Medicina clinica
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To evaluate the treatment modalities and their effects in primary Sjögren's syndrome (pSS) patients with interstitial lung disease (ILD). ⋯ AZA, MMF, and RTX have similar effects on pulmonary functions in pSS-ILD and provide disease stabilization.
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Multicenter Study
Digital devices for heart rhythm monitoring in atrial fibrillation patients scheduled for elective electrical cardioversion.
Management in recent-onset atrial fibrillation (AF) is to achieve sinus rhythm (SR) by cardioversion (CV). However, frequently SR is spontaneously restored, making scheduled admission unnecessary and causing misutilization of healthcare resources. Emerging medical technology allows accurate heart rhythm monitoring. This study evaluated this technology in these patients, preventing unnecessary admission and providing an earlier management. ⋯ Digital devices for heart rhythm monitoring can optimize the management of AF patients scheduled for elective CV, preventing unnecessary admissions and providing a more rational use of healthcare resources.
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Cardiac implantable electronic devices have transformed medicine as they improve quality of life and prevent premature death. In palliative care settings, deactivation of these devices must be discussed, particularly at end-of-life. In terminally ill patients it is consensual to recommend implantable cardioverter defibrillator deactivation once shocks are frequent and painful. ⋯ Regarding cardiac resynchronization therapy, deactivation is not recommended as it can worsen symptoms. Left ventricular assistance device deactivation at end-of-life is a well-accepted practice, since it has the benefit of ending the physical burden associated with the device. Advance care planning should be encouraged and patients should be informed that deactivation is possible.