Dans les addictions comportementales, plusieurs Quizartinib in vitro revues de la littérature sur l’efficacité du topiramate dans les troubles du comportement

alimentaire ont été réalisées [17] mais il n’en existe pas concernant le jeu pathologique. L’objectif de cette revue de la littérature était de synthétiser les connaissances sur l’efficacité du topiramate dans le traitement des conduites addictives. En outre, il n’existe pas d’article sur ce sujet dans la littérature francophone. Nous avons interrogé trois bases de données en décembre 2013 : Medline, Cochrane Library, et clinicaltrials.gov. Sur Medline (www.ncbi.nlm.nih.gov/pubmed), nous avons recherché les articles dont le titre contenait le mot clé « topiramate » associé à un mot clé relatif à l’addictologie. Nous avons formulé une requête unique afin d’éviter les redondances soit : substance abuse[title] AND topiramate[title] OR dependence[title] AND topiramate[title] OR alcohol[title] AND topiramate[title] OR tobacco[title] AND topiramate[title] OR smoking[title] AND topiramate[title] OR nicotine[title] AND topiramate[title] OR cocaine[title] AND topiramate[title] OR methamphetamine[title] AND topiramate[title] OR opiate[title] AND topiramate[title] OR heroin[title]

AND topiramate[title] OR benzodiazepine[title] AND topiramate[title] OR cannabis[title] AND topiramate[title] OR bulimia nervosa[title] AND topiramate[title] OR binge eating disorder[title] AND topiramate[title] OR gambling[title] find more AND topiramate[title]. Nous avons obtenu 104 résultats. Nous avons exclu 76 articles correspondant à des essais animaux, des essais en laboratoire, des case-reports, des séries de cas, des revues, des réponses

aux auteurs, et des articles sans rapport avec le sujet ( figure 1). Nous avons inclus 28 publications (dont une TCL méta-analyse) issues de 19 essais cliniques contrôlés randomisés. Pour chaque essai, nous avons étudié l’efficacité du topiramate ainsi que l’existence d’effets indésirables, en particulier de glaucome, effet indésirable le plus grave du topiramate : glaucoma[title] AND topiramate[title]. Dans la Cochrane Library (www.thecochranelibrary.com), nous avons recherché les articles dont le titre, le résumé ou les mots clés contenaient le mot topiramate : title, abstract or keywords : « topiramate ». Nous avons obtenu 18 résultats : 14 revues et quatre protocoles. Deux résultats appartenaient au champ de la psychiatrie, et deux au champ de l’addictologie. Sur clinicaltrials.gov, 209 études évaluant l’efficacité du topiramate étaient recensées, dont 35 concernaient les troubles liés aux substances (Substance Related Disorders). Parmi celles-ci, deux étaient terminées avec des résultats publiés, 11 étaient terminées sans résultats publiés, 15 étaient en cours de réalisation (« not yet recruiting ; recruiting ; active, not recruiting »), deux étaient abandonnées, une suspendue et trois avaient un statut inconnu.

Il existe des moyens directs pour objectiver la non-observance (pilulier électronique, dosage des médicaments), mais leur usage n’est pas applicable à la pratique clinique courante. L’usage d’un questionnaire adapté à la recherche d’une mauvaise observance chez l’hypertendu a été évalué en pratique quotidienne et a apporté une aide à la prise en charge d’hypertendus non contrôlés [12]. La recherche d’une mauvaise Obeticholic Acid chemical structure observance chez l’hypertendu résistant apporte souvent une information utile comme l’indique une étude réalisée en Pologne

qui se base sur la détection des médicaments dans les urines et révèle une mauvaise observance du traitement chez 53 % des patients avec chez 16 % une absence totale de prise des médicaments prescrits [13]. Les analyses des bases de données de délivrance des prescriptions des antihypertenseurs ont noté que c’est dans l’année MDV3100 cell line suivant la première prescription que la fréquence d’arrêt de la prise quotidienne est la plus élevée. Une étude réalisée à partir de la base de données de l’Assurance maladie en France [14] montre qu’à 12 mois de la première délivrance d’antihypertenseur, 35 % des patients ont arrêté le traitement initialement prescrit et que 63 % ont connu

au moins une période d’arrêt temporaire (plus de 14 jours) de leur traitement. Certains paramètres sont associés à un meilleur suivi du traitement (persistance de la prescription) : un âge plus élevé, la présence Calpain d’un diabète ou d’antécédents cardiovasculaires, un nombre réduit de comprimés, la délivrance d’associations fixes. Pour améliorer l’observance au suivi du traitement antihypertenseur, des études d’intervention ont été réalisées afin de tester les effets de l’information du patient, de l’éducation thérapeutique et de l’automesure tensionnelle. Les résultats de ces études ne sont le plus souvent pas démonstratifs. Il est suggéré de rechercher un facteur favorisant la résistance aux traitements (excès de sel, alcool, dépression et interférences médicamenteuses) ou des médicaments et substances ayant une action vasopressive ( Encadré 1 and Encadré 2). Anti-angiogéniques

Anti-inflammatoires non stéroïdiens Les conseils concernant les mesures d’habitudes de vie sont similaires chez l’hypertendu résistant et chez l’hypertendu contrôlé : • perte de poids en cas de surpoids (IMC > 25 kg/m2) ou d’obésité (IMC > 30 kg/m2) ; La réalisation d’un recueil des urines des 24 heures permet la mesure de la natriurèse qui quantifie les apports en sel. Un consommateur excessif de sel est dépisté si la natriurèse dépasse 12 g/jour (200 mmol). L’objectif d’une élimination par 24 heures inférieure à 6 g de NaCl (100 mmol) sera recommandé. Un interrogatoire alimentaire détaillé dépistera les consommations d’aliments riches en sel caché (fromage, pain, charcuterie, pizza, bouillons cubes…).

To verify N. caninum immunostaining, IFAT was performed with mouse sera collected at 45 d.a.i. as previously described [29]. Slides NVP-BKM120 mw containing formolized tachyzoites were incubated with serum samples diluted 1:50, and then with FITC-labeled goat anti-mouse IgG (1:50; Sigma). Slides were overlaid with buffered glycerol and examined in fluorescence microscope (EVOS, Advanced Microscopy Group, Inc., Mill Creek, WA). Two weeks after the last immunization (45 d.a.i.), three mice from each group were euthanized and

their spleens were aseptically removed for cell culture and cytokine production assay. Mouse spleens were dissociated in RPMI medium and cell suspensions were washed in medium, treated with lysis buffer (0.16 M NH4Cl and 0.17 M Tris–HCl, pH 7.5), washed again and resuspended in complete RPMI medium containing 10% CFS. Viable cells (2 × 105 cells/200 μl/well) were cultured in triplicate in

96-well plates in the presence of antigen (NLA, 10 μg/ml), mitogen (Concanavalin A – ConA, 2.5 μg/ml) or medium alone and incubated at 37 °C in 5% CO2. After 48 h, cell-free supernatants were collected and stored at −70 °C for cytokine quantification. IL-10 and IFN-γ measurements were carried out by sandwich ELISAs according to manufacturer’s http://www.selleckchem.com/screening/anti-infection-compound-library.html instructions (R&D Systems, Minneapolis, MN). The limit of detection for each assay was 31 pg/ml and intra-assay variation coefficients were below 15%. After 30 days of the last immunization (60 d.a.i.), the remaining animals of each group (10 per group) were challenged intraperitoneally (200 μl/mouse) with 2 × 107 low-passage Nc-1 tachyzoites. Animals were observed daily for clinical signs through morbidity scores, body weight changes

and mortality during 30 days post-infection (d.p.i.). Morbidity scores were calculated as described elsewhere [32], with minor modifications as follows: sleek/glossy coat, bright and active (score 0); ruffled coat (score 1); hunched, tottering gait, starry stiff coat (score 2), reluctance to move (score 3). Results were expressed as the mean of the scores given daily to each animal for each group. After 30 days of challenge, surviving animals were euthanized and blood 17-DMAG (Alvespimycin) HCl samples and brain tissues were collected. Serum samples were tested for N. caninum serology and brain tissues were sliced longitudinally, being half of them stored at −70 °C for polymerase chain reaction (PCR) assay. The remaining tissue was fixed in 10% buffered formalin, embedded in paraffin and routinely processed for immunohistochemical and histological assays. Brain parasite load was determined by quantitative real-time PCR as previously described [29], using primer pairs (sense 3′ GCTGAACACCGTATGTCGTAAA-5′; antisense 3′-AGAGGAATGCCACATAGAAGC-5′) to detect the N. caninum Nc-5 sequence through SYBR green detection system (Invitrogen, San Francisco, CA). DNA extraction was performed from 20 mg of murine brain tissues (Genomic DNA kit, Promega Co.

Higher than 20-fold levels of expression (p < 0.01) was sustained in LD 10–87 VERO cells at p250 and

in A4497 (p > 200) VERO cells, which are tumorigenic in both newborn and adult nude mice [10]. Three of the six miRNAs (miR-376a, miR-543 and miR-299-3p) were overexpressed more than 4-10 fold compared with pAGMK control cells and the LD 10–87 VERO cell passages before the expression of the tumorigenic phenotype was detected at p194 ( Table 1 and Fig. 1A). These results suggest that these miRNA-based biomarkers may be capable of predicting the pre-tumor stages of neoplastic development in VERO cells. To verify the accuracy and specificity of these results, we assessed the six miRNAs in HD VERO cells that were passaged independently at higher, confluent densities. The trend in the alteration of miRNA expression was generally similar Sirolimus between the LD 10–87 VERO cell lines and the HD 10–87 VERO cell lines. When compared with the pAGMK controls, five of these six miRNAs were over-expressed by greater than 4-fold in the tumorigenic PKC signaling HD 10–87 VERO cells at p183, and all six were

over-expressed by 6- to >50-fold at p250 ( Table 2). To further evaluate the ability of individual miRNA to reflect the expression of the tumorigenic phenotype in VERO cells, we examined three miRNA data sets (miR-376a, miR-654-3P, and miR-543) from experiments shown in Table 1 and Table 2. The expression pattern of each of these miRNA followed the progression of neoplastic development and peaked at p194 (Fig. either 4A) where the ability of LD 10–87 VERO cells

to form tumors was detected (Fig. 1). In HD 10–87 VERO cells, the same association between elevated expression levels of the same miRNAs and tumorigenicity was observed at p183; however, the expression levels in cells at p250 increased by an additional 4-fold compared with cells at p183 (Fig. 4B). Together, regardless of how the tumor-forming cells were established, whether by passaging at low density or high density, the individual miRNA expression pattern correlated with the detection of the tumorigenic phenotype. Therefore, these six miRNAs appeared to be biomarkers for this property of VERO cells. Managing the threats posed by emerging and re-emerging infectious diseases, such as pandemic influenza, call for the rapid production of large, possibly unprecedented, amounts of vaccines to immunize populations worldwide [31], [32] and [33]. Current production methods may be insufficient to meet these demands in the short period required to manage pandemics successfully [33]. Cell-culture technology based on immortalized cell substrates provides a possible method for increasing the efficiency of vaccine manufacture and improving vaccine efficacy [1], [3], [6], [8], [31], [32], [34], [35], [36] and [37]. Regulatory agencies have recommended that the tumorigenic potential of immortalized cell substrates proposed for human vaccine production be evaluated (21 Code of Federal Regulations 610.18).

Within each pair of twins, Dose 1 and Dose 2 of HRV vaccine/placebo was administered on the same day. In view of providing find protocol benefit to the infants receiving placebo during the course of the study, an additional dose of HRV vaccine was administered to all infants (aged < 6 months) at 7-weeks after the second vaccine/placebo dose in an open-labeled manner. All infants received three doses of combined diphtheria, tetanus, acellular pertussis, hepatitis B, inactivated poliovirus and Haemophilus influenzae

vaccine (DTPa-HBV-IPV-Hib [Infanrix hexa™, GSK Biologicals]). Infants were not allowed to take part in the study if they had received any investigational drug or vaccine 30 days preceding the first study vaccine/placebo dose or had a history of allergic disease likely to be exacerbated by the vaccine or had a history of chronic gastrointestinal diseases. They were also excluded if they were immunosuppressed or had an acute disease at the time of study enrolment. Hypersensitivity

to the vaccine/placebo and intussusception were adverse events that established absolute contraindication to further administration of vaccine/placebo doses. This study was conducted between January 2007 and February 2008, following Good Clinical Practice and the Declaration of Helsinki; the protocol and related documents were reviewed and approved by the ethics committee of the study centers. Parents or guardians of the participating twins provided consent for study participation by signing second the informed consent form. Rotarix™ (HRV) vaccine contained at least 106.0 median cell culture infectious dose of the selleck chemicals vaccine strain per vaccine dose (1 ml). The placebo had the same constituents as the active vaccine but without the vaccine virus and was identical in appearance to the vaccine. The lyophilized vaccine and placebo were reconstituted with the supplied liquid calcium carbonate buffer before oral administration [10]. Presence of the vaccine strain in the placebo group for any of the stool samples collected at pre-determined time points

was considered a positive transmission case. To evaluate rotavirus antigen shedding (ELISA, Dr. Ward’s Lab, USA), stool samples were collected by the parents/guardians in each pair of twins (HRV vaccine/placebo) at pre-determined time points—before the administration of the first and second HRV vaccine/placebo dose (or on the day of vaccination), three times a week (every two days) up to six weeks after each dose of HRV vaccine/placebo and at the post-vaccination blood sampling time point (7 weeks post-Dose 2). To ensure proper stool sample collection, surveillance was performed by a social worker at the time of stool sample collection. The study staff stuck appropriate labels on the stool collection containers to avoid mix-up of samples by the parents/guardians.

They noted that there were exceptions, and also that diagnosis depended upon exclusion of all other myopathies that might mimic the IIM–in itself a challenging task. Future research would show fundamental differences in the immunopathogenic mechanisms in DM and PM, that the muscle pathology of DM could be seen in patients without a rash, and that almost certainly many patients diagnosed as having PM on Bohan and Peter criteria actually had sIBM. At this point in the chronology it is appropriate to comment upon the emergence

of sIBM and development of its diagnostic criteria. From its first ABT-737 order recognition as a separate disorder in the late 1960s [10] we now realise that sIBM is the most prevalent of the IIM (ignoring for the moment the question of whether it is truly a primary inflammatory myopathy). As with the seminal papers of Bohan and Peter for DM and PM, a single paper stands out concerning diagnostic criteria for sIBM [11]. And as with Bohan and Peter, rigid adherence to these initial criteria may to some extent have clouded further thought. A slightly unusual feature learn more of the Griggs’ criteria is that a diagnosis of definite

sIBM can be made on histological grounds alone, without the need to fulfill any clinical criteria. In practice, there is little evidence that this approach might lead to erroneous diagnosis–that is, the pathological criteria as defined appear to be 100% specific for sIBM. The problem, some have

argued, is that there are many patients who indubitably Adenosine have sIBM who do not, at the time of their first diagnostic biopsy, show the canonical pathological features insisted upon by Griggs [12], [13] and [14]. The evidence that they “indubitably have sIBM” is three-fold. Firstly, they have the highly distinctive, some would say essentially pathognomonic, clinical features of sIBM in terms of distribution of weakness, and follow the typical natural history of the condition in terms of rate of progression. Secondly, if a second biopsy is taken from another muscle shortly after the first biopsy, the canonical features may be seen. Thirdly, if the biopsy is repeated some time later then again the characteristic features may be seen. These latter two observations suggest two possibilities. Firstly, as is seen in DM, the pathological changes throughout the body may be patchy–whether the characteristic changes are seen is something of a lottery. The second, and more concerning possibility, is that the canonical pathological features may represent a late stage of the disease, and are indeed absent early on. sIBM is recognised as being highly resistant to immunomodulatory therapies (an argument against it being primarily an immune-mediated disorder) but maybe such treatments initiated at an earlier stage in the disease process would be more successful.

For the purpose of the present research question, the data from the randomised trial are analysed as a cohort study, because the trial showed no differences between the usual care group and the physical therapy group (van Rijn et al 2007). Nevertheless, in the present study the interventions were also considered as potential prognostic factors. Patients with a lateral ankle sprain were eligible for this study if they were aged between 18 and 60 years and their first visit to the physician was within 1 week of the injury. Patients were excluded if they had a history of an injury of the same ankle during the previous two years or if they had ever had a fracture of the

same learn more ankle. All participants were asked to complete a baseline questionnaire containing questions about potential prognostic factors (Appendix 1, see the eAddenda for Appendix 1.) The following characteristics were measured at baseline: demographic factors (age, gender, body mass index), clinical factors (setting, intervention, injury grade, earlier injury, self-reported

swelling, Ankle Function Score measured according to de Bie et al 1997, instability, and pain at rest, during walking and running), and ankle load factors (ankle load during work and ankle load during hobby/sports). Ankle load was determined by asking, Osimertinib ‘Are your working/sporting tasks aggravating for your ankle?’ Loading was categorised as none, light, or heavy. The outcome measures evaluated by questionnaires at 3 and 12 months follow-up were subjective recovery, instability, re-sprains, ankle Ketanserin function, and pain at rest, during walking, and during running. Subjective recovery was measured on a numerical rating scale (range 0–10, where 0 = no recovery and 10 = full recovery.) Subjective instability was measured using six

questions about instability and a feeling of giving way: the degree of a feeling of giving way during walking on flat ground, walking on uneven ground, walking uphill, walking downhill, and sport activities (each measured on a numerical rating scale from 0 to 10), and instability (measured on a 6-point scale from ‘never a feeling of giving way’ to ‘a feeling of giving way with every step’.) The outcome ‘instability’ was dichotomised as being ‘present’ if at least one answer to these six questions was positive, or ‘absent’ if the answers were negative on all six questions. Participants were asked whether any re-sprains had occurred, so re-sprains were self-reported. Ankle function was measured using the Ankle Function Score, which consists of five categories: pain, instability, weight bearing, swelling, and gait pattern. In each category, the number of points can be summed to a maximum overall score of 100, which indicates minimal severity (de Bie et al 1997). Pain intensity was measured on a numerical rating scale (range 0-10, where 0 = no pain and 10 = unbearable pain.

For Ratio spectrum of GBP, MCB and ALP, spectrum of the mixture was divided by standard spectrum of MCB (0.5 μg/ml) and ALP (100 μg/ml); GBP (100 μg/ml) and ALP (100 μg/ml); and MCB (0.5 μg/ml)

and GBP (100 μg/ml) respectively. Obtained ratio spectra were smoothed (Δλ = 10) and converted to first order derivative spectrum (Δλ = 10, SF = 10 for GBP and MCB; Δλ = 10, SF = 1 for ALP). Amplitude (dA/dλ) of GBP, MCB and ALP were measured at 731.10 nm, 768.53 nm and 242.21 nm Hydroxychloroquine supplier respectively. Concentrations of GBP, MCB and ALP were computed by putting value of their amplitudes in respective standard regression equation obtained from calibration curve. The analysis procedure was repeated six times with tablet formulation. Excellent linearity was obtained for all the three drugs in the range of 100–500 μg/ml for GBP and ALP; and 0.5–2.5 μg/ml MCB. Linearity of GBP, MCB and ALP were shown in Fig. 2, Fig. 3 and Fig. 4 respectively. The correlation coefficients (r2) were found to be greater than 0.998 (n = 6) in all instances. LOD and LOQ were found to be 3.09 μg/ml and 9.37 μg/ml for GBP; 0.03 μg/ml and 0.10 μg/ml for MCB; and 4.79 μg/ml and 14.52 μg/ml for ALP ( Table 1). The proposed method afforded high recoveries for GBP,

MCB and ALP tablets. Results obtained from recovery studies shown in Table 2 indicate that see more this assay procedure can be used for routine quality control analysis of this ternary mixture in tablets. Precision of the analytical method was found to be reliable based on % RSD (<2%) corresponding to the peak areas. The % RSD values were less than 2, for intra-day and inter-day precision. Hence, the method was found to be precise for all the three

drugs. In all deliberately varied conditions for robustness study, the % RSD of GBP, MCB and ALP were found to be well within the acceptable limit (<1.5%) for robustness study ( Table 3). The validated method was used in the analysis of marketed conventional tablet trigabantin 100 with a label claim: 100 mg GBP, 500 μg MCB and 100 mg ALP per tablet. The results for the drugs assay shown in Table 4 indicate a good agreement with the label claims. The spectrum of blank does not show any interference at the detection from of GBP, MCB and ALP as it can be seen from the respective spectra ( Fig. 5). The results of stability study of drugs shown in Table 5. The developed Ratio spectra derivative spectroscopic method is simple, accurate and precise for the simultaneous determination of GBP, MCB and ALP from tablets. It was successfully validated in terms of linearity, range, accuracy, precision, LOD, LOQ and robustness in accordance with ICH Guidelines. Thus, the described method is suitable for routine analysis and quality control of pharmaceutical preparations containing these drugs in combination. All authors have none to declare.

Finally the bias towards a more cellular response by the liposomes could also be attributed to the presence of DOPE in the liposomes. DOPE, a neutral pH-sensitive lipid, is capable of improving delivery of CpG into the cytosol following APC uptake [46]. Endosomal escape is crucial for MHC I presentation of the antigen and the induction of CTL responses. It has been reported that liposomes

complexed with antigen and either CpG or poly(I:C), which binds to TLR3 that is also expressed intracellularly, are capable of cross priming CD8+ T cells [47]. Whether this is also the case after ID immunisation with our liposomes requires further investigation, but the elevated IFN-γ production is a first indication that a CTL response could be induced [48]. In conclusion, the advantage of co-encapsulation of check details BI-6727 antigen and TLR ligand in cationic liposomes is their potency to steer the immune bias. This depends on the type of TLR ligand used, as CpG, binding to the intracellular TLR9, induced the production of IgG2a antibodies and a potent cellular immune response after ID immunisation, whereas PAM, ligand of extracellular TLR2, did not. This research was performed under the framework of

TI Pharma project number D5-106 “vaccine delivery: alternatives for conventional multiple injection vaccines”. The authors thank Bram Slütter for critically reading the manuscript. “
“In June 2009, WHO declared the first influenza pandemic in over 40 years. The emergence of this new influenza virus initiated a robust and rapid response from public health partners around the world, including the research-based vaccine industry. As the 2009 A(H1N1) virus enters its post-pandemic Non-specific serine/threonine protein kinase phase, international institutions, national governments and individual manufacturers are conducting reviews to identify which aspects of the response were successful, and which can be improved. As part of this global assessment process, the international and European organizations that represent the world’s major influenza

vaccine manufacturers (the IFPMA IVS taskforce and EVM respectively) have worked together to compile an industry perspective. This is intended to complement the reviews conducted by other organizations, and ultimately to help inform future preparedness activities. Vaccines are a crucial tool in the fight against pandemic influenza, and consequently the vaccine industry has an essential role to play when called on by public health authorities. In answering this call, the manufacturers’ role is clear: the rapid development, production and supply of safe and effective pandemic vaccines to enable the immunization of local populations. However, fulfilling this role is challenging. Influenza vaccine manufacture is complex and time consuming, and requires specialist facilities and highly trained personnel.

Additionally, as is usual with trials of complex interventions, the outcome measures were not the same. This meant that we had to calculate a standardised mean difference from the meta-analysis, which is less clinically useful than a mean difference. Finally, only half of the trials measured the outcomes some time after the cessation of intervention. There is a need for a large high quality trial with adequate power and follow-up to investigate the effect of biofeedback in this population. In conclusion, this systematic review provides evidence that

augmenting feedback through the use of biofeedback is superior to usual therapy/placebo at improving lower limb activities in people after stroke. Importantly, it appears superior to therapist feedback. Furthermore, these benefits are largely maintained in the longer term. Given that many biofeedback CHIR-99021 molecular weight machines are relatively inexpensive, KU-55933 molecular weight biofeedback could be utilised more widely in clinical practice. The authors gratefully acknowledge Tien-Hsin Chang, Oktay Irmak, Helen Preston, J Rebecca Winbom, and Nikki Yang for assistance with translation. We would also like to thank Domenico Intiso and

Johanna Jondottir for providing us with additional information and data. “
“Chronic heart failure is characterised by dyspnoea, fatigue, and exercise intolerance. It is an increasingly common public health problem that leads to a poor prognosis and is associated with increased morbidity and decreased quality of life (Bennett et al 2003, Gwadry-Sridhar et al 2004). Some previous studies have

demonstrated that co-existing psychological conditions such as anxiety or depression are common among people with chronic heart failure in the community. These concomitant psychological conditions may lead to deterioration in the health of people with chronic heart failure and increase the risk of adverse outcomes (Friedmann et al 2006, Haworth et al 2005, Holzapfel et al 2009, Rumsfeld et al 2003, Tsuchihashi-Makaya et al 2009). Anxiety is also more likely as chronic heart disease becomes more severe on the New York Heart Association classification Vasopressin Receptor system (Haworth et al 2005). Quality of life might also be affected by these psychological conditions in people with chronic heart failure. However, the relationship that anxiety and depression have with quality of life and physical function remains to be determined. Exercise improves depression and anxiety scores in the general population and in some clinical populations (Herring et al 2010, Mead et al 2009). Several studies have investigated the psychological changes after exercise training in chronic heart failure patients (Koukouvou et al 2004, Kulcu et al 2007, Radzewitz et al 2002). However, the results are inconsistent.