Irish journal of medical science
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Chronic complex diseases like atrial fibrillation have potential long-term economical and personal consequences. Shared decision-making principles may promote therapeutic compliance, satisfaction and outcomes. Pharmacists, as patient-advocates, play a key role in guiding them through complex clinical decisions about their chronic disease management and anticoagulation choices. ⋯ The study highlights pharmacist-led shared decision making in atrial fibrillation that contributes to patient satisfaction and appropriateness of therapy.
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It is increasingly recognised that older patients may not present with typical symptoms of COVID-19. ⋯ Older patients with atypical presentation of COVID-19 in the community are equally susceptible to poor outcomes. Early detection may improve outcomes and limit community transmission. Primary care practitioners should be vigilant and consider prompt onward referral.
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Caregiving demands contribute to both psychological and physical health of caregivers. Physical workload (PW) can be an important cause of musculoskeletal disorders in caregivers of children with cerebral palsy (CP). ⋯ Caregivers of a child having an ID and walking disability had higher PW. These caregivers had more problems related to musculoskeletal disorders, higher depressive symptoms, and lower HRQOL. Higher PW was associated with lower level of gross motor function of child and older age, higher body mass index, higher level of lower extremity disfunction and low back pain disability, and lower HRQOL of caregivers.
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Invasive coronary angiography (ICA) and coronary computed tomography angiography (CCTA) are used in the diagnosis of coronary artery disease (CAD). The medical benefits, as well as the ethical and logistical implications, should be explored, particularly in the scarcity of medical resources. We explore the perception of medical staff toward the interest of CCTA and ICA in diagnosis CAD to maximize the utility of both procedures. ⋯ Efficient diagnostic benefits of CCTA and overuse of ICA for stable CAD are documented. Clear diagnostic strategy with medical, ethical, and logistical issues should be considered when selecting the CCTA or ICA for diagnosis CAD.