A significant proportion of patients develop atrial fibrillation (AF) following cavotricuspid isthmus (CTI) ablation for typical atrial flutter (AFl). The objective of this study was to assess ...whether the presence of advanced interatrial block (aIAB) was associated with an elevated risk of AF after CTI ablation in patients with typical AFl and no prior history of AF.
This study included patients with typical AFl and no prior history of AF that were referred for CTI ablation. Patients were excluded when they had received repeat ablations or did not demonstrate a bidirectional block. In all patients, a post-ablation electrocardiogram (ECG) in sinus rhythm was evaluated for the presence of aIAB, defined as a P-wave duration ≥120 ms and biphasic morphology in the inferior leads. New-onset AF was identified from 12-lead ECGs, Holter monitoring, and device interrogations. The cohort comprised 187 patients (age 67 ± 10.7 years; ejection fraction 55.8 ± 11.2%). Advanced interatrial block was detected in 18.2% of patients, and left atrium was larger in patients with aIAB compared with those without aIAB (46.2 ± 5.9 vs. 43.1 ± 6.0 mm; P = 0.01). Over a median follow-up of 24.2 months, 67 patients (35.8%) developed new-onset AF. The incidence of new-onset AF was greater in patients with aIAB compared with those without aIAB (64.7 vs. 29.4%; P < 0.001). After a comprehensive multivariate analysis, aIAB emerged as the strongest predictor of new-onset AF odds ratio (OR) 4.2, 95% confidence interval (CI): 1.9-9.3; P < 0.001.
Advanced interatrial block is a key predictor for high risk of new-onset AF after a successful CTI ablation in patients with typical AFl.
Abstract Background Post–coronary artery bypass grafting atrial fibrillation (PCAF) is associated with increased morbidity, mortality, and system costs. Few studies have explored obstructive sleep ...apnea (OSA) as a risk factor for PCAF. We aimed to systematically review and synthesize the evidence associating OSA with PCAF. Methods We conducted a search of MEDLINE, EMBASE, Google Scholar, and Web of Science, as well as abstracts, conference proceedings, and reference lists until June 2014. Eligible studies were in English, were conducted in humans, and assessed OSA with polysomnography (PSG) or a validated questionnaire. Two reviewers independently selected studies, with disagreement resolved by consensus. Piloted forms were used to extract data and assess risk of bias. Results Five prospective cohort studies were included (n = 642). There was agreement in study selection (κ statistic, 0.89; 95% confidence interval CI, 0.75-1.00). OSA was associated with a higher risk of PCAF (odds ratio OR, 1.86; 95% CI 1.24-2.80; P = 0.003; I2 = 35%). We conducted 3 subgroup analyses. The associations increased for data that used PSG to assess OSA (OR, 2.34; 95% CI, 1.48-3.70), when severe OSA was included from 1 study (OR, 2.59; 95% CI, 1.63-4.11), and when adjusted analyses were pooled (OR, 2.38; 95% CI, 1.57-3.62; P < 0.001 in all), with no heterogeneity detected in any subgroup analysis (I2 < 0.01% in all). Conclusions OSA was shown to be a strong predictor of PCAF.
Background The management of postoperative pain is paramount to facilitate the delivery of day case surgical programs. In recent years, the complexity of procedures carried out has increased to ...include laparoscopic cholecystectomy. The aim of this study was to evaluate the impact of laparoscopic-assisted 4-quadrant transversus abdominis plane (TAP) block vs periportal local anesthetic wound infiltration in managing postoperative pain. Study Design A prospective, randomized, double-blinded trial was conducted with patients undergoing elective laparoscopic cholecystectomy. Patients were randomized using computerized “random number table” into a test group that received laparoscopic-assisted TAP block with bupivacaine with periportal saline injection and a control group that received a laparoscopic-assisted TAP block with saline and periportal bupivacaine. All patients received intraperitoneal instillation of bupivacaine in the gallbladder bed. Postoperative pain scores were recorded using numerical rating scores at rest and coughing at dedicated time points. Statistical analysis was carried out using GraphPad Prism software, version 5 (GraphPad Software) and p < 0.05 was considered significant. Results Eighty patients (70 female and 10 male) were enrolled; 40 patients were randomized to each group. Age, American Society of Anesthesiologists score, operative time, and BMI were comparable between the groups. No adverse events were encountered with the administration of TAP blocks. Numerical rating scores were significantly reduced in the test group at 1, 3, and 6 hours at rest (p = 0.025, p = 0.03, and p = 0.007, respectively). Numerical rating score was significantly reduced at 1, 3, and 6 hours during coughing (p = 0.026, p = 0.02, and p = 0.03, respectively). Difference in postoperative analgesic requirements between both groups was statistically insignificant (p = 0.17). Conclusions This analysis has confirmed the therapeutic benefit of laparoscopically delivered TAP blocks in elective laparoscopic cholecystectomy.
This study aims to prove the ideology of resistance of Leila Salikha Chudori towards oppressive force via Laut Bercerita. Literary work is a product of the author’s critical thinking; therefore, it ...is important to understand Chudori’s ideology in her work. From a Marxist point of view, there is a battle for domination in every society. This study tries to understand where is the ideological position of Chudori in the battle for domination. The method used to conduct this research is qualitative descriptive. Research on Laut Bercerita was a literature study that uses a Marxist approach. Theories that will be used are Antonio Gramsci's Theory of Hegemony and Louis Althusser's Theory of State Apparatus. The study concludes that Chudori is a figure of resistance in a battle for domination, which means Chudori's ideological position belongs to the group that refuses to be dominated.
This research was carried out to understand the relationship between Batak cultural values and patriarchal ideology, which is reflected in the masculinity of the male characters (Mr. Domu, Domu, ...Gabe, and Sahat) in the film Ngeri-Ngeri Sedap, directed by Bene Dion Rajagukguk. This research was carried out based on interpreting the emerging patriarchal ideology in the film Ngeri-Ngeri Sedap through signs of masculinity of male characters who live in Toba, North Sumatra, or those who choose to emigrate. The method used in this research is a qualitative approach through the sociology of literature and gender (masculinity) and literature study. The theory used in analyzing this film is the theory of masculinity by Tuncay. The results found are that there is a relationship between patriarchal ideology, which is reflected through the masculinity of male characters in films, and Batak cultural values. Individuals who live their lives with strong Batak cultural values almost every day will have a higher level of masculinity, which will result in a stronger patriarchal ideology that they display. Meanwhile, individuals who live a life with strong Batak cultural values will show less of their patriarchal ideology to those around them.
This article frames the Museum of Modern Art, Hayama’s 2017 exhibition on Japanese modernism during the simultaneously vibrant and tumultuous 1930s through the lens of Japan’s uneven capitalist ...development and wartime mobilization. The author suggests that the exhibition’s unique international scope, rich selection of figurative and abstract modernist works, and emphasis on the year 1937 as a nexus through which the decade’s competing tendencies can be reevaluated readily disclose the constitutive, dialectical relationships between historical difference, total war, and modernist form in imperial Japan and its colonies. The exhibition’s featured works and curator Asaki Yuka’s direction together emphasized the inseparability of Japanese modernism from the encroaching conditions of world war during the late 1930s, thereby contributing to a growing body of scholarship and series of exhibitions challenging the received oppositions between autonomous modernism, proletarian realism, and wartime propaganda. After introductory remarks on the reassessment of 1930s-era Japanese avant-garde aesthetics, the article provides a series of close readings of significant paintings included in the exhibition, including Murai Masanari’s 1937 Urban, Matsumoto Shunsuke’s 1935 Building, and Uchida Iwao’s 1937 Port. These formal readings explore how the year 1937 marked a pivotal “branch point” for Japanese society, not only in terms of the confluence of various artistic trends but also in terms of the fierce opposition between socialism and fascism that bifurcated potentialities for Japan’s future. KCI Citation Count: 0
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