Fear of exercise and health-related quality of life in patients with an implantable cardioverter defibrillator

Several studies have reported improved survival rates thanks to the use of an implantable cardioverter defibrillator (ICD) in the treatment of patients with life-threatening arrhythmia. However, the effects of the ICD on health-related quality of life (HR-QoL) of these patients are not clear. The aim of this study is to describe HR-QoL and fear of exercise in ICD patients. Eighty-nine ICD patients from the University Hospital in Groningen, the Netherlands, participated in this study. HR-QoL was measured using the Rand-36 and the Quality of Life After Myocardial Infarction Dutch language version questionnaires. Fear of exercise was measured using the Tampa Scale for Kinesiophobia, Dutch version and the Fear Avoidance Beliefs Questionnaire, Dutch version. Association between outcome variables was analysed by linear regression analyses. Study results show that the HR-QoL of patients with ICDs in our study population is significantly worse than that of normal healthy people. Furthermore, fear of exercise is negatively associated with HR-QoL corrected for sex, age and number of years living with an ICD. After implantation of the ICD, patients with a clear fear of exercise should be identified and interventions should be considered in order to increase their HR-QoL

Fear Modulates Visual Awareness Similarly for Facial and Bodily Expressions

Background: Social interaction depends on a multitude of signals carrying information about the emotional state of others. But the relative importance of facial and bodily signals is still poorly understood. Past research has focused on the perception of facial expressions while perception of whole body signals has only been studied recently. In order to better understand the relative contribution of affective signals from the face only or from the whole body we performed two experiments using binocular rivalry. This method seems to be perfectly suitable to contrast two classes of stimuli to test our processing sensitivity to either stimulus and to address the question how emotion modulates this sensitivity. Method: In the first experiment we directly contrasted fearful, angry, and neutral bodies and faces. We always presented bodies in one eye and faces in the other simultaneously for 60 s and asked participants to report what they perceived. In the second experiment we focused specifically on the role of fearful expressions of faces and bodies. Results: Taken together the two experiments show that there is no clear bias toward either the face or body when the expression of the body and face are neutral or angry. However, the perceptual dominance in favor of either the face of the body is a function of the stimulus class expressing fear

The road goes ever on:innovations and paradigm shifts in atrial fibrillation management

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Treatment of a life-threatening dapsone intoxication

The case report describes a case of a severe dapsone (more than 200 tablets dapsone 100 mg) and mild methotrexate intoxication (10 tablets methotrexate 10 mg) as an attempt to commit suicide, resulting in severe cyanosis with elevation in methemoglobin concentration, treated with methylene blue, ascorbic acid, folinic acid, multidose activated charcoal and hemodialysis. Measurements of blood gases, dapsone and methotrexate levels were performed. Furthermore a hepatitis, pulmonary artery thrombus and a strange taste sensation were diagnosed, probably related to dapsone. The patient recovered and was discharged from hospital after five days. Acute intoxication from excessive dapsone intake is uncommon and clear treatment guidelines are lacking. We here report the treatment modalities as a result of a dapsone intoxication, including the effects on the overall condition of the patient.</p