Internal and emergency medicine
-
Living in a hospice department is an intense experience for patients, caregivers, and healthcare professionals. End-of-life care aims to conduct vulnerable dying patients towards a painless and peaceful death. The importance of a strong staff-patient relationship and the perspective of pain and suffering from patients has already been studied. ⋯ Predictably, terminally ill patients seem to fear pain and incoming death. Even though patients had everything they needed in the hospice, their main thoughts were always focused on human relationships. End-of-life medicine should improve the quality of time that each patient could spend with significant others to improve end-of-life care.
-
Obstructive sleep apnea (OSA) has been reported to be a cause of hypertension in 40-80% of hypertensive patients. However, there are limited data available on the prevalence and predictors of OSA in young hypertensive patients. This study was conducted between October 2017 and October 2018. ⋯ There were two independent predictors for OSA: age and body mass index with adjusted odds ratios (95% confidence interval) of 1.280 (1.049, 1.562) and 1.258 (1.083, 1.462), respectively. In conclusion, after excluding other possible causes of hypertension, we found OSA to be highly prevalent in hypertensive patients younger than 35 years old. Increasing age and high body mass index were predictors for OSA in young hypertensive patients.
-
Pulmonary embolism (PE) is the third most frequent acute cardiovascular syndrome. Annual PE incidence and PE-related mortality rates rise exponentially with age, and consequently, the disease burden imposed by PE on the society continues to rise as the population ages worldwide. Recently published landmark trials provided the basis for new or changed recommendations included in the 2019 update of the European Society of Cardiology Guidelines (developed in cooperation with the European Respiratory Society). ⋯ Besides, the 2019 Guidelines endorse multidisciplinary teams for coordinating the acute-phase management of high-risk and (in selected cases) intermediate-risk PE. For normotensive patients, physicians are advised to include the assessment of the right ventricle on top of clinical severity scores in further risk stratification, especially if early discharge of the patient is envisaged. Further important updates include guidance (1) on extended anticoagulation after PE, taking into account the improved safety profile of NOACs; and (2) on the overall care and follow-up of patients who have suffered PE, with the aim to prevent, detect and treat late sequelae of venous thromboembolism.