Polskie Archiwum Medycyny Wewnętrznej
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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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Pol. Arch. Med. Wewn. · Mar 2024
Use of antihypertensive drug classes and combination therapies during the COVID-19 pandemic in Poland: a cross-sectional, nation-wide study 2019-2021.
The 2018 European Society of Cardiology / European Society of Hypertension guidelines recommended the use of combination therapy, especially in the form of single‑pill combinations (SPCs), for treatment of hypertension. ⋯ During the COVID‑19 pandemic, a decrease in the frequency of combination treatments and an increase in the frequency of dual and triple SPC use were observed. Despite the slow increase in the frequency of prescribing the guideline‑recommended drug combinations, their use remains suboptimal.
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Pol. Arch. Med. Wewn. · Mar 2024
Genetic predisposition to differentiated thyroid cancer among Polish population.
Genome sequencing technologies reveal molecular mechanisms of differentiated thyroid cancer (DTC). Unlike somatic mutation analysis from thyroidectomy samples, germline mutations showing genetic susceptibility to DTC are less understood. ⋯ Even though the Polish population is genetically similar to the other European populations, there are significant differences in variant frequencies contributing to the disease development and progression, such as those in the RET, CHEK2, BRCA1, SLC26A4, or TERT genes. Further studies are needed to identify genomic variants associated directly with DTC.
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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.
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Pol. Arch. Med. Wewn. · Mar 2024
24-hours urine metanephrines excretion in patients diagnosed with adrenal incidentaloma: impact of commonly used drugs on clinical decision.
Incidentaloma is an adrenal tumor detected during diagnostic imaging performed for extra‑adrenal causes. Evaluation of metanephrine concentrations in a 24‑hour urine collection can be a significant challenge in patients with multiple medications and comorbidities. ⋯ Many drug groups interfere with the measurement of urinary fractionated metanephrines. These interactions should be taken into account during interpretation of a hormonal evaluation, as they can be crucial for further management, especially for making a decision on surgical treatment.