Global perspectives on heart disease rehabilitation and secondary prevention: a scientific statement from the Association of Cardiovascular Nursing and Allied Professions, European Association of Preventive Cardiology, and International Council of Cardiovascular Prevention and Rehabilitation.

Cardiovascular disease is a leading cause of death, morbidity, disability, and reduced health-related quality of life, as well as economic burden worldwide, with some 80% of disease burden occurring in the low- and middle-income country (LMIC) settings. With increasing numbers of people living longer with symptomatic disease, the effectiveness and accessibility of secondary preventative and rehabilitative health services have never been more important. Whilst LMICs experience the highest prevalence and mortality rates, the global approach to secondary prevention and cardiac rehabilitation, which mitigates this burden, has traditionally been driven from clinical guidelines emanating from high-income settings. This state-of-the art review provides a contemporary global perspective on cardiac rehabilitation and secondary prevention, contrasting the challenges of and opportunities for high vs. lower income settings. Actionable solutions to overcome system, clinician, programme, and patient level barriers to cardiac rehabilitation access in LMICs are provided.

Levels of nitric oxide in smokers and nonsmokers with chronic periodontitis before and after nonsurgical periodontal treatment.

Introduction: The purpose of this study was to determine the level of nitric oxide (NO) in both serum and saliva of smokers and nonsmokers with chronic periodontitis before and after scaling and root planing, as well as to compare the same (NO levels) with the severity of periodontitis. Materials and Methods: Sixty people took part in the study and were divided into three groups. The control group (Group I) involved 20 patients who were nonsmokers with healthy periodontium. The other two groups included 20 patients each, where Group II was nonsmokers with chronic periodontitis and Group III was smokers with chronic periodontitis. In addition, NO generation was quantified indirectly in this study using the Griess reaction to determine the nitrite level in serum and saliva. Results: The mean value of salivary and serum NO was higher in Group III than in Group II, and NO decreased considerably (P < 0.01) in both Groups II and III after treatment compared to before treatment. Conclusion: Serum and salivary NO levels can be used as a good predictor of the inflammatory condition of the periodontium in smokers.

Effect of adding ribbond fibres on marginal adaptation in class II composite restorations in teeth with affected dentine.

OBJECTIVE: To evaluate the feasibility and effect on marginal adaptation in class II composite restoration reinforced with polyethylene fibres in teeth with affected dentine using scanning electron microscopy. METHOD AND MATERIAL: Class II cavities with dimension 1.5 +0 .25 pulpal depth and 4 ± 0.25 mm buccolingual width/.were prepared on proximal surfaces extracted human molars or premolar with affected/sound dentine on gingival margin. The etching priming and restorations were done in prepared samples as per manufacture directions. The samples were divided in 2 groups depending on use of ribbond inserts in composite restorative material. Samples were finished, stored in distilled water and then thermocycled manually and then sectioned longitudinally through the restorations. The marginal adaptation was evaluated using scanning electron microscope (SEM). RESULT: The result showed that there was a definite gap all along the interface between caries affected dentine and the composite material in both the groups. The bigger gap was present in group II compared to group I.

Determination of levels of nitric oxide in smoker and nonsmoker patients with chronic periodontitis.

PURPOSE: Cigarette smoking is a major risk factor in periodontal diseases. The pathogenesis of periodontal diseases may be affected by alterations of the inflammatory response by smoke. Nitric oxide (NO) is a gaseous, colorless, highly reactive, short-lived free radical with a pivotal role in the regulation of various physiological and pathological mechanisms in the body. It is important in host defense and homeostasis, on the one hand, whereas, on the other hand, it modulates the inflammatory response in periodontitis, leading to harmful effects. The aim of this study was to assess the levels of NO in both the serum and saliva of smokers and nonsmokers having chronic periodontitis and to compare them with periodontally healthy controls. METHODS: SIXTY SUBJECTS PARTICIPATED IN THE STUDY AND WERE DIVIDED INTO THREE GROUPS: group I, healthy nonsmoking subjects; group II, nonsmoking patients with chronic periodontitis; group III, smoking patients with chronic periodontitis. Each group consisted of twenty subjects. The biochemical estimation of NO in the collected serum and in the saliva was performed using the Griess colorimetric reaction. RESULTS: The results showed that the mean value of the salivary and serum NO was greater in group II than in group I, and also greater in group III than in group II. CONCLUSIONS: NO appears to play an important and rather complex role in the immuno-inflammatory process and in the remodeling and maintenance of osseous structures. It is therefore logical that modulation of this mediator has potential for the treatment of a number of inflammatory conditions including periodontal disease.