Search results for "comorbid"

Recommendations of the Geriatric Cardiology Section of the Spanish Society of Cardiology for the Assessment of Frailty in Elderly Patients With Heart…

2018

Frailty is an age-associated clinical syndrome characterized by a decrease in physiological reserve in situations of stress, constituting a state of vulnerability that involves a higher risk of adverse events. Its prevalence in Spain is high, especially in elderly individuals with comorbidity and chronic diseases. In cardiovascular disease, frailty is associated worse clinical outcomes and higher morbidity and mortality in all scenarios, in both acute and chronic settings, and could consequently influence diagnosis and treatment. However, frailty is often not addressed or included when planning the management of elderly patients with heart disease. In this article, we review the available s…

Informed consent in high-risk renal transplant recipients.

2009

Abstract Before performing a clinical, diagnostic, and/or therapeutic action, the doctor is required to provide the patient with a bulk of information defined as informed consent. This expression was used for the first time in 1957 during a court case in California and the two words— informed and consent —are used together to underline the fact that the patient cannot give his or her true consent without first receiving correct information concerning the medical act in question. With regard to the medicolegal aspects governing organ transplants, despite the bulk of detailed work performed by health service workers involved in this surgical field with the aim of preparing adequate informed c…

Complex regional pain syndrome: An optimistic perspective.

2014

Complex regional pain syndrome (CRPS) presents with clinical symptoms that can no longer be explained by the initial trauma, including pain, sensory, motor, and trophic symptoms, and impairment of autonomic control of the limb. These symptoms spread distally and go beyond single nerve innervation territories. Typically, the symptoms change through the course of CRPS as a result of the varying pathophysiology. Diagnosis is made clinically after the rigorous elimination of other possible causes, and 3-phase bone scintigraphy can be a useful tool for confirming CRPS. In acute stages, inflammatory symptoms prevail and should be treated with anti-inflammatory agents (steroids), bisphosphonates, …

THU0582 Prognostic Factors of Macrophage Activation Syndrome in Adults: Analysis of 40 Cases in 2 Tertiary Referral Centers

2016

Background Macrophage activation syndrome (MAS) is a rare, life-threatening disease in which early diagnosis and aggressive therapeutic strategy may improve the outcome [1]. Due to its rarity, epidemiologic data are still lacking. Hyperferritinemia is frequently associated with MAS and might modulate the cytokines storm the latter contributing to the development of multi-organ failure [2]. Objectives In the current study, we aimed to investigate clinical data, treatments, and outcome of adult MAS patients secondary to autoimmune rheumatic disease. Methods We retrospectively investigated clinical data, treatments, and outcome of 40 adult MAS patients secondary to autoimmune rheumatic disease…

Cardiovascular comorbidity in multiple sclerosis patients treated with mitoxantrone therapy: a cohort study

2017

Abstract Background Mitoxantrone (MX) has been used as second line therapy for aggressive multiple sclerosis (MS). Potential cardiotoxic effects of MX limit its use; a cumulative dose of up to 100 mg/m2, has been long considered relatively safe. We calculated the frequency of cardiac side effects in MS patients treated with MX. Methods We performed a cohort study including all MS patients treated with MX at the Neurological Department of the University Hospital of Palermo, Italy. Two hundred-sixty-four MS patients diagnosed according to validated criteria were included and followed-up until the end of September 2010. Patients were treated with MX as a second line therapy if they had no prev…

Positive Airway Pressure Treatment Reduces Glycated Hemoglobin (HbA1c) Levels in Obstructive Sleep Apnea Patients: Longitudinal Data from the Esada

2019

European-Respiratory-Society (ERS) International Congress -- SEP 28-OCT 02, 2019 -- Madrid, SPAIN

Applicability of the STOPP/START criteria to older polypathological patients in a long-term care hospital

2017

Objectives To analyse the applicability of the STOPP/START criteria as a tool to identify patients with potentially inappropriate medications (PIM) during pharmaceutical validation of prescriptions in a long-term care hospital, to identify risk factors for PIM and to characterise the physiological systems and drugs more frequently associated with these PIM. Methods An interventional, prospective and longitudinal study was conducted in polypathological patients aged >65 years. Usual pharmaceutical care and the STOPP/START criteria were used to identify PIM and to plan pharmaceutical interventions at admission. At discharge, the discharge summaries were reviewed using the STOPP/START criteria…

Prognostic value of two geriatric screening tools in a cohort of older patients with early stage Non-Small Cell Lung Cancer treated with hypofraction…

2020

Objectives: To investigatewhether assessmentwith two geriatric screening tools shows a correlationwith clinical outcomes of patients aged 65 years or more, with early-stage Non-Small Cell Lung Cancer (es-NSCLC) treated with hypofractionated stereotactic radiotherapy. Methods: FromMarch 2014 to June 2018we retrospectively evaluated 42 patientswith stage I and II lung tumors. Patients were assessed with Charlson Comorbidity Index (CCI) and G8 screening tool. Median age was 74 years (range, 65–91). Stereotactic radiotherapy was performed with Helical Tomotherapy delivering 50–70 Gray (Gy) in 8–10 fractions. Toxicity was evaluated using Common Terminology Criteria for Adverse Events v4.0 criter…

Indicaciones actuales de revascularización

2012

Randomized controlled trials in patients with chronic ischemic heart disease and stable angina indicate that the majority of cases can be managed by optimum medical treatment. The exceptions are patients with conditions that could benefit from revascularization, such as recurrent angina, extensive inducible ischemia or complex coronary anatomy. However, since studies have traditionally excluded patients with significant comorbidity, it is not clear which treatment approach would be best in these circumstances. Although patients with comorbidities are usually treated conservatively in routine clinical practice, some recent studies in elderly patients have raised the possibility that this sub…

2018

Insomnia and obstructive sleep apnea (OSA) are often both present in patients with sleep-disordered-breathing (SDB). The coexistence of the two disorders shows an increase in cumulative morbidity and an overall greater illness severity. There is still considerable controversy regarding management decisions in this group of patients. This systematic review focused on more recent evidence regarding treatment of patients presenting with both clinical entities of comorbid insomnia and OSA (COMISA) in terms of their management, especially using combinations of positive airway pressure [PAP, namely aPAP, cPAP, adaptive servo-ventilation (ASV)] and CBTi as well as each one of these two modalities …