Miles Witham

..The impact of exercise programmes for heart failure on those close to the patient is largely unknown. We examined the effect of a hospital and home-based exercise intervention on burden, anxiety and depression of informal caregivers...

..We tested whether vitamin D supplementation could reduce blood pressure and improve markers of vascular health in patients who had previously suffered a stroke...

..We aimed to compare the reliability, responsiveness and completion rates of the six minute walk with a new test of aerobic exercise capacity - the endurance shuttle walk test...

..We tested whether an exercise program tailored to the needs of these patients could improve exercise capacity and quality of life or reduce costs to the National Health Service...

..It is unclear whether screening tools such as the Birmingham Nutrition Risk (BNR) score and the Malnutrition Universal Screening Tool (MUST) can successfully predict outcome in this patient group...

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

..Exercise capacity and daily activity are key outcomes for older, frail heart failure patients. Little is known about the determinants of these outcomes in this patient group...

..Most studies of exercise training for heart failure have been conducted on relatively young patients with little comorbidity. Such programmes are unsuitable for the majority of older frail heart failure patients...

..To determine the predictive power of B-type natriuretic peptide (BNP) regarding death in older, functionally impaired patients with multiple comorbidity...

..the prevalence of obesity is rapidly increasing in older adults. Information is required about what interventions are effective in reducing obesity and influencing health outcomes in this age group...

..The Patient Generated Index is a recently introduced tool that allows individualised assessment of quality of life...

..To test the ease of use, reliability, responsiveness and construct validity of the Patient Generated Index, an individualised quality of life score, in older people attending a Medicine for Older People Day Hospital...

..6 m/month in nonattenders; P=.03). Similar results were seen for other outcomes. Only a small proportion of the variance in change of any of the outcomes was explained by differences in baseline variables...

..We tested whether vitamin D supplementation of patients with heart failure and vitamin D insufficiency can improve physical function and quality of life...

..We compared the effect of 100,000 and 200,000 IU doses of vitamin D(3) on endothelial function, blood pressure and markers of glycaemic control in patients with type 2 diabetes...

..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...

..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...

..To realize these potential benefits, exercise programs that are suitable for older, frail people need to be established and tested in an older, frail, unselected population with comorbidities...

..Vitamin D insufficiency has been linked to hypertension and cardiovascular events in observational studies. It is unclear whether vitamin D supplementation can reduce blood pressure, and, if so, by how much...

..The prevalence of echocardiographic LVH in patients with high cardiovascular risk appears to be high, even in patients currently considered normotensive...

..To ascertain trends in function and mortality after admission to a medicine for the elderly rehabilitation unit, and to analyze factors associated with these outcomes...

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

..Further studies are needed to establish whether larger doses of vitamin D given over a longer period of time can reduce symptoms, hospitalization, and mortality in heart failure...

..We sought to examine the effect of the angiotensin-converting-enzyme (ACE) inhibitor perindopril on physical function in elderly people with functional impairment who had no heart failure or left ventricular systolic dysfunction...

..This study aimed to examine the effect of accelerometer placement, use of walking aids, and different types of physical activity on Stay- Healthy RT3 triaxial accelerometer readings in older people...

..We conclude that neurohormonal dysfunction is an important component of chronic heart failure, which is affected by aldosterone and can be modified by the use of aldosterone receptor blockade...

..Little information exists about diet in the management of heart failure...

..This article reviews the physiology and function of vitamin D, examines the current observational and intervention data in cardiovascular disease, and discusses future research and current practice recommendations...

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..Further studies are needed to clarify these issues and to examine the role of informal caregivers in the management of CHF in the community...