Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Oct 2021
Multicenter Study Observational StudyDistrict versus academic hospital - clinical outcomes of patients with atrial fibrillation. MultiCenter expeRience in Atrial Fibrillation Patients Treated With Oral Anticoagulants (CRAFT) study.
Introduction: Atrial fibrillation (AF) is associated with increased hospitalization. Objectives: We aimed to compare long-term outcomes in patients with AF hospitalized in academic and district hospitals. Patients and methods: This retrospective observational study included data from the Multicenter Experience in Atrial Fibrillation Patients Treated with Oral Anticoagulants (CRAFT; NCT02987062) study which included AF patients hospitalized between 2011 and 2016 in academic and district hospitals. The primary end point was a major adverse event (MAE) defined as all-cause death and thromboembolic and hemorrhagic events during the median 4-year follow-up. Results: We analyzed 2983 patients with AF: 2271 (76%) from academic and 712 (24%) from district hospitals. ⋯ Heart failure, renal failure, and vitamin K antagonist (in academic hospitals), and coronary artery disease (in district hospitals) were associated with greater likelihood of hemorrhagic events. District (vs academic) conditions were associated with higher risk of MAEs and all-cause death in men and those with low risk of bleeding, and with higher incidence of thromboembolic events in women, elderly patients, and those with high risk of bleeding and with diabetes. Conclusions: Patients with AF treated at district hospitals had worse long-term outcomes than those treated in academic conditions.
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Pol. Arch. Med. Wewn. · Aug 2021
Multicenter StudyEffects of cardiac rehabilitation on risk factor management and quality of life in patients with ischemic heart disease: A multicenter cross-sectional study.
While cardiac rehabilitation (CR) improves survival outcomes in patients with ischemic heart disease (IHD), the long‑ term benefits of short term programs are still discussed. ⋯ Cardiac rehabilitation is moderately effective if performed only once and without a continuous support program. Further efforts to increase referrals for CR in patients with IHD must be accompanied by a long‑ term strategy to sustain the beneficial effects.
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Pol. Arch. Med. Wewn. · Jul 2021
Multicenter StudyExtremely high mortality in COVID-19 hemodialyzed patients in before anty-SARS-CoV-2 vaccination era. The first large database from Poland.
Preliminary reports suggested high incidence and mortality rates of SARS‑ CoV 2 infection in patients receiving kidney replacement therapy. ⋯ The results of this study show the extremely high mortality rate of COVID‑ 19 in hemodialysis patients during the first and second waves of the epidemic in Pomerania Province, before the vaccination era.
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Pol. Arch. Med. Wewn. · Jun 2021
Multicenter StudyRisk factors and causes for early mortality in patients with newly diagnosed multiple myeloma in a "real world" study: experiences of the Polish Myeloma Group.
INTRODUCTION Despite the progress made in the treatment of multiple myeloma (MM), approximately 10% to 15% of patients die within the first year of diagnosis. OBJECTIVES The aim of the study was to determine risk factors of early mortality in patients with newly diagnosed MM treated with new drugs in clinical practice. PATIENTS AND METHODS This multicenter analysis included 197 patients with symptomatic MM, diagnosed between October 2006 and November 2019, with a survival of less than 12 months. ⋯ In a multivariable analysis, the Zubrod performance score (P = 0.02), history of cardiovascular disease (P = 0.04), dependence on renal dialysis (P = 0.03), and MM response (P <0.001) were associated with early mortality. CONCLUSIONS Early mortality in MM patients requires further studies. When qualifying patients with newly diagnosed MM for chemotherapy, it is necessary to consider performance status and the history of comorbidities, including cardiovascular diseases.
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Pol. Arch. Med. Wewn. · May 2021
Multicenter StudyFallen dogmas - recent advances in locoregionally advanced melanoma.
Last decade brought new achievements in the melanoma research, which resulted in an important changes in the clinical management of stage III melanoma. The article summarizes recent updates with particular focus on practical aspects. ⋯ These findings led to fall of another dogma in oncology: lack of effective adjuvant therapy for stage III melanoma at acceptable toxicity. At the end of the day in 2021 modern multidisciplinary approach incorporating newest findings offer stage III melanoma patients less surgical complications of better tailored surgery and longer survival in result of efficient adjuvant therapy.