Women report higher levels of general and shock-related anxiety, and higher levels of body image concerns than men. Women showed more improvement in physical functioning. Screening patients before and after ICD implantation for general and shock anxiety may help determine patients who could benefit from psychological counseling.
Remote monitoring of cardiac implanted electronic devices (CIED: pacemaker, cardiac resynchronisation therapy device and implantable cardioverter defibrillator) has been developed for technical control and follow-up using transtelephonic data transmission. In addition, automatic or patient-triggered alerts are sent to the cardiologist or allied professional who can respond if necessary with various interventions. The advantage of remote monitoring appears obvious in impending CIED failures and suspected symptoms but is less likely in routine follow-up of CIED. For this follow-up the indications, quality of care, cost-effectiveneness and patient satisfaction have to be determined before remote CIED monitoring can be applied in daily practice. Nevertheless remote CIED monitoring is expanding rapidly in the Netherlands without professional agreements about methodology, responsibilities of all the parties involved and that of the device patient, and reimbursement. The purpose of this consensus document on remote CIED monitoring and follow-up is to lay the base for a nationwide, uniform implementation in the Netherlands. This report describes the technical communication, current indications, benefits and limitations of remote CIED monitoring and follow-up, the role of the patient and device manufacturer, and costs and reimbursement. The view of cardiology experts and of other disciplines in conjunction with literature was incorporated in a preliminary series of recommendations. In addition, an overview of the questions related to remote CIED monitoring that need to be answered is given. This consensus document can be used for future guidelines for the Dutch profession.
Objective: To establish the prevalence of Type D personality in patients with somatic symptoms and related disorders and to evaluate the association of Type D personality with treatment outcomes. This study explores the effect of Type D personality and its two traits, negative affectivity (NA) and social inhibition (SI). Methods: In this longitudinal observational cohort study, we assessed the prevalence of Type D in 212 patients presenting themselves at a clinic in Tilburg, the Netherlands. We explored psychological and physical treatment outcomes of a multimodal treatment tailored to patient needs in relation to Type D scores. We explored the differences with regard to physical symptoms, anxiety, and depression. We also explored the differences between patients with and without Type D personality who completed treatment with regard to the baseline scores of physical symptoms, anxiety, and depression. We explored the association between Type D personality and treatment outcome using the traditional dichotomous method and the dimensional method (with main effects of NA and SI, and the interaction of NA × SI). Results: Of the 212 patients with Somatic Symptom and Related Disorders (SSRD), those with Type D personality (181: 61.8%) had experienced significantly higher levels of depression [ t = 4.404, p < .001] and anxiety [ t = 3.757, p < .001]. Of the 212, 187 patients completed treatment. Mean scores improved significantly for the whole patient group after treatment with regard to depression ( p < .001), anxiety ( p < .001), and physical symptoms ( p < .001). At baseline, patients with Type D personality had significantly higher scores in anxiety [ F = 15.707, p < .001] and depression [ F = 19.392] than patients without Type D personality who completed treatment. After controlling for the high baseline scores with regard to physical symptoms, anxiety, or depression, only the effect of Type D personality on remission of anxiety was significant ( OR = .33, p = 0.39). Neither NA and SI nor the interaction of NA × SI was associated with the treatment outcome. Conclusions: This study shows that Type D personality occurs frequently in patients with SSRD. Type D personality only decreases the probability of remission of anxiety as a treatment outcome, and both NA and SI play a role in this. Type D personality did not decrease remission either of physical symptoms or of depression. Hence, both NA and SI factors may be expressions of anxiety mostly in type D.
A computer program has been developed for stage-scanning cytophotometry of double-stained microscopical specimens. The program permits the simultaneous measurement of absorbance values at two wavelengths in each measuring spot. To account for overlap in the absorbance spectra of the two stained endproducts, the program incorporates correction of the measured data to compensate for the contribution of each chromophore to the absorbance measured for the other. The program will compute the corrected local absorbance values at specified wavelengths for each chromophore at each measuring spot and integrate these values over the total object to give separate totals for each stain. It is also possible to have integrated the absorbance values of one chromophore for all those measuring spots where the local corrected absorbance value of the other chromophore exceeds a preset minimum value. When this other chromophore is a nuclear DNA stain, it is possible to obtain an approximate measure of the content of any compound in the nuclear area which can be stained with a chromophore having an absorbance spectrum different from the DNA stain. The validity of the program was investigated on model preparations consisting of two (differently) coloured films of which the absorbance values could be measured either individually or in combination, by partially overlaying one film on the other. The program's potential has been demonstrated by using the combination of either Naphthol Yellow S or dinitrofluorobenzene as protein stains with the Feulgen-pararosaniline(SO2) procedure for DNA in chicken erythrocytes and rat liver cells.
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