Healthcare Utilization and Quality of Life Improvement after Ablation for Paroxysmal AF in Younger and Older Patients

Background Atrial fibrillation (AF) prevalence increases significantly with age. Little is known about the effect of AF ablation on quality of life and healthcare utilization in the elderly. The objective of this study was to quantify the healthcare utilization and quality of life benefits of catheter ablation for AF, for patients ≥65 years compared to patients <65 years. Methods Two multicenter U.S. registry studies enrolled patients with paroxysmal AF. Baseline characteristics and acute outcomes were collected for 736 patients receiving catheter ablation with the Navistar® ThermoCool® SF Catheter (Biosense Webster, Inc., Diamond Bar, CA, USA). Healthcare utilization and quality of life outcomes were collected through 1 year postablation for 508 patients. Results The rates of acute pulmonary vein isolation were high and similar between patients ≥65 years and <65 years (97.5% vs 95.8%, P = 0.2130). Length of stay for the index procedure was similar between age groups with 82.2% of the older group and 83.2% of the younger group having one-day hospitalization. Disease-specific quality of life instrument scores improved significantly and similarly for older and younger patients at 1 year postablation, compared to baseline. AF-related hospitalizations and emergency department visits were similar or lower in older patients compared to younger patients, as reported at 1 year postablation. Conclusion For older patients undergoing catheter ablation for paroxysmal AF, healthcare utilization parameters were lower or not significantly different than for younger patients, and quality of life outcomes were similarly improved. These findings support the use of catheter ablation as a treatment option in older patients with paroxysmal AF

The Vehicle, Spring 1981

Vol. 22, No. 2 Table of Contents Old Farmers at the Arcade CafeJohn Stockmanpage 4 ConfettiCathy Georgepage 6 Ode to a Corned Beef SandwichJeff Bennettpage 6 The Ice on Kirschner\u27s CreekScott Fishelpage 7 Love Poem to LindaJohn Stockmanpage 7 Grandfather\u27s PortraitJames Marshpage 8 The MassageKathleen Alakspage 9 A Driving ForceSandy Youngpage 10 King DandelionNancy Siebenpage 12 One Afternoon - Contemplating HouseworkKelli Sanderpage 13 Tent WallsAndy Sudkamppage 14 The SentinelElise Hempelpage 16 Daddy\u27s AftershaveJeff Bennettpage 16 The WeddingChris Goerlichpage 17 UntitledCarol Hansenpage 17 Treasures in the YardScott Fishelpage 18 Hitchhiker\u27s BootsAndy Sudkamppage 20 The RaffleLaura Henrypage 21 A Walk at NightJudi Jinespage 24 Morning in the DumpJeff Bennettpage 24 In Praise of Chocolate Ice CreamJohn Stockmanpage 25 Summer on the Isle of PalmsElisabeth Cristpage 26 The WaveHerbert S. Demminpage 27 RememberingJohn Kleinsteiberpage 27 PotatoJohn Stockmanpage 28 Late ShowChris Goerlichpage 30 Love in Him - JoeDebbie Klinnertpage 31 ShoeScott Fishelpage 35 The DrinkerBob Huntpage 36 The WidowGeorge Ndu Igbudupage 37 ElectricityScott Fishelpage 37 Hatchet JackB.L. Davidsonpage 39 Walking Home LateJohn Stockmanpage 41 NovemberCindy Hubbarttpage 41 On the BusLaura Henrypage 42 HaikuJames Marshpage 43 SpillwayGloria Rhoadspage 43 Art Cover design by Linda Fraembs PhotographRobin Scholzpage 3 PhotographRobin Scholzpage 5 PhotographMichelle Glassmeyerpage 15 PhotographRobert Schinaglpage 19 PhotographTom Robertspage 38 PhotographRobert Schinaglpage 44https://thekeep.eiu.edu/vehicle/1039/thumbnail.jp

Plasminogen deficiency suppresses pancreatic ductal adenocarcinoma disease progression

Pancreatic ductal adenocarcinoma (PDAC) is a highly fatal metastatic disease associated with robust activation of the coagulation and fibrinolytic systems. However, the potential contribution of the primary fibrinolytic protease plasminogen to PDAC disease progression has remained largely undefined. Mice bearing C57Bl/6-derived KPC (KRasG12D , TRP53R172H ) tumors displayed evidence of plasmin activity in the form of high plasmin-antiplasmin complexes and high plasmin generation potential relative to mice without tumors. Notably, plasminogen-deficient mice (Plg- ) had significantly diminished KPC tumor growth in subcutaneous and orthotopic implantation models. Moreover, the metastatic potential of KPC cells was significantly diminished in Plg- mice, which was linked to reduced early adhesion and/or survival of KPC tumor cells. The reduction in primary orthotopic KPC tumor growth in Plg- mice was associated with increased apoptosis, reduced accumulation of pro-tumor immune cells, and increased local proinflammatory cytokine production. Elimination of fibrin(ogen), the primary proteolytic target of plasmin, did not alter KPC primary tumor growth and resulted in only a modest reduction in metastatic potential. In contrast, deficiencies in the plasminogen receptors Plg-RKT or S100A10 in tumor cells significantly reduced tumor growth. Plg-RKT reduction in tumor cells, but not reduced S100A10, suppressed metastatic potential in a manner that mimicked plasminogen deficiency. Finally, tumor growth was also reduced in NSG mice subcutaneously or orthotopically implanted with patient-derived PDAC tumor cells in which circulating plasminogen was pharmacologically reduced. Collectively, these studies suggest that plasminogen promotes PDAC tumor growth and metastatic potential, in part through engaging plasminogen receptors on tumor cells

Whither Haiti?

Dr. Donald E. Schulz looks at the prospects for political stability, democratization, and socioeconomic development. His conclusions are sobering. While by no means dismissing the possibility that Haiti can make it, he presents a portrait of the imposing obstacles that must still be overcome and a detailed discussion of the things that could go wrong. In a nutshell, he argues that without a much greater willingness on the part of the United States and the international community to stay the course in terms of providing long-term security and socioeconomic aid, Haiti is unlikely to make a successful transition to a stable, democratic, economically modernizing nation. (Even with continuing assistance, the outlook will be problematic.) He argues that unless the United States and other foreign donors recognize this and do what is necessary to give the Haitian experiment a better chance to succeed, the tactical success that has been enjoyed so far will sooner or later be transformed into a strategic failure. His policy recommendations, in particular, deserve close scrutiny.https://press.armywarcollege.edu/monographs/1218/thumbnail.jp

O enquadramento das Missões de Paz (PKO) nas teorias da guerra e de polícia

A clareza original do que sejam as operações de manutenção, ou Missões de Paz - PKO - já não existe, se é que algum dia ela de fato existiu. No decorrer desse artigo Busca-se enquadrar as PKO nas teorias de guerra e de polícia, com base no entendimento sobre força e violência, uso da força, guerra e paz. Ao final, há algumas observações sobre a utilidade desses enquadramentos.<br>The original meaning of what are the Peacekeeping Operations - PKO - no longer exists, that is, if some day it really existed. This article tries to fit the PKO in the theories of war and police, based on the comprehension of strength and violence, the use of strength, war, and peace. In conclusion, there are some observations about the utility of those allocations