Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Mar 2020
Multicenter StudyAdherence to the ABC (Atrial fibrillation Better Care) pathway in the Balkan region: the BALKAN-AF survey.
The Atrial fibrillation Better Care (ABC) pathway provides a useful way of simplifying decision‑making considerations in a holistic approach to atrial fibrillation management. ⋯ Physicians' adherence to integrated AF management based on the ABC pathway was suboptimal. Addressing the identified clinical and system‑related factors associated with A+B+C-nonadherent management using targeted approaches is needed to optimize treatment of patients with AF in the Balkan region.
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Pol. Arch. Med. Wewn. · Mar 2020
ReviewClinical significance of slightly reduced von Willebrand factor activity.
Von Willebrand disease (VWD) is the most common congenital bleeding disorder, with a clinical presentation of mucocutaneous and surgical bleeding varying from mild to severe. It is inherited in an autosomal dominant or autosomal recessive manner. The disease is caused by quantitative or qualitative deficiency of the von Willebrand factor (VWF) and is classified as type 1, 2 (2A, 2B, 2M, 2N), and 3. ⋯ Recently, it was documented in a large group of patients with type 1 VWD and low VWF that bleeding score does not correlate with VWF:Ag and bleeding symptoms in type 1 VWD (<30 IU/dl) and low VWF can change from infrequent and moderate to severe bleeds. Because the plasma concentration of VWF depends on many physiological and pathological factors that may mask the diagnosis of VWD, separation of the group of patients with low VWF (30-50 IU/dl) from those with type 1 VWD may delay or prevent them from receiving appropriate treatment. Diagnosis of VWD in each case, particularly those with a slight decrease in VWF (30-50 IU/dl), should be based primarily on the clinical manifestations and family history of hemorrhagic diathesis.