Canadian Journal of Medicine

The aim of this study was to evaluate the care burden, psychological distress, and psychiatric disorders of the companions of adult patients in the hospital. This study is a cross-sectional descriptive study. The study questionnaire included a sociodemographic information form, the Zarit Caregiver Burden Scale (ZCBS), and the Brief Symptom Inventory (BSI) were administered to the companions. Simple descriptive and inferential statistics were performed. The Mann-Whitney U test was used when there was no normal distribution. Correlation coefficients and statistical significance were calculated by using the Spearman test for at least one non-normal distributed relationship. A multiple linear regression analysis was performed for determining factors associated with BSI scores. The type 1 error level was used as 5% for statistical significance. All p-values of less than .05 were considered significant. Three hundred companions were included in the study. An emotional commitment was the leading cause of companionship. The mean values of the companions’ ZCBS and BSI scores were 20.2 and 34.4, respectively. There was a moderately positive correlation (r = .50) between the ZCBS and BSI scores, and it was found to be statistically significant. ZCBS scores were positively associated with BSI scores. Psychological distress increases as the care burden of companions increases. Companions need more assistance from health care institutions, family members, and the community. The support of health workers and family members reduced the companions’ care burden and psychological distress. Physicians working in the hospital should take into account that companions may be hidden patients.

Percutaneous coronary intervention through right radial artery access significantly reduces vascular complications compared to femoral access—an 80-year-old woman presented with non-ST segment elevation acute coronary syndromes (NSTE ACS).  Coronary angiography performed using right radial artery access showed left anterior descendent artery disease with multiple stenoses, which was treated percutaneously. Ten minutes after the procedure, the patient presented dyspnea, hypotension, neck edema, and jugular turgor. She was immediately intubated and treated with invasive ventilation, fluid expansion, corticosteroids, and vasopressors. Urgent computerized tomography showed brachiocephalic artery trunk dissection and perforation with extravascular hemorrhage in the mediastinum and neck with venous compression without any sign of aortic, carotid, or subclavian dissection. Two days later, the percutaneous endovascular repair was performed, and a covered self-expanding stent was successfully positioned in the brachiocephalic trunk, sealing the perforation and treating the dissection. The patient progressively recovered and was discharged for rehabilitation. We provided the first report of a brachiocephalic trunk perforation using a radial approach, causing mediastinal and neck hematoma treated with percutaneous endovascular repair showing that vascular complications can be successfully treated percutaneously if be performed by an experienced team.