Polskie Archiwum Medycyny Wewnetrznej最新文献

{"title":"2015 in hematology and thromboembolism. Dr. Mark Crowther in an interview with Dr. Roman Jaeschke: part 1.","authors":"M. Crowther, R. Jaeschke","doi":"10.20452/pamw.3776","DOIUrl":"https://doi.org/10.20452/pamw.3776","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"18 1","pages":"1024"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89459104","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":"Internal medicine: I cannot live without you as you are my destiny.","authors":"J. Małyszko","doi":"10.20452/pamw.3741","DOIUrl":"https://doi.org/10.20452/pamw.3741","url":null,"abstract":"1060 Some time ago, Professor Anetta Undas, Editor­ ­in ­Chief of the Polish Archives of Internal Medicine and Professor Jacek Imiela, national consultant in internal medicine, invited me to write about my life as an internist and the role of internal med­ icine in today’s world of narrow specialization. My adventure with internal medicine started a long time ago during my medical education. As a 3rd­grade medical student, I went to Montreal in Canada. It was 30 years ago. I had a chance to do my clinical summer practice with wonderful physicians, including Dr. Stefan Horny, in sev­ eral places in the province of Quebec. When I crossed the doors of the Polish ­Canadian Wel­ fare Institute in Montreal, which was a home to elderly Poles requiring medical and nursing assis­ stance, I was asked about my practical achieve­ ments and skills acquired during my studies. This was followed by a sort of a practical exam in in­ ternal medicine as well as some theoretical exam in English. The staff at the Institute was fluent in English and French. Finally, I was accepted and I was told that I could assisst Dr. Horny in his du­ ties as a physician in the Institute. Dr. Horny offered me a possibility for clinical practice at an internal medicine ward in the Re­ gional Hospital in Salaberry ­de ­Valleyfield in Quebec. I was very excited at the opportunity to learn more, to improve my English and learn some French, as well as to discuss different symptoms, diagnoses, and treatment plans. However, it was also a tough time for me as a nonnative speaker of English. In order not to lose such an opportuni­ ty, I was trying to do my best and spent much of my summer holidays in the hospital or in the In­ stitute. I was also lucky to spent some time in Royal Victoria Hospital, Montreal, not only in an internal medicine ward but also inthe operat­ ing rooms where I assissted during cardiac sur­ geries and other procedures, such as parathyre­ idectomy. My stay in Canada was very rewarding in terms of improving my medical knowledge as well as my English­ and French­speaking skills. FORUM FOR INTERNAL MEDICINE","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"55 68 1","pages":"1060-1061"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80738554","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":"Abernethy malformation type I (congenital absence of the portal vein) in a patient with chronic kidney disease.","authors":"J. Kopeć, M. Krzanowski, J. Królczyk, J. Jaworek-Troć, K. Krzanowska, W. Sułowicz","doi":"10.20452/pamw.3729","DOIUrl":"https://doi.org/10.20452/pamw.3729","url":null,"abstract":"1012 as well as immunological markers were negative. On the basis of electroencephalography and head computed tomography (CT), the patient was di‐ agnosed with nonconvulsive epilepsy (treated with valproic acid). An abdominal CT scan re‐ vealed polysplenia (FIGURE 1A) and the absence of the portal vein (FIGURE 1B). It also showed that the splenic and intestinal venous blood flowed via the splenic and mesenteric veins to the in‐ ferior vena cava and to the left renal vein with‐ out passing through the liver (FIGURE 1C). On por‐ tovenography with the occlusion test (FIGURE 1D), the liver was not perfused with portal blood and the superior mesenteric vein and splenic vein did not join to form confluence (abernethy malfor‐ mation type IB). A 31 ‐year ‐old male patient with chronic membra‐ noproliferative glomerulonephritis (confirmed by biopsy) treated with immunosuppression (steroids, cyclosporine, mycophenolate mofetil) was admitted to the hospital due to nephrotic syndrome with chronic kidney disease stage 3 and coma (rigid pupils with bilateral Babinski sign). Blood tests revealed elevated concentra‐ tions of ammonia (288 μmol/l), serum creati‐ nine (258 μmol/l), urea (31.2 mmol/l), serum albumin (27 g/l), alanine aminotransferase (37 U/l), aspartate aminotransferase (30 U/l), biliru‐ bin (24 μmol/l), γ‐glutamyltranspeptidase (138 U/l), cholinesterase (3678 U/l), ceruloplasmin (0.26 g/l), and alkaline phosphatase (205 U/l). Se‐ rological markers for hepatitis A, B, C, G viruses, CLINICAL IMAGE","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"21 1","pages":"1012-1013"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74232650","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":"Forum for internal medicine: opinions and controversies.","authors":"J. Manitius","doi":"10.20452/pamw.3743","DOIUrl":"https://doi.org/10.20452/pamw.3743","url":null,"abstract":"1062 The lack of internists, or rather their relative shortage, is a progressive and, even worse, irre‐ versible phenomenon. This is undoubtedly due to the dynamic development of specializations de‐ riving from traditional internal medicine. The said specializations are attractive not only for finan‐ cial reasons, but also by virtue of the well ‐earned prestige enjoyed by their holders among both fel‐ low professionals and patients. In this context, a specialist in internal medicine is recognized as a physician whose competences, and hence skills, are not clearly specified. Such a specialist is per‐ ceived this way not only by their own profession‐ al community, but also by patients. Nowadays, there is a belief and a consequent expectation among patients that they qualify for specialist treatment every time they suffer from any symptom or ailment. My 40‐year long clini‐ cal experience has given me the impression that the subjective well ‐being of a patient is based on the frequency of their visits to a specialist, and not on objective treatment effects which translate into the broadly taken improvement of life quali‐ ty. I presume that this is associated with substan‐ tial deficiencies in the society’s health education, which is based on the premise that health should be regarded from a holistic and quality ‐oriented perspective. It could therefore be concluded that there is no part to be played by an internal dis‐ eases specialist within medicine as a domain so grossly divided into specialties. However, the mir‐ ror image of this conclusion is the fact that it is in such a highly branched medicine that a stable role should be occupied by an experienced physician, who is able to draw final conclusions based on in‐ formation obtained from individual specialists. Adopting such a solution would entail the re‐ evaluation of the role of an internal medicine spe‐ cialist with respect to 2 central processes: diag‐ nostics and treatment. Thus, within the structure of a hospital, an internist should be the person responsible for planning the diagnostic process. Through referring patients to relevant specialists FORUM FOR INTERNAL MEDICINE","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"3 1","pages":"1062-1065"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78278939","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":"Validation of the Polish version of the Duke University Religion Index (PolDUREL).","authors":"B. Dobrowolska, K. Jurek, A. Pilewska-Kozak, J. Pawlikowski, Mariola Drozd, H. Koenig","doi":"10.20452/pamw.3721","DOIUrl":"https://doi.org/10.20452/pamw.3721","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"4 1","pages":"1005-1008"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90509250","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 internal medicine in crisis: the analysis of causes and proposed changes.","authors":"M. Olesińska","doi":"10.20452/pamw.3747","DOIUrl":"https://doi.org/10.20452/pamw.3747","url":null,"abstract":"1068 intensity and nature, depending on the country which it encompasses; however, most frequently, the attention is called to general specialties, such as pediatrics, general surgery, and in particular internal medicine. There are 5 criteria defining “medical specialty in crisis”. The lack of proper candidates interested in training related to a giv‐ en area of medicine, the difficulties in finding em‐ ployees, excessive workload due to the limited number of employees in a doctors’ team, the sal‐ ary considered by the doctors as too low and lim‐ ited possibilities for additional income, low qual‐ ity of professional life.1 The experiences of the countries that have sim‐ ilar health care structure as Poland indicate that the causes of the crisis of medical specialties, such as internal medicine, stem from 3 different areas. Within the first area, namely the health care sys‐ tem and its affiliations, the following problems can be noticed: insufficient funding for the med‐ ical procedures performed in internal diseases units, the payer not taking into account the com‐ plexity of the care provided in internal diseases units, and no continuation of specialist inter‐ nal medicine care in an outpatient department.2 Those issues are of particular importance if we consider the extended human longevity and mul‐ tiple morbidities that intensify at an older age. Other problems within the system include short‐ age of training spots, an issue which is not given enough attention, as well as training programs for specialists that were not particularly interesting. The second group of causes underlying the cri‐ sis are the issues related to hospital management with the preference being placed on the profit‐ able narrow specialty units and the elimination of the cost of intensive internal diseases units. Another problem in this area is the lack of proper task planning and a clear definition of responsi‐ bilities, which would make it possible for medical personnel to feel more comfortable at work and to properly address the patient’s needs. The fact that due to the economic reasons the hiring of Introduction For at least 20 years now, we have been observing a continued crisis of some of the medical specialties that are important for the society’s health. This problem is of varying FORUM FOR INTERNAL MEDICINE","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"46 1 1","pages":"1068-1073"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87685256","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 role of an internal medicine specialist in the health care system: going back to the past?","authors":"L. Polonski","doi":"10.20452/pamw.3749","DOIUrl":"https://doi.org/10.20452/pamw.3749","url":null,"abstract":"1074 doctors. It may be good for the doctors but it is definitely not good for the patients. The obser‐ vations coming from the cardiological examina‐ tions are not positive. What is disturbing is not only the lack of basic knowledge in the area of in‐ ternal diseases but also the more frequent lack of knowledge about cardiology outside the field in which the person taking the exam works. We hear excuses like “I work in a hemodynamics laborato‐ ry and that is why my knowledge of echocardiog‐ raphy is limited.” Such a narrow specialty has its pros. Performing numerous procedures the ma‐ jority of doctors (but not all) achieves true mas‐ tery in their field. On the other hand, with this approach we provide treatment for example for coronary arteries instead of for a coronary heart disease, and certainly not for a patient suffer‐ ing from a coronary heart disease. This is a dan‐ gerous tendency, especially that we come in con‐ tact with older and older patients suffering from multiple diseases. If we stick to the cardiocentric approach, we can make mistakes. A doctor who does not have sufficient knowledge either does not see the problem or prefers not to see it if he does not know the solution for it. That is why the system of consultations is developing. But here we come across another problem, in order to ask for a consultation one has to notice the prob‐ lem and describe it. And how should one do this without knowing the significance of wheezes over the lung fields or what the symptoms of fluid in the peritoneal cavity are or what the erysipelas looks like? Specialist consultations, whose value cannot be questioned in some situations, must not be treated as a fundamental method of diag‐ nostics and treatment. Such a method prolongs the diagnosis time, is certainly inconvenient for the patient, especially if it happens in an outpa‐ tient clinic and the patient has to move between different places where the consultations are pro‐ vided and in the end this is an expensive course of action. What is more is that such a situation very often leads to polypharmacy and the associated I have no doubts that an internal medicine doc‐ tor should be a key figure in the health care sys‐ tem. One ‐degree specialties that have been imple‐ mented for the last few years have led to the very fast but at the same time very narrow training of FORUM FOR INTERNAL MEDICINE","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"261 1","pages":"1074-1078"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74360914","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 2016 World Thrombosis Day in Poland.","authors":"K. Zawilska, T. Urbanek","doi":"10.20452/pamw.3767","DOIUrl":"https://doi.org/10.20452/pamw.3767","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"72 1","pages":"1021-1023"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79329249","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":"Dawn and dusk of internal medicine: a view of a qualified oncologist and hematologist.","authors":"A. Deptała","doi":"10.20452/pamw.3731","DOIUrl":"https://doi.org/10.20452/pamw.3731","url":null,"abstract":"1040 An internal medicine specialist! When I received my diploma from the Rector of the Medical Acade‐ my of Warsaw, Professor Jan Nielubowicz, I knew that achieving this professional status had been a dream of mine and many of my colleagues. For years the internal medicine specialist has been a symbol of the highest level of medical profession as he could treat all diseases which affect the in‐ ternal organs in a human body. During 30 years of my doctor’s practice, I had a chance to witness the enormous progress that took place in med‐ icine, but at the same time also the lowering of prestige and social faith in a doctor who is only an internal medicine specialist. In the meantime, the doctor training system has changed as well as the system for financing medical services. Nar‐ row specialties are now preferred in those areas. Both in Poland and abroad we are observing the aging of societies and the increased number of diseases affecting a single person. For several de‐ cades now we have been observing the epidemics of the cardiovascular system diseases and differ‐ ent types of cancer. Epidemiologists estimate that within the next 50 years different types of cancer will have become the major cause of mortality in Poland. Right now in Poland over 150 000 new cancer cases are diagnosed yearly, out of which over 90 000 patients die within the same year and the number of deaths is increasing from year to year. The main killers of the Polish people current‐ ly are: lung cancer, colorectal cancer, breast cancer, prostate cancer but also gastric cancer, pancreatic cancer, ovarian cancer, head and neck cancer. This FORUM FOR INTERNAL MEDICINE","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"44 1","pages":"1040-1045"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83329140","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":"Pol Arch Med Wewn becomes Pol Arch Intern Med.","authors":"A. Undas","doi":"10.20452/pamw.3769","DOIUrl":"https://doi.org/10.20452/pamw.3769","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"1 1","pages":"962"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90287254","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}