Remotely monitored physical activity from older people with cardiac devices associates with physical functioning.

INTRODUCTION: Accelerometer-derived physical activity (PA) from cardiac devices are available via remote monitoring platforms yet rarely reviewed in clinical practice. We aimed to investigate the association between PA and clinical measures of frailty and physical functioning. METHODS: The PATTErn study (A study of Physical Activity paTTerns and major health Events in older people with implantable cardiac devices) enrolled participants aged 60 + undergoing remote cardiac monitoring. Frailty was measured using the Fried criteria and gait speed (m/s), and physical functioning by NYHA class and SF-36 physical functioning score. Activity was reported as mean time active/day across 30-days prior to enrolment (30-day PA). Multivariable regression methods were utilised to estimate associations between PA and frailty/functioning (OR = odds ratio, ß = beta coefficient, CI = confidence intervals). RESULTS: Data were available for 140 participants (median age 73, 70.7% male). Median 30-day PA across the analysis cohort was 134.9 min/day (IQR 60.8-195.9). PA was not significantly associated with Fried frailty status on multivariate analysis, however was associated with gait speed (ß = 0.04, 95% CI 0.01-0.07, p = 0.01) and measures of physical functioning (NYHA class: OR 0.73, 95% CI 0.57-0.92, p = 0.01, SF-36 physical functioning: ß = 4.60, 95% CI 1.38-7.83, p = 0.005). CONCLUSIONS: PA from cardiac devices was associated with physical functioning and gait speed. This highlights the importance of reviewing remote monitoring PA data to identify patients who could benefit from existing interventions. Further research should investigate how to embed this into clinical pathways.

[Effect of N-3 polyunsaturated fatty acids on the modulation of T lymphocytes in vitro and redox status in obese women with hypertension]. / Effet des acides gras polyinsaturés N-3 sur la modulation in vitro des lymphocytes T et le statut redox chez les femmes obèses hypertendues.

OBJECTIVES: Deepen our knowledge of the immune system alterations associated with obesity-related hypertension and demonstrate that polyunsaturated fatty acids can enhance the proliferation and their profile oxidant/antioxidant and subsequently involved in the strategy prevention and treatment in obese hypertensives. METHODS: T cells are isolated from the blood of the control and obese women with hypertension the University Hospital of Tlemcen (Algeria), these cells are incubated in the presence of a synthetic mixture of PUFA to 30µM (DHA/EPA/LA) and stimulated by mitogens for 48hours. The cells are counted and used to assess intracellular oxidative status. The biochemical parameters are determined by the use of plasma. RESULTS: In obese women with hypertension, a significant increase in plasma levels of (glucose, uric acid, creatinine, urea, total cholesterol and triglycerides) compared to controls. In addition, decreased cell proliferation, basal or stimulated by Con A was observed in obese women with hypertension compared with controls. The mixture of PUFA to 30µM reduced lymphoproliferation as well in obese women with hypertension than in controls. The rates in malondialdéhyde (MDA) and protein carbonyl lymphocytes are elevated in hypertensive obese women. PUFA supplementation to 30µM seems correct this redox status in hypertensive obese since rates in protein carbonyl, are similar to those of controls. CONCLUSION: The mixture of PUFA (n-3 and n-6) can modulate the activity of T lymphocyte proliferation and correct the intracellular redox status in hypertensive obese women.

Vascular access strategy for delivering long-term antimicrobials to patients with infective endocarditis: device type, risk of infection and mortality.

BACKGROUND: This paper reports the use of different vascular access devices and the incidence of intravascular catheter-related infection (CRI) in patients receiving intravenous antibiotics for infective endocarditis (IE). AIM: To examine whether rates of infection vary with type of vascular access device, and assess the impact of CRI on mortality in IE. METHODS: A prospective observational service evaluation of all inpatients who received intravenous antibiotics for IE was performed. In total, 114 inpatients were evaluated. All cases of CRI [including exit-site infection, intravascular catheter-related bloodstream infection (CRBSI) and mortality] were recorded. Tunnelled and non-tunnelled central venous catheters (CVCs), and peripherally inserted cannulae were used for antibiotic delivery. FINDINGS: There were 15 episodes of CRI, 11 of which were CRBSI (all associated with CVC use). The remainder comprised uncomplicated exit-site infections. Use of tunnelled CVCs [hazard ratio (HR) 16.95, 95% confidence interval (CI) 2.13-134.93; P = 0.007] and non-tunnelled CVCs (HR 24.54, 95% CI 2.83-212.55; P = 0.004) was associated with a significantly increased risk of CRI. Risk of mortality increased significantly with Staphylococcus aureus as the cause of IE (P < 0.001) and CRBSI (P = 0.034). CONCLUSION: Risk of CRI in patients with IE is linked to the type of vascular access device used. Rates of CRBSI were greatest with CVCs, while peripheral venous cannulae were not associated with CRBSI or serious sequelae. Many patients (40%) tolerated complete treatment courses delivered via peripheral cannulae. These findings confirm the importance of device selection in reducing the risk of CRI; a potentially modifiable variable that impacts on outcome and mortality in IE.

[2-hydroxy-methyl-1(N-phtaloyltryptophyl) aziridine stimulates in vitro human lymphocyte proliferation and interleukin secretion]. / 2-hydroxy-methyl-1(N-phtaloyltryptophyl) aziridine stimule la prolifération in vitro des lymphocytes humains et la sécrétion des interleukines.

UNLABELLED: AIM OF THIS WORK: Aziridines have been shown to possess marked immunotropic activity. In this study, the in vitro effects of a new aziridine, 2-hydroxy-methyl-1-(N-phtaloyltryptophyl) aziridine, were determined on the proliferative responses of human lymphocytes stimulated by mitogens and on interleukin (IL-2, IL-6) secretion. MATERIAL AND METHODS: Peripheral blood lymphocytes were isolated using differential centrifugation on a density gradient of Ficoll-Paque. They were cultured with or without mitogens (Concanavalin A and lipopolysaccharide), and with different concentrations of the aziridine. Proliferation was monitored by direct cell counts and confirmed by MTT [3-(4,5-dimethyl thiazol-2-yl)-2,5-diphenyl tetrazolium bromide] assay. After different incubations, IL-2 and IL-6 were determined by using commercially available Elisa kits. RESULTS: The aziridine tested significantly stimulated the resting and mitogen T and B lymphocyte proliferation at concentrations between 1 microM and 1 mM, in a dose-dependent manner. It also increased IL-2 and IL-6 secretion. CONCLUSION: 2-hydroxy-methyl-1-(N-phtaloyltryptophyl) aziridine displayed immunomodulatory properties and is potentially immunostimulant. It could be used to provide non-specific cell-mediated immune responses.