Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Jun 2021
ReviewCardiovascular manifestations in obstructive sleep apnea: current evidence and potential mechanisms.
Obstructive sleep apnea (OSA) is an increasingly prevalent health concern characterized by repeated episodes of pharyngeal collapse during sleep. It is frequently associated with daytime sleepiness and impaired functional capacity, but it is also linked to cardiovascular disease by a growing body of epidemiological, clinical, and translational research. The severity of OSA is traditionally evaluated by the apnea‑hypopnea index (AHI), but the value of this marker as a predictor of cardiovascular outcomes is limited. ⋯ These mechanisms lead to sympathetic activation, inflammation, and oxidative stress, which may result in the clinical consequences of OSA such as hypertension, coronary artery disease, heart failure, and cerebrovascular disease. This review focuses on the epidemiology and potential mechanisms of cardiovascular diseases in OSA. Furthermore, we will briefly discuss the role of personalized medicine, alternative treatment options, and precise phenotyping to optimize treatment of this complex condition and its associated cardiovascular risk.
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Pol. Arch. Med. Wewn. · Jun 2021
Associations between constipation symptoms and the sleep quality in non-dialysis chronic kidney disease patients: a cross-sectional study.
INTRODUCTION Sleep disturbances, similarly to constipation‑related symptoms, are common problems in patients with chronic kidney disease (CKD) and are associated with worse health-related quality of life. OBJECTIVES The aim of the study was to investigate sleep problems in conservatively treated patients with CKD and to assess association between sleep quality and constipation in that population. PATIENTS AND METHODS In this cross‑sectional study, 100 conservatively treated outpatients with CKD filled questionnaires addressing sleep quality (The Medical Outcomes Study 12‑item Sleep Scale-Revised [MOS‑Sleep‑R]) and constipation‑related symptoms (PAC‑SYM, Rome III criteria). ⋯ The scores from the PAC-SYM abdominal and stool subscales correlated with all assessed sleep quality domains. In both univariable and multivariable regression models adjusted for key clinical data, functional constipation, less than 7 bowel movements a week, abdominal discomfort, and pain as well as too small bowel movements were independently associated with increased prevalence ratio of decreased sleep quality. CONCLUSIONS In patients with nondialysis CKD, sleep disorders might have common etiological factors with constipation-related symptoms.
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Pol. Arch. Med. Wewn. · Jun 2021
Coronavirus disease 2019 (COVID-19) among hospitalized patients in Poland: a study based on a national hospital registry.
INTRODUCTION COVID‑19 has been identified by the World Health Organization as a pandemic. Poland introduced extensive antiepidemic measures relatively early in order to slow down the spread of the disease. OBJECTIVES The study aims to present recent data on COVID‑19 hospitalizations during the first months of the disease outbreak in Poland. ⋯ In the period subject to analysis, 1073 in‑hospital deaths were observed (13% of all patients), 965 of which occurred during first‑time hospitalizations (11.7% of all patients). In the study group, patients who died during hospitalization compared with those who survived hospitalization were significantly older, more frequently lived in urban areas, and had more comorbidities. CONCLUSIONS The findings of our study, especially the differences between survivors and nonsurvivors with COVID-19, may be helpful in recognizing patients requiring special medical care and preventive measures during hospitalization.
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Pol. Arch. Med. Wewn. · Jun 2021
Increase in the prevalence of the metabolic syndrome in Poland. Comparison of the results of the WOBASZ (2003-2005) and WOBASZ II (2013-2014) studies.
INTRODUCTION Metabolic syndrome (MS) significantly increases cardiovascular risk. Knowledge about the current prevalence of MS in the Polish population is limited. OBJECTIVES The aim of this study was to assess the prevalence of MS in the Polish population based on the results of the WOBASZ II study (2013-2014) and to compare the obtained data with the results of the WOBASZ study (2003-2005). ⋯ In the decade between the WOBASZ and WOBASZ II studies, there was a significant increase in the prevalence of MS in Polish adults aged 20 to 74 years: by 3.3 percentage points in women (26.6% vs 29.9%; P <0.001) and by 8.8 percentage points in men (30.7% vs 39.4%; P <0.001). The increase in the frequency of carbohydrate metabolism disorders was the greatest contributor to this phenomenon; however, abdominal obesity and lipid disorders were also significantly more frequent. CONCLUSIONS It is alarming that in the decade between the WOBASZ and WOBASZ II studies there was such a significant increase in the prevalence of MS and its individual components in Poland.