The Impact of Home Cardiac Rehabilitation on Quality of Life and Psychological Well-Being in Patients with Coronary Heart Disease: A Randomized Controlled Study.

BACKGROUND Percutaneous coronary intervention (PCI), a therapeutic approach to coronary heart disease, significantly alleviates symptoms of coronary heart disease (CHD) and substantially improves quality of life. This study aimed to investigate the effect of home cardiac rehabilitation (HCR) on patients after PCI. MATERIAL AND METHODS We randomly divided 106 patients after PCI into an Intervention group (n=52) and a Control group (n=53). Left ventricular ejection fraction (LVEF), blood pressure, blood glucose, and low-density lipoprotein were measured in both groups before hospital discharge and after 3 months of engaging in the intervention. Patients were assessed using the short-form health survey (SF-12) scale and Hospital Anxiety and Depression Scale (HADS) scale. RESULTS After 3 months of HCR intervention, SF-12 scores of patients in the Intervention group were significantly higher compared to patients in the Control group (physical component summary (PCS): 47.46±9.86 vs 43.28±8.21; and Mental Component Summary (MCS): 50.68±9.82 vs 48.26±9.69) (P.

Prevention of catheter tip malposition with an ultrasound-guided finger-pressure method to block the internal jugular vein during PICC placement: a meta-analysis.

Introduction: Peripherally inserted central catheters (PICC) are a type of deep venipuncture, for which the catheter tip malposition rate is high. Aim: To examine the feasibility of preventing catheter tip malposition during PICC placement using an ultrasound-guided finger-pressure method to block the internal jugular vein. Material and methods: We conducted a double-blinded randomized controlled trial (RCT) at a tertiary public hospital in Hubei province, China. A total of 600 patients were recruited and randomly allocated to the ultrasound-guided finger compression method (UGFCM) and traditional partial head method (TPHM) group (n = 300/group). Incidence of catheter tip malposition was assessed as the primary outcome of the study. A systematic literature review and meta-analysis was performed. We searched MEDLINE, EMBASE, Cochrane Library, China-National Knowledge Infrastructure, and Chinese Biomedicine Database and performed publication bias and sensitivity analyses on 10 extracted studies. Results: There were no significant differences in baseline demographic and clinical characteristics between the two groups (p > 0.05). Overall incidence of catheter tip malposition was significantly lower in the UGFCM and TPHM group (1.67% vs. 10.3%) and particularly the incidence of malposition in the internal jugular vein (1% vs. 9%). In the meta-analysis of 10 eligible studies, with 1263 cases using the UGFCM method while 1261 adopted the TPHM method, the results showed that the incidence of catheter tip malposition was significantly lower in the group using the UGFCM method (OR = 0.17, 95% CI: 0.11-0.27, p < 0.01), which is in line with the results of our RCT study. Conclusions: This study may add valuable evidence on adopting the finger-pressure method for blocking neck veins to reduce the incidence of catheter tip malposition, particularly in the internal jugular vein.

[Efficacy of repetitive transcranial magnetic stimulation for alleviating clinical symptoms and suicidal ideation in elderly depressive patients: a randomized controlled trial].

OBJECTIVE: To assess the efficacy of repetitive transcranial magnetic stimulation (rTMS) for alleviating the clinical symptoms and suicidal ideation in elderly patients with depression. METHODS: A total of 178 elderly depressive patients with suicidal ideation were randomized into rTMS treatment group (n=80) and control group (n=98) and treated with rTMS or sham rTMS treatment for 4 weeks in addition to conventional therapy with medications. The 24-item Hamilton Depression Scales (HAMD) and Self-rating Idea of Suicide Scale (SIOSS) were used to assess the severity of depression and the risk of suicide at the baseline and after 2 and 4 weeks of treatment. The treatment response was defined as a 25% reduction in HAMD scores from baseline, and an early improvement as 20% reduction in HAMD scores after 2 weeks of treatment. RESULTS: The two groups of patients were comparable for baseline socio-demographic characteristics and baseline SIOSS and HAMD scores (P>0.05). After 2 and 4 weeks of treatment, both SIOSS and HAMD scores were improved in the two groups, but the patients in rTMS group showed a significantly faster score reduction. A significantly higher rate of early improvement at 2 weeks (52.5% vs 28.6%; χ2=10.569, P<0.01) and a higher response rate at 4 weeks (77.5% vs 53.1%; χ2=15.470, P<0.05) were observed in rTMS group. CONCLUSIONS: rTMS combined with medications can effectively improve sleep quality, cognitive impairment and somatization symptom and reduce suicidal ideation in elderly patients with depression.