Choice and Outcomes of Rate Control versus Rhythm Control in Elderly Patients with Atrial Fibrillation: A Report from the REPOSI Study

Background: Among rate-control or rhythm-control strategies, there is conflicting evidence as to which is the best management approach for non-valvular atrial fibrillation (AF) in elderly patients. Design: We performed an ancillary analysis from the ‘Registro Politerapie SIMI’ study, enrolling elderly inpatients from internal medicine and geriatric wards. Methods: We considered patients enrolled from 2008 to 2014 with an AF diagnosis at admission, treated with a rate-control-only or rhythm-control-only strategy. Results: Among 1114 patients, 241 (21.6%) were managed with observation only and 122 (11%) were managed with both the rate- and rhythm-control approaches. Of the remaining 751 patie…

Does Public Deliberation really Need Normative Constraints? Recovering the Aristotelian Rhetorical Theory

There was recently an attempt to correlate some sectors of the studies on argumentation and the theory of democracy. The relationship between these two areas concerns the fact that in both cases there is a significant interest in normative models of good argumentation. In these models there is no place for rhetoric. Our work has a twofold aim: (1) to show that, starting from the Aristotelian rhetoric, it is possible to develop a more suitable model of argumentation in the public sphere and (2) to doubt the very need to identify normative constraints for this type of argument.

Rhetorical deliberation. A sustainable normativism from a Gorgianic-Aristotelian perspective

Starting from the discursive turn that has characterized democracy since the 80s of the last century, our article tries to outline a form of sustainable normativism. To do this, we use a theoretical framework derived from ancient Greek rhetoric and in particular from the reflection of Gorgias and Aristotle. In our perspective, on the one hand, the Gorgianic view is a useful reminder of the role that the pursuit of power and the possibility of conflict unavoidably play in the form of argumentation specific to the public sphere, that is, deliberation. On the other hand, Aristotle, thanks to his emphasis on the link between logos and desire and his analysis of truth available in deliberative c…

Are Humans Poor at Arguing? From the ‘Argumentative Theory of Reasoning’ back to a Rhetorical Theory of Argumentation

Starting from Sperber and Mercier’s theory (2011) on the relationship between reasoning and arguing, we will try to rethink the link between rhetoric and argumentation. Using Aristotelian rhetoric as a theoretical framework, we will focus on two related features: 1) the nature and the role of argumentation inferences in classical models of rhetoric; 2) the role of normativity in assessing a naturalistic description of what we make when we argue.

Adherence to antithrombotic therapy guidelines improves mortality among elderly patients with atrial fibrillation: insights from the REPOSI study

Background: Atrial fibrillation (AF) is associated with a substantial risk of thromboembolism and mortality, significantly reduced by oral anticoagulation. Adherence to guidelines may lower the risks for both all cause and cardiovascular (CV) deaths. Methods: Our objective was to evaluate if antithrombotic prophylaxis according to the 2012 European Society of Cardiology (ESC) guidelines is associated to a lower rate of adverse outcomes. Data were obtained from REPOSI; a prospective observational study enrolling inpatients aged ≥65 years. Patients enrolled in 2012 and 2014 discharged with an AF diagnosis were analysed. Results: Among 2535 patients, 558 (22.0 %) were discharged with a diagnos…

Foreword

Heart failure and chronic kidney disease in a registry of internal medicine wards

Background: The aim of the present study was to evaluate the association between heart failure (HF) and chronic kidney disease (CKD) in tertiary care centers using the clinical records of patients enrolled in internal medicine departments.Patients and methods: We used the clinical records of 1380 elderly patients to identify patients with a history of HF and CKD using admission ICD codes and glomerular filtration rate (GFR) formulas. Magnitude and strength of such associations were investigated by univariable and multivariable analysis.Results: Of the 1380 patients enrolled, 27.9% had HF (age 80 ± 7, BMI 27 ± 6 kg/m2) and 17.4% CKD (age 81 ± 7, BMI 26.8 ± 6 kg/m2). Both groups were signific…