Filip Ratusznik, Jakub Ratusznik, Weronika Zastrzeżyńska, Kamil Polok, Bożena Żurowicz, Krzysztof Sładek
{"title":"Toxic epidermal necrolysis as a rare complication of pembrolizumab immunotherapy in the treatment of squamous cell lung cancer.","authors":"Filip Ratusznik, Jakub Ratusznik, Weronika Zastrzeżyńska, Kamil Polok, Bożena Żurowicz, Krzysztof Sładek","doi":"10.20452/pamw.17145","DOIUrl":"https://doi.org/10.20452/pamw.17145","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"First-in-class oral HIF-2α inhibitor in von Hippel-Lindau disease: a new era of targeted therapy.","authors":"Katarzyna Bornikowska, Wojciech Zgliczyński","doi":"10.20452/pamw.17142","DOIUrl":"https://doi.org/10.20452/pamw.17142","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gabriela Trąd-Wójcik, Krzysztof Sładek, Lucyna Mastalerz
{"title":"Sarcoid-like reaction induced by aspirin treatment following aspirin desensitization in a patient with aspirin-exacerbated respiratory disease.","authors":"Gabriela Trąd-Wójcik, Krzysztof Sładek, Lucyna Mastalerz","doi":"10.20452/pamw.17138","DOIUrl":"https://doi.org/10.20452/pamw.17138","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Magdalena Piróg, Michał Ząbczyk, Joanna Natorska, Robert Jach, Saulius Butenas, Anetta Undas
{"title":"Altered fibrin clot properties and the risk of thromboembolism in women with obstetric antiphospholipid syndrome: a cohort study.","authors":"Magdalena Piróg, Michał Ząbczyk, Joanna Natorska, Robert Jach, Saulius Butenas, Anetta Undas","doi":"10.20452/pamw.17140","DOIUrl":"https://doi.org/10.20452/pamw.17140","url":null,"abstract":"<p><strong>Introduction: </strong>Formation of denser and poorly lysable fibrin clots has been reported in thrombotic antiphospholipid syndrome (APS). However, it is not known whether unfavorably altered fibrin clot properties and suppressed fibrinolysis characterize women with obstetric APS (OAPS) free of thromboembolic events (TE).</p><p><strong>Objectives: </strong>This study sought to investigate fibrin clot characteristics and if they predict TE in OAPS women. Patients and methods: In 62 women with OAPS and 62 controls plasma fibrin clot properties, i.e., permeability (Ks) and clot lysis time (CLT), along with thrombin activatable fibrinolysis inhibitor (TAFI), plasminogen activator inhibitor-1 (PAI-1), plasminogen, and endogenous thrombin potential (ETP) were determined. During a median follow-up of 54 months, TE were recorded.</p><p><strong>Results: </strong>OAPS patients had lower Ks (-16.4%) and longer CLT (+16.9%), with slightly higher ETP (+4.2%), TAFI antigen (+15.6%), lower plasminogen (-7.9%) and similar PAI-1 antigen when compared to controls (all P <0.05). High-risk OAPS (n = 47, 75.8%) and lupus anticoagulant (LA)-positive OAPS patients, compared with the low-risk and LA-negative subjects had lower Ks and longer CLT. There were no differences in fibrin clot properties and ETP between single-positive aPL patients and controls. During follow-up higher odds of developing TE were observed in patients with OAPS (adjusted OR = 5.26; 95%CI 1.27-21.87) and OAPS who experienced TE (16.1%, 2.2/year) had lower baseline Ks (-17.5 %) and longer CLT (+12.2, both P <0.05). Reduced Ks (≤6.1x10-9 cm2) predicted TE in OAPS patients.</p><p><strong>Conclusions: </strong>Prothrombotic fibrin clot properties characterize patients with OAPS, which may increase the risk of TE.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Krzysztof Drygalski, Krzysztof Pastuszak, Beata Modzelewska
{"title":"The assessment of non-inferiority of oral vs. subcutaneous semaglutide: a systematic review and meta-analysis.","authors":"Krzysztof Drygalski, Krzysztof Pastuszak, Beata Modzelewska","doi":"10.20452/pamw.17141","DOIUrl":"https://doi.org/10.20452/pamw.17141","url":null,"abstract":"<p><strong>Introduction: </strong> This systematic review and meta-analysis is the first to comprehensively compare oral and subcutaneous semaglutide for type 2 diabetes.</p><p><strong>Objectives: </strong> The aim of the study was to determine whether oral semaglutide is non-inferior to the subcutaneous, assess potential superiority, and provide evidence-based guidance for clinical decisions.</p><p><strong>Patients and methods: </strong> We searched clinical trial registries and bibliographic databases through April 30, 2025. Twelve randomized controlled trials involving 6253 adults with type 2 diabetes were analyzed. Following PRISMA and Cochrane guidelines (PROSPERO CRD420251017953), data were extracted on efficacy, safety, and clinical outcomes. Non-inferiority was assessed using predefined margins; post hoc superiority analyses examined secondary endpoints. Evidence certainty was evaluated using GRADE.</p><p><strong>Results: </strong> Both formulations of semaglutide significantly reduced HbA1c: oral by -1.16 percentage points (95% CI, -1.22--1.09) and subcutaneous by -1.40 percentage points (95% CI, -1.47--1.33). Oral semaglutide met the non-inferiority margin at 50% of the subcutaneous effect. Subcutaneous semaglutide was superior for weight loss (-2.19 kg; 95% CI, -3.57--0.81; P <0.01), BMI reduction (-0.88 kg/m2; 95% CI, -1.55--0.21; P <0.05), and triglyceride lowering (-0.09 mmol/L; 95% CI, -0.14--0.04; P <0.001).</p><p><strong>Conclusions: </strong> Both forms of semaglutide effectively improve glycemic control in type 2 diabetes. Oral semaglutide is non-inferior in lowering HbA1c, while subcutaneous semaglutide is superior in weight, BMI, and triglyceride reductions. Given similar safety profiles and modest differences in other outcomes, treatment selection should be guided by clinical goals and patient preferences.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Who may benefit from oral anticoagulation following an embolic stroke of undetermined source?","authors":"Nikolaos Kakaletsis, George Ntaios","doi":"10.20452/pamw.17139","DOIUrl":"https://doi.org/10.20452/pamw.17139","url":null,"abstract":"<p><p>Embolic stroke of undetermined source (ESUS) represents up to one-sixth of ischemic strokes and is associated with an annual recurrence risk of 4%-5% despite contemporary secondary prevention. The hypothesis that oral anticoagulation would reduce recurrence compared with aspirin has been tested in large randomized trials, yet NAVIGATE-ESUS and RE-SPECT ESUS failed to demonstrate superiority of direct oral anticoagulants in the unselected ESUS population. These neutral findings reflect the heterogeneity of underlying mechanisms captured within the ESUS definition, which includes occult atrial fibrillation, atrial cardiopathy, structural cardiac disease, patent foramen ovale, and supracardiac atherosclerosis. Subgroup analyses, however, generate the hypothesis that anticoagulation may benefit selected patient groups: rivaroxaban reduced recurrence in patients with left atrial enlargement, left ventricular dysfunction and PFO in NAVIGATE-ESUS, and dabigatran was more effective in patients aged 75 years or older in RE-SPECT ESUS. ATTICUS highlighted the importance of atrial high-rate episodes as predictors of future atrial fibrillation, and ARCADIA underscored the need for refined definitions of atrial cardiopathy. Meta-analyses further support anticoagulation in patients with low-risk supracardiac atherosclerosis, atrial cardiopathy, or medically managed patent foramen ovale, although these effects remain inconsistent. Overall, ESUS should not be considered as an indication for anticoagulation. A precision-medicine approach, integrating cardiovascular imaging and biomarkers, is essential to identify subgroups most likely to benefit. Future research needs to refine risk stratification and target pathophysiologically homogeneous cohorts to improve secondary prevention in ESUS.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Agata Oskroba, Anna M Dworakowska, Magdalena Rdzanek, Magdalena Bujalska-Zadrożny
{"title":"Enhancing chronic kidney disease screening through community pharmacists: a systematic review of pharmacist-led strategies.","authors":"Agata Oskroba, Anna M Dworakowska, Magdalena Rdzanek, Magdalena Bujalska-Zadrożny","doi":"10.20452/pamw.17136","DOIUrl":"https://doi.org/10.20452/pamw.17136","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease (CKD) affects over 700 million people worldwide, with its prevalence rising steadily each year. Early diagnosis remains challenging due to a lack of awareness of CKD risk factors and the absence of noticeable symptoms in the initial stages. Pharmacists can play a pivotal role in CKD screening and patient education.</p><p><strong>Objectives: </strong>The primary aim of this systematic review was to identify specific pharmacist-led interventions in community pharmacy settings that support CKD detection, assess their effectiveness, and evaluate their impact on patient outcomes.</p><p><strong>Patients and methods: </strong>The review was conducted in accordance with PRISMA 2020 guidelines and included non-randomized controlled trials and observational studies, given the absence of randomized trials. A comprehensive search was carried out across three databases in 2025: PubMed, Embase, and The Cochrane Library.</p><p><strong>Results: </strong>Nine original clinical research articles met the inclusion criteria. The findings indicate that pharmacist-led interventions in community pharmacies are diverse but consistently contribute to the early detection of CKD. Moreover, pharmacists can play an extended role by supporting ongoing CKD management, enhancing collaboration with general practitioners within coordinated care frameworks, and increasing public awareness of the disease.</p><p><strong>Conclusions: </strong>The main conclusions highlight that pharmacist involvement in CKD screening improves public understanding of CKD risk factors, facilitates earlier initiation of treatment, and contributes to better long-term patient outcomes.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Min Liu, Lishuo Yu, Li Cai, Zhiying Xu, Weilong Li
{"title":"Prostate-specific membrane antigen expression in bone metastases of lung adenocarcinoma: implications for diagnostic and therapeutic strategies.","authors":"Min Liu, Lishuo Yu, Li Cai, Zhiying Xu, Weilong Li","doi":"10.20452/pamw.17134","DOIUrl":"https://doi.org/10.20452/pamw.17134","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}