Subject(s)
Heart Failure , Midodrine , Humans , Midodrine/therapeutic use , Heart Failure/drug therapy , Blood PressureABSTRACT
No disponible
Subject(s)
Humans , Dyskinesias/diagnosis , Hypercalcemia/complications , Renal Insufficiency, Chronic/drug therapy , Dyskinesias/complications , Hyperparathyroidism/complications , Diagnosis, Differential , Diphosphonates/therapeutic use , Glomerular Filtration Rate , Antibodies, Monoclonal/therapeutic useSubject(s)
Brain Diseases , Cefepime , Anti-Bacterial Agents , Humans , Prognosis , Retrospective StudiesABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Crohn Disease/complications , Crohn Disease/drug therapy , Tuberculosis, Miliary/diagnostic imaging , Tuberculosis, Miliary/drug therapy , Tomography, X-Ray Computed/methods , Bronchoscopy/methods , Mycobacterium tuberculosis/pathogenicity , Adalimumab/adverse effectsABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Colitis/etiology , Granulomatosis with Polyangiitis/complications , Granulomatosis with Polyangiitis/diagnostic imaging , Granulomatosis with Polyangiitis/pathology , Abdominal Pain/etiology , Radiography, Thoracic , Pericardial Effusion/diagnostic imaging , Colonoscopy , Biopsy , Colon/pathologySubject(s)
Churg-Strauss Syndrome/diagnosis , Colitis/etiology , Aged , Azathioprine/therapeutic use , Churg-Strauss Syndrome/complications , Churg-Strauss Syndrome/drug therapy , Churg-Strauss Syndrome/pathology , Colonoscopy , Female , Humans , Immunosuppressive Agents/therapeutic use , Pericardial Effusion/etiology , Prednisone/therapeutic useSubject(s)
Adalimumab/adverse effects , Antirheumatic Agents/adverse effects , Crohn Disease/drug therapy , Tuberculosis, Miliary/etiology , Adalimumab/therapeutic use , Antirheumatic Agents/therapeutic use , Crohn Disease/complications , Disease Susceptibility , Female , Humans , Latent Tuberculosis/complications , Middle Aged , Tuberculosis, Miliary/diagnostic imagingABSTRACT
To date, there are no sufficient data to make firm recommendations on the treatment of patients with severe thrombocytopenia who require antiplatelet therapy after experiencing acute coronary syndrome. Therefore, we think that it is important to communicate the experience with individual cases. We report the case of a patient who presented with pericardial effusion causing cardiac tamponade. He had thrombocytopenia associated with myelodysplastic syndrome, and ten weeks before this admission, percutaneous transluminal coronary angioplasty with implantation of drug-eluting stents was performed for non-ST-segment elevation acute coronary syndrome. Platelets in myelodysplastic syndromes are dysfunctional, which exacerbates bleeding from thrombocytopenia, and the management of atherosclerotic cardiovascular disease in these patients is challenging.
Subject(s)
Coronary Artery Disease/therapy , Myelodysplastic Syndromes/complications , Platelet Aggregation Inhibitors/therapeutic use , Thrombocytopenia/complications , Acute Coronary Syndrome/therapy , Aged , Cardiac Tamponade/etiology , Drug-Eluting Stents , Humans , Male , Pericardial Effusion/complications , Platelet Aggregation Inhibitors/adverse effectsABSTRACT
ANTECEDENTES: Muy pocos estudios analizan cuáles son las intervenciones médicas en los últimos días de vida. OBJETIVO: Valorar los tratamientos y cuidados proporcionados a los pacientes fallecidos en el Servicio de Medicina Interna en los que la muerte era esperable. MÉTODO: Realizamos un estudio retrospectivo de los pacientes fallecidos en el Servicio de Medicina Interna desde mayo a agosto de 2011. Definimos muerte esperable como aquella en la que el médico responsable de la asistencia comentaba en la historia clínica la posibilidad de fallecimiento. RESULTADOS: Analizamos los últimos días de vida en los 102 pacientes en los que la muerte era esperable. La edad media de los pacientes era de 80,91 años (DT 9,59), la mayoría eran varones 53 (52%), con una elevada comorbilidad. Las causas más frecuentes de muerte fueron: broncoaspiración en 20 (19,6%), enfermedad neoplásica en 18 (17,6%) e ICC en 13 (12,7%). En la mayoría de los pacientes (95; 93,1%) había algún síntoma recogido en la historia médica, y en un porcentaje elevado de casos (86,3%) se instauraba tratamiento para control de estos síntomas. Las órdenes de no reanimación cardiopulmonar aparecían recogidas en 80 pacientes (78,4%). En 35 pacientes (34,3%) se realizó sedación paliativa. CONCLUSIONES: La mayoría de los pacientes que fallecían en nuestro servicio eran personas mayores, con enfermedades crónicas o neoplásicas avanzadas, y con necesidad de atención paliativa, en los que la muerte era esperable. Aunque había un porcentaje alto de pacientes que recibía tratamiento sintomático paliativo y se registraba la indicación de no reanimación cardiopulmonar, existían otros aspectos claramente mejorables, como es la sedación paliativa (AU)
BACKGROUND: Very few studies analyze the medical interventions performed in the last days of life. OBJECTIVE: To assess the treatments and care provided to dying patients in Internal Medicine Service in whom the death was expected. Method: A retrospective study was conducted on patients who died in the Internal Medicine Service from May to August 2011. Expected death was defined as when the doctor responsible for the care had made a note of the possibility of death in the medical history. RESULTS: The last days of life were analyzed in 102 patients whose death was expected. The mean age of the patients was 80.91 (SD 9.59), the majority (53; 52%) being males, with high comorbidity. The most frequent causes of death were: bronchoaspiration in 20 (19.6%), neoplastic disease in 18 (17.6%), and congestive heart failure in 13 (12.7%). In the majority of patients (95; 93.1%) at least one symptom was noted in the medical history and a treatment to control the symptoms was ruled in a high percentage of patients (86.3%). Do not resuscitate orders were written for 80 patients (78.4%). Palliative sedation was administered in 35 (34.3%) PATIENTS: CONCLUSIONS: The majority of patients who died in Internal Medicine were elderly, who suffered end-stage chronic or neoplastic diseases, needed palliative care, in whom the death was expected. Although there were a high percentage of patients who received symptomatic palliative treatment, and do not resuscitate orders were written, there were other aspects that could be improved, such as palliative sedation
Subject(s)
Humans , Hospice Care/statistics & numerical data , Hospital Mortality , Delivery of Health Care/statistics & numerical data , Internal Medicine/statistics & numerical data , Hypnotics and Sedatives/therapeutic use , Retrospective Studies , Cardiopulmonary ResuscitationABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Ileitis/microbiology , Cytomegalovirus Infections/complications , Cytomegalovirus/isolation & purification , Diagnosis, Differential , Antiviral Agents/therapeutic useABSTRACT
No disponible