Clinical and echocardiographic features influencing recovery of atrial function after cardioversion of atrial fibrillation

Atrial mechanical dysfunction after cardioversion for atrial fibrillation has been widely evaluated in recent years. Nevertheless, the influence of many clinical and echocardiographic parameters is not yet understood. The aim of the present study was to evaluate the influence of clinical and echocardiographic parameters on the return of effective atrial contraction. A total of 109 patients were evaluated: 41 patients had spontaneous recovery of sinus rhythm and 68 patients were randomly treated using either direct-current (DC) shock or intravenous procainamide. Elective cardioversion was accomplished pharmacologically in 23 patients (67%) and with DC shock in 29 patients (85%). Patients underwent a complete echocardiographic examination 1 hour after the restoration of sinus rhythm and after 1 and 7 days and 1 month. The following parameters were evaluated: patient age, cardiac disease, duration and etiology of atrial fibrillation, mode of cardioversion, left ventricular diameters and function, and left atrial diameter and function assessed as atrial ejection force. The relation between these variables and atrial ejection force was tested. Atrial ejection force was greater immediately and 24 hours after cardioversion in patients who had spontaneous recovery of sinus rhythm and in patients treated with drugs than in patients treated with DC shock. The mode of cardioversion was significantly associated with the recovery of atrial mechanical function by day 1 in univariate and multivariate analyses (odds ratio 0.14; 95% confidence interval 0.02 to 1.2). The other variable associated with the recovery of function was normal left atrial size (odds ratio 0.16; 95% confidence interval 0.12 to 1.6). In conclusion, atrial ejection force is a noninvasive parameter that can be easily measured and can provide accurate information about the recovery of left atrial mechanical function. The recovery of atrial function was influenced by the mode of cardioversion and the size of the left atrium.     

Women and cancer

Cancer will be diagnosed in more than a half a million women this year. Prognosis and curability are associated with the stage of the cancer at diagnosis. If cancer is detected at an early stage, more than 75% of women can expect long-term survival or cure for the most common cancers, excluding lung. Promoting health behaviors that reduce risk and recommending screening tests are critical activities for the practitioner that may affect survival rates and quality of life of women with cancer diagnoses. Risk factors, incidence, presenting symptoms, staging, treatment and 5-year survival rates associated with 12 major cancer sites in women are presented. Diagnosis and survival for minority populations are reviewed, highlighting the need to improve cancer screening and detection for this group of women.     

Identity and recovery.

Examines processes involved in successful recovery from addiction through the lens of identity theory and explores the identity processes involved in 12-step programs, psychotherapy with substance abusers, and religious drug-treatment programs. P. Biernacki (1986) found 3 paths that the addict followed in becoming a nonaddict: identity reversion, identity extension, and identity emergence. One part of 12-step programs is the ritual identification of each member in terms of addiction. The individual in such programs is involved in restructuring his or her identity hierarchy. This restructuring also occurs in religious programs, such as those offered by the Black Muslims for heroin addicts. Identity theory can help reveal commonalities in seemingly disparate treatments and be useful in creating alternative approaches. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Shape recovery and phase

The deformation behavior and morphology of martensite in Ni-AI alloys have been studied by means of compression tests, optical microscopy, and transmission electron microscopy. Mar- tensite deformation modes were investigated by examining microstructure changes upon compression. The shape memory effect is quantified by studying the incremental strain by compression testing below theM _ftemperature and measuring the shape recovery in a high- temperature dilatometer. The martensite features internal twins, and the twin plane is determined as {11l}_fct. The magnitude of the lattice invariant shear (by twinning) is determined by measuring the relative thickness of twin pairs and is 0.128. Formerly with the Department of Materials Science and Engineering, University of Illinois at Urbana-Champaign     

Dichloroacetate enhanced myocardial functional recovery post-ischemia : ATP and NADH recovery

This study was undertaken to determine the effect of dichloroacetate (DCA) on myocardial functional and metabolic recovery following global ischemia. Isolated rabbit hearts were subjected to 120 min of mildly hypothermic (34 degrees C), cardioplegic arrest with multidose, modified St. Thomas' cardioplegia. Hearts were reperfused with either physiologic salt solution (PSS) as controls, (CON, n = 10) or PSS containing DCA (DCA, n = 6) at a concentration of 1 mM. Functional and metabolic indices were determined at baseline and at 15, 30, and 45 min of reperfusion. In four DCA and four CON hearts, myocardial biopsies were taken at baseline, end-ischemia, 15 and 45 min for nucleotide levels. Functional recovery was significantly better in hearts reperfused with DCA as demonstrated by recovery of baseline developed pressure (DCA = 69 +/- 5%, CON = 45 +/- 9%) and dP/dt (DCA = 64% +/- 10% versus CON = 48% +/- 10%). Coronary blood flow was not different between groups either at baseline or during reperfusion, but myocardial oxygen consumption (MVO2) was increased in the DCA versus CON hearts (79% +/- 20% of baseline vs 50% +/- 18%). Recovery of myocardial adenylate energy status was improved in the DCA versus CON hearts (ATP recovered to 45% +/- 20% versus 8% +/- 6% of baseline). Coronary sinus lactate concentration was decreased in DCA perfused hearts at 45 min of reperfusion. Percent of baseline NADH values was similar at 15 min of reperfusion, but at 45 min, DCA hearts showed a decrease in NADH levels, while CON hearts showed an increase (DCA = 48%; CON = 121%). The enhanced myocardial function and improved metabolic status noted with DCA may result from increased oxidative phosphorylation due to altered pyruvate dehydrogenase (PDH) activity.     

Women and power in nursing

Power is inherent in all relationships and is subject to social and political amendment. In addition social relationships can be and are dynamic, flexible, variable and may provide unlimited possibilities for influencing the course of events in the workplace. Because of such potential, an element of competitiveness amongst leaders (and thus nurse managers) for the retention of their power base is created. Since the potential for power struggles is a realistic possibility the author contends that nurse managers need to acquaint themselves with political game playing techniques and ways of enhancing their social rank on an institution wide basis. This could be effected by concerted efforts to act in relation to others and by equipping themselves with more than basic preparation in administration and management. Nurses should use their individual and collective power, influence and authority to ensure that the nursing profession may prosper and grow. Contrary to the view that women are the weaker sex, numerically they dominate the nursing profession in South Africa. They should therefore regard the reshaping of their future role and status as a responsibility, a privilege and a challenge to the power inherent in them.     

鲁迅和他生命中的五位重要女性

在鲁迅先生的一生中,有五位重要女性.她们是鲁瑞、朱安、许羡苏、许广平和山本初枝,对鲁迅先生的生活、思想、创作、战斗产生了不可忽视的影响.     

Women and discrimination in academe

Affirmative action on the campus has led to some changes, but women and minorities have made little headway, especially in terms of being hired. At some institutions, after a year or two of affirmative action, the number and percentage of women has decreased while the number and percentage of men increased. The greatest progress has been in the areas of new legislation, general awareness, and correction of salary inequities. Various laws and court decisions relative to discrimination are discussed, as well as the relationship between women's and minority issues--Sandler, B. Women and discrimination in academe.     

Women and the doctor-patient relationship

What little is known about the doctor-patient relationship in Australia has been sought and written from the profession's point of view. This article will concentrate on the consumer; especially women, who have special problems and difficulties not shared with male patients.     

中风恢复期患者的家庭康复护理体会

中风的学名是急性脑血管疾病,具有致残率高的特点.因此,减轻不同程度的后遗症,帮助患者恢复自理能力是患者和社会共同关注的话题,尤其是出院后的家庭康复更是不可缺少.我院采用出院指导、定期随访、家庭康复护理相结合的办法,取得了较好的效果.