Activity

Background and aim Lifestyle factors heavily influence the development of cardiovascular disease (CVD); therefore, interventions delivering adequate lifestyle changes may improve the prognosis among patients at cardiovascular (CV) risk. Recently published research on the effectiveness of dietary and exercise intervention programmes, alone or combined, on reducing risk factors associated with CVD as well as preventing CV events have been now assessed. Methods and results Using the Medline database via PubMed, we searched for prospective studies published between January 2000 and January 2020 assessing the efficacy of dietary interventions alone or in combination with exercise on reducing CV risk factors or events in human adults at risk. Study quality was assessed using the American Dietetic Association Quality Criteria Checklist. From 934 articles, 21 prospective experimental design studies (15 randomized controlled trials (RCTs), one cluster RCT, and five quasi-experimental intervention studies with a control group) met inclusion and exclusion criteria. Most interventions improved at least some markers of CV risk and the most improvement was time devoted to physical activity increased. A low-fat intervention diet seemed to be effective only when coupled with moderate intensity exercise and weight loss, while a Mediterranean diet (MedDiet) intervention without physical activity, decreased both systolic and diastolic blood pressure, major CV events rate and risk of developing type 2 diabetes. Conclusion The MedDiet appears to have the most beneficial effect on CV events and increased hours of physical training are strongly related to greater improvement of risk factors; nevertheless, adherence to intervention is fundamental as it directly relates to health outcomes.Background and aims Glucagon-like Peptide 1 Receptor Agonists (GLP1-RA) has been associated with a reduction of major cardiovascular events (MACE) and mortality on the basis of the results of cardiovascular outcome trials (CVOT). Several meta-analyses on this issue have been recently published; however, they were all restricted to CVOT, with the exclusion of all studies designed for other endpoints; moreover, other cardiovascular endpoints, such as atrial fibrillation and heart failure have not been fully explored. Methods and results A Medline search for GLP-1 receptor agonists (exenatide, liraglutide, lixisenatide, albiglutide, dulaglutide, or semaglutide) was performed, collecting all randomized clinical trials with a duration ≥52 weeks, enrolling patients with type 2 diabetes, and comparing a GLP-1 receptor agonist with placebo or any other non-GLP-1 receptor agonist drug. We included 43 trials, enrolling 63,134 patients. Selleckchem PD98059 A significant reduction of MACE (MH-OR 0.87 [0.83, 0.92]), all-cause mortality (MH-OR 0.89 [0.83, 0.96]), and a nonstatistical trend toward reduction of heart failure (MH-OR 0.93 [0.85, 1.01]) was observed – GLP1-RA did not increase the risk of atrial fibrillation (MH-OR 0.94 [0.84, 1.04]). Conclusion The present meta-analysis confirms the favorable effects of glucagon-like peptide-1 receptor agonists on major cardiovascular events, cardiovascular and all-cause mortality, stroke, and possibly myocardial infarction. Conversely, the effects on heart failure remain uncertain. Available data on atrial fibrillation seems to exclude any major safety issues in this respect. Registration number (prospero) CRD42018115577.A 58-year-old female patient presented with a single-digit clubbing on the second finger of her right hand two years previously. After investigation with imaging and incisional biopsy, superficial acral fibromyxoma was diagnosed. A brief review on single-digit clubbing and its causes is presented, focusing on superficial acral fibromyxoma.Objective To investigate the effect of a reduction of approximately 25% in total sleep time (TST) on sleep parameters, sleepiness and reaction time (RT) in short, long and intermediate sleepers. Design Twenty healthy young men with a TST of ≤6 h (n = 6), between 6 h and 8 h (n = 7) and > 8 h (n = 7), respectively considered as short, intermediate and long sleepers, underwent 5 consecutive nights with an approximately 25% reduction in TST, produced by delaying their usual bedtimes. All participants were subjected to 6 consecutive nights of polysomnography and assessments of sleep, sleepiness and RT at pre- and post-sleep time. The Linear Mixed Model (LMM) was mainly used to assess the effect of the group, time, and their interaction on the main outcomes. Results Long and short sleepers showed the most significant changes regarding sleep parameters and sleepiness. However, short sleepers showed more lapses and more sleepiness. Conclusions We report novel evidence of the association between cognitive function (assessed via reaction time) and sleep restriction-related risks based on real-life since individual sleep schedules were personally determined. Both long and short sleepers showed the most significant alterations of delaying bedtime regarding sleep parameters and sleepiness. However, the short sleepers showed more sleepiness, attention lapses and increased reaction times.Objectives To assess the benefits of training in mindfulness-based stress reduction (MBSR) or moderate intensity exercise (EX) for improving sleep quality. Design Randomized controlled trial. Setting Outpatient, community-based. Participants Healthy adults (n = 413) aged 30-69 who did not regularly exercise or practice meditation, and who had no known prior sleep problems. Interventions 1) 8-weeks of MBSR training; 2) matched EX training; or 3) wait-list control. Measurements The Pittsburgh Sleep Quality Index (PSQI) was administered at baseline and at 1, 3, 5, and 7-month follow-up visits. Analysis Total PSQI scores and three PSQI factors (perceived sleep quality; daily disturbances, sleep efficiency) were assessed using linear mixed effects regression models for longitudinal data. Results Compared to controls, PSQI global scores improved significantly for EX (mean change -0.98 points [95% CI -1.56, -0.41] p = 0.001) and marginally for MBSR (-0.53 [-1.10, 0.04] p = 0.07). The perceived sleep quality factor improved for both EX (-0.