Wiadomości lekarskie (Warsaw, Poland : 1960)
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The aim of the research is to identify specific of AI in healthcare, its nature, and specifics and to establish complexities of AI implementation in healthcare and to propose ways to eliminate them. ⋯ Conclusion: The conducted analysis makes it possible to admit a number of pros and cons in the field of AI using in healthcare. Undoubtedly this is a promising area with a lot of gaps and grey zones to fill in. Furthermore, the main challenge is not on technology itself, which is rapidly growing, evolving, and uncovering new areas of its use, but rather on the legal framework that is clearly lacking appropriate regulations and some political, ethical, and financial transformations. Thus, the core questions regarding is this technology by its nature is suitable for healthcare at all? Is the current legislative framework looking appropriate to regulate AI in terms of safety, efficiency, premarket, and postmarked monitoring? How the model of liability with connection to AI technology using in healthcare should be constructed? How to ensure privacy without the restriction of AI technology use? Should intellectual privacy rights prevail over public health concerns? Many questions to address in order to move in line with technology development and to get the benefits of its practical implementation.
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Non-vitamin K antagonist oral anticoagulants (NOACs) are currently recommended for oral anticoagulation in patients with non-valvular atrial fibrillation. In the setting, NOACs effectively prevent from stroke and systemic embolic events. In spite of the favorable safety profile of NOACs when compared with vitamin K antagonists, the use of any kind of anticoagulation is associated with an increased risk of bleeding. ⋯ Moreover, some patients on chronic NOAC therapy may require urgent surgery or invasive procedures. Specific reversal agents for NOACs have been developed, i.e. more widely available idarucizumab for the factor IIa inhibitor (dabigatran) and andexanet alfa for the factor Xa inhibitors (rivaroxaban, apixaban, edoxaban) with limited availability. This review summarizes the occurrence and management of NOAC-related bleeding complications with a particular emphasis on hematuria.
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Catastrophic antiphospholipid syndrome is the most dangerous form of the antiphospholipid syndrome, which is characterized by rapid onset of thrombosis in small vessels of many organs and intravascular coagulation, thrombocytopenia and hemolytic anemia. The syndrome develops over a short period of time with acute multi-organ failure, including kidney, respiratory, cardiovascular, central nervous system and adrenal glands, often associated with disseminated thrombotic microangiopathy. ⋯ Early diagnosis and aggressive treatment of patients with catastrophic antiphospholipid syndrome is essential to save the life of these patients. In the last 10 years, the mortality in this disease decreased from 50% to 30% with simultaneous treatment with anticoagulants, corticosteroids, plasmapheresis and immunoglobulins.
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Stem cell transplantation is now a routine and successful therapeutic method in many hematopoietic disorders and cancers. Unfortunately, toxicity of the procedure significantly worsens the outcomes, with acute and chronic kidney injury among the others. Etiology of kidney failure is multifactorial with nephrotoxicity of drugs, septic complications, sinusoidal occlusion syndrome, thrombotic microangiopathy and acute/chronic graft-versus-host disease (GvHD). Understanding these syndromes enables early recognition and proper intervention that can reduce incidence and severity of kidney injury and improve outcomes.
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Despite cardiopulmonary resuscitation guidelines and their regular updates, the results of cardiac arrest victims treatment are still disappointingly poor. Complex treatment including providing artificial ventilation, circulatory support and prevention of secondary damage from ischemia and hypoxia is a complicated process and its result is unpredictable. The aim of the paper is to present the main steps in post-resuscitation syndrome treatment including ventilatory and circulatory stabilization, central nervous system protection and prognostic value of biochemical and neurophysiological tests.