Evaluation of a Newly Designed Shirt-Based ECG and Breathing Sensor for Home-Based Training as Part of Cardiac Rehabilitation for Coronary Artery Disease.

Evaluation of a newly designed shirt-based ECG and breathing sensor for home-based training as part of cardiac rehabilitation for coronary artery disease.

Eur J Prev Cardiol. 2013 Jun 3;
Skobel E, Martinez-Romero A, Scheibe B, Schauerte P, Marx N, Luprano J, Knackstedt C

BACKGROUND: Participation in phase-III cardiac rehabilitation (CR) remains low but adherence could potentially be improved with supervised home-based CR. New technological approaches are needed to provide sufficient supervision with respect to safety and performance of individual exercise programmes. DESIGN: The newly designed closed-loop tool, HeartCycle’s guided exercise (GEX) system, will support professionals and patients during exercise-based CR. Patients wear a dedicated shirt with incorporated wireless sensors, and ECG, heart rate (HR), breathing frequency (BF), and activity are monitored during exercise. This information is streamed live to a mobile device (PDA) that processes these parameters. METHODS: A phase-I study was performed to evaluate feasibility, function, and reliability of this GEX device and compare it to conventional cardiac exercise testing (CPX, spiroergometry) in 50 patients (seven women, mean?±?SD age 69?±?9 years, body mass index 26?±?3?kg/m(2), ejection fraction 58?±?10%). ECG, HR, and BF were monitored using standard equipment and the GEX device simultaneously. Furthermore, HR recorded on the PDA was compared with CPX measurements. RESULTS: The fit of the shirt and the sensor was good. No technical problems were encountered. All occurring arrhythmia were reliably detected. There was an acceptable comparability between HR on the GEX device vs. CPX, a good comparability between HR on the PDA vs. CPX, and a moderate comparability between BF on the GEX device vs. CPX. CONCLUSIONS: Comparability between CPX and the GEX device was acceptable for HR measurement and moderate for BF; arrhythmias were reliably detected. HR processing and display on the PDA was even better comparable. The whole system seems suitable for monitoring home-based CR. Further studies are now needed to implement training prescription to facilitate individual exercise. HubMed – rehab


Quality of life in head and neck cancer patients after tumor therapy and subsequent rehabilitation: an exploratory study.

Qual Life Res. 2013 Jun 4;
Nagy J, Braunitzer G, Antal M, Berkovits C, Novák P, Nagy K

PURPOSE: The aim of the study was to evaluate patient-reported quality of life effects of post-treatment intraoral and extraoral rehabilitation in head and neck cancer by repeated measures. METHODS: Fifty-nine patients were involved. Basic socio-demographic, oncological and epidemiological data were gathered, and the type of rehabilitation was recorded. For the assessment of quality of life changes, two widely used brief questionnaires, the University of Washington Quality of Life Questionnaire and the Head and Neck module of the European Organization of Research and Treatment for Cancer Quality of Life Questionnaire, were used. The questionnaires were administered to patients two times: the first time after tumor therapy, but before rehabilitation (upon arriving for rehabilitation) and the second time 6 months after the application of any particular method of rehabilitation. Quality of life data were gathered prospectively, while socio-demographic data were gathered from patient files. RESULTS: Quality of life after rehabilitation was significantly enhanced as compared to the post-treatment status, in all domains of both questionnaires (p < 0.05 and p < 0.01, Mann-Whitney U). CONCLUSIONS: The results support the hypothesis that post-treatment maxillofacial rehabilitation in head and neck cancer does not only restore lost physical capabilities, but also brings about profound changes in patients' quality of life in general. HubMed – rehab


Genetic risk factors for intracranial aneurysms: A meta-analysis in more than 116,000 individuals.

Neurology. 2013 Jun 4; 80(23): 2154-65
Alg VS, Sofat R, Houlden H, Werring DJ

There is an urgent need to identify risk factors for sporadic intracranial aneurysm (IA) development and rupture. A genetic component has long been recognized, but firm conclusions have been elusive given the generally small sample sizes and lack of replication. Genome-wide association studies have overcome some limitations, but the number of robust genetic risk factors for IA remains uncertain.We conducted a comprehensive systematic review and meta-analysis of all genetic association studies (including genome-wide association studies) of sporadic IA, conducted according to Strengthening the Reporting of Genetic Association Studies and Human Genome Epidemiology Network guidelines. We tested the robustness of associations using random-effects and sensitivity analyses.Sixty-one studies including 32,887 IA cases and 83,683 controls were included. We identified 19 single nucleotide polymorphisms associated with IA. The strongest associations, robust to sensitivity analyses for statistical heterogeneity and ethnicity, were found for the following single nucleotide polymorphisms: on chromosome 9 within the cyclin-dependent kinase inhibitor 2B antisense inhibitor gene (rs10757278: odds ratio [OR] 1.29; 95% confidence interval [CI] 1.21-1.38; and rs1333040: OR 1.24; 95% CI 1.20-1.29), on chromosome 8 near the SOX17 transcription regulator gene (rs9298506: OR 1.21; 95% CI 1.15-1.27; and rs10958409: OR 1.19; 95% CI 1.13-1.26), and on chromosome 4 near the endothelin receptor A gene (rs6841581: OR 1.22; 95% CI 1.14-1.31).Our comprehensive meta-analysis confirms a substantial genetic contribution to sporadic IA, implicating multiple pathophysiologic pathways, mainly relating to vascular endothelial maintenance. However, the limited data for IA compared with other complex diseases necessitates large-scale replication studies in a full spectrum of populations, with investigation of how genetic variants relate to phenotype (e.g., IA size, location, and rupture status). HubMed – rehab