ABSTRACT
Background@#and Purpose Orthostatic hypotension (OH) is common in patients with Parkinson’s disease (PD). Early recognition OH is required with sensitive assessments. The purpose of this study was to determine whether blood pressure (BP) changes during exercise can predict the occurrence of OH in PD. @*Methods@#This prospective cohort study included 80 consecutive patients with PD. All patients agreed to participate in a baseline evaluation and cardiopulmonary exercise test (CPET).According to the initial active standing test (AST), those without OH (PD-nonOH) at baseline had their AST results followed up for 6 months. The main outcome was defined as whether patients without OH at baseline would develop OH after 6 months. Logistic regression analysis was applied to identify the relevant variables. A nomogram was constructed based on clinical features and identified variables. The concordance index (C-index) and area under the receiver operating characteristic curve (AUC) were used to evaluate the accuracy and predictive ability of the nomogram, respectively. @*Results@#CPET results indicated that peak load, peak heart rate, heart rate recovery at 1 min, and systolic BP change (ΔSBP) were lower in those with OH than in the PD-nonOH group (p<0.05) at baseline. Logistic regression analysis indicated that peak load and ΔSBP during CPET had significant effects on OH (p<0.05). Age, sex, peak load, and ΔSBP were used to construct the nomogram model (C-index=0.761). The prediction model had an AUC of 0.782 (95% confidence interval=0.649–0.889) and a specificity and sensitivity of 70.0% and 81.8%, respectively. @*Conclusions@#This study has identified predictive factors for OH development in patients with PD. CPET could be used as a complementary examination to identify patients at a high risk of OH.
ABSTRACT
Pneumonia is the most common type of post-stroke infection, with an incidence of up to 57%, and is independently associated with poor outcome after stroke. Ozone is a harmless therapy working for anti-inflammatory, anti-oxidative stress and improving oxygenation through various molecular ways, which may be a potential therapy for post-stroke pneumonia.
ABSTRACT
Objective :To observe therapeutic effect of diet guidance on dysphagia after stroke .Methods :A total of 90 patients with dysphagia after stroke were randomly and equally divided into traditional rehabilitative training group (received traditional swallowing rehabilitative training ) and diet guidance group (received diet guidance based on traditional rehabilitative training group ) ,and 30d was treated as a course .Kubota drinking test was used to assess dysphagia before and after treatment ,and therapeutic effect was assessed by Fujishima Ichiro criteria of swallowing therapeutic effect evaluation .Results : Compared with before treatment , there was significant rise in swallowing function score in both groups after treatment ,and that of diet guidance group was significantly higher than that of traditionalrehabilitativetraininggroup[(8.72±1.33)scoresvs .(6.14±1.78)scores,P＝0.001all].Totaleffec-tive rate of diet guidance group was significantly higher than that of traditional rehabilitative training group (88. 9%vs.68.9%, P＝ 0.020).Conclusion : Compared with pure swallowing rehabilitative training ,diet guidance com-bined swallowing rehabilitative training can significantly improve dysphagia in patients with stroke .
ABSTRACT
<p><b>OBJECTIVE</b>The exercise rehabilitation in patient with chronic heart failure (CHF) is standard clinical practice, but it is rare using CardioPulmonary Exercise Testing (CPET) guide to prescribe exercise rehabilitation in China.</p><p><b>METHODS</b>We performed symptom limited maximal CPET in 10 patients with CHF, randomly divided into two groups: 5 patients as control without exercise and 5 exercise patients used Δ50%W intensity to exercise 30 min/d, 5 d/w, x12 w. Before and after 12 w rehabilitation, we evaluated functions.</p><p><b>RESULTS</b>There were no significant difference between two groups patients (P > 0.05). The exercise duration was increased from 8 min to 23 min after rehabilitation (P < 0.001); distance 6 minutes walking was increased from 394 m to 470 m (P < 0.05); score of Minnesota quality of life was decreased from 25 to 3 in exercise group (P < 0.01). However, there were nosignificant changes in control group (P>0.05) and their changes were smaller than those in exercise group (P < 0.01).</p><p><b>CONCLUSION</b>The CPET guiding exercise rehabilitation is safe and effective for patients with CHF.</p>