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Castel Guelfo di Bologna, Italy

Williams P.T.,Lawrence Berkeley National Laboratory | Thompson P.D.,Cardiology
PLoS ONE | Year: 2013

Purpose: Test whether: 1) walking intensity predicts mortality when adjusted for walking energy expenditure, and 2) slow walking pace (≥24-minute mile) identifies subjects at substantially elevated risk for mortality. Methods: Hazard ratios from Cox proportional survival analyses of all-cause and cause-specific mortality vs. usual walking pace (min/mile) in 7,374 male and 31,607 female recreational walkers. Survival times were left censored for age at entry into the study. Other causes of death were treated as a competing risk for the analyses of cause-specific mortality. All analyses were adjusted for sex, education, baseline smoking, prior heart attack, aspirin use, diet, BMI, and walking energy expenditure. Deaths within one year of baseline were excluded. Results: The National Death Index identified 1968 deaths during the average 9.4-year mortality surveillance. Each additional minute per mile in walking pace was associated with an increased risk of mortality due to all causes (1.8% increase, P=10-5), cardiovascular diseases (2.4% increase, P=0.001, 637 deaths), ischemic heart disease (2.8% increase, P=0.003, 336 deaths), heart failure (6.5% increase, P=0.001, 36 deaths), hypertensive heart disease (6.2% increase, P=0.01, 31 deaths), diabetes (6.3% increase, P=0.004, 32 deaths), and dementia (6.6% increase, P=0.0004, 44 deaths). Those reporting a pace slower than a 24-minute mile were at increased risk for mortality due to all-causes (44.3% increased risk, P=0.0001), cardiovascular diseases (43.9% increased risk, P=0.03), and dementia (5.0-fold increased risk, P=0.0002) even though they satisfied the current exercise recommendations by walking ?7.5 metabolic equivalent (MET)-hours per week. Conclusions: The risk for mortality: 1) decreases in association with walking intensity, and 2) increases substantially in association for walking pace ≥24 minute mile (equivalent to <400m during a six-minute walk test) even among subjects who exercise regularly. Source

Kosowan S.,Cardiology
Canadian journal of cardiovascular nursing = Journal canadien en soins infirmiers cardio-vasculaires | Year: 2011

Family presence (FP) during cardiopulmonary resuscitation (CPR) is becoming an increasing practice. Within current literature, the attitudes and beliefs towards FP of cardiac health care professionals in Canada are limited. The purpose of this project was to examine the perceptions of cardiac health care professionals (n=368) concerning FP during CPR. A survey was conducted to explore the attitudes and beliefs of cardiac health care professionals towards family presence during CPR within five Edmonton and surrounding area hospitals. The response rate was 46%, with the greatest response from nurses and physicians. Of the respondents, 44.3% believed that family should have the option to be present, and 40.9% believed that family should be allowed at the bedside during CPR. Less than half of the respondents had experience with FP during CPR. The barriers identified towards FP were lack of support for families, the experience would be too traumatic for families, families would not understand the procedures, fear of families physically interfering with procedures, FP would increase stress levels among staff, and tradition and politics excludes FP. Despite less than half the respondents supporting FP the majority endorsed development of policy and procedures to overcome barriers to FP during CPR. Source

Nguyen K.A.,Cardiology | Sampson E.F.,Methodist Hospital
American Journal of Health-System Pharmacy | Year: 2012

Purpose. The development, implementation, challenges, and future opportunities associated with a pharmacy observership program are described. Summary. In the summer of 2010, the pharmacy observership committee at The Methodist Hospital created a formalized, institution-based pharmacy observership program to introduce first- and second-year pharmacy students to the diverse areas of pharmacy practice. The two-month experience includes opportunities for students to participate in various departmental research projects and to observe the responsibilities of pharmacy staff. Four students have completed the observership program thus far. All observers commented that the program was a valuable introduction to hospital pharmacy. Feedback was obtained from the observers and each preceptor. Limitations of the program include a lack of funding for parking and lodging expenses, a lack of pagers, and a lack of a stipend for the observers. Although there was not an established budget for the program, our perceived costs were approximately $10,000. Conclusion. An observership program was established to allow first- and second-year pharmacy students to gain exposure to various aspects of hospital pharmacy outside of a formal internship. Copyright © 2012, American Society of Health-System Pharmacists, Inc. All rights reserved. Source

Agarwal S.K.,Cardiology
Cardiovascular Revascularization Medicine | Year: 2014

Dual antiplatelet therapy including aspirin and a P2Y12 ADP receptor antagonist is given after percutaneous coronary intervention to avoid catastrophic complication of stent thrombosis. Dual antiplatelet therapy is associated with increased bleeding risk and may not be tolerated by many patients. This article presents the patients, which had to be given single antiplatelet therapy after percutaneous coronary intervention and discusses the possible factors responsible for the success of single antiplatelet therapy strategy in these patients, in the current era of newer antiplatelet agents and coronary stents. © 2014 Elsevier Inc. Source

Singh R.,Yale University | De Aguiar R.B.,Yale University | Naik S.,Yale University | Mani S.,Yale University | And 6 more authors.
Cell Metabolism | Year: 2013

Common genetic variations in Wnt signaling genes have been associated with metabolic syndrome and diabetes by mechanisms that are poorly understood. A rare nonconservative mutation in Wnt coreceptor LRP6 (LRP6R611C) has been shown to underlie autosomal dominant early onset coronary artery disease, type 2 diabetes, and metabolic syndrome. We examined the interplay between Wnt and insulin signaling pathways in skeletal muscle and skin fibroblasts of healthy nondiabetic LRP6R611C mutation carriers. LRP6 mutation carriers exhibited hyperinsulinemia and reduced insulin sensitivity compared to noncarrier relatives in response to oral glucose ingestion, which correlated with a significant decline in tissue expression of the insulin receptor and insulin signaling activity. Further investigations showed that the LRP6 R611C mutation diminishes TCF7L2-dependent transcription of the IR while it increases the stability of IGFR and enhances mTORC1 activity. These findings identify the Wnt/LRP6/TCF7L2 axis as a regulator of glucose metabolism and a potential therapeutic target for insulin resistance. © 2013 Elsevier Inc. Source

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