Disability and quality of life in heart failure patients: a cross-sectional study.

BACKGROUND: Although both hospitalization and mortality due to heart failure (HF) have been widely studied, less is known about the impact of HF on disability and quality of life. AIM: To assess the degree of disability and quality of life in HF patients attended at family medicine centres. DESIGN AND SETTING: Cross-sectional study of a cohort of HF patients attended at family medicine centres. METHODS: Disability was assessed with the WHODAS 2 questionnaire, which provides a global and six domain scores that is understanding and communication, getting around, self-care, getting along with people, life activities and participation in society. Quality of life was assessed with the Minnesota Living with Heart Failure Questionnaire, which furnishes a global and two domain scores, physical and emotional. RESULTS: A breakdown of the results showed that 28% of patients had moderate disability and 16.7% had severe disability, with the most important areas affected being: life activities, 8.9% extreme disability and 30.3% severe disability; getting around, 34.6% severe disability and 2% extreme disability; and participation in society, 53.3% moderate-severe disability. Quality of life was mildly affected. New York Heart Association (NYHA) Functional Classification and sex were the major determinants of disability and quality of life. Angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists were associated with better scores in the "getting around" and "life activity" domains. CONCLUSION: HF patients in primary care show an important degree of disability and an acceptable quality of life.

Local Application of Growth Hormone to Enhance Osseointegration in Osteoporotic Bones: A Morphometric and Densitometric Study.

PURPOSE: The aim of this study was to assess the effect of local application of growth hormone on osseointegration of dental implants inserted in osteoporotic bones. MATERIALS AND METHODS: Twenty female New Zealand rabbits were used in this study. Ten were ovariectomized and fed a low-calcium diet for 6 weeks, and the others remained intact. A titanium implant was inserted into each tibia, in both groups. In half of the rabbits, 2 IU of growth hormone was placed into the ostectomy prior to the implant insertion. Two weeks after implant surgery, all animals were sacrificed. Tibiae were dissected from soft tissues, and included in methacrylate to be studied under light microscopy. Bone-to-implant contact (BIC) and bone mineral density (BMD) were measured by morphometric and densitometric analysis, respectively. Multifactorial analysis of variance (ANOVA) was used for statistical evaluation. P < .05 was considered to be significant. RESULTS: Ovariectomy induced less BIC and BMD in regions closer to the implant compared with the control group. Local application of growth hormone was able to increase the BIC in the ovariectomized group, with statistically significant differences with respect to the control group (P < .01). Regarding the BMD, no statistically significant differences were found. CONCLUSION: Within the limitations of this experimental study, local application of 2 IU of recombinant human growth hormone at the moment of titanium implant insertion in rabbit tibiae significantly enhanced the BIC around titanium implants 15 days after the implantation in this experimental osteoporotic animal model, without affecting the BMD.

Validation of an osteoporotic animal model for dental implant analyses: an in vivo densitometric study in rabbits.

PURPOSE: The achievement of primary stability in porous and soft bone, where implants are more likely to fail, is one of the unresolved challenges of implant dentistry. Therefore, the aim of the study was to validate an osteoporotic animal model for analysis of poor-quality bone. MATERIALS AND METHODS: Sixteen female New Zealand rabbits, each 6 months old and weighing 4 to 5 kg, were used in this study. The animals were anesthetized, and an in vivo densitometric analysis was performed by dual-energy x-ray absorptiometry (DEXA) to measure bone mineral density (BMD) in the calvaria, cervical spine, and tibia. Ovariectomy was then performed, and animals were fed a low-calcium diet that featured 0.07% calcium, rather than the 0.45% calcium of a standard diet, for 6 weeks. After this period, new densitometric measurements were carried out. Two-way analysis of variance was used for statistical evaluation. A P value of less than .05 was considered to be significant. RESULTS: Together, ovariectomy and a low-calcium diet were able to induce a quick decrease in BMD, as measured at 6 weeks by DEXA. This decrease was statistically significant in the calvaria (P < .001) and the cervical spine (P < .05) but not in the tibia. CONCLUSION: Based upon this study, ovariectomy and a low-calcium diet are able to induce experimental osteoporosis in rabbits in a short period of time.