Distinct Trajectories of Physical Activity Among Patients with COPD During and After Pulmonary Rehabilitation.

Little is known about longitudinal trends in objectively measured physical activity (PA) during and after pulmonary rehabilitation (PR) for individuals with Chronic Obstructive Pulmonary Disease (COPD). The purpose of this study was to examine the PA trajectories of patients with COPD during and after PR and whether demographic, clinical, or program characteristics differed across these trajectories. The study was approved by Research Ethics Boards at all participating institutions, and written informed consent was obtained from each participant prior to study inclusion.

Does a lower carbohydrate protein substitute impact on blood phenylalanine control, growth and appetite in children with PKU?

Background: In children with phenylketonuria (PKU), it is possible that high carbohydrate protein substitutes may adversely affect blood phenylalanine control. We evaluated if a low carbohydrate, 'ready-to-drink' protein substitute would impact on short term blood phenylalanine control, weight and appetite in children with PKU aged 3-10 years.

Methods: This was a 3-part, 5-week randomised, controlled, crossover study in which two different carbohydrate/protein-equivalent ratios in protein substitute [control protein substitute (CPS) median 1:1; trial protein substitute (TPS) 0.

Heart failure clinics are associated with clinical benefit in both tertiary and community care settings: data from the Improving Cardiovascular Outcomes in Nova Scotia (ICONS) registry.

Background: Heart failure (HF) clinics are known to improve outcomes of patients with HF. Studies have been limited to single, usually tertiary centres whose experience may not apply to the general HF population.

Objectives: To determine the effectiveness of HF clinics in reducing death or all-cause rehospitalization in a real-world population.

Outreach monitoring service for patients with indolent B-cell and plasma cell disorders: a UK experience.

Disease progression occurs in over 1% of monoclonal gammopathy of undetermined significance, monoclonal B-cell lymphocytosis and early stage chronic lymphocytic leukaemia patients every year therefore regular monitoring is indicated. We assessed the efficacy of an outreach service to replace clinic monitoring using local phlebotomy with central haematologist review of laboratory parameters and symptoms identified by a patient self-assessment questionnaire. The service was used by 299 patients for 2 years and provided accurate monitoring, improved patient satisfaction, support for primary care and reduced the burden on haematology clinics without an increase in inter-assessment admissions due to disease progression.