Introduction: given the recent experience with the COVID-19 vaccine campaign, an optimal global p... more Introduction: given the recent experience with the COVID-19 vaccine campaign, an optimal global policy to control future pandemics and ensure infectious security globally is highly relevant. Objective: the study aims to determine the optimal vaccination strategy to reduce COVID-19 morbidity and mortality during a pandemic. Method: a systematic search of studies on infectious disease control and vaccination strategies for the period 2000-2023 in PubMed, Scopus, Web of Science and Google Scholar databases using keywords was conducted for the review. Relevant publications, data extraction and systematisation were selected. Results: the findings of the analysis highlight the importance of integrated interventions in global vaccination strategies, including health systems strengthening, innovative technologies for outbreak detection and international collaboration. Vaccination, as an effective preventive measure, significantly reduces the spread of infectious diseases. Vaccination with different types of vaccines has been shown to improve immune response compared to the use of the same type of vaccine. This approach, where the first and second vaccine doses are different, may increase the effectiveness of the immune response. Conclusions: studies confirm that vaccination reduces the number of cases and deaths, reducing the economic burden. A variety of vaccines, including mRNA, vector, and inactivated vaccines, provide high efficacy in preventing COVID-19 infection and mortality, especially when a heterologous vaccination regimen is used. This review identifies the most effective infectious disease control strategies for the development of global health recommendations.
Abstract : Introduction: Cardio-respiratory rehabilitation is the set of coordinated intervention... more Abstract : Introduction: Cardio-respiratory rehabilitation is the set of coordinated interventions needed to provide the best physical, psychological, and social conditions so that patients with chronic or post-acute cardiopulmonary disease, with their efforts, maintain or resume optimal functioning in society through improved health behaviors. Purpose: To study the effectiveness of the application of Cardio-Respiratory Rehabilitation in the typology of patients with chronic or post-acute cardiomyopathy and chronic respiratory diseases in order to facilitate their therapeutic use and to improve the overall quality of life. Material and Method: This is a prospective study including patients with COPD and cardiac disease who were included in the rehabilitation program during the period January 2019 - November 2021. The study was conducted at the University Hospital Center "Mother Teresa" in Tirana, University Hospital "SHEFQET NDROQI", AMERICAN Hospital, HYGEA Hospital, and "Our Lady of Good Counsel, Tirana". An individual chart was used to collect sociodemographic, physical, clinical, and functional examinations for each patient. Results: The study included 253 patients, with a mean age of 62.1 (± 7.9) years, ranging from 48 to 82 years. (67.6%) of the patients were males, and (32.4%) female. Male patients predominated in all age groups, with a statistically significant difference with females (p<0.01). The most common cardiac pathologies are coronary artery bypass (24%), cerebral stroke (9%), myocardial infarction (17%), Stent placement (8%) (p<0.01). Correlation matrix of risk factors found a significant correlation of alcohol consumption with diabetes, smoking, dyslipidemia, sedentary life, obesity, AVC, and hypertension. Functional capacity estimated by change in metabolic equivalents (MET) improved by 46% from 4. ±2.2 to 7.2± .8 METs (p<0.01). Duration of exercise after rehabilitation was increased by 21% compared to baseline (p<0.01). The mean score of all three subscales of the questionnaire: symptoms (p=0.03), activity (p<0.01), and impact (p<0.01) after rehabilitation, was lower compared to pre-rehabilitation. Conclusions: The rehabilitation program has impacted on improving the quality of life, reducing symptoms, reducing the impact of negative factors on daily life, and reducing dyspnea during daily activities. Keywords : cardio-respiratory rehabilitation, physical exercise, quality of life, diseases
World Academy of Science, Engineering and Technology International Journal of Nursing and Health Sciences
Abstract : Objectives: The target of this paper is (1) to explain objectively physical activity ... more Abstract : Objectives: The target of this paper is (1) to explain objectively physical activity model throughout three chronic cardiopulmonary conditions, and (2) to study the connection among physical activity dimensions with disease severity, self reported physical and emotional functioning, and exercise performance. Design: Cross-sectional study. Setting: Participants` domestic environment. Participants: Patients with cardiopulmonary diseases: chronic obstructive pulmonary diseases (COPD) (n=63), coronary heart failure (n=60), and patients with implantable cardioverter defibrillator (n=60). Interventions: Not applicable. Main results measures: Seven ambulatory physical activity dimensions (total steps, percentage time active, percentage time ambulating at low, medium, and hard intensity, maximum cadence for 30 non-stop minutes, and peak performance) have been measured with an accelerometer. Results: Subjects with COPD had the lowest amount of ambulatory physical activity compared with topics with coronary heart failure and cardiac dysrhythmias (all 7 interest dimensions, P<.05); total step counts have been: 5319 as opposed to 7464 as opposed to 9570, respectively. Six-minute walk distance become correlated (r=.44-.65, P<.01) with all physical activity dimensions with inside the COPD pattern, the most powerful correlations being with total steps and peak performance. In topics with cardiac impairment, maximal oxygen intake had most effective small to slight correlations with five of the physical activity dimensions (r=.22-.40, P<.05). In contrast, correlations among 6-minute walk test distance and physical activity have been higher (r=.48-.61, P<.01) albeit in a smaller pattern of most effective patients with coronary heart failure. For all three samples, self-reported physical and mental health functioning, age, frame mass index, airflow obstruction, and ejection fraction had both exceptionally small and no significant correlations with physical activity. Conclusions: Findings from this study present a profitable benchmark of physical activity patterns in individuals with cardiopulmonary diseases for comparison with future studies. All seven dimensions of ambulatory physical activity disfavor between subjects with COPD, heart failure, and cardiac dysrhythmias. Depending on the research or clinical goal, use of one dimension such as total steps may be sufficient. Although physical activity had high correlations with performance on a six-minute walk test relative to other variables, accelerometers-based physical activity monitoring provides unique, important information about real-world behavior in patients with cardiopulmonary not already captured with existing measures. Keywords : ambulatory physical activity, walking, monitoring, COPD, heart failure, implantable defibrillator, exercise performance
International Journal of Ecosystems and Ecology Sciences (IJEES)
ABSTRACT
Chronic Obstructive Pulmonary Disease (COPD) is now a leading cause of disability in th... more ABSTRACT Chronic Obstructive Pulmonary Disease (COPD) is now a leading cause of disability in the developed world. The progress of COPD is associated with increasing breathlessness, disability and frequent hospitalisations. An ageing population in the developed world and increasing cigarette consumption in developing countries compounds the global impact of this condition. The disability associated with COPD leads to a reduction in physical activity and loss of functional independence. The aim of this study was to investigate the effects of PR in patients with normal exercise capacity on health-related quality of life and exercise capacity. The mean FEV1/FVC was 59.4± 14.1%, and the mean FEV1 was 64.8± 23.0% of predicted. Most subjects had mild to moderate COPD. The PImax and PEmax were normal. These subjects had no previous participation in home-based or hospital-based PR. All the subjects had normal maximal V˙O2 and work rate before PR. After PR there were still significant improvements in maximal V˙O2 (mean increase of 101.3 mL/min, p <0.001) and work rate (mean increase of 8.2 watts, p<0.001). Ventilation, heart rate, and mean blood pressure were unchanged following PR. The maximum oxygen pulse at maximum exercise was significantly increased with PR (p<0.02). The SpO2 and end-tidal PCO2 at peak exercise did not significantly change after PR. Although dyspnea scores at rest were low and did not change significantly with PR, dyspnea at end-exercise was significantly improved after PR (p=0.01). PR should be part of the clinical management of patients with COPD, even for those with normal exercise capacity. However, benefits on disease progression, hospitalization, and survival for these patients remain unknown. Key words: pulmonary rehabilitation; COPD; exercise capacity.
Shortness of breath associated with cardiorespiratory abnormalities and peripheral muscle discomf... more Shortness of breath associated with cardiorespiratory abnormalities and peripheral muscle discomfort are the major factors that limit exercise capacity in patients with chronic obstructive pulmonary disease (COPD) and those with congestive heart failure (CHF). Both of these symptoms negatively impact on patients' daily physical activity levels. In turn, poor daily physical activity is commonly associated with increased rates of morbidity and mortality. Among those coronary artery disease patients referred, CR completion is associated with improved survival and decreased hospitalization. This is a prospective study of patient who underwent cardiac and pulmonary surgery at university hospital centre "Mother Theresa" in Tirana, Albania over the period 2012-2014. Patients were evaluated before and after cardiac rehabilitation (CR). Tailored pulmonary rehabilitation programs should be considered for COPD patients of all stages, who have respiratory symptoms and/or who have intolerance to physical effort despite optimal pharmacological treatment.
Abstract. Cardiopulmonary rehabilitation among patients with heart and chronic obstructive pulmon... more Abstract. Cardiopulmonary rehabilitation among patients with heart and chronic obstructive pulmonary disease in a hospital in Tirana. Ledi Necaj. It is a well-known factor that the implementation of cardiopulmonary rehabilitation leads to a decrease in the number of deaths and morbidity, however, this method is not widely used in Albania. One of the possible factors of low demand is the ignorance of patients regarding the benefits and effectiveness of this method. The purpose of this study is to find out the level of awareness of patients with cardiopulmonary diseases. During the study, a cross-sectional survey method was used among patients with this disease. Interest in and use of this rehabilitation was assessed using questionnaires that were given to 690 patients who underwent a course of treatment in university clinics and research hospitals that provide cardiopulmonary resuscitation services. The results of the study show that a third of patients learned information about cardiopulmonary rehabilitation (CPR) from medical personnel, and the other part received it from doctors. Despite the fact that almost half of the patients knew that they should perform certain physical activities and exercises to maintain their positive dynamics in relation to cardiopulmonary disease, only one third of the patients understood that such everyday activities as climbing stairs and a brisk walk down the street do not constitute threats to their heart and lungs, respectively. It was also found that a significant part of the patients regularly played sports. Certain types of exercises were offered to one half of the patients, at that time, the rest of them performed various exercises. 69% of all patients who were given detailed information about CPR were ready to participate in this program. Despite the fact, that numerous people were ready to undergo this method of rehabilitation, not all of them were sufficiently knowledgeable and did not fully understand the essence of this technique. Also, an important factor in the positive dynamics of the patient's recovery is his relationship with the doctor and medical personnel involved in the treatment of patients with cardiopulmonary diseases. Key words: aetiology, physical activity, heart disease, awareness, personal habits
chronic Obstructive Pulmonary Disease (cOPD) is now the main cause of disability in the developed... more chronic Obstructive Pulmonary Disease (cOPD) is now the main cause of disability in the developed world. the advance of cOPD is related to increasing breathlessness, disability and periodic hospitalizations. an aging population in the developed world and increasing cigarette consumption in developing countries expand the global impact of this condition. the disorder associated with cOPD leads to a decrease in physical activity and failure of functional independence. The aim of this study was to evaluate the effects of Pr in patients with normal exercise capacity on health-related quality of life and exercise capacity. the mean FeV1/FVc was 59.4± 14.1%, and the mean FeV1 was 64.8± 23.0% as expected. Most topics had mild to moderate cOPD. the P imax and P emax were normal. these subjects had no previous participation in home-based or hospital-based Pr. all the subjects had normal maximal V˙O2 and work rate before PR. After PR there were still considerable improvements in maximal V˙O2 (mean increase of 101.3 mL/min, p <0.001) and work rate (mean increase of 8.2 watts, p<0.001). Ventilation, heart rate, and mean blood pressure were constant following PR. The maximum oxygen pulse at maximum exercise was significantly increased with PR (p<0.02). The SpO2 and end-tidal PCO2 at peak exercise did not significantly improve after PR. Although dyspnea scores at rest were low and did not improve significantly with PR, dyspnea at end-exercise was significantly improved after Pr (p=0.01). Pr should be the responsibility of the clinical management of patients with cOPD, even for those with normal exercise capacity. However, the benefits of disease progression, hospitalization, and survival for these patients remain unknown. the main role in the management of any chronic disease, including lung disease, is to improve the quality of life (Ql) in patients. Conclusion; Although strongly recommended by scientific societies pulmonary rehabilitation programs still need to be more widely implemented. PR programs have shown a high level of evidence of benefits in chronic respiratory patients, particularly those with cOPD.
ABSTRACT
Cardiac
Rehabilitation to
Reduce Heart
Failure
Objective: The purpose of this study... more ABSTRACT Cardiac Rehabilitation to Reduce Heart Failure Objective: The purpose of this study was to examine if early involvement in cardiac rehabilitation (CR) decreases readmissions after heart failure (HF) hospitalization. Study Design: A Retrospective Study Place and Duration of Study: This study was conducted at the University Hospital Center "Mother Teresa" in Tirana, University Hospital "SHEFQET NDROQI", AMERICAN Hospital, HYGEA Hospital, and "Our Lady of Good Counsel, Tirana" from January 2019 - November 2021. Materials and Methods: There were 120 patients of both gender had heart failure included in this study. Age of the patients was between 18-80 years of age. Patients were equally divided in two groups. Group I had 60 patients were discharged after getting 30-days hospitalization without getting cardiac rehabilitation while in group II 30-patients received at-least 1-sesssion of cardiac rehabilitation in hospitalization. Outcomes among both groups were compared in terms of readmission because of HF. SPSS 24.0 was used to analyze all data. Results: Among 120 patients, 69 (57.5%) were males and 61 (42.5%) were females. Mean age of the patients was 53.24±11.64 years and had mean BMI 24.11±6.37 kg/m2. There were 71 (59.2%) patients had hypertension and diabetes mellitus was found in 44 (36.7%) cases, Smoking history was found in 57 (47.5%) cases. There were 10 (8.3%) cases had heat stroke among all cases. Early cardiac rehabilitation dramatically decreased hospital readmissions and cardiac mortality in patients. The cardiac rehabilitation group that had re-hospitalization had higher rates of diabetes, hyperkalemia, and low PETCO2. An independent risk factor for re-hospitalization was low PETCO2 (Partial pressure of end-tidal carbon) at anaerobic threshold ( ≤33.5 mmHg). Conclusion: We found that people with acute myocardial infarction who started cardiac rehabilitation right away had fewer major cardiac events later on. As a risk factor for readmission, decreased PETCO2 at the anaerobic threshold can be utilized to evaluate the efficacy of early cardiac rehabilitation. Key Words: Heart Failure, Cardiac Rehabilitation, Readmission, PETCO2, Hyperkalemia
The purpose of the study was to analyse the quality of vaccination among the
population and to e... more The purpose of the study was to analyse the quality of vaccination among the population and to evaluate strategies that contribute to reducing the prevalence of infectious diseases, the number of complications, and the severity of disease. The study also examined pathogens that pose a global threat to the population, which have high risks of outbreaks due to global changes in climatic conditions. The development of vaccines capable of preventing or eliminating an infectious disease, reducing the severity of the disease and the rate of hospitalisation has been studied. In addition, the issue of the causes of low vaccination coverage in Kyrgyzstan, Albania, Bulgaria, and Latvia has been investigated. It was found that diseases that have a geographical distribution in certain climatic zones have a risk of zone expansion due to global climate warming and changes in the habitat of the pathogen or its vectors to other regions. Global health systems are constantly working to create new vaccines and modernise old ones. Despite this, there are many reasons why vaccination coverage is not reaching the target values. These reasons include the availability of vaccines to the public, the level of knowledge of medical personnel and the trust of doctors in vaccination, the level of education of the population and the availability of information about the vaccine, commitment to vaccination in patients, and trust in international medical health systems. This means that low vaccination coverage can lead to a decrease in collective immunity, the occurrence of outbreaks of infectious diseases, and an increase in the burden on the health care system. Therefore, the main strategy for immunisation of the population is to eliminate the causes of low vaccination coverage, take measures to inform the population about vaccines, and increase people’s confidence in health systems. Keywords: Contagious diseases; Zoonotic diseases; Epidemic; Pandemic; Infection prevention
Chronic Obstructive Pulmonary Disease (COPD) is now the main cause of disability in the developed... more Chronic Obstructive Pulmonary Disease (COPD) is now the main cause of disability in the developed world. The advance of COPD is related to increasing breathlessness, disability, and periodic hospitalizations. An aging population in the developed world and increasing cigarette consumption in developing countries expand the global impact of this condition. The disorder associated with COPD leads to a decrease in physical activity and failure of functional independence. The aim of this study was to evaluate the effects of PR in patients with normal exercise capacity on health-related quality of life and exercise capacity. The mean FEV1/FVC was 59.4± 14.1%, and the mean FEV1 was 64.8± 23.0% as expected. Most topics had mild to moderate COPD. The PImax and PEmax were normal. These subjects had no previous participation in home-based or hospital-based PR. All the subjects had normal maximal V˙O2 and work rate before PR. After PR there were still considerable improvements in maximal V˙O2 ...
It is a well-known factor that the implementation of cardiopulmonary rehabilitation leads to a de... more It is a well-known factor that the implementation of cardiopulmonary rehabilitation leads to a decrease in the number of deaths and morbidity, however, this method is not widely used in Albania. One of the possible factors of low demand is the ignorance of patients regarding the benefits and effectiveness of this method. The purpose of this study is to find out the level of awareness of patients with cardiopulmonary diseases. During the study, a cross-sectional survey method was used among patients with this disease. Interest in and use of this rehabilitation was assessed using questionnaires that were given to 690 patients who underwent a course of treatment in university clinics and research hospitals that provide cardiopulmonary resuscitation services. The results of the study show that a third of patients learned information about cardiopulmonary rehabilitation (CPR) from medical personnel, and the other part received it from doctors. Despite the fact that almost half of the pat...
Introduction: given the recent experience with the COVID-19 vaccine campaign, an optimal global p... more Introduction: given the recent experience with the COVID-19 vaccine campaign, an optimal global policy to control future pandemics and ensure infectious security globally is highly relevant. Objective: the study aims to determine the optimal vaccination strategy to reduce COVID-19 morbidity and mortality during a pandemic. Method: a systematic search of studies on infectious disease control and vaccination strategies for the period 2000-2023 in PubMed, Scopus, Web of Science and Google Scholar databases using keywords was conducted for the review. Relevant publications, data extraction and systematisation were selected. Results: the findings of the analysis highlight the importance of integrated interventions in global vaccination strategies, including health systems strengthening, innovative technologies for outbreak detection and international collaboration. Vaccination, as an effective preventive measure, significantly reduces the spread of infectious diseases. Vaccination with different types of vaccines has been shown to improve immune response compared to the use of the same type of vaccine. This approach, where the first and second vaccine doses are different, may increase the effectiveness of the immune response. Conclusions: studies confirm that vaccination reduces the number of cases and deaths, reducing the economic burden. A variety of vaccines, including mRNA, vector, and inactivated vaccines, provide high efficacy in preventing COVID-19 infection and mortality, especially when a heterologous vaccination regimen is used. This review identifies the most effective infectious disease control strategies for the development of global health recommendations.
Abstract : Introduction: Cardio-respiratory rehabilitation is the set of coordinated intervention... more Abstract : Introduction: Cardio-respiratory rehabilitation is the set of coordinated interventions needed to provide the best physical, psychological, and social conditions so that patients with chronic or post-acute cardiopulmonary disease, with their efforts, maintain or resume optimal functioning in society through improved health behaviors. Purpose: To study the effectiveness of the application of Cardio-Respiratory Rehabilitation in the typology of patients with chronic or post-acute cardiomyopathy and chronic respiratory diseases in order to facilitate their therapeutic use and to improve the overall quality of life. Material and Method: This is a prospective study including patients with COPD and cardiac disease who were included in the rehabilitation program during the period January 2019 - November 2021. The study was conducted at the University Hospital Center "Mother Teresa" in Tirana, University Hospital "SHEFQET NDROQI", AMERICAN Hospital, HYGEA Hospital, and "Our Lady of Good Counsel, Tirana". An individual chart was used to collect sociodemographic, physical, clinical, and functional examinations for each patient. Results: The study included 253 patients, with a mean age of 62.1 (± 7.9) years, ranging from 48 to 82 years. (67.6%) of the patients were males, and (32.4%) female. Male patients predominated in all age groups, with a statistically significant difference with females (p<0.01). The most common cardiac pathologies are coronary artery bypass (24%), cerebral stroke (9%), myocardial infarction (17%), Stent placement (8%) (p<0.01). Correlation matrix of risk factors found a significant correlation of alcohol consumption with diabetes, smoking, dyslipidemia, sedentary life, obesity, AVC, and hypertension. Functional capacity estimated by change in metabolic equivalents (MET) improved by 46% from 4. ±2.2 to 7.2± .8 METs (p<0.01). Duration of exercise after rehabilitation was increased by 21% compared to baseline (p<0.01). The mean score of all three subscales of the questionnaire: symptoms (p=0.03), activity (p<0.01), and impact (p<0.01) after rehabilitation, was lower compared to pre-rehabilitation. Conclusions: The rehabilitation program has impacted on improving the quality of life, reducing symptoms, reducing the impact of negative factors on daily life, and reducing dyspnea during daily activities. Keywords : cardio-respiratory rehabilitation, physical exercise, quality of life, diseases
World Academy of Science, Engineering and Technology International Journal of Nursing and Health Sciences
Abstract : Objectives: The target of this paper is (1) to explain objectively physical activity ... more Abstract : Objectives: The target of this paper is (1) to explain objectively physical activity model throughout three chronic cardiopulmonary conditions, and (2) to study the connection among physical activity dimensions with disease severity, self reported physical and emotional functioning, and exercise performance. Design: Cross-sectional study. Setting: Participants` domestic environment. Participants: Patients with cardiopulmonary diseases: chronic obstructive pulmonary diseases (COPD) (n=63), coronary heart failure (n=60), and patients with implantable cardioverter defibrillator (n=60). Interventions: Not applicable. Main results measures: Seven ambulatory physical activity dimensions (total steps, percentage time active, percentage time ambulating at low, medium, and hard intensity, maximum cadence for 30 non-stop minutes, and peak performance) have been measured with an accelerometer. Results: Subjects with COPD had the lowest amount of ambulatory physical activity compared with topics with coronary heart failure and cardiac dysrhythmias (all 7 interest dimensions, P<.05); total step counts have been: 5319 as opposed to 7464 as opposed to 9570, respectively. Six-minute walk distance become correlated (r=.44-.65, P<.01) with all physical activity dimensions with inside the COPD pattern, the most powerful correlations being with total steps and peak performance. In topics with cardiac impairment, maximal oxygen intake had most effective small to slight correlations with five of the physical activity dimensions (r=.22-.40, P<.05). In contrast, correlations among 6-minute walk test distance and physical activity have been higher (r=.48-.61, P<.01) albeit in a smaller pattern of most effective patients with coronary heart failure. For all three samples, self-reported physical and mental health functioning, age, frame mass index, airflow obstruction, and ejection fraction had both exceptionally small and no significant correlations with physical activity. Conclusions: Findings from this study present a profitable benchmark of physical activity patterns in individuals with cardiopulmonary diseases for comparison with future studies. All seven dimensions of ambulatory physical activity disfavor between subjects with COPD, heart failure, and cardiac dysrhythmias. Depending on the research or clinical goal, use of one dimension such as total steps may be sufficient. Although physical activity had high correlations with performance on a six-minute walk test relative to other variables, accelerometers-based physical activity monitoring provides unique, important information about real-world behavior in patients with cardiopulmonary not already captured with existing measures. Keywords : ambulatory physical activity, walking, monitoring, COPD, heart failure, implantable defibrillator, exercise performance
International Journal of Ecosystems and Ecology Sciences (IJEES)
ABSTRACT
Chronic Obstructive Pulmonary Disease (COPD) is now a leading cause of disability in th... more ABSTRACT Chronic Obstructive Pulmonary Disease (COPD) is now a leading cause of disability in the developed world. The progress of COPD is associated with increasing breathlessness, disability and frequent hospitalisations. An ageing population in the developed world and increasing cigarette consumption in developing countries compounds the global impact of this condition. The disability associated with COPD leads to a reduction in physical activity and loss of functional independence. The aim of this study was to investigate the effects of PR in patients with normal exercise capacity on health-related quality of life and exercise capacity. The mean FEV1/FVC was 59.4± 14.1%, and the mean FEV1 was 64.8± 23.0% of predicted. Most subjects had mild to moderate COPD. The PImax and PEmax were normal. These subjects had no previous participation in home-based or hospital-based PR. All the subjects had normal maximal V˙O2 and work rate before PR. After PR there were still significant improvements in maximal V˙O2 (mean increase of 101.3 mL/min, p <0.001) and work rate (mean increase of 8.2 watts, p<0.001). Ventilation, heart rate, and mean blood pressure were unchanged following PR. The maximum oxygen pulse at maximum exercise was significantly increased with PR (p<0.02). The SpO2 and end-tidal PCO2 at peak exercise did not significantly change after PR. Although dyspnea scores at rest were low and did not change significantly with PR, dyspnea at end-exercise was significantly improved after PR (p=0.01). PR should be part of the clinical management of patients with COPD, even for those with normal exercise capacity. However, benefits on disease progression, hospitalization, and survival for these patients remain unknown. Key words: pulmonary rehabilitation; COPD; exercise capacity.
Shortness of breath associated with cardiorespiratory abnormalities and peripheral muscle discomf... more Shortness of breath associated with cardiorespiratory abnormalities and peripheral muscle discomfort are the major factors that limit exercise capacity in patients with chronic obstructive pulmonary disease (COPD) and those with congestive heart failure (CHF). Both of these symptoms negatively impact on patients' daily physical activity levels. In turn, poor daily physical activity is commonly associated with increased rates of morbidity and mortality. Among those coronary artery disease patients referred, CR completion is associated with improved survival and decreased hospitalization. This is a prospective study of patient who underwent cardiac and pulmonary surgery at university hospital centre "Mother Theresa" in Tirana, Albania over the period 2012-2014. Patients were evaluated before and after cardiac rehabilitation (CR). Tailored pulmonary rehabilitation programs should be considered for COPD patients of all stages, who have respiratory symptoms and/or who have intolerance to physical effort despite optimal pharmacological treatment.
Abstract. Cardiopulmonary rehabilitation among patients with heart and chronic obstructive pulmon... more Abstract. Cardiopulmonary rehabilitation among patients with heart and chronic obstructive pulmonary disease in a hospital in Tirana. Ledi Necaj. It is a well-known factor that the implementation of cardiopulmonary rehabilitation leads to a decrease in the number of deaths and morbidity, however, this method is not widely used in Albania. One of the possible factors of low demand is the ignorance of patients regarding the benefits and effectiveness of this method. The purpose of this study is to find out the level of awareness of patients with cardiopulmonary diseases. During the study, a cross-sectional survey method was used among patients with this disease. Interest in and use of this rehabilitation was assessed using questionnaires that were given to 690 patients who underwent a course of treatment in university clinics and research hospitals that provide cardiopulmonary resuscitation services. The results of the study show that a third of patients learned information about cardiopulmonary rehabilitation (CPR) from medical personnel, and the other part received it from doctors. Despite the fact that almost half of the patients knew that they should perform certain physical activities and exercises to maintain their positive dynamics in relation to cardiopulmonary disease, only one third of the patients understood that such everyday activities as climbing stairs and a brisk walk down the street do not constitute threats to their heart and lungs, respectively. It was also found that a significant part of the patients regularly played sports. Certain types of exercises were offered to one half of the patients, at that time, the rest of them performed various exercises. 69% of all patients who were given detailed information about CPR were ready to participate in this program. Despite the fact, that numerous people were ready to undergo this method of rehabilitation, not all of them were sufficiently knowledgeable and did not fully understand the essence of this technique. Also, an important factor in the positive dynamics of the patient's recovery is his relationship with the doctor and medical personnel involved in the treatment of patients with cardiopulmonary diseases. Key words: aetiology, physical activity, heart disease, awareness, personal habits
chronic Obstructive Pulmonary Disease (cOPD) is now the main cause of disability in the developed... more chronic Obstructive Pulmonary Disease (cOPD) is now the main cause of disability in the developed world. the advance of cOPD is related to increasing breathlessness, disability and periodic hospitalizations. an aging population in the developed world and increasing cigarette consumption in developing countries expand the global impact of this condition. the disorder associated with cOPD leads to a decrease in physical activity and failure of functional independence. The aim of this study was to evaluate the effects of Pr in patients with normal exercise capacity on health-related quality of life and exercise capacity. the mean FeV1/FVc was 59.4± 14.1%, and the mean FeV1 was 64.8± 23.0% as expected. Most topics had mild to moderate cOPD. the P imax and P emax were normal. these subjects had no previous participation in home-based or hospital-based Pr. all the subjects had normal maximal V˙O2 and work rate before PR. After PR there were still considerable improvements in maximal V˙O2 (mean increase of 101.3 mL/min, p <0.001) and work rate (mean increase of 8.2 watts, p<0.001). Ventilation, heart rate, and mean blood pressure were constant following PR. The maximum oxygen pulse at maximum exercise was significantly increased with PR (p<0.02). The SpO2 and end-tidal PCO2 at peak exercise did not significantly improve after PR. Although dyspnea scores at rest were low and did not improve significantly with PR, dyspnea at end-exercise was significantly improved after Pr (p=0.01). Pr should be the responsibility of the clinical management of patients with cOPD, even for those with normal exercise capacity. However, the benefits of disease progression, hospitalization, and survival for these patients remain unknown. the main role in the management of any chronic disease, including lung disease, is to improve the quality of life (Ql) in patients. Conclusion; Although strongly recommended by scientific societies pulmonary rehabilitation programs still need to be more widely implemented. PR programs have shown a high level of evidence of benefits in chronic respiratory patients, particularly those with cOPD.
ABSTRACT
Cardiac
Rehabilitation to
Reduce Heart
Failure
Objective: The purpose of this study... more ABSTRACT Cardiac Rehabilitation to Reduce Heart Failure Objective: The purpose of this study was to examine if early involvement in cardiac rehabilitation (CR) decreases readmissions after heart failure (HF) hospitalization. Study Design: A Retrospective Study Place and Duration of Study: This study was conducted at the University Hospital Center "Mother Teresa" in Tirana, University Hospital "SHEFQET NDROQI", AMERICAN Hospital, HYGEA Hospital, and "Our Lady of Good Counsel, Tirana" from January 2019 - November 2021. Materials and Methods: There were 120 patients of both gender had heart failure included in this study. Age of the patients was between 18-80 years of age. Patients were equally divided in two groups. Group I had 60 patients were discharged after getting 30-days hospitalization without getting cardiac rehabilitation while in group II 30-patients received at-least 1-sesssion of cardiac rehabilitation in hospitalization. Outcomes among both groups were compared in terms of readmission because of HF. SPSS 24.0 was used to analyze all data. Results: Among 120 patients, 69 (57.5%) were males and 61 (42.5%) were females. Mean age of the patients was 53.24±11.64 years and had mean BMI 24.11±6.37 kg/m2. There were 71 (59.2%) patients had hypertension and diabetes mellitus was found in 44 (36.7%) cases, Smoking history was found in 57 (47.5%) cases. There were 10 (8.3%) cases had heat stroke among all cases. Early cardiac rehabilitation dramatically decreased hospital readmissions and cardiac mortality in patients. The cardiac rehabilitation group that had re-hospitalization had higher rates of diabetes, hyperkalemia, and low PETCO2. An independent risk factor for re-hospitalization was low PETCO2 (Partial pressure of end-tidal carbon) at anaerobic threshold ( ≤33.5 mmHg). Conclusion: We found that people with acute myocardial infarction who started cardiac rehabilitation right away had fewer major cardiac events later on. As a risk factor for readmission, decreased PETCO2 at the anaerobic threshold can be utilized to evaluate the efficacy of early cardiac rehabilitation. Key Words: Heart Failure, Cardiac Rehabilitation, Readmission, PETCO2, Hyperkalemia
The purpose of the study was to analyse the quality of vaccination among the
population and to e... more The purpose of the study was to analyse the quality of vaccination among the population and to evaluate strategies that contribute to reducing the prevalence of infectious diseases, the number of complications, and the severity of disease. The study also examined pathogens that pose a global threat to the population, which have high risks of outbreaks due to global changes in climatic conditions. The development of vaccines capable of preventing or eliminating an infectious disease, reducing the severity of the disease and the rate of hospitalisation has been studied. In addition, the issue of the causes of low vaccination coverage in Kyrgyzstan, Albania, Bulgaria, and Latvia has been investigated. It was found that diseases that have a geographical distribution in certain climatic zones have a risk of zone expansion due to global climate warming and changes in the habitat of the pathogen or its vectors to other regions. Global health systems are constantly working to create new vaccines and modernise old ones. Despite this, there are many reasons why vaccination coverage is not reaching the target values. These reasons include the availability of vaccines to the public, the level of knowledge of medical personnel and the trust of doctors in vaccination, the level of education of the population and the availability of information about the vaccine, commitment to vaccination in patients, and trust in international medical health systems. This means that low vaccination coverage can lead to a decrease in collective immunity, the occurrence of outbreaks of infectious diseases, and an increase in the burden on the health care system. Therefore, the main strategy for immunisation of the population is to eliminate the causes of low vaccination coverage, take measures to inform the population about vaccines, and increase people’s confidence in health systems. Keywords: Contagious diseases; Zoonotic diseases; Epidemic; Pandemic; Infection prevention
Chronic Obstructive Pulmonary Disease (COPD) is now the main cause of disability in the developed... more Chronic Obstructive Pulmonary Disease (COPD) is now the main cause of disability in the developed world. The advance of COPD is related to increasing breathlessness, disability, and periodic hospitalizations. An aging population in the developed world and increasing cigarette consumption in developing countries expand the global impact of this condition. The disorder associated with COPD leads to a decrease in physical activity and failure of functional independence. The aim of this study was to evaluate the effects of PR in patients with normal exercise capacity on health-related quality of life and exercise capacity. The mean FEV1/FVC was 59.4± 14.1%, and the mean FEV1 was 64.8± 23.0% as expected. Most topics had mild to moderate COPD. The PImax and PEmax were normal. These subjects had no previous participation in home-based or hospital-based PR. All the subjects had normal maximal V˙O2 and work rate before PR. After PR there were still considerable improvements in maximal V˙O2 ...
It is a well-known factor that the implementation of cardiopulmonary rehabilitation leads to a de... more It is a well-known factor that the implementation of cardiopulmonary rehabilitation leads to a decrease in the number of deaths and morbidity, however, this method is not widely used in Albania. One of the possible factors of low demand is the ignorance of patients regarding the benefits and effectiveness of this method. The purpose of this study is to find out the level of awareness of patients with cardiopulmonary diseases. During the study, a cross-sectional survey method was used among patients with this disease. Interest in and use of this rehabilitation was assessed using questionnaires that were given to 690 patients who underwent a course of treatment in university clinics and research hospitals that provide cardiopulmonary resuscitation services. The results of the study show that a third of patients learned information about cardiopulmonary rehabilitation (CPR) from medical personnel, and the other part received it from doctors. Despite the fact that almost half of the pat...
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Ledi Necaj by Ledi Necaj
physical, psychological, and social conditions so that patients with chronic or post-acute cardiopulmonary disease, with their
efforts, maintain or resume optimal functioning in society through improved health behaviors. Purpose: To study the
effectiveness of the application of Cardio-Respiratory Rehabilitation in the typology of patients with chronic or post-acute
cardiomyopathy and chronic respiratory diseases in order to facilitate their therapeutic use and to improve the overall quality
of life. Material and Method: This is a prospective study including patients with COPD and cardiac disease who were included
in the rehabilitation program during the period January 2019 - November 2021. The study was conducted at the University
Hospital Center "Mother Teresa" in Tirana, University Hospital "SHEFQET NDROQI", AMERICAN Hospital, HYGEA Hospital,
and "Our Lady of Good Counsel, Tirana". An individual chart was used to collect sociodemographic, physical, clinical, and
functional examinations for each patient. Results: The study included 253 patients, with a mean age of 62.1 (± 7.9) years,
ranging from 48 to 82 years. (67.6%) of the patients were males, and (32.4%) female. Male patients predominated in all age
groups, with a statistically significant difference with females (p<0.01). The most common cardiac pathologies are coronary
artery bypass (24%), cerebral stroke (9%), myocardial infarction (17%), Stent placement (8%) (p<0.01). Correlation matrix of
risk factors found a significant correlation of alcohol consumption with diabetes, smoking, dyslipidemia, sedentary life, obesity,
AVC, and hypertension. Functional capacity estimated by change in metabolic equivalents (MET) improved by 46% from 4.
±2.2 to 7.2± .8 METs (p<0.01). Duration of exercise after rehabilitation was increased by 21% compared to baseline (p<0.01).
The mean score of all three subscales of the questionnaire: symptoms (p=0.03), activity (p<0.01), and impact (p<0.01) after
rehabilitation, was lower compared to pre-rehabilitation. Conclusions: The rehabilitation program has impacted on improving
the quality of life, reducing symptoms, reducing the impact of negative factors on daily life, and reducing dyspnea during daily
activities.
Keywords : cardio-respiratory rehabilitation, physical exercise, quality of life, diseases
cardiopulmonary conditions, and (2) to study the connection among physical activity dimensions with disease severity, self
reported physical and emotional functioning, and exercise performance. Design: Cross-sectional study. Setting: Participants`
domestic environment. Participants: Patients with cardiopulmonary diseases: chronic obstructive pulmonary diseases (COPD)
(n=63), coronary heart failure (n=60), and patients with implantable cardioverter defibrillator (n=60). Interventions: Not
applicable. Main results measures: Seven ambulatory physical activity dimensions (total steps, percentage time active,
percentage time ambulating at low, medium, and hard intensity, maximum cadence for 30 non-stop minutes, and peak
performance) have been measured with an accelerometer. Results: Subjects with COPD had the lowest amount of ambulatory
physical activity compared with topics with coronary heart failure and cardiac dysrhythmias (all 7 interest dimensions, P<.05);
total step counts have been: 5319 as opposed to 7464 as opposed to 9570, respectively. Six-minute walk distance become
correlated (r=.44-.65, P<.01) with all physical activity dimensions with inside the COPD pattern, the most powerful
correlations being with total steps and peak performance. In topics with cardiac impairment, maximal oxygen intake had most
effective small to slight correlations with five of the physical activity dimensions (r=.22-.40, P<.05). In contrast, correlations
among 6-minute walk test distance and physical activity have been higher (r=.48-.61, P<.01) albeit in a smaller pattern of most
effective patients with coronary heart failure. For all three samples, self-reported physical and mental health functioning, age,
frame mass index, airflow obstruction, and ejection fraction had both exceptionally small and no significant correlations with
physical activity. Conclusions: Findings from this study present a profitable benchmark of physical activity patterns in
individuals with cardiopulmonary diseases for comparison with future studies. All seven dimensions of ambulatory physical
activity disfavor between subjects with COPD, heart failure, and cardiac dysrhythmias. Depending on the research or clinical
goal, use of one dimension such as total steps may be sufficient. Although physical activity had high correlations with
performance on a six-minute walk test relative to other variables, accelerometers-based physical activity monitoring provides
unique, important information about real-world behavior in patients with cardiopulmonary not already captured with existing
measures.
Keywords : ambulatory physical activity, walking, monitoring, COPD, heart failure, implantable defibrillator, exercise
performance
Chronic Obstructive Pulmonary Disease (COPD) is now a leading cause of disability in the developed world. The
progress of COPD is associated with increasing breathlessness, disability and frequent hospitalisations. An ageing
population in the developed world and increasing cigarette consumption in developing countries compounds the
global impact of this condition. The disability associated with COPD leads to a reduction in physical activity and
loss of functional independence. The aim of this study was to investigate the effects of PR in patients with normal
exercise capacity on health-related quality of life and exercise capacity. The mean FEV1/FVC was 59.4± 14.1%,
and the mean FEV1 was 64.8± 23.0% of predicted. Most subjects had mild to moderate COPD. The PImax and PEmax
were normal. These subjects had no previous participation in home-based or hospital-based PR. All the subjects had
normal maximal V˙O2 and work rate before PR. After PR there were still significant improvements in maximal
V˙O2 (mean increase of 101.3 mL/min, p <0.001) and work rate (mean increase of 8.2 watts, p<0.001). Ventilation,
heart rate, and mean blood pressure were unchanged following PR. The maximum oxygen pulse at maximum
exercise was significantly increased with PR (p<0.02). The SpO2 and end-tidal PCO2 at peak exercise did not
significantly change after PR. Although dyspnea scores at rest were low and did not change significantly with PR,
dyspnea at end-exercise was significantly improved after PR (p=0.01). PR should be part of the clinical management
of patients with COPD, even for those with normal exercise capacity. However, benefits on disease progression,
hospitalization, and survival for these patients remain unknown.
Key words: pulmonary rehabilitation; COPD; exercise capacity.
in a hospital in Tirana. Ledi Necaj. It is a well-known factor that the implementation of cardiopulmonary rehabilitation
leads to a decrease in the number of deaths and morbidity, however, this method is not widely used in Albania. One of
the possible factors of low demand is the ignorance of patients regarding the benefits and effectiveness of this method.
The purpose of this study is to find out the level of awareness of patients with cardiopulmonary diseases. During the study, a cross-sectional survey method was used among patients with this disease. Interest in and use of this rehabilitation
was assessed using questionnaires that were given to 690 patients who underwent a course of treatment in university
clinics and research hospitals that provide cardiopulmonary resuscitation services. The results of the study show that a
third of patients learned information about cardiopulmonary rehabilitation (CPR) from medical personnel, and the other
part received it from doctors. Despite the fact that almost half of the patients knew that they should perform certain
physical activities and exercises to maintain their positive dynamics in relation to cardiopulmonary disease, only one
third of the patients understood that such everyday activities as climbing stairs and a brisk walk down the street do not
constitute threats to their heart and lungs, respectively. It was also found that a significant part of the patients regularly
played sports. Certain types of exercises were offered to one half of the patients, at that time, the rest of them performed
various exercises. 69% of all patients who were given detailed information about CPR were ready to participate in this
program. Despite the fact, that numerous people were ready to undergo this method of rehabilitation, not all of them were
sufficiently knowledgeable and did not fully understand the essence of this technique. Also, an important factor in the
positive dynamics of the patient's recovery is his relationship with the doctor and medical personnel involved in the
treatment of patients with cardiopulmonary diseases.
Key words: aetiology, physical activity, heart disease, awareness, personal habits
Cardiac
Rehabilitation to
Reduce Heart
Failure
Objective: The purpose of this study was to examine if early involvement in cardiac rehabilitation (CR) decreases
readmissions after heart failure (HF) hospitalization.
Study Design: A Retrospective Study
Place and Duration of Study: This study was conducted at the University Hospital Center "Mother Teresa" in
Tirana, University Hospital "SHEFQET NDROQI", AMERICAN Hospital, HYGEA Hospital, and "Our Lady of
Good Counsel, Tirana" from January 2019 - November 2021.
Materials and Methods: There were 120 patients of both gender had heart failure included in this study. Age of the
patients was between 18-80 years of age. Patients were equally divided in two groups. Group I had 60 patients were
discharged after getting 30-days hospitalization without getting cardiac rehabilitation while in group II 30-patients
received at-least 1-sesssion of cardiac rehabilitation in hospitalization. Outcomes among both groups were compared
in terms of readmission because of HF. SPSS 24.0 was used to analyze all data.
Results: Among 120 patients, 69 (57.5%) were males and 61 (42.5%) were females. Mean age of the patients was
53.24±11.64 years and had mean BMI 24.11±6.37 kg/m2. There were 71 (59.2%) patients had hypertension and
diabetes mellitus was found in 44 (36.7%) cases, Smoking history was found in 57 (47.5%) cases. There were 10
(8.3%) cases had heat stroke among all cases. Early cardiac rehabilitation dramatically decreased hospital
readmissions and cardiac mortality in patients. The cardiac rehabilitation group that had re-hospitalization had
higher rates of diabetes, hyperkalemia, and low PETCO2. An independent risk factor for re-hospitalization was low
PETCO2 (Partial pressure of end-tidal carbon) at anaerobic threshold ( ≤33.5 mmHg).
Conclusion: We found that people with acute myocardial infarction who started cardiac rehabilitation right away
had fewer major cardiac events later on. As a risk factor for readmission, decreased PETCO2 at the anaerobic
threshold can be utilized to evaluate the efficacy of early cardiac rehabilitation.
Key Words: Heart Failure, Cardiac Rehabilitation, Readmission, PETCO2, Hyperkalemia
population and to evaluate strategies that contribute to reducing the prevalence of
infectious diseases, the number of complications, and the severity of disease. The
study also examined pathogens that pose a global threat to the population, which
have high risks of outbreaks due to global changes in climatic conditions. The
development of vaccines capable of preventing or eliminating an infectious disease,
reducing the severity of the disease and the rate of hospitalisation has been studied.
In addition, the issue of the causes of low vaccination coverage in Kyrgyzstan,
Albania, Bulgaria, and Latvia has been investigated. It was found that diseases that
have a geographical distribution in certain climatic zones have a risk of zone
expansion due to global climate warming and changes in the habitat of the pathogen
or its vectors to other regions. Global health systems are constantly working to create
new vaccines and modernise old ones. Despite this, there are many reasons why
vaccination coverage is not reaching the target values. These reasons include the availability of vaccines to the public, the level of knowledge of medical personnel
and the trust of doctors in vaccination, the level of education of the population and
the availability of information about the vaccine, commitment to vaccination in
patients, and trust in international medical health systems. This means that low
vaccination coverage can lead to a decrease in collective immunity, the occurrence of
outbreaks of infectious diseases, and an increase in the burden on the health care
system. Therefore, the main strategy for immunisation of the population is to
eliminate the causes of low vaccination coverage, take measures to inform the
population about vaccines, and increase people’s confidence in health systems.
Keywords: Contagious diseases; Zoonotic diseases; Epidemic; Pandemic; Infection
prevention
Papers by Ledi Necaj
physical, psychological, and social conditions so that patients with chronic or post-acute cardiopulmonary disease, with their
efforts, maintain or resume optimal functioning in society through improved health behaviors. Purpose: To study the
effectiveness of the application of Cardio-Respiratory Rehabilitation in the typology of patients with chronic or post-acute
cardiomyopathy and chronic respiratory diseases in order to facilitate their therapeutic use and to improve the overall quality
of life. Material and Method: This is a prospective study including patients with COPD and cardiac disease who were included
in the rehabilitation program during the period January 2019 - November 2021. The study was conducted at the University
Hospital Center "Mother Teresa" in Tirana, University Hospital "SHEFQET NDROQI", AMERICAN Hospital, HYGEA Hospital,
and "Our Lady of Good Counsel, Tirana". An individual chart was used to collect sociodemographic, physical, clinical, and
functional examinations for each patient. Results: The study included 253 patients, with a mean age of 62.1 (± 7.9) years,
ranging from 48 to 82 years. (67.6%) of the patients were males, and (32.4%) female. Male patients predominated in all age
groups, with a statistically significant difference with females (p<0.01). The most common cardiac pathologies are coronary
artery bypass (24%), cerebral stroke (9%), myocardial infarction (17%), Stent placement (8%) (p<0.01). Correlation matrix of
risk factors found a significant correlation of alcohol consumption with diabetes, smoking, dyslipidemia, sedentary life, obesity,
AVC, and hypertension. Functional capacity estimated by change in metabolic equivalents (MET) improved by 46% from 4.
±2.2 to 7.2± .8 METs (p<0.01). Duration of exercise after rehabilitation was increased by 21% compared to baseline (p<0.01).
The mean score of all three subscales of the questionnaire: symptoms (p=0.03), activity (p<0.01), and impact (p<0.01) after
rehabilitation, was lower compared to pre-rehabilitation. Conclusions: The rehabilitation program has impacted on improving
the quality of life, reducing symptoms, reducing the impact of negative factors on daily life, and reducing dyspnea during daily
activities.
Keywords : cardio-respiratory rehabilitation, physical exercise, quality of life, diseases
cardiopulmonary conditions, and (2) to study the connection among physical activity dimensions with disease severity, self
reported physical and emotional functioning, and exercise performance. Design: Cross-sectional study. Setting: Participants`
domestic environment. Participants: Patients with cardiopulmonary diseases: chronic obstructive pulmonary diseases (COPD)
(n=63), coronary heart failure (n=60), and patients with implantable cardioverter defibrillator (n=60). Interventions: Not
applicable. Main results measures: Seven ambulatory physical activity dimensions (total steps, percentage time active,
percentage time ambulating at low, medium, and hard intensity, maximum cadence for 30 non-stop minutes, and peak
performance) have been measured with an accelerometer. Results: Subjects with COPD had the lowest amount of ambulatory
physical activity compared with topics with coronary heart failure and cardiac dysrhythmias (all 7 interest dimensions, P<.05);
total step counts have been: 5319 as opposed to 7464 as opposed to 9570, respectively. Six-minute walk distance become
correlated (r=.44-.65, P<.01) with all physical activity dimensions with inside the COPD pattern, the most powerful
correlations being with total steps and peak performance. In topics with cardiac impairment, maximal oxygen intake had most
effective small to slight correlations with five of the physical activity dimensions (r=.22-.40, P<.05). In contrast, correlations
among 6-minute walk test distance and physical activity have been higher (r=.48-.61, P<.01) albeit in a smaller pattern of most
effective patients with coronary heart failure. For all three samples, self-reported physical and mental health functioning, age,
frame mass index, airflow obstruction, and ejection fraction had both exceptionally small and no significant correlations with
physical activity. Conclusions: Findings from this study present a profitable benchmark of physical activity patterns in
individuals with cardiopulmonary diseases for comparison with future studies. All seven dimensions of ambulatory physical
activity disfavor between subjects with COPD, heart failure, and cardiac dysrhythmias. Depending on the research or clinical
goal, use of one dimension such as total steps may be sufficient. Although physical activity had high correlations with
performance on a six-minute walk test relative to other variables, accelerometers-based physical activity monitoring provides
unique, important information about real-world behavior in patients with cardiopulmonary not already captured with existing
measures.
Keywords : ambulatory physical activity, walking, monitoring, COPD, heart failure, implantable defibrillator, exercise
performance
Chronic Obstructive Pulmonary Disease (COPD) is now a leading cause of disability in the developed world. The
progress of COPD is associated with increasing breathlessness, disability and frequent hospitalisations. An ageing
population in the developed world and increasing cigarette consumption in developing countries compounds the
global impact of this condition. The disability associated with COPD leads to a reduction in physical activity and
loss of functional independence. The aim of this study was to investigate the effects of PR in patients with normal
exercise capacity on health-related quality of life and exercise capacity. The mean FEV1/FVC was 59.4± 14.1%,
and the mean FEV1 was 64.8± 23.0% of predicted. Most subjects had mild to moderate COPD. The PImax and PEmax
were normal. These subjects had no previous participation in home-based or hospital-based PR. All the subjects had
normal maximal V˙O2 and work rate before PR. After PR there were still significant improvements in maximal
V˙O2 (mean increase of 101.3 mL/min, p <0.001) and work rate (mean increase of 8.2 watts, p<0.001). Ventilation,
heart rate, and mean blood pressure were unchanged following PR. The maximum oxygen pulse at maximum
exercise was significantly increased with PR (p<0.02). The SpO2 and end-tidal PCO2 at peak exercise did not
significantly change after PR. Although dyspnea scores at rest were low and did not change significantly with PR,
dyspnea at end-exercise was significantly improved after PR (p=0.01). PR should be part of the clinical management
of patients with COPD, even for those with normal exercise capacity. However, benefits on disease progression,
hospitalization, and survival for these patients remain unknown.
Key words: pulmonary rehabilitation; COPD; exercise capacity.
in a hospital in Tirana. Ledi Necaj. It is a well-known factor that the implementation of cardiopulmonary rehabilitation
leads to a decrease in the number of deaths and morbidity, however, this method is not widely used in Albania. One of
the possible factors of low demand is the ignorance of patients regarding the benefits and effectiveness of this method.
The purpose of this study is to find out the level of awareness of patients with cardiopulmonary diseases. During the study, a cross-sectional survey method was used among patients with this disease. Interest in and use of this rehabilitation
was assessed using questionnaires that were given to 690 patients who underwent a course of treatment in university
clinics and research hospitals that provide cardiopulmonary resuscitation services. The results of the study show that a
third of patients learned information about cardiopulmonary rehabilitation (CPR) from medical personnel, and the other
part received it from doctors. Despite the fact that almost half of the patients knew that they should perform certain
physical activities and exercises to maintain their positive dynamics in relation to cardiopulmonary disease, only one
third of the patients understood that such everyday activities as climbing stairs and a brisk walk down the street do not
constitute threats to their heart and lungs, respectively. It was also found that a significant part of the patients regularly
played sports. Certain types of exercises were offered to one half of the patients, at that time, the rest of them performed
various exercises. 69% of all patients who were given detailed information about CPR were ready to participate in this
program. Despite the fact, that numerous people were ready to undergo this method of rehabilitation, not all of them were
sufficiently knowledgeable and did not fully understand the essence of this technique. Also, an important factor in the
positive dynamics of the patient's recovery is his relationship with the doctor and medical personnel involved in the
treatment of patients with cardiopulmonary diseases.
Key words: aetiology, physical activity, heart disease, awareness, personal habits
Cardiac
Rehabilitation to
Reduce Heart
Failure
Objective: The purpose of this study was to examine if early involvement in cardiac rehabilitation (CR) decreases
readmissions after heart failure (HF) hospitalization.
Study Design: A Retrospective Study
Place and Duration of Study: This study was conducted at the University Hospital Center "Mother Teresa" in
Tirana, University Hospital "SHEFQET NDROQI", AMERICAN Hospital, HYGEA Hospital, and "Our Lady of
Good Counsel, Tirana" from January 2019 - November 2021.
Materials and Methods: There were 120 patients of both gender had heart failure included in this study. Age of the
patients was between 18-80 years of age. Patients were equally divided in two groups. Group I had 60 patients were
discharged after getting 30-days hospitalization without getting cardiac rehabilitation while in group II 30-patients
received at-least 1-sesssion of cardiac rehabilitation in hospitalization. Outcomes among both groups were compared
in terms of readmission because of HF. SPSS 24.0 was used to analyze all data.
Results: Among 120 patients, 69 (57.5%) were males and 61 (42.5%) were females. Mean age of the patients was
53.24±11.64 years and had mean BMI 24.11±6.37 kg/m2. There were 71 (59.2%) patients had hypertension and
diabetes mellitus was found in 44 (36.7%) cases, Smoking history was found in 57 (47.5%) cases. There were 10
(8.3%) cases had heat stroke among all cases. Early cardiac rehabilitation dramatically decreased hospital
readmissions and cardiac mortality in patients. The cardiac rehabilitation group that had re-hospitalization had
higher rates of diabetes, hyperkalemia, and low PETCO2. An independent risk factor for re-hospitalization was low
PETCO2 (Partial pressure of end-tidal carbon) at anaerobic threshold ( ≤33.5 mmHg).
Conclusion: We found that people with acute myocardial infarction who started cardiac rehabilitation right away
had fewer major cardiac events later on. As a risk factor for readmission, decreased PETCO2 at the anaerobic
threshold can be utilized to evaluate the efficacy of early cardiac rehabilitation.
Key Words: Heart Failure, Cardiac Rehabilitation, Readmission, PETCO2, Hyperkalemia
population and to evaluate strategies that contribute to reducing the prevalence of
infectious diseases, the number of complications, and the severity of disease. The
study also examined pathogens that pose a global threat to the population, which
have high risks of outbreaks due to global changes in climatic conditions. The
development of vaccines capable of preventing or eliminating an infectious disease,
reducing the severity of the disease and the rate of hospitalisation has been studied.
In addition, the issue of the causes of low vaccination coverage in Kyrgyzstan,
Albania, Bulgaria, and Latvia has been investigated. It was found that diseases that
have a geographical distribution in certain climatic zones have a risk of zone
expansion due to global climate warming and changes in the habitat of the pathogen
or its vectors to other regions. Global health systems are constantly working to create
new vaccines and modernise old ones. Despite this, there are many reasons why
vaccination coverage is not reaching the target values. These reasons include the availability of vaccines to the public, the level of knowledge of medical personnel
and the trust of doctors in vaccination, the level of education of the population and
the availability of information about the vaccine, commitment to vaccination in
patients, and trust in international medical health systems. This means that low
vaccination coverage can lead to a decrease in collective immunity, the occurrence of
outbreaks of infectious diseases, and an increase in the burden on the health care
system. Therefore, the main strategy for immunisation of the population is to
eliminate the causes of low vaccination coverage, take measures to inform the
population about vaccines, and increase people’s confidence in health systems.
Keywords: Contagious diseases; Zoonotic diseases; Epidemic; Pandemic; Infection
prevention