Effect of continuous versus episodic amiodarone treatment on quality of life in persistent atrial fibrillation

Aims Amiodarone is associated with significant adverse effects. We hypothesized that episodic amiodarone treatment would be associated with better quality of life (QoL) compared with continuous treatment in the prevention of recurrent atrial fibrillation (AF). Methods and results Quality of life was assessed in 158 patients from the Continuous vs. Episodic Prophylactic Treatment with Amiodarone for the Prevention of AF (CONVERT) study, using the Short Form (SF)-36 health survey and University of Toronto AF Severity Scale (AF severity scale) questionnaires at baseline and 1 year. The episodic group received amiodarone 1 month peri-cardioversion, the continuous group continued amiodarone. Patients were assessed for major adverse events and maintenance of sinus rhythm during follow-up (i.e. no AF recurrences at every follow-up visit). Quality of life (assessed by SF-36 and AF severity scale) was comparable between both treatment groups at baseline and 12 months, with similar incidence rates of major adverse events. Fewer patients in the episodic group had maintenance of sinus rhythm during follow-up [27 (36%) vs. 49 (59%), P = 0.004]. In the episodic group, maintenance of sinus rhythm was associated with a significant improvement on four SF-36 subscales and AF severity scale at 12 months. In contrast, in the continuous group no significant differences in QoL were seen between patients with continued maintenance of sinus rhythm compared with those with AF recurrence at the end of follow-up. Conclusion Quality of life was comparable in the episodic and continuous treated group after 12 months of follow-up. Continued maintenance of sinus rhythm was associated with an improvement in QoL in the episodic but not the continuous treated group

Digging dilettanti: The first Dutch excavation in Italy, 1952–58

Dutch collectors, antiquarians, academics and (museum) archaeologists have explored the ancient heritage of the Mediterranean for over four centuries. Nevertheless, the institutionalised practice of archaeology in these areas is a relatively young discipline. This chapter deals specifically with the birth of Dutch archaeology in Italy. The first Dutch excavations, under the aegis of the Royal Netherlands Institute in Rome (KNIR), started in the 1950s and continued for more than a decade. This chapter examines the disciplinary infrastructure and the social, political and intellectual contexts of the first Dutch dig in Italy. Two issues are central in this research. One is to understand better the changing social, intellectual and political networks that commence and evolve during the process of an archaeological fieldwork project in a foreign country. The second is to place the many narratives produced by these academic networks in their contemporary contexts. This chapter deals with the questions: In which political context did foreign archaeological practice in Italy emerge? Who were the Dutch scholars that started the first excavation project? Which institutional context made the first Dutch excavation in Italy possible? Why dig beneath the Santa Prisca church

Paroxysmal atrial fibrillation, quality of life and neuroticism

BACKGROUND: Paroxysmal atrial fibrillation (AF) is associated with significant impairment of quality of life (QoL), which is to a large extent independent of objective measures of disease severity. We sought to investigate the potential role of neuroticism in the impairment of QoL in patients with paroxysmal AF. METHODS: The study group (AF group) comprised 73 patients with paroxysmal AF (mean age 55.5 +/- 113.3 years, 50 males). On average, patients had a three-year history of one symptomatic paroxysm a week lasting two hours. QoL was assessed using the Medical Outcomes Study Short Form (SF-36) and neuroticism was assessed using the short-scale Eysenck Personality Questionnaire (EPQ). RESULTS: The degree of neuroticism in the AF patient group did not differ from the degree of neuroticism in a group of age- and sex-matched controls (mean EPQ score on neuroticism 4.1 +/- 3.0 and 3.9 +/- 3.1, respectively; p = NS). Within the AF group, multivariate regression analyses showed that QoL in the physical domain (SF-36 physical functioning, physical role function, vitality and pain subscales) was not related the degree of neuroticism. In contrast, significant inverse relations were observed between scores on the mental health and social functioning subscales and the degree of neuroticism (beta coefficients p < .05), independent of age, sex and symptoms. CONCLUSION: Based on the present study, patients with paroxysmal AF appear to have on average a degree of neuroticism similar to age- and sex-matched controls. However, the impairment of QoL in these patients, in particular regarding social functioning and mental health, seems to be related to a relatively high degree of neuroticism, independent of age and sex