The "thirsty dropsy": Early descriptions in medical and non-medical authors of thirst as symptom of chronic heart failure.

BACKGROUND: Patients with chronic heart failure may suffer from severe thirst, even if mechanisms that cause thirst in subjects affected by this condition are not clear. Medical and non-medical authors may have already recognized this symptom during the classical age. METHODS: We analyzed association between thirst and dropsy (an ancient medical term used to indicate different conditions including chronic heart failure) in past medical and non-medical literature. RESULTS: Hippocrates and Celsus first recognized thirst as a symptom of dropsy in the classical age. Greco-Roman intellectuals (Polybius, Ovid, Horace) and theologians belonging to the first years of the Christian era (Augustine, Caesarius, Gregory I) showed to know that dropsy people were often thirsty. These authors also influenced medieval poets and writers, including Dante Alighieri. In the Renaissance, the physician and alchemist Paracelsus again evidenced this symptom and the iatrochemist Robert Fludd tried to explain pathophysiology of dropsy, basing on thirst. CONCLUSIONS: The relationship between thirst and dropsy was well known by physicians and intellectuals in the classical age and in the first years of the Christian era, so influencing the Renaissance physicians.

Changes in physical activity among coronary and hypertensive patients: A longitudinal study using the Health Action Process Approach.

OBJECTIVES: Physical activity (PA) is a key factor in cardiovascular disease prevention. Through the Health Action Process Approach (HAPA), the present study investigated the process of change in PA in coronary patients (CPs) and hypertensive patients (HPs). DESIGN: Longitudinal survey study with two follow-up assessments at 6 and 12 months on 188 CPs and 169 HPs. MAIN OUTCOME MEASURES: Intensity and frequency of PA. RESULTS: A multi-sample analysis indicated the equivalence of almost all the HAPA social cognitive patterns for both patient populations. A latent growth curve model showed strong interrelations among intercepts and slopes of PA, planning and maintenance self-efficacy, but change in planning was not associated with change in PA. Moreover, increase in PA was associated with the value of planning and maintenance self-efficacy reached at the last follow-up Conclusions: These findings shed light on mechanisms often neglected by the HAPA literature, suggesting reciprocal relationships between PA and its predictors that could define a plausible virtuous circle within the HAPA volitional phase. Moreover, the HAPA social cognitive patterns are essentially identical for patients who had a coronary event (i.e. CPs) and individuals who are at high risk for a coronary event (i.e. HPs).