The novel coronavirus disease(COVID-19)has hit the healthcare system worldwide.The risk of severe infection and mortality increases with advancing age,especially in subjects with comorbidities such as cardiovascular d...The novel coronavirus disease(COVID-19)has hit the healthcare system worldwide.The risk of severe infection and mortality increases with advancing age,especially in subjects with comorbidities such as cardiovascular disease,hypertension,diabetes,obesity and cancer.Moreover,cardiovascular complications such as myocardial injury,heart failure and thromboembolism are frequently observed in COVID-19 cases,and several biomarkers(troponin,NTpro BNP and D-Dimer)have been identified as prognostic indicators of disease severity and worst outcome.Currently,there is no specific therapy against SARS-Co V-2,although many medications are under investigation.The aim of this review will be to explore the intertwined relationship between COVID-19 disease and the cardiovascular system,focusing on elderly population.The available supportive treatments along with the related concerns in elderly patients,due to their comorbidities and polypharmacotherapy,will be explored.展开更多
Background: Delirium is a high prevalent postoperative complication in older cardiac surgery patients and can have drastic consequence for the patient. Preventive interventions, diagnosis and treatment of delirium req...Background: Delirium is a high prevalent postoperative complication in older cardiac surgery patients and can have drastic consequence for the patient. Preventive interventions, diagnosis and treatment of delirium require specialized knowledge and skills. Objective: To gain insight in the current opinion and beliefs of nurses in hospitals concerning prevention, diagnosis and treatment of delirium in older hospital patients in general and specifically in older cardiac surgery patients. Methods: In a cross-sectional study from February to July 2010, we distributed a survey on beliefs on delirium care among 368 nurses in three hospitals in the Netherlands, in one hospital in all wards with older patients and in two hospitals in the cardiac surgery wards only. Results: Although in literature incidence rates up to 54.9% in cardiac surgery patients in hospitals are reported, with a response rate of 68% (250), half of the nurses believe that the incidence of delirium is not even 10%. Two thirds think that delirium in patients is preventable. Although, the Delirium Observation Scale is most often used for screening delirium, nearly all nurses do not routinely screen patients for delirium. Opinions on delirium of nurses working in cardiac surgery wards did not differ from nurses caring for older patients in other hospital wards. Conclusions: Nurses do have knowledge on delirium care, but there is a gap between the reported incidence in literature and the estimation of the occurrence of delirium by nurses. A two-way causal relationship emerges: because nurses underestimate the occurrence, they do not screen patients on a routine basis. And because they do not screen patients on a routine basis they underestimate the incidence.展开更多
文摘The novel coronavirus disease(COVID-19)has hit the healthcare system worldwide.The risk of severe infection and mortality increases with advancing age,especially in subjects with comorbidities such as cardiovascular disease,hypertension,diabetes,obesity and cancer.Moreover,cardiovascular complications such as myocardial injury,heart failure and thromboembolism are frequently observed in COVID-19 cases,and several biomarkers(troponin,NTpro BNP and D-Dimer)have been identified as prognostic indicators of disease severity and worst outcome.Currently,there is no specific therapy against SARS-Co V-2,although many medications are under investigation.The aim of this review will be to explore the intertwined relationship between COVID-19 disease and the cardiovascular system,focusing on elderly population.The available supportive treatments along with the related concerns in elderly patients,due to their comorbidities and polypharmacotherapy,will be explored.
文摘Background: Delirium is a high prevalent postoperative complication in older cardiac surgery patients and can have drastic consequence for the patient. Preventive interventions, diagnosis and treatment of delirium require specialized knowledge and skills. Objective: To gain insight in the current opinion and beliefs of nurses in hospitals concerning prevention, diagnosis and treatment of delirium in older hospital patients in general and specifically in older cardiac surgery patients. Methods: In a cross-sectional study from February to July 2010, we distributed a survey on beliefs on delirium care among 368 nurses in three hospitals in the Netherlands, in one hospital in all wards with older patients and in two hospitals in the cardiac surgery wards only. Results: Although in literature incidence rates up to 54.9% in cardiac surgery patients in hospitals are reported, with a response rate of 68% (250), half of the nurses believe that the incidence of delirium is not even 10%. Two thirds think that delirium in patients is preventable. Although, the Delirium Observation Scale is most often used for screening delirium, nearly all nurses do not routinely screen patients for delirium. Opinions on delirium of nurses working in cardiac surgery wards did not differ from nurses caring for older patients in other hospital wards. Conclusions: Nurses do have knowledge on delirium care, but there is a gap between the reported incidence in literature and the estimation of the occurrence of delirium by nurses. A two-way causal relationship emerges: because nurses underestimate the occurrence, they do not screen patients on a routine basis. And because they do not screen patients on a routine basis they underestimate the incidence.
