Paradoxical decrease in isoprostane and increase in superoxide dismutase following CPAP withdrawal in OSA

Abstract

The strength of EPC is its holistic approach. This means that this palliative hour is run not only by the pulmonologist but also by a palliative care physician, a psychologist, a social worker, a palliative nurse and a thoracic oncology nurse. Each team member has their own specific domain to discuss. For example, the palliative nurse will empower the patient to talk about the EoL and give more practical information about the different possibilities, such as home care, hospice care, palliative sedation, etc. Since this palliative hour is implemented in our standard oncology care, short-notice, unplanned appointments are always possible. Specific problems needing another profession are planned in the patients' ambulatory service (e.g. neurologist) and information exchange is linked with the weekly patient discussions.As mentioned before, the first appointment is always planned with the pulmonologist. This way, we make a clear statement that EPC is integrated into our standard oncology care. The second appointment is with the palliative care physician to discuss topics that have not been covered yet and to check if palliative home care has already started. When making follow-up appointments, we make sure that each team member attends the patient once, to assure better psychosocial support.In conclusion, we have developed tools for the pulmonologist to implement EPC in daily practice. These tasks mainly consist of assuring adequate symptom control, and transparent communication with patients, relatives and team members. As EPC needs a holistic approach, collaboration with other members of the palliative team is necessary.

Overnight urinary isoprostanes as a marker of oxidative stress in obstructive sleep apnoea

“…Following on from concerns raised by MONNERET and BONNEFONT-ROUSSELOT [2], we took the opportunity to look at the levels of urinary isoprostanes in overnight urine samples, rather than early morning samples, which had been collected in a subset of patients from our original trial. This allowed us to address two concerns, the timing of our original samples, and the possible effects of urine dilution on the levels of urinary isoprostanes (by correcting for both creatinine levels and urine production).…”