Arterial hypertension is one of the world’s leading risk factors for death and disability. With the number of people living with this disease doubling between 1990 and 2019 from 650 million to 1.3 billion, it is a global burden that increases mortality from cardiovascular and kidney diseases. It is extremely important to use all possible diagnostic methods, indicating the possibility of early detection that subsequently leads to effective prevention of disease development. The phenomenon called hypertensive response to exercise (HRE) is one such method. The HRE is defined as a pathological, excessive increase in blood pressure as a result of exposure to the stressor, which is physical exercise. There is no consensus about precise cutoffs in the definition of this condition, which is most commonly diagnosed based on systolic blood pressure (SBP) ≥ 210 mm Hg in men and ≥190 mm Hg in women at peak exercise intensity. The fact that exercise hypotension is a pathologic sign is universally accepted. Accumulating data deliver the information that HRE is also connected to higher overall cardiovascular risk. It was demonstrated that HRE is associated with functional and structural impairment of the left ventricle and the future development of hypertension. HRE should act as a warning signal of increased cardiovascular risk, leading to the need for profound clinical care.
The coronavirus disease 2019 (COVID-19) shows high incidence of thromboembolic events in humans. In the present study, we aimed to evaluate if anticoagulation prior to COVID-19 infection may impact clinical profile, as well as mortality rate among patients hospitalized with COVID-19. The study was based on retrospective analysis of medical records of patients with laboratory confirmed SARS-CoV-2 infection. After propensity score matching (PSM), a group of 236 patients receiving any anticoagulant treatment prior to COVID-19 infection (AT group) was compared to 236 patients without previous anticoagulation (no AT group). In 180 days, the observation we noted comparable mortality rate in AT and no AT groups (38.5% vs. 41.1%, p = 0.51). Similarly, we did not observe any statistically significant differences in admission in the intensive care unit (14.1% vs. 9.6%, p = 0.20), intubation and mechanical ventilation (15.0% vs. 11.6%, p = 0.38), catecholamines usage (14.3% vs. 13.8%, p = 0.86), and bleeding rate (6.3% vs. 8.9%, p = 0.37) in both groups. Our results suggest that antithrombotic treatment prior to COVID-19 infection is unlikely to be protective for morbidity and mortality in patients hospitalized with COVID-19.
Background: Total Hip Replacement (THR) is a standard treatment for advanced hip osteoarthritis; yet, its effects on gait recovery remain understudied. This study examines gait pattern changes in women undergoing monitored rehabilitation after unilateral THR, using Statistical Parametric Mapping (SPM) to detect significant motion differences over time. Methods: This longitudinal study included 32 women who underwent primary cementless THR. Gait was assessed preoperatively and postoperatively at 6 weeks, 3 months, 6 months, and 12 months using a motion analysis system. Repeated measures ANOVA and post hoc SPM{t} analyses were conducted to evaluate significant gait changes across time points. Results: Significant improvements (p < 0.05) were observed in spatio-temporal parameters. Velocity increased from 0.42 ± 0.10 m/s (Ex1) to 0.72 ± 0.06 m/s (Ex5), stride length from 0.85 ± 0.12 m to 1.15 ± 0.07 m, and step length (involved leg) from 0.32 ± 0.08 m to 0.48 ± 0.05 m. Cycle time decreased from 1.50 ± 0.20 s to 1.22 ± 0.10 s, indicating improved gait efficiency. Post hoc SPM{t} analysis revealed significant kinematic changes in hip flexion-extension, knee flexion, and pelvic tilt, particularly between Ex2 and Ex3. Statistically significant improvements (p < 0.001) were observed in key spatio-temporal parameters. Conclusions: Gait parameters improved significantly within the first year post-THR, with the most pronounced changes occurring between the early and mid-term recovery phases. These findings support the need for targeted rehabilitation strategies in the first six months post-surgery. SPM analysis provides a robust method for detecting subtle gait adaptations, contributing to the refinement of post-THR rehabilitation strategies.