Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Mar 2024
Dietary salt intake in chronic kidney disease. Recent studies and their practical implications.
Epidemiological studies in the general population show that the level of dietary salt intake is associated with increases in blood pressure, cardiovascular events and mortality. Trial data show that reducing salt intake reduces blood pressure, cardiovascular events and mortality. On the basis of this evidence, the World Health Organization and other bodies recommend restricting salt intake. ⋯ However, these trials have typically used resource-intensive approaches to dietary salt reduction that are not suitable for routine clinical care and salt intake typically remains high in people with CKD. The OxSalt care bundle is a low-cost intervention that was demonstrated in the OxCKD1 trial to help people with CKD to lower their salt intake and could be applied in routine clinical practice.
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Pol. Arch. Med. Wewn. · Mar 2024
Does the atrial fibrillation still increase the risk of death? Results from the NOMED study in one-year follow-up.
Although atrial fibrillation (AF) is a well‑known risk factor for ischemic stroke and hospitalization, its effect on mortality has not been clearly established. ⋯ AF is an independent risk factor for death and cardiovascular hospitalization. The risk of death and stroke in patients with AF is significantly higher than in the patients without this arrhythmia. Oral anticoagulation in patients with AF significantly reduces the rates of death and stroke; however, its use is suboptimal in this group of patients.
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Endoscopic stenting is a commonly applied method of treatment in patients with malignant biliary strictures. It involves the use of self‑expandable metal stents (SEMSs) or plastic stents (PSs). ⋯ In patients with malignant strictures of the biliary tree SEMSs outperform PSs. SEMSs should be used as a treatment of choice for biliary drainage in that group of patients.