing dietary sodium.
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