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Introduction: Cardiac rehabilitation (CR) improves the functional capacity and the prognosis of patients with coronary artery disease (CAD). Similar results have also been found in patients with dilated cardiomyopathy (DCM). Aim: To assess the relationship between functional improvement (evaluated with 6-minute walking test–6MWT) and the improvement in left ventricular ejection fraction (LVEF) after CR. Methods: we collected data from 260 patients that performed CR after an Acute Coronary Syndrome (ACS). The functional improvement after CR was expressed as the Δ between distance covered at the final versus the initial 6MWT normalized for the initial 6MWT, while LVEF was calculated with transthoracic echocardiogram at the beginning and at the end of the CR. Results: in the whole population functional improvement was 44.07% (baseline 6MWT 421.22 m vs follow-up 6MWT 597.28 m, p ≤ 0.05) while EF improvement was 2.48% (baseline EF 53.37% vs follow-up EF 55.91%, p ≤ 0.05). No significant correlation between the normalized Δmeter and ΔEF was founded. When patients were divided accordingly to their pre-rehab LVEF (≥ 55, 40–55 and

Intiso D, Amoruso L, Zarrelli M, Pazienza L, Basciani M, Grimaldi G, Iarossi A, Di Rienzo F. Long-term functional outcome and health status of patients with critical illness polyneuromyopathy. Acta Neurol Scand: 2011: 123: 211–219. © 2010 John Wiley & Sons A/S. Objective The aim of this study was to investigate the long-term functional outcome and health status of patients with critical illness polyneuromyopathy (CIPNM). Method and subjects One hundred and twenty-four consecutive survival intensive care unit patients admitted to a neuro-rehabilitation Unit from January 2003 to December 2007 were identified. Patients with proven CIPNM by the electromyography were prospectively followed. The Barthel and modified Rankin Scales (mRS) were administered to all patients at baseline, discharge and follow-up. The SF-36 questionnaire was administered to ascertain health status. Each patient underwent an individually tailored rehabilitation therapy. Results Forty-two subjects (23M, 19F, mean age 58.4 ± 13.9) were enrolled. Of these, 30 patients were diagnosed electrophysiologically with CIP, six with critical illness myopathy (CIM) and six with a finding combination of CIP and CIM (CIP/CIM) subtype. The mean Barthel scores at baseline, discharge and follow-up were 16.7 ± 8.6, 81.7 ± 16.4 and 86.7 ± 15.9 (P

We set out to define the prevalence, clinical features and severity of chronic headache among the affiliates of two groups of general practitioners (GPs) and to illustrate the diagnostic and therapeutic modalities employed. A semistructured questionnaire was completed for 2291 children and adults, seen at office or home consultations over a 6-month period by 44 GPs in two areas of Northern Italy (Varese and Sondrio) and Southern Italy (San Giovanni Rotondo), to assess the presence and the clinical features of chronic headache, the severity of the disease (i.e. the degree of interference with work and daily living activities), the diagnostic work-up, and the main treatment modalities. GPs attempted the classification of headache according to the International Headache Society (IHS) criteria. The sample comprised 910 men and 1381 women aged 2-92 years; 39% of cases reported chronic headache (Varese/Sondrio 40%; San Giovanni Rotondo 38%; men 28%; women 47%). Headache was mostly present for >10 years, with one to three attacks/month lasting 4-24 h. Headache was mild in 18% of cases, moderate in 29%, severe in 24%, and very severe in 29%. Diagnostic assessment and treatment varied in the study areas. Diagnostic work-up, hospital admissions, referral to headache centres, and treatment modalities tended to be correlated with headache severity. The GPs could not classify headache using the IHS categories in 27% of cases (Varese/Sondrio 11%; San Giovanni Rotondo 78%). An inverse correlation was found between case classification and use of subsidiary diagnostic and therapeutic aids. Chronic headache is common among individuals seen in general practice. The patterns of health care use tend to be correlated to its severity. A better knowledge of the IHS criteria may be directly related to lower management costs.

OBJECTIVE To assess whether arterial hypertension (AH) is an independent risk factor for chronic symmetric polyneuropathy (CSP) in the elderly. BACKGROUND A strong relationship has been detected between AH and distal symmetric polyneuropathy in insulin-dependent and non-insulin-dependent diabetes. However, the correlation between AH and polyneuropathy caused by other clinical conditions has not yet been studied. METHODS Four thousand one hundred and ninety-one subjects aged > or = 55 years seen in office consultations by 25 general practitioners (GPs) from two separate areas in Italy were interviewed, using a pretested semistructured questionnaire covering conditions commonly associated with neuropathy and symptoms of peripheral nerve disease. A neurologist later visited individuals with > or = 2 symptoms of polyneuropathy and a diagnosis of CSP was made in the presence of bilateral, fairly symmetric impairment of at least two among strength, sensation and tendon reflexes. AH was ascertained when known to the GP and/or if the patient was being treated with antihypertensive drugs. RESULTS One hundred and fifty one subjects had CSP (3.6%). Diabetes was the commonest associated condition (18%). AH was present in 47 patients with CSP (31%). The odds ratio (OR) of AH in patients with CSP was 4.5 [95% confidence interval (CI) 3.1-6.6]. The OR of AH was 3.2 (95% CI 1.5-6.9) in patients with diabetes, and 5.7 (95% CI 3.6-9.3) in those without diabetes. The OR of AH was 4.8 (95% CI 4.4-5.2) after adjusting for the commonest risk factors for CSP. CONCLUSION AH may be an independent risk factor for CSP in the elderly.