{"title":"Small intestinal bacterial overgrowth in adult patients with type 1 diabetes.","authors":"M. Bulanda, T. Gosiewski, M. Brzychczy-Wloch","doi":"10.20452/pamw.3574","DOIUrl":"https://doi.org/10.20452/pamw.3574","url":null,"abstract":"623 SIBO is defined as an overgrowth of bacterial flora inhabiting the small intestine and is usually described in association with irritable bowel syn‐ drome.5 A number of studies reported the devel‐ opment of SIBO in patients who had undergone surgical treatment of gastrointestinal tumors[6] or other abnormalities in the gastrointestinal tract.7,8 In their paper, Adamska et al4 claimed that there had been no studies on the occurrence of SIBO in the course of diabetes, including type 1 diabetes. Indeed, there are few such studies, but isolated reports concerning type 1 and 2 di‐ abetes are available. For example, Rana et al9 ex‐ amined patients with type 2 diabetes and dem‐ onstrated a significant increase in the incidence of SIBO compared with the healthy population. Ojetti et al10 demonstrated that SIBO is present much more often in patients with type 1 diabe‐ tes who also have autonomic neuropathy, which is associated with a higher daily supply of insu‐ lin. Faria et al11 proved that intestinal transit can be inhibited in the course of type 1 diabetes, but the incidence of SIBO in this patient group is not significantly higher. This study was also cited by Adamska et al.4 It is therefore clear that the prob‐ lem is not completely new, but it has not been well documented. In their study, Adamska et al4 employed hydro‐ gen breath testing to diagnose SIBO. The authors were right to point out that the gold standard for the diagnosis of SIBO is microbiological testing of a duodenal or jejunal aspirate; however, it is an in‐ vasive method.4 Breath testing enables a quick and noninvasive diagnosis of SIBO, but false results are possible (sensitivity of the test when lactu‐ lose is applied is 52%, and specificity—86%).12 Increased intestinal transit can reduce the sen‐ sitivity of the breath test, which causes a rapid removal of lactulose from the proximal small in‐ testine. On the other hand, advanced lung dis‐ eases, such as tumors or inflammations, can re‐ sult in false positive results due to the presence of abundant bacterial flora in the lungs.12 It seems In recent years, our understanding of the func‐ tion of the human gastrointestinal tract has vast‐ ly improved, especially as regards the role of gas‐ trointestinal microbiota (commensal intestinal flora). There is growing evidence for the signifi‐ cant effect of these microbes on the function and health of the human body. Commensal flora of the gastrointestinal tract plays a vital role in di‐ gestion and absorption of nutrients and protects against the invasion of pathogenic microorgan‐ isms by creating resistance to colonization and af‐ fecting the immune system of the host organism. The gastrointestinal tract, especially in its final section, contains an enormous number of bacte‐ ria, which form a peculiar ecosystem. Gastroin‐ testinal flora is an important part of the body. Its role and significance are increasingly recognized, which helps explain the course and causes of nu‐ merous diseas","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"19 1","pages":"623-624"},"PeriodicalIF":0.0,"publicationDate":"2016-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77926584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The moving target of clopidogrel response variability: new tricks of the old dog?","authors":"V. Serebruany","doi":"10.20452/pamw.3576","DOIUrl":"https://doi.org/10.20452/pamw.3576","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"70 1","pages":"625-627"},"PeriodicalIF":0.0,"publicationDate":"2016-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85069419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Sławińska, W. Barańska-Rybak, M. Sobjanek, A. Wilkowska, A. Mital, R. Nowicki
{"title":"Ibrutinib-induced pyoderma gangrenosum.","authors":"M. Sławińska, W. Barańska-Rybak, M. Sobjanek, A. Wilkowska, A. Mital, R. Nowicki","doi":"10.20452/pamw.3578","DOIUrl":"https://doi.org/10.20452/pamw.3578","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"15 1","pages":"710-711"},"PeriodicalIF":0.0,"publicationDate":"2016-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84700111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Whether and how can the doctor help the patient who asks for death?","authors":"R. Voltz","doi":"10.20452/pamw.3580","DOIUrl":"https://doi.org/10.20452/pamw.3580","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"8 1","pages":"712-714"},"PeriodicalIF":0.0,"publicationDate":"2016-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79636824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Asymmetric dimethylarginine: a risk indicator or pathogenic factor?","authors":"D. Fuchs, K. Kurz, J. Gostner","doi":"10.20452/pamw.3572","DOIUrl":"https://doi.org/10.20452/pamw.3572","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"68 1","pages":"621-622"},"PeriodicalIF":0.0,"publicationDate":"2016-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80800425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The conundrum of watchful waiting versus pre-emptive surgery in asymptomatic aortic stenosis: are we any closer to an answer?","authors":"M. Desai, A. Mentias","doi":"10.20452/pamw.3570","DOIUrl":"https://doi.org/10.20452/pamw.3570","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"57 1","pages":"619-620"},"PeriodicalIF":0.0,"publicationDate":"2016-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89672627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"In memoriam: Professor Karel Horký.","authors":"E. Kucharz","doi":"10.20452/pamw.3565","DOIUrl":"https://doi.org/10.20452/pamw.3565","url":null,"abstract":"617 a DSc degree. He was twice a visiting scientist at the Clinical Research Institute in Montreal, Canada (1969–1970, 1984), where he was work‐ ing on endocrine and metabolic aspects of hy‐ pertension. Upon return to Prague, he founded the Laboratory for Endocrine and Metabolic Re‐ search at the Third Department of Internal Med‐ icine, and became head of this unit. He went on to become the head of the Second Department of Internal Medicine in 1990, and contributed to the development of the department until re‐ tirement in 1998. Following his retirement, Pro‐ fessor Horký served as professor emeritus and was an active personality in scientific societies. He was a president of the Czech Society of Inter‐ nal Medicine (1991–2005), and earlier, he was a president of the Czech Society of Hyperten‐ sion (1994–1998). He passed away on August 11, 2016, in Prague. Professor Karel Horký authored more than 450 original papers and about 15 handbooks and monographs. Still a student, he was attracted to clinical pharmacology by Professor Jiří Štefl (1904–1961). Professor Štefl was famous for se‐ ceding from the Communist Party to protest against political show trials. He was prosecuted and finally he lost the university position dur‐ ing incompetent Masaryk University manage‐ ment purges during these times. Interestingly, he was also an author of a few novels. In Prague, Professor Horký worked under the auspices of the famous Professor Josef Charvát (1897–1984), founder of the Third Department of Internal Med‐ icine in Prague and a great endocrinologist as well as author of several philosophical works. Profes‐ sor Josef Charvát was an honorary member of the Polish Society of Internal Medicine. Endo‐ crinological and metabolic research of Professor Horký was fruitfully carried out under the super‐ vision of Professor Jacques Genest (born 1919) in Montreal. They were working on the role of so‐ dium, aldosterone, and angiotensin II in the re‐ nin–angiotensin system in arterial hyperten‐ sion as well as on the natriuretic factor present in the heart atria. Professor Horký conducted research until the last years of his life, focusing Great sadness and deep affection marked the re‐ cent passing of Professor Karel Horký, a great Czech internist, great mind, an honorary mem‐ ber of the Polish Society of Internal Medicine, and a long ‐time friend of mine. Professor Karel Horký was born in Brno (Czechoslovakia, now Czech Republic) on May 9, 1933. He completed a high school in Třebíči. In 1951, he entered the Medical Faculty of the Ma‐ saryk University in Brno, and he graduated from the university in 1957. For 3 years, he worked at the Regional Hospital in Děčín. There he re‐ ceived the first degree of board certification in internal medicine. In 1960, he moved to Prague and started his professional career as an assis‐ tant at the Third Department of Internal Medi‐ cine of the Charles University. There be obtained the second degree of board certification in in‐ ternal m","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"14 1","pages":"617-618"},"PeriodicalIF":0.0,"publicationDate":"2016-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84868953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Antończyk, M. Szulik, M. Zakliczyński, M. Zembala, M. Zembala, T. Kukulski
{"title":"Recurrent asymptomatic acute cellular rejection after heart transplantation: monitoring with speckle-tracking echocardiography.","authors":"K. Antończyk, M. Szulik, M. Zakliczyński, M. Zembala, M. Zembala, T. Kukulski","doi":"10.20452/pamw.3563","DOIUrl":"https://doi.org/10.20452/pamw.3563","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"16 1","pages":"700-703"},"PeriodicalIF":0.0,"publicationDate":"2016-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90225568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Foss-Nieradko, M. Franaszczyk, M. Śpiewak, A. Oreziak, R. Płoski, Z. Bilińska
{"title":"Novel truncating desmoplakin mutation as a potential cause of sudden cardiac death in a family.","authors":"B. Foss-Nieradko, M. Franaszczyk, M. Śpiewak, A. Oreziak, R. Płoski, Z. Bilińska","doi":"10.20452/pamw.3567","DOIUrl":"https://doi.org/10.20452/pamw.3567","url":null,"abstract":"704 available family members (mother and sister) and revealed no abnormalities. A genetic study was performed to gain insight into SCD in the family and identify family members at potential risk. DNA was extracted from peripheral blood by phenol extraction. Next-generation sequencing (NGS) in the proband was performed using the TruSight One (TSO, Illumina, San Diego, California, United States) sequencing panel. Selected genetic variants identified by NGS were followed up in the proband and relatives, using Sanger sequencing. We identified the frameshift deletion p.Thr2625fs (c.7871_7872delAC), annotated to transcript NM_004415.2 of the desmoplakin (DSP) gene, in the proband, but not in his healthy mother or sister (FIGURE 1F and 1G). Desmoplakin is a critical component of desmosome structures in the cardiac muscle, and the role of DSP mutations, including protein-truncating mutations, in the pathogenesis of cardiomyopathies is well established.1,2 The identified variant has not been described in the literature before or found in genomic databases (Phase 3 of 1000 Genomes, NHLBI GO Exome Sequencing Project [ESP] 6500 and Version 0.3 of ExAC). Although the recommendation of an implantable cardioverter defibrillator (ICD) as primary prevention remains controversial,3 it was necessary in this case. ICD was implemented owing to signs of biventricular involvement on CMR, the family history of SCD, and the result of genetic study in the patient with complex ventricular arrhythmia. A 2-year follow-up revealed that the patient remained asymptomatic, and cardiac function was stable with readings from the ICD memory Sudden cardiac death (SCD) of young, apparently healthy individuals raises questions about whether other family members are also at risk of SCD. A 30-year-old patient treated with bisoprolol (5 mg once daily) for ventricular arrhythmia for 6 months was admitted to our hospital for evaluation. A family history of SCD was identified: the patient’s brother died suddenly at the age of 39 years while working at the computer. A physical examination of our patient was unremarkable. A standard 12-lead electrocardiogram showed sinus bradycardia (47 bpm) and low voltage, fragmented QRS in limb leads (FIGURE 1A). A transthoracic 2-dimensional echocardiogram revealed a nondilated left ventricle with borderline ejection fraction; however, the right ventricle was dilated with mild global contractile dysfunction. Subsequent cardiac magnetic resonance (CMR) revealed a significantly enlarged right ventricle and a slightly enlarged left ventricle (right ventricular [RV] end-diastolic volume, 151 ml/m2, n <111, and left ventricular [LV] end-diastolic volume, 111 ml/m2, n <101) with slightly reduced LV and RV ejection fractions (49% and 46%, respectively) and global hypokinesis. Additionally, diffuse changes on late gadolinium enhancement (LGE) were found (FIGURE 1B–D). On 24-hour Holter monitoring, sinus bradycardia (without pauses), single premature ventricular c","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"126 9 1","pages":"704-707"},"PeriodicalIF":0.0,"publicationDate":"2016-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87163193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Gąsior, D. Pres, W. Wojakowski, P. Buszman, Z. Kalarus, M. Hawranek, M. Gierlotka, A. Lekston, K. Mizia-Stec, M. Zembala, L. Polonski, M. Tendera
{"title":"Causes of hospitalization and prognosis in patients with cardiovascular diseases. Secular trends in the years 2006-2014 according to the SILesian CARDiovascular (SILCARD) database.","authors":"M. Gąsior, D. Pres, W. Wojakowski, P. Buszman, Z. Kalarus, M. Hawranek, M. Gierlotka, A. Lekston, K. Mizia-Stec, M. Zembala, L. Polonski, M. Tendera","doi":"10.20452/pamw.3557","DOIUrl":"https://doi.org/10.20452/pamw.3557","url":null,"abstract":"INTRODUCTION Despite the progress in cardiology in recent years, cardiovascular (CV) diseases remain the main cause of death in European countries. The knowledge concerning the structure of hospital admissions for CV diseases and clinical outcomes is fragmentary. OBJECTIVES The aim of the study was to analyze the characteristics and outcome of patients with CV disease, hospitalized between 2006 and 2014 and included in the Silesian Cardiovascular Database (SILCARD) covering a population of 4.6 million patients. PATIENTS AND METHODS SILCARD is based on the data from the Regional Department of the National Health Fund in Poland. The enrollment criteria were any hospitalization at a department of cardiology, cardiac surgery, diabetology or vascular surgery and hospitalization with a cardiovascular diagnosis at a department of internal medicine or intensive care. The data come from 310 hospital departments and 1863 outpatient clinics, and contain information on 487 518 patients and 956 634 hospitalizations. RESULTS Heart failure (20%) and stable coronary artery disease (18.5%) were the most frequent primary causes of hospitalization. The number of hospitalizations due to heart failure, aortic stenosis, and pulmonary embolism significantly increased. The highest 12‑month mortality was reported in patients with heart failure and pulmonary embolism (>30%). A decrease in 12‑month mortality in patients with heart failure, stable coronary artery disease, myocardial infarction, and atrial fibrillation was noted, although for some disease entities, it remained relatively high. CONCLUSIONS Between the years 2006 and 2014, in‑hospital and 12‑month mortality showed a trend for decline in many disease entities, with considerable space for prognostic improvement.","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"56 1","pages":"754-762"},"PeriodicalIF":0.0,"publicationDate":"2016-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90980485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}