Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Mar 2022
Multicenter StudyAssociation of antineutrophil cytoplasmic antibody (ANCA) specificity with the demographic and clinical characteristics of patients with ANCA-associated vasculitides.
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is characterized by the presence of proteinase‑3 (PR3) or myeloperoxidase (MPO) ANCA. In over 90% of cases, PR3‑ANCA is associated with granulomatosis with polyangiitis (GPA). However, it is also rarely found in microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA). On the other hand, MPO‑ANCA being characteristic of MPA (>90% of cases), is also found in about 40% of EGPA and 5% of GPA patients. On the ground of this overlap, clinical importance of ANCA specificity identification has been questioned. ⋯ The presence and specificity of ANCA in AAV patients are related to sex and age, determine their organ involvement and influence mortality as previously shown. Patients with MPO‑ANCA-positive AAV constitute a clinically homogeneous group, whereas PR3‑ANCA-positive patients are much more clinically heterogeneous. ANCA-negative AAV patients are characterized by better prognosis. Thus, ANCA identification is an indispensable element and should not be omitted in establishing AAV diagnosis.
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Pol. Arch. Med. Wewn. · Mar 2022
Multicenter StudyThe impact of overweight on diverticular disease: a cross-sectional multicentre study.
The prevalence of colonic diverticulosis and diverticulitis has significantly increased in recent years. Obesity is a well‑known risk factor for diverticulitis, but far less is known about the association between diverticulitis and overweight. ⋯ Overweight was associated with an increased risk of diverticulitis among patients with diverticulosis. Since overweight is a modifiable factor, this observation has preventive importance.
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Pol. Arch. Med. Wewn. · Feb 2022
Multicenter StudyTranscatheter aortic valve-in-valve implantation for failed surgical bioprostheses: results from Polish Transcatheter Aortic Valve-in-Valve Implantation (ViV-TAVI) Registry.
Transcatheter aortic valve‑in ‑valve implantation (ViV‑TAVI) has emerged as an alternative to redo surgery in patients with failed surgical aortic bioprosthesis. ⋯ Transcatheter treatment of failed bioprostheses is increasingly common, with the best hemodynamic effect shown for supra ‑annular valves. The introduction of second‑generation valves has improved procedural and clinical outcomes.
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Pol. Arch. Med. Wewn. · Dec 2021
Multicenter StudyPatterns of multimorbidity in 4588 older adults. Implications for non-geriatrician specialist.
Multimorbidity has been recognized as an important factor in geriatric medicine. However, its importance for other specialists is still to be fully appreciated. ⋯ The age-specific analysis of clustering revealed differences in prevalence and patterns of comorbidities, which stresses the importance of individual approach to older patients.
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Pol. Arch. Med. Wewn. · Nov 2021
Multicenter StudyBurden of multimorbidity in a Polish cohort of ambulatory and hospitalized heart failure patients from two large European registry programs: prognostic implications.
Introduction: Individual comorbidities have been shown to adversely affect prognosis in heart failure (HF). However, our knowledge of multimorbidity in HF and understanding of its prognostic implications still remain incomplete. Objectives: We aimed to analyze the prevalence of multimorbidity in Polish HF patients and to investigate the quantitative and qualitative impact of comorbidity burden on 12-month outcomes in that population. Patients and methods: We retrospectively analyzed data of 1765 Polish patients with ambulatory or acute (requiring hospitalization) HF from 2 multicenter observational European Society of Cardiology registries: the ESC-HF Pilot Survey (2009–2010) and ESC-HF-LT Registry (2011–2013). Results: Arterial hypertension and coronary artery disease were the most prevalent comorbidities, similarly to the entire European cohort. The great majority of HF patients had more than 1 predefined comorbidity and the most frequent number of comorbidities was 3. ⋯ The best accuracy for predicting the adjusted 12-month rate of all-cause death was ensured by the model including only anemia and kidney dysfunction. The model including 4 comorbidities—anemia, kidney dysfunction, diabetes, and coronary artery disease—provided best accuracy for predicting 12-month rate of composite all-cause death or HF hospitalization. Conclusions: Multimorbidity is highly prevalent in a real-world cohort of Polish HF patients and the quantitative burden of comorbidities is related to increased mortality. In such patients, the clinical profile characterized by pathophysiological continuum of diabetes, kidney dysfunction, and anemia is particularly associated with unfavorable outcomes.