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Background: The home treatment of elderly patients with chronic heart failure (CHF) is often accompanied by malnutrition, which increases the risk of re-hospitalisation and affects the prognosis. Therefore, how to effectively improve the nutritional self-management of patients is a current focus of medical research. This study aims to test the effect of home-based nutritional intervention method on improving the nutritional status of elderly patients with CHF.
Methods: A total of 90 hospitalised elderly patients with CHF were randomly divided into the experimental group (n = 45) and the control group (n = 45). The patients in both groups were given standardised drug therapy and their nutritional status was evaluated using a body composition analyser prior to discharge (protein, body fat percentage, visceral fat area, skeletal muscle, upper arm muscle circumference, left lower limb and right lower limb muscle mass), with the cardiopulmonary function evaluated using a six-minute walk test and the metabolic equivalents method. The control group was given general nutrition education and routine dietary guidance from cardiac rehabilitation nurses, while the experimental group was given an individualised nutrition prescription by dietitians based on the evaluation results, according to which one-to-one food exchange dietary intervention training was given until the patients mastered the process.
Results: The nutritional indexes at the end of the study were significantly higher in the experimental group than in the control group and were higher than those before the intervention (P < 0.05). The muscle circumference of the upper arm, the muscle mass of the left lower limb and the right lower limb had no statistical significance following the intervention compared to the control group and before the intervention (P > 0.05). The cardiopulmonary function indexes were significantly better in the experimental group at the end of the study than before the intervention and were better than those in the control group, with statistically significant differences (P < 0.05), while no significant changes were observed in the control group before and after the intervention (P > 0.05).
Conclusion: The home-based nutritional intervention method of food exchange portions can effectively improve the nutritional status of elderly patients with CHF, with the distribution of visceral fat more reasonable and the cardiopulmonary function and exercise endurance improved.
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http://dx.doi.org/10.1186/s12872-023-03072-7 | DOI Listing |
JMIR Res Protoc
September 2025
Department of Health Services Research & Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States.
Background: With the availability of more advanced and effective treatments, life expectancy has improved among patients with metastatic breast cancer (MBC), but this makes communication with their medical oncologist more complex. Some patients struggle to learn about their therapeutic options and to understand and articulate their preferences. Mobile health (mHealth) apps can enhance patient-provider communication, playing a crucial role in the diagnosis, treatment, quality of life, and outcomes for patients living with MBC.
View Article and Find Full Text PDFJAMA Neurol
September 2025
Department of Radiology, University of Washington, Seattle.
Importance: Recent longitudinal studies in patients with unruptured intracranial aneurysms (UIAs) suggested that aneurysm wall enhancement (AWE) on magnetic resonance imaging (MRI) predicts growth and rupture. However, because these studies were limited by small sample size and short follow-up duration, it remains unclear whether this radiological biomarker has predictive value for UIA instability.
Objective: To determine the 4-year risk of instability of UIAs with AWE and investigate whether AWE is an independent predictor of UIA instability.
JAMA Pediatr
September 2025
Department of Pediatrics and Emergency Medicine, Children's National Hospital, George Washington University, Washington, DC.
Importance: Adolescents account for almost half of the 2.5 million diagnosed sexually transmitted infections in the US annually, and the emergency department functions as the primary source of health care for many adolescents. No recommendations exist for emergency department gonorrhea and chlamydia screening.
View Article and Find Full Text PDFJAMA Netw Open
September 2025
School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Importance: The cost-effectiveness of adding early in-bed cycling to usual physiotherapy among adults receiving mechanical ventilation in the intensive care unit (ICU) compared with usual physiotherapy alone is unknown.
Objective: To evaluate the cost-effectiveness of in-bed cycling plus usual physiotherapy compared with usual therapy alone in the Critical Care Cycling to Improve Lower Extremity Strength (CYCLE) randomized clinical trial.
Design, Setting, And Participants: This trial-based economic evaluation with a 90-day time horizon compared early cycling plus usual physiotherapy vs usual physiotherapy alone from a societal perspective.
JAMA Netw Open
September 2025
Department of Urology, Center for Health Outcomes Research and Dissemination, University of Washington, Seattle.
Importance: Black individuals have a twofold higher rate of prostate cancer death in the US compared with the average population with prostate cancer. Few guidelines support race-conscious screening practices among at-risk Black individuals.
Objective: To examine structural factors that facilitate or impede access to prostate cancer screening among Black individuals in the US.