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PubMed · 5074753

A clinical perspective on dying.

R G Janes
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Abstract

There is continuing need for dissemination of already available, clinically useful knowledge concerning the psychological needs of the seriously ill and dying. Against the changing social context of dying, some of our erroneous assumptions about these patients are explored and the genuine fears and personal needs are discussed. The implications of this knowledge for medical education are recognized.

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DeathEducation, MedicalMaleNurse-Patient RelationsPhysician-Patient RelationsPsychologyTerminal CareJournal Article

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R G Janes. 1972-09-09. A clinical perspective on dying.. https://pubmed.ncbi.nlm.nih.gov/5074753/

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Increased risk of cardiac death in primary hyperparathyroidism: what is a role of electrical instability?

BACKGROUND: Increased risk of death in patients with primary hyperparathyroidism (PHPT) is referred to cardiovascular complications induced by hypercalcemia. At the moment the role of bioelectrical risk and of enhanced sympathetic activity, not related to cardiovascular complications, is unknown in PHPT patients. METHODS: The study was designed to evaluate the QT parameters and sympathovagal balance in 28 PHPT uncomplicated patients compared to 29 healthy subjects (HS). Nine of 28 patients were restudied after parathyroidectomy. Standard ECG, short and 24-h ECG monitoring were performed to calculate QT parameters and Heart Rate Variability (HRV). RESULTS: QTc interval resulted shorter in PHPT patients than in HS and QTc dispersion resulted higher in PHPT patients than HS. The physiological adaptation of QT length to R-R interval was lacking in PHPT patients. Enhanced sympathetic tone was found in PTHP patients than controls. These data were confirmed after parathyroidectomy. CONCLUSION: Our findings revealed an increased risk to develop life-threatening arrhythmias in PHPT patients due to bioelectrical instability induced by hypercalcemia. Parathyroidectomy doesn't seem to reverse this abnormality.

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