ABSTRACT
BACKGROUND: Recent studies have suggested an association between sleep duration and cardiovascular diseases; however, the link to AF is inconclusive. This study aimed to explore the relationship between sleep duration and AF by conducting a systematic review and meta-analysis of primary studies to provide evidence of the link between insufficient sleep and AF. METHODS: A review of the existing literature was conducted to identify the primary studies that examined the association between AF and sleep duration. The inquiry spanned databases, including PubMed, Embase, MEDLINE, and Google Scholar, from their inception through October 2023. RESULTS: Meta-analysis revealed a statistically significant association (p < 0.01) between shorter sleep duration and the incidence of AF (hazard ratio (HR), 1.18; 95% CI, 1.03-1.34; I2 = 89%). Conversely, longer sleep duration did not exhibit a statistically significant association with the incidence of AF (HR, 1.03; 95% CI, 0.92-1.14; I2 = 66%, p = 0.02). The sensitivity analysis demonstrated reduced heterogeneity after excluding specific studies. CONCLUSION: Insufficient sleep duration was associated with an increased risk of AF, whereas a longer sleep duration did not show a significant correlation. Standardized methods for sleep assessment and AF diagnosis as well as adjustments for confounding factors are suggested for future studies to improve the clarity and understanding of these associations.
Subject(s)
Atrial Fibrillation , Sleep , Humans , Atrial Fibrillation/epidemiology , Atrial Fibrillation/etiology , Sleep/physiology , Incidence , Risk Factors , Time Factors , Female , Male , Sleep DurationABSTRACT
BACKGROUND: The left atrial septal pouch (LASP) is a small anatomical septal recess in the heart that has been linked with cardioembolic events. A systematic appraisal of the existing literature is necessary to establish a better understanding of the risk as studies continue to indicate a correlation between LASPs and cryptogenic strokes. OBJECTIVES: To determine the level of association between the presence of LASP and the risk of developing cryptogenic stroke. METHODS: We searched PubMed, EMBASE and Scopus for studies comparing the prevalence of LASP in patients with cryptogenic stroke against non-cryptogenic stroke control groups from inception till December, 2023. The Newcastle Ottawa scale was used for quality assessment and Comprehensive Meta-Analysis Version 3.3 was used for data analysis with odds ratio (OR) as the effect measure. RESULTS: Our review included a total of 10 retrospective, observational studies published between 2010 to 2022. A total of 683 cases of cryptogenic strokes were identified, out of which 33.1 % (n = 271) were associated with a LASP. Among the non-cryptogenic stroke controls (n = 2641), LASP was present in 20.6 % cases (n = 476). The aggregate OR for cryptogenic stroke was 1.618 times greater than non-cryptogenic stroke (p < 0.001) among LASP cases, CONCLUSION: The presence of a septal pouch in the left atrium is significantly linked to a higher risk of developing cryptogenic strokes. As a potential site of thrombus formation and subsequent dislodgement, further large-scale studies are necessary to establish the guidelines for management and prophylaxis to prevent embolic events.
Subject(s)
Atrial Septum , Ischemic Stroke , Humans , Atrial Septum/pathology , Heart Septal Defects, Atrial/epidemiology , Heart Septal Defects, Atrial/diagnosis , Heart Septal Defects, Atrial/complications , Heart Septal Defects, Atrial/surgery , Ischemic Stroke/epidemiology , Ischemic Stroke/prevention & control , Ischemic Stroke/etiology , Observational Studies as Topic , Risk Assessment/methods , Risk FactorsABSTRACT
This study assessed the effectiveness of an intervention designed to foster more positive attitudes towards persons with mental illness among college students in Delhi. A total of 50 young people participated in a one-time education and contact based intervention. Attitudes towards persons with mental illness were assessed before the intervention, immediately after it and at a one week follow-up. Results indicated increased feelings of benevolence, community mental health ideology and less authoritarianism at the post-intervention assessments. Reduction in endorsement of social restrictiveness was also observed but only in the case of the immediate post-assessment. We also observed a greater recognition of needs, increased positive descriptions, decreased negative descriptions and reduced labelling after the intervention. These results support the efficacy of education and contact-based strategies for reducing mental illness stigma. Implications of the findings for low-middle income countries like India are discussed
El estudio valoró la eficacia de una intervención diseñada para favorecer unas actitudes más positivas hacia las personas con trastornos mentales entre los universitarios de Delhi. Un total de 50 jóvenes participaron en una intervención educativa y de contacto. Se evaluaron las actitudes hacia las personas con enfermedades mentales antes, justo después y una semana después de la intervención. Los resultados aumentaron los sentimientos de benevolencia, y la ideología de salud mental comunitaria y redujeron el autoritarismo en las evaluaciones después de la intervención. También se apreció una disminución del apoyo de la restricción social, pero solo en el caso de la evaluación inmediatamente posterior. Asimismo, se observó un mayor reconocimiento de las necesidades, más descripciones positivas, menos descripciones negativas y se redujeron las etiquetas después de la intervención. Estos resultados respaldan la eficacia de las estrategias de educación y contacto para reducir el estigma de los trastornos mentales. Se discuten las implicaciones de estos hallazgos para países de ingresos bajos-medios como la India