BackgroundObstructive sleep apnea (OSA) is associated with elevated risk of cardiovascular events. The early stages of vascular complications can be visualized by means of ultrasound. Intima-media thickness (IMT) correlates with the presence of risk factors of cardiovascular diseases such as hypertension, diabetes, tobacco smoking, or hyperlipidemia. However, little is known whether OSA itself may be the cause of IMT thickening.MethodsThe study group was composed of 28 patients (6 women, 22 men; mean age = 53.8 years, mean BMI = 27.1 kg/m2, mean AHI = 22.4/h) with OSA who had no comorbidities. The control group consisted of 28 healthy subjects (6 women, 22 men; mean age = 53.9 years; mean BMI = 27.5 kg/m2). In both groups IMT was assessed in common carotid arteries with the use of ultrasonography. Additionally, in patients with OSA, pulse wave velocity, echocardiography, 24-h automated blood pressure monitoring, clinical signs and symptoms, and blood tests were performed to investigate possible correlations with IMT.ResultsMedian IMT was 0.41 mm in OSA patients and 0.46 mm in the control group (p = 0.087). Echocardiography revealed left ventricle hypertrophy in 21 %, systolic disorders in 8 %, and diastolic disorders in 57 % of the patients. In a large majority of patients, pulse wave velocity was found to be normal. IMT correlated with age (r = 0.446, p = 0.017), total cholesterol (r = 0.518, p = 0.005), daytime systolic blood pressure (r = 0.422, p = 0.025), pulse pressure 24 h and daytime (r = 0.424, p = 0.027 and r = 0.449, p = 0.019), early mitral flow/atrial mitral flow (E/A) (r = −0.429, p = 0.023), and posterior wall diameter (PWD) (r = 0.417, p = 0.270).ConclusionIn a relatively nonobese group of patients, no significant differences were found in the intima-media thickness between OSA patients without concomitant cardiovascular diseases and healthy controls. This may lead to the conclusion that IMT does not reflect increased risk of cardiovascular events in patients with isolated OSA.
Despite the many new possibilities, cancer pain treatment is not always effective and often poses a challenge for practitioners. At the end-of-life care, both oral and subcutaneous drug delivery very often are not attainable. The increasing number of patients in terminal stage of chronic diseases forced us to look for the alternative ways of administration of pain treatment. In this context, the potentially rapid onset of action and ease of use make aerosolized drug delivery an attractive option in palliative care settings. The objective of this review was to identify literature on pain relief with inhaled opioids. The evidence suggests that nebulized opioids might be effective in the treatment of pain in various aetiologies; however, randomized controlled studies on nebulization therapy for cancer pain are lacking.
Introduction: Computer Tomography (CT) findings of COVID-19 are well described in the literature and include predominantly peripheral, bilateral Ground-Glass Opacities (GGOs), combination of GGOs with consolidations, and/or septal thickening creating a “crazy-paving” pattern [1]. COVID-19 pneumonia may mimic different infectious and non-infectious diseases [2]. However, it is rare for pulmonary changes to be accompanied by osteal changes suggesting malignant etiology. It needs a special attention and vigilance in diagnostic process. COVID changes may have misleading character and implicates the diagnosis and treatment.
Background: Palliative patients who stay at home require exceptional medical care provided by General Practitioners (GPs) in conjunction with specialists in palliative medicine. To ensure effective treatment, proper cooperation between them is essential. Aim: An assessment of the knowledge and attitudes of GPs towards palliative medicine Design: The research was based on a survey questionnaire, consisting of 8 multiple choice questions. A total of participated anonymously in the survey. The data analysis included descriptive statistics and logistic regression. Participants: 83 GPs from the Pomeranian Region, 58 female and 25 male practitioners. Results: 59% of respondents defined palliative care as an activity that improves the quality of life of patients and their families facing problems related to a life-threatening illness. The coordination of the work of the palliative team was the most important task for the specialist in palliative medicine (58% of respondents). The majority stated that the most important activity was the prescription of painkillers (86%) and 84% found that being available during business hours was the most important. The next most important activity was delivering bad news (42% of respondents). Conclusions: Most of the GPs knew the correct definition of palliative care and the basics of pain management. Experienced physicians declared a lower willingness to be available during working hours and less often delivered bad news to terminal patients, compared to their younger colleagues. Individual treatment planning (98% of respondents) and reducing antibiotic therapy seem to be the most important aspects in pharmacotherapy.
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