Considerations on How to Prevent Parkinson's Disease Through Exercise.

The increasing prevalence of people with Parkinson's disease (PD) necessitates a high priority for finding interventions to delay or even prevent the onset of PD. There is converging evidence that exercise may exert disease-modifying effects in people with clinically manifest PD, but whether exercise also has a preventive effect or is able to modify the progression of the pathology in the prodromal phase of PD is unclear. Here we provide some considerations on the design of trials that aim to prevent PD through exercise.

Orally Inhaled Flecainide for Conversion of Atrial Fibrillation to Sinus Rhythm: INSTANT Phase 2 Trial.

Background: INSTANT (INhalation of flecainide to convert recent-onset SympTomatic Atrial fibrillatioN to sinus rhyThm) was a multicenter, open-label, single-arm study of flecainide acetate oral inhalation solution (FlecIH) for acute conversion of recent-onset (≤48 hours) symptomatic atrial fibrillation (AF) to sinus rhythm.

Objectives: This study investigated the efficacy and safety in 98 patients receiving a single dose of FlecIH delivered via oral inhalation.

Methods: Patients self-administered FlecIH over 8 minutes in a supervised medical setting using a breath-actuated nebulizer and were continuously monitored for 90 minutes using a 12-lead Holter.

Clinical Trial Highlights - Interventions Promoting Physical Activity in Parkinson's Disease.

Despite increasing evidence on exercise in Parkinson's disease (PD) it remains unclear what type and intensity of exercise are most effective. Currently, most evidence favors moderate- to high-intensity aerobic exercise for its positive effects on motor symptoms as well as disease modifying potential. On the other hand, observational studies have shown that the sheer volume of exercise matters as well, independent of intensity.

Effect of Using the HEART Score in Patients With Chest Pain in the Emergency Department: A Stepped-Wedge, Cluster Randomized Trial.

Background: The HEART (History, Electrocardiogram, Age, Risk factors, and initial Troponin) score is an easy-to-apply instrument to stratify patients with chest pain according to their short-term risk for major adverse cardiac events (MACEs), but its effect on daily practice is unknown.

Objective: To measure the effect of use of the HEART score on patient outcomes and use of health care resources.

Design: Stepped-wedge, cluster randomized trial.