Objective: We investigated medical comorbidities in patients with functional seizures (FS) and those with epilepsy (idiopathic generalized epilepsies [IGEs] or temporal lobe epilepsy [TLE]). We hypothesized that the nature of medical comorbidities differs between these three groups. This might be helpful to postulate on the pathophysiology of FS. Materials and Methods: In a retrospective study, all adult patients with a diagnosis of IGE, TLE, or FS were recruited at the outpatient epilepsy clinic at Shiraz University of Medical Sciences, Iran, from 2008 until 2020. The three groups of patients were matched with regard to their age. Age, sex, and medical comorbidities were registered routinely for all patients at the time of the first visit. Results: Nine hundred and sixty-six patients were studied (254 patients with IGE, 467 persons with TLE, and 245 individuals with FS). The groups differed significantly with regard to having medical comorbidities. The most striking difference was comorbid thyroid disorders; this was more common among patients with FS. The diagnosis of FS was independently significantly associated with thyroid disorder comorbidity (odds ratio: 2.77, 95% confidence interval: 1.06–7.23; P = 0.038). Conclusion: Thyroid disorders are significantly associated with FS. We can make the following suggestions to advance the field: a. It is necessary to reproduce this observation in larger multicenter studies; b. We recommend to evaluate thyroid function in all patients with FS; c. It might be helpful to design clinical trials to investigate whether correction of any clinical or subclinical thyroid disorders changes the treatment outcome in patients with FS.
{"title":"Functional (psychogenic) seizures are associated with thyroid disorders","authors":"A. Asadi-Pooya, Mohsen Farazdaghi","doi":"10.4103/hm.hm_37_21","DOIUrl":"https://doi.org/10.4103/hm.hm_37_21","url":null,"abstract":"Objective: We investigated medical comorbidities in patients with functional seizures (FS) and those with epilepsy (idiopathic generalized epilepsies [IGEs] or temporal lobe epilepsy [TLE]). We hypothesized that the nature of medical comorbidities differs between these three groups. This might be helpful to postulate on the pathophysiology of FS. Materials and Methods: In a retrospective study, all adult patients with a diagnosis of IGE, TLE, or FS were recruited at the outpatient epilepsy clinic at Shiraz University of Medical Sciences, Iran, from 2008 until 2020. The three groups of patients were matched with regard to their age. Age, sex, and medical comorbidities were registered routinely for all patients at the time of the first visit. Results: Nine hundred and sixty-six patients were studied (254 patients with IGE, 467 persons with TLE, and 245 individuals with FS). The groups differed significantly with regard to having medical comorbidities. The most striking difference was comorbid thyroid disorders; this was more common among patients with FS. The diagnosis of FS was independently significantly associated with thyroid disorder comorbidity (odds ratio: 2.77, 95% confidence interval: 1.06–7.23; P = 0.038). Conclusion: Thyroid disorders are significantly associated with FS. We can make the following suggestions to advance the field: a. It is necessary to reproduce this observation in larger multicenter studies; b. We recommend to evaluate thyroid function in all patients with FS; c. It might be helpful to design clinical trials to investigate whether correction of any clinical or subclinical thyroid disorders changes the treatment outcome in patients with FS.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":"6 1","pages":"58 - 61"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44263308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We report a rare case of dense mitral annular calcification in a 26-year-old male presenting with recurrent palpitation for the last year with a plethora of mitral annular premature ventricular complexes (PVCs). PVCs had right bundle branch block morphology, were notched in inferior leads with negative QRS complexes in aVL suggestive of likely origin from the lateral mitral annulus. Patients with PVCs from mitral annulus are usually advised to undergo cardiac magnetic resonance imaging to localize the site of subtle mitral annular calcification and plan subsequent delivery of radiofrequency lesions at the same site during radiofrequency ablation. Dense calcification of the lateral mitral annulus is extremely rare to encounter in such a young age of below 30 years without the presence of any predisposing risk factors for calcification. Our case is the first illustration of dense mitral annular calcification secondary to the plethora of mitral annular PVCs in a symptomatic young person below the age of 30 years. PVCs-induced excessive local excursion with wear and tear phenomenon and secondary dystrophic calcification may be the plausible explanation behind this interesting presentation.
{"title":"An unusual case of dense mitral annular calcification in a young with plethora of mitral annular premature ventricular complexes","authors":"Debasish Das, Tutan Das, Subhash R. Pramanik","doi":"10.4103/hm.hm_57_21","DOIUrl":"https://doi.org/10.4103/hm.hm_57_21","url":null,"abstract":"We report a rare case of dense mitral annular calcification in a 26-year-old male presenting with recurrent palpitation for the last year with a plethora of mitral annular premature ventricular complexes (PVCs). PVCs had right bundle branch block morphology, were notched in inferior leads with negative QRS complexes in aVL suggestive of likely origin from the lateral mitral annulus. Patients with PVCs from mitral annulus are usually advised to undergo cardiac magnetic resonance imaging to localize the site of subtle mitral annular calcification and plan subsequent delivery of radiofrequency lesions at the same site during radiofrequency ablation. Dense calcification of the lateral mitral annulus is extremely rare to encounter in such a young age of below 30 years without the presence of any predisposing risk factors for calcification. Our case is the first illustration of dense mitral annular calcification secondary to the plethora of mitral annular PVCs in a symptomatic young person below the age of 30 years. PVCs-induced excessive local excursion with wear and tear phenomenon and secondary dystrophic calcification may be the plausible explanation behind this interesting presentation.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":"6 1","pages":"92 - 95"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42607612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anxiety is a commonly prevalent mental problem in patients with cardiovascular diseases (CVD), but its significance and clinical management have been neglected until recently. Similar to depression, anxiety has been demonstrated to be prevalent and hinging the quality of life and optimal outcome of patients with CVD. Although research evidence is still limited, clinical management for depression may be adopted for the care of anxiety in patients with CVD. Special attention needs to be paid when diagnosing anxiety disorder in patients with CVD because the fear may be a normal reaction of these patients and anxiety may manifest somatically.
{"title":"Anxiety in individuals with cardiovascular diseases: A narrative review and expert opinion","authors":"Weiguang Jiang","doi":"10.4103/hm.hm_5_22","DOIUrl":"https://doi.org/10.4103/hm.hm_5_22","url":null,"abstract":"Anxiety is a commonly prevalent mental problem in patients with cardiovascular diseases (CVD), but its significance and clinical management have been neglected until recently. Similar to depression, anxiety has been demonstrated to be prevalent and hinging the quality of life and optimal outcome of patients with CVD. Although research evidence is still limited, clinical management for depression may be adopted for the care of anxiety in patients with CVD. Special attention needs to be paid when diagnosing anxiety disorder in patients with CVD because the fear may be a normal reaction of these patients and anxiety may manifest somatically.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":"6 1","pages":"52 - 57"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46118892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrew M Del Re, Krissia M. Rivera Perla, Ghazal Aghagoli, K. Bellam, F. Sellke, A. Ehsan
Purpose: Coronary artery disease is a major cause of morbidity and mortality in the United States, representing the highest proportion of deaths due to cardiovascular disease. Treatment of coronary artery disease ranges from prevention to intervention, with the latter warranting a decision between surgical versus percutaneous revascularization. Medical optimization before coronary artery bypass grafting (CABG) is an important step in the care continuum. While the optimization of many risk factors such as smoking has been studied extensively, the inclusion of mental health conditions in preoperative health assessment is not yet standard of care. Major depressive disorder (MDD) is the most prevalent mental health disorder and has been shown to affect physiological processes that are critical in recovery after cardiac surgery. Methods: We queried the national inpatient sample from 2000 to 2017 for patients ≥18 years undergoing CABG with and without MDD. Patients who left against medical advice were excluded. Patients with a diagnosis of MDD were compared against those without. Our primary outcomes were in-hospital mortality, favorable discharge (home or home with services), and length of stay. Multivariable models were used for the various outcomes and each model adjusted for confounding variables. Results: A total of 2,988,997 met clinical criteria for inclusion including 108,782 with an MDD diagnosis. Most patients were male (n = 2,135,804, 71.46%), White (n = 2,417,216, 80.87%), and the average age was 66.3 years (standard deviation = 10.8 years). After adjustment, patients with a diagnosis of MDD were found to have lower odds of in-hospital mortality (odds ratio [OR] [95% confidence interval {CI}] 0.64 [0.56–0.73], P < 0.001) and had decreased odds of home discharge (OR = 0.66 [0.63–0.69], P < 0.001) after CABG. Overall, length of stay was similar between the groups, with MDD patients having a slightly longer length of stay (β-coefficient = 1.03 [1.03–1.04], P < 0.001). Patients with a diagnosis of MDD were also found to have lower odds of acute kidney injury (OR = 0.70 [0.61–0.81], P < 0.001), cardiogenic shock (OR = 0.75 [0.68–0.83], P < 0.001), infection (OR = 0.78 [0.69–0.89], P < 0.001), transient ischemic attack/stroke (OR = 0.75 [0.63–0.89], P = 0.001), acute liver injury (OR = 0.45 [0.34–0.61], P < 0.001), and acute limb ischemia (OR = 0.57 [0.40–0.82], P = 0.003). Conclusions: Patients with a diagnosis of MDD have decreased odds of postoperative morbidity and mortality after CABG in addition to having lower odds of home discharge. The present study suggests a need for prospective investigations on the impact of MDD diagnosis and outcomes after CABG to further understand this relationship.
目的:冠状动脉疾病是美国发病率和死亡率的主要原因，在心血管疾病死亡中所占比例最高。冠状动脉疾病的治疗范围从预防到干预，后者需要在手术与经皮血管重建术之间做出决定。冠状动脉旁路移植术(CABG)前的医疗优化是护理连续性的重要步骤。虽然对吸烟等许多危险因素的优化已经进行了广泛的研究，但在术前健康评估中纳入心理健康状况尚未成为标准的护理。重度抑郁症(MDD)是最普遍的精神健康障碍，已被证明会影响心脏手术后恢复的关键生理过程。方法:我们查询了2000年至2017年全国住院患者样本，包括≥18岁的伴有和不伴有MDD的CABG患者。不遵医嘱离开的患者被排除在外。将诊断为重度抑郁症的患者与未诊断为重度抑郁症的患者进行比较。我们的主要结局是住院死亡率、出院情况良好(在家或有服务的在家)和住院时间。各种结果采用多变量模型，每个模型对混杂变量进行调整。结果:共有298,997人符合临床入选标准，其中108,782人诊断为重度抑郁症。患者以男性(n = 2135804, 71.46%)、白人(n = 2417216, 80.87%)居多，平均年龄66.3岁(标准差= 10.8岁)。调整后发现，诊断为重度抑郁症的患者在CABG后住院死亡率较低(比值比[OR][95%可信区间{CI}] 0.64 [0.56-0.73]， P < 0.001)，出院率较低(OR = 0.66 [0.63-0.69]， P < 0.001)。总体而言，两组间的住院时间相似，重度抑郁症患者的住院时间稍长(β-系数= 1.03 [1.03 - 1.04]，P < 0.001)。诊断为MDD的患者发生急性肾损伤(OR = 0.70 [0.61-0.81]， P < 0.001)、心源性休克(OR = 0.75 [0.68-0.83]， P < 0.001)、感染(OR = 0.78 [0.69-0.89]， P < 0.001)、短暂性脑缺血发作/卒中(OR = 0.75 [0.63-0.89]， P = 0.001)、急性肝损伤(OR = 0.45 [0.34-0.61]， P < 0.001)、急性肢体缺血(OR = 0.57 [0.40-0.82]， P = 0.003)的几率也较低。结论:诊断为重度抑郁症的患者在CABG术后发病率和死亡率以及出院率均较低。目前的研究表明，有必要对冠脉搭桥后重度抑郁症诊断和预后的影响进行前瞻性调查，以进一步了解这种关系。
{"title":"Trends and outcomes of coronary artery bypass grafting in patients with major depressive disorder: A perspective from the national inpatient sample","authors":"Andrew M Del Re, Krissia M. Rivera Perla, Ghazal Aghagoli, K. Bellam, F. Sellke, A. Ehsan","doi":"10.4103/hm.hm_62_21","DOIUrl":"https://doi.org/10.4103/hm.hm_62_21","url":null,"abstract":"Purpose: Coronary artery disease is a major cause of morbidity and mortality in the United States, representing the highest proportion of deaths due to cardiovascular disease. Treatment of coronary artery disease ranges from prevention to intervention, with the latter warranting a decision between surgical versus percutaneous revascularization. Medical optimization before coronary artery bypass grafting (CABG) is an important step in the care continuum. While the optimization of many risk factors such as smoking has been studied extensively, the inclusion of mental health conditions in preoperative health assessment is not yet standard of care. Major depressive disorder (MDD) is the most prevalent mental health disorder and has been shown to affect physiological processes that are critical in recovery after cardiac surgery. Methods: We queried the national inpatient sample from 2000 to 2017 for patients ≥18 years undergoing CABG with and without MDD. Patients who left against medical advice were excluded. Patients with a diagnosis of MDD were compared against those without. Our primary outcomes were in-hospital mortality, favorable discharge (home or home with services), and length of stay. Multivariable models were used for the various outcomes and each model adjusted for confounding variables. Results: A total of 2,988,997 met clinical criteria for inclusion including 108,782 with an MDD diagnosis. Most patients were male (n = 2,135,804, 71.46%), White (n = 2,417,216, 80.87%), and the average age was 66.3 years (standard deviation = 10.8 years). After adjustment, patients with a diagnosis of MDD were found to have lower odds of in-hospital mortality (odds ratio [OR] [95% confidence interval {CI}] 0.64 [0.56–0.73], P < 0.001) and had decreased odds of home discharge (OR = 0.66 [0.63–0.69], P < 0.001) after CABG. Overall, length of stay was similar between the groups, with MDD patients having a slightly longer length of stay (β-coefficient = 1.03 [1.03–1.04], P < 0.001). Patients with a diagnosis of MDD were also found to have lower odds of acute kidney injury (OR = 0.70 [0.61–0.81], P < 0.001), cardiogenic shock (OR = 0.75 [0.68–0.83], P < 0.001), infection (OR = 0.78 [0.69–0.89], P < 0.001), transient ischemic attack/stroke (OR = 0.75 [0.63–0.89], P = 0.001), acute liver injury (OR = 0.45 [0.34–0.61], P < 0.001), and acute limb ischemia (OR = 0.57 [0.40–0.82], P = 0.003). Conclusions: Patients with a diagnosis of MDD have decreased odds of postoperative morbidity and mortality after CABG in addition to having lower odds of home discharge. The present study suggests a need for prospective investigations on the impact of MDD diagnosis and outcomes after CABG to further understand this relationship.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":"6 1","pages":"62 - 69"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48839619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kiriaki Mavromoustakou, I. Doundoulakis, S. Soulaidopoulos, P. Arsenos, A. Laina, S. Sideris, P. Dilaveris, D. Tsiachris, A. Kordalis, K. Tsioufis, K. Gatzoulis
Background and Aim: The association of atrial fibrillation (AF) with the ischemic stroke has emerged as an area of clinical research. The purpose of the present study is to investigate possible correlations between the severity, progress, and outcome of ischemic stroke and the presence of AF. Materials and Methods and Results: The clinical assessment of patients was based on the neurological status at the time of diagnosis utilizing the National Institutes of Health Stroke Scale (NIHSS), the neurological semiology during hospitalization (improvement, deterioration, and without differentiation), and the final outcome at the end of the treatment optimizing the modified Rankin scale (mRS). A total of 344 patients diagnosed with an ischemic stroke were enrolled in the study. The presence of AF was found to be associated with higher severity, poorer progress, and more adverse clinical outcomes of the ischemic stroke. Furthermore, a lower frequency of transient ischemic attacks was observed in patients with AF. Finally, patients with AF presented higher incidence of middle cerebral artery occlusion and were more frequently found with a lesion on the left brain hemisphere. Conclusion: AF was found to be highly associated with higher severity and poorer prognosis of ischemic strokes, independently from the presence of other cardiovascular risk factors.
{"title":"Impact of atrial fibrillation on the severity, progress, and disability of the ischemic stroke patients","authors":"Kiriaki Mavromoustakou, I. Doundoulakis, S. Soulaidopoulos, P. Arsenos, A. Laina, S. Sideris, P. Dilaveris, D. Tsiachris, A. Kordalis, K. Tsioufis, K. Gatzoulis","doi":"10.4103/hm.hm_27_21","DOIUrl":"https://doi.org/10.4103/hm.hm_27_21","url":null,"abstract":"Background and Aim: The association of atrial fibrillation (AF) with the ischemic stroke has emerged as an area of clinical research. The purpose of the present study is to investigate possible correlations between the severity, progress, and outcome of ischemic stroke and the presence of AF. Materials and Methods and Results: The clinical assessment of patients was based on the neurological status at the time of diagnosis utilizing the National Institutes of Health Stroke Scale (NIHSS), the neurological semiology during hospitalization (improvement, deterioration, and without differentiation), and the final outcome at the end of the treatment optimizing the modified Rankin scale (mRS). A total of 344 patients diagnosed with an ischemic stroke were enrolled in the study. The presence of AF was found to be associated with higher severity, poorer progress, and more adverse clinical outcomes of the ischemic stroke. Furthermore, a lower frequency of transient ischemic attacks was observed in patients with AF. Finally, patients with AF presented higher incidence of middle cerebral artery occlusion and were more frequently found with a lesion on the left brain hemisphere. Conclusion: AF was found to be highly associated with higher severity and poorer prognosis of ischemic strokes, independently from the presence of other cardiovascular risk factors.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":"6 1","pages":"26 - 31"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48997645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prenatal depression and preeclampsia (PE) are well-known risk factors of maternal and fetal mortality and morbidity. In recent years, there are emerging evidence suggesting that prenatal depression and PE could be environmental risk factors for several neurodevelopment disorders of offspring. Prenatal depression and PE were also found to be risk factors of each other. At present, the mechanism (s) of how prenatal depression and PE affect one another and their roles in the development of maternal and fetal adverse outcomes are uncertain. In this review, we outline the most recent clinical studies on the effects of prenatal depression and PE on the neurodevelopmental outcomes of offspring, as well as the plausible mechanism(s) of how these two maternal conditions affect each other and their roles in the neurodevelopment of offspring, including inflammation, oxidative stress, and maternal immune activation. We postulate that the overproduction of pro-inflammatory cytokines and increased cortisol levels in maternal depression can alter fetal neurodevelopment, and the autonomic nervous system dysfunction caused by maternal depression may accelerate heart rate and elevate blood pressure in mothers. Similarly, in PE, the elevated inflammation and exaggerated oxidative stress in the mothers, placenta, and fetus could negatively affect maternal depression on and impair the neurodevelopment of offspring. Further studies are needed to examine the combined effects of prenatal depression and PE on the health outcomes of mothers and offspring, to explore the mechanism of maternal depression in the development of PE and to investigate their roles in the neurodevelopment of offspring.
{"title":"Maternal depression and preeclampsia: Effects on the maternal and offspring's mental and physical health","authors":"D. Lin, Yequn Chen","doi":"10.4103/hm.hm_41_21","DOIUrl":"https://doi.org/10.4103/hm.hm_41_21","url":null,"abstract":"Prenatal depression and preeclampsia (PE) are well-known risk factors of maternal and fetal mortality and morbidity. In recent years, there are emerging evidence suggesting that prenatal depression and PE could be environmental risk factors for several neurodevelopment disorders of offspring. Prenatal depression and PE were also found to be risk factors of each other. At present, the mechanism (s) of how prenatal depression and PE affect one another and their roles in the development of maternal and fetal adverse outcomes are uncertain. In this review, we outline the most recent clinical studies on the effects of prenatal depression and PE on the neurodevelopmental outcomes of offspring, as well as the plausible mechanism(s) of how these two maternal conditions affect each other and their roles in the neurodevelopment of offspring, including inflammation, oxidative stress, and maternal immune activation. We postulate that the overproduction of pro-inflammatory cytokines and increased cortisol levels in maternal depression can alter fetal neurodevelopment, and the autonomic nervous system dysfunction caused by maternal depression may accelerate heart rate and elevate blood pressure in mothers. Similarly, in PE, the elevated inflammation and exaggerated oxidative stress in the mothers, placenta, and fetus could negatively affect maternal depression on and impair the neurodevelopment of offspring. Further studies are needed to examine the combined effects of prenatal depression and PE on the health outcomes of mothers and offspring, to explore the mechanism of maternal depression in the development of PE and to investigate their roles in the neurodevelopment of offspring.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":"6 1","pages":"16 - 21"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42188173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Lifestyle, social environment, physiological environment and cardiovascular disease","authors":"Xuerui Tan","doi":"10.4103/hm.hm_1_22","DOIUrl":"https://doi.org/10.4103/hm.hm_1_22","url":null,"abstract":"","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":"6 1","pages":"1 - 2"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44882176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Loures, Gabriela S. Chaves, Renata Ribas, R. Britto, M. Marchiori, Gabriela M. Ghisi
Objective: The objective of this study was to identify socioeconomic and clinical factors associated with disease-related knowledge of cardiac rehabilitation (CR) patients. Methods: Adults with coronary artery disease (CAD) were recruited during CR Phase 1 and completed questionnaires on the 1st day of Phase 2. Disease-related knowledge was assessed by the short version of the CAD Education Questionnaire. Socioeconomic status was defined by educational level, family income, and employment status. MannWhitney U and Spearman correlation were calculated to determine the association of knowledge with socioeconomic factors, number of risk factors, and wait time between hospital discharge and start of outpatient CR. Results: A convenience sample of 39 patients were recruited. Overall, the mean knowledge was 12.00 ± 3.3, which corresponds to 60% of possible scores. Monthly family income and number of risk factors influenced medical condition knowledge (P < 0.05), and employment status influenced total knowledge (P = 0.005) and risk factor knowledge (P = 0.002). Participants with three or more risk factors presented significantly higher knowledge (P = 0.02). Those that waited more than 17 weeks to start the CR presented significantly lower knowledge (P = 0.04). Conclusion: Participants with low income and unemployed were more likely to have inadequate disease-related knowledge; however, the entire sample presented low understanding of their condition. Public health strategies and educational interventions must continue to focus on these vulnerable groups.
{"title":"Socioeconomic and clinical factors associated with disease-related knowledge of cardiac rehabilitation patients in Brazil","authors":"J. Loures, Gabriela S. Chaves, Renata Ribas, R. Britto, M. Marchiori, Gabriela M. Ghisi","doi":"10.4103/hm.hm_64_21","DOIUrl":"https://doi.org/10.4103/hm.hm_64_21","url":null,"abstract":"Objective: The objective of this study was to identify socioeconomic and clinical factors associated with disease-related knowledge of cardiac rehabilitation (CR) patients. Methods: Adults with coronary artery disease (CAD) were recruited during CR Phase 1 and completed questionnaires on the 1st day of Phase 2. Disease-related knowledge was assessed by the short version of the CAD Education Questionnaire. Socioeconomic status was defined by educational level, family income, and employment status. MannWhitney U and Spearman correlation were calculated to determine the association of knowledge with socioeconomic factors, number of risk factors, and wait time between hospital discharge and start of outpatient CR. Results: A convenience sample of 39 patients were recruited. Overall, the mean knowledge was 12.00 ± 3.3, which corresponds to 60% of possible scores. Monthly family income and number of risk factors influenced medical condition knowledge (P < 0.05), and employment status influenced total knowledge (P = 0.005) and risk factor knowledge (P = 0.002). Participants with three or more risk factors presented significantly higher knowledge (P = 0.02). Those that waited more than 17 weeks to start the CR presented significantly lower knowledge (P = 0.04). Conclusion: Participants with low income and unemployed were more likely to have inadequate disease-related knowledge; however, the entire sample presented low understanding of their condition. Public health strategies and educational interventions must continue to focus on these vulnerable groups.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":"6 1","pages":"36 - 42"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44198791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The mind and the heart are inextricably linked. Depression, worry, loneliness, anger, and chronic stress are all negative mental states that can increase the risk of heart disease or worsen existing cardiac problems. Cardiomyopathy develops in response to suddenly hearing stressful news, such as a loved one diagnosed with cancer. Thus, intense emotions, such as anger, can also lead to abnormal heart rhythms. When you are stressed, your blood pressure and heart rate both rise. Chronic stress causes your body to produce harmful quantities of stress hormones such as cortisol, which can alter blood clots. All of these factors can lead to a heart attack or a stroke. Negative thoughts, feelings, or emotions may influence lifestyle patterns, increasing the risk of heart disease. People who are chronically stressed, nervous, sad, or angry are more likely to consume excessive amounts of alcohol, smoke, overeat, and exercise insufficiently– all harmful habits that are detrimental to their heart health.
{"title":"Heart diseases, anxiety disorders, and negative thoughts","authors":"M. Karki, G. Mahara","doi":"10.4103/hm.hm_45_21","DOIUrl":"https://doi.org/10.4103/hm.hm_45_21","url":null,"abstract":"The mind and the heart are inextricably linked. Depression, worry, loneliness, anger, and chronic stress are all negative mental states that can increase the risk of heart disease or worsen existing cardiac problems. Cardiomyopathy develops in response to suddenly hearing stressful news, such as a loved one diagnosed with cancer. Thus, intense emotions, such as anger, can also lead to abnormal heart rhythms. When you are stressed, your blood pressure and heart rate both rise. Chronic stress causes your body to produce harmful quantities of stress hormones such as cortisol, which can alter blood clots. All of these factors can lead to a heart attack or a stroke. Negative thoughts, feelings, or emotions may influence lifestyle patterns, increasing the risk of heart disease. People who are chronically stressed, nervous, sad, or angry are more likely to consume excessive amounts of alcohol, smoke, overeat, and exercise insufficiently– all harmful habits that are detrimental to their heart health.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":"6 1","pages":"22 - 25"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45681529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Idean Pourshams, Bryant Lin, Paul Wang, R. Stafford
Background: Patient education before the placement of an implantable cardioverter-defibrillator (ICD) is strongly recommended to prevent or mitigate feelings of regret and frustration in ICD recipients. Medicare guidelines for ICDs require a shared decision-making approach that focuses on patients' health goals, values, and preferences before implantation. However, many patients are not fully informed of what to expect when recovering from ICD placement or living with an ICD long-term. Objectives: Our objective is to understand decision-making processes and decisional regret in patients requiring ICDs using in-depth interviews. Methods: Nineteen patients at Stanford University Medical Center were recruited to participate in individual interviews using closed-ended and open-ended questions to engage dialogue. Notes taken during interviews were assessed and used to identify major themes. Results: Participants described a lack of adequate education about ICD postoperative recovery and long-term, postimplantation considerations such as avoiding electromagnetic fields, false-positive ICD shocks, and the esthetic effect of ICD implantation. In addition, feelings of fear and anxiety were prevalent in participants' recollections of accepting an ICD. Conclusion: Further improvement in patient education before ICD placement is needed. The decision-making process can be simplified and patient regret and frustration minimized by providing reliable information that is accessible and interactive.
{"title":"Decision-making experiences and decisional regret in patients receiving implanted cardioverter-defibrillators","authors":"Idean Pourshams, Bryant Lin, Paul Wang, R. Stafford","doi":"10.4103/hm.hm_51_21","DOIUrl":"https://doi.org/10.4103/hm.hm_51_21","url":null,"abstract":"Background: Patient education before the placement of an implantable cardioverter-defibrillator (ICD) is strongly recommended to prevent or mitigate feelings of regret and frustration in ICD recipients. Medicare guidelines for ICDs require a shared decision-making approach that focuses on patients' health goals, values, and preferences before implantation. However, many patients are not fully informed of what to expect when recovering from ICD placement or living with an ICD long-term. Objectives: Our objective is to understand decision-making processes and decisional regret in patients requiring ICDs using in-depth interviews. Methods: Nineteen patients at Stanford University Medical Center were recruited to participate in individual interviews using closed-ended and open-ended questions to engage dialogue. Notes taken during interviews were assessed and used to identify major themes. Results: Participants described a lack of adequate education about ICD postoperative recovery and long-term, postimplantation considerations such as avoiding electromagnetic fields, false-positive ICD shocks, and the esthetic effect of ICD implantation. In addition, feelings of fear and anxiety were prevalent in participants' recollections of accepting an ICD. Conclusion: Further improvement in patient education before ICD placement is needed. The decision-making process can be simplified and patient regret and frustration minimized by providing reliable information that is accessible and interactive.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":"6 1","pages":"32 - 35"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49543399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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