Family caregiving and congestive heart failure. Review and analysis.

Background: There is increasing evidence that discharge planning and post-discharge support for CHF patients can contribute greatly to the medical management of heart failure (CHF) in the community and that the quality of the CHF patient's close personal relationships can influence outcome in CHF. However, there has been little research on the impact of CHF on the family or the role of the family in the management of the condition. In this paper, we provide a review and analysis of studies that have explicitly investigated these issues in the informal carers of CHF patients.

Effect of a seated exercise program to improve physical function and health status in frail patients > or = 70 years of age with heart failure.

Eighty-two patients aged > or = 70 years with heart failure were randomized to a gentle, seated exercise program or to usual care. Six-minute walk distance and quality of life did not change between groups, but daily activity as measured by accelerometry increased in the exercise group relative to the control group.

Tolerability of spironolactone in patients with chronic heart failure -- a cautionary message.

Aim: To assess how well heart failure patients tolerate spironolactone in routine clinical practice.

Design: Retrospective analysis of 226 patients attending a specialist heart failure clinic.

Results: One hundred and thirty of 226 (57.

Age is not a significant risk factor for failed trial of beta-blocker therapy in older patients with chronic heart failure.

Objectives: To evaluate how well older heart failure patients tolerate beta-blockers in everyday clinical practice.

Design: Retrospective casenote analysis.

Setting: Specialist heart failure clinic in a large teaching hospital.

Exercise training as a therapy for chronic heart failure: can older people benefit?

Despite recent advances in pharmacological therapy, chronic heart failure remains a major cause of morbidity and mortality in older people. Studies of exercise training in younger, carefully selected patients with heart failure have shown improvements in symptoms and exercise capacity and in many pathophysiological aspects of heart failure, including skeletal myopathy, ergoreceptor function, heart rate variability, endothelial function, and cytokine expression. Data on mortality and hospitalization are lacking, and effects on everyday activity, depression, and quality of life are unclear.

Occult transfixation of the sigmoid colon by suprapubic catheter.

Presentation: A 75-year old man with severe cerebrovascular disease underwent a routine change of suprapubic catheter three months after first insertion. One day after the catheter was changed, he passed faeculent material in the catheter and became unwell with abdominal pain. The catheter tip was visible per rectum.