Prehabilitation and heart failure: perspective in primary outcomes, a randomized controlled trial.

OBJECTIVE: Prehabilitation, intended as a multidisciplinary approach where physical training is combined with educational and counselling training, in cardiology could optimizing care, and has been shown to be able to reduce morbidity and mortality in several diseases. The present study aims to assess the effectiveness of a prehabilitation program in elderly patients (over 65) with chronic heart failure and to evaluate functional and quality indices of life. PATIENTS AND METHODS: This is randomized, single blind controlled trial. Fourteen older adult patients diagnosed with chronic heart failure were enrolled. Patients were randomly assigned into the study or the control group. Patients in the study group underwent physical training organized into 10 twice-weekly meetings, nutritional and lifestyle counseling. RESULTS: In the Study Group, the quality of life improved significantly (EQoL-5D), and between the two groups there is a statistically significant difference in the motor dimension of SF-36. CONCLUSIONS: Because of our preliminary results, prehabilitation program should be included among the management strategies of in elderly patients with chronic heart failure to better manage their disease and to improve their Quality of Life.

Selenium Concentrations and Mortality among Community-Dwelling Older Adults: Results from IlSIRENTE Study.

BACKGROUND: Selenium has a wide range of pleiotropic effects, influencing redox homeostasis, thyroid hormone metabolism, and protecting from oxidative stress and inflammation. Serum selenium levels are reduced in the older population. OBJECTIVES: to investigate the association of serum selenium levels with all-cause mortality in a sample of community-dwelling older adults. DESIGN AND SETTING: Data are from the 'Invecchiamento e Longevità nel Sirente' (Aging and Longevity in the Sirente geographic area, ilSIRENTE) study, a prospective cohort study that collected information on individuals aged 80 years and older living in an Italian mountain community (n=347). The main outcome was risk of death after ten years of follow-up. PARTICIPANTS AND MEASUREMENTS: Participants were classified according to the median value of selenium (105.3 µg/L) in two groups: high selenium and low selenium. RESULTS: A total of 248 deaths occurred during a 10-year follow-up. In the unadjusted model, low levels of selenium was associated with increased mortality (HR, 0.66; 95% CI 0.51-0.85). After adjusting for potential confounders the relationship remained significant (HR, 0.71; 95% CI 0.54-0.92). CONCLUSIONS: Low serum levels of selenium are associated with reduced survival in elderly, independently of age and other clinical and functional variables.

Performance of two macrophyte species in experimental wetlands receiving variable loads of anaerobically treated municipal wastewater.

Two highly productive emergent macrophytes, Zizaniopsis bonariensis and Typha subulata were established in experimental subsurface flow, sand-based wetlands receiving anaerobically treated municipal wastewater. The hydraulic loading rate was tested in two levels, sequentially, 6.8 cm x d(-1) and 13.6 cm x d(-1), for 70 days each. In the 13.6 cm x d(-1)-loading treatment, among all monitored variables only COD, PO4-Total-P, and Turbidity were removed more efficiently by the planted beds in comparison to unplanted sand beds (P<0.001). When the 6.7 cm x d(-1)-loading rate was applied no significant improvement in removal was found comparing macrophyte beds to unplanted sand beds, except for PO4-P. T. subulata beds were significantly more efficient than Zbonariensis beds for most of the variables. The highest significant differences (P< 0.001) were related to the main effect of the factor hydraulic loading rate, with decreased removal for increased load when considering the variables Total Coliforms (99.4% to 87.7%), Fecal Coliforms (100% to 89.7%). NH3-N (95.8% to 55.2%), NO3(-)-N (-54% to -396%), Total-N (90.4% to 59.6%), and TSS (86.1% to 46.1%). The performance similarity of planted and unplanted wetland beds in the lower loading condition, except for PO4-P, indicates that plants may not be needed under low loading. However aquatic macrophytes improved wetland efficiency under high loading.