Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine最新文献

{"title":"Conquering the giant: successful endovascular treatment of renal arteriovenous fistula.","authors":"Zuzanna Wojtczak, Michał Sajdek, Krzysztof Lamparski, Rafał Maciąg, Magdalena Januszewicz, Zbigniew Gałązka","doi":"10.20452/pamw.16812","DOIUrl":"10.20452/pamw.16812","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789641","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":"How to treat patients with thrombotic antiphospholipid syndrome in 2024?","authors":"Ciprian Jurcut, Simona Caraiola, Massimo Radin, Savino Sciascia","doi":"10.20452/pamw.16863","DOIUrl":"10.20452/pamw.16863","url":null,"abstract":"<p><p>Antiphospholipid syndrome (APS) encompasses a range of clinical conditions, particularly thrombotic or obstetrical manifestations, associated with the presence of antiphospholipid antibodies. Managing thrombotic APS in daily clinical practice can be challenging and requires thorough risk stratification and tailored treatment strategies. Primary prophylaxis focuses on correcting the traditional thrombotic risk factors and, in certain situations, may include low‑dose aspirin and / or prophylactic anticoagulants (eg, low‑molecular‑weight heparin). Treatment of thrombotic APS primarily involves long‑term anticoagulation with vitamin K antagonists (VKAs). In some cases, a combination of VKAs and low‑dose aspirin, increased doses of VKAs with an international normalized ratio target greater than 3, or a switch to therapeutic doses of low‑molecular‑weight heparin might be employed. The use of hydroxychloroquine is essential in patients with secondary systemic lupus erythematosus and may be considered in individuals with recurrent thrombosis. In other selected situations, the use of immunomodulatory agents can be considered.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479087","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":"Challenges of laboratory testing in patients suspected of antiphospholipid syndrome: practical implications for clinicians.","authors":"Katrien M J Devreese, Denis Wahl","doi":"10.20452/pamw.16849","DOIUrl":"10.20452/pamw.16849","url":null,"abstract":"<p><p>This paper focuses on laboratory tests necessary for a diagnosis of antiphospholipid syndrome (APS). The diagnosis starts with a selection of patients suspected of APS. Timing related to a clinical event is important to avoid false classification of APS patients. To correctly interpret the test results for antiphospholipid antibodies (aPL), it is necessary to understand all possible pitfalls and interferences. Lupus anticoagulant (LA) measurement remains a complex procedure with many challenges. The effect of anticoagulant therapy, the main confounder of LA measurement, can be overcome by removal agents for direct oral anticoagulants (DOACs) or by considering assays such as Taipan snake venom time / Ecarin clotting time not affected by antivitamin K therapy and anti‑Xa DOACs. However, both procedures have limitations. Solid‑phase assays for anticardiolipin antibodies (aCL) and anti‑β2 glycoprotein I antibodies (aβ2GPI) show interassay differences. Diagnosis is based on the measurement of 3 groups of aPL: LA, aCL, and aβ2GPI, of immunoglobulin (Ig) G and IgM isotype. This allows the clinicians for developing antibody profiles that help identify patients at risk. Other aPL, such as antibodies against domain I of β2GPI and anti‑phosphatidylserine / prothrombin antibodies may be useful in risk stratification of APS patients, and in some specific situations of patients with an incomplete antibody profile, but are not needed for diagnosis. Laboratory diagnosis of APS remains challenging. To increase the diagnostic efficacy and reliability, an integrated interpretation of all results and an interpretative comment should be provided on the laboratory report. Therefore, a close interaction between clinical pathologists and clinicians is mandatory.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308919","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":"Mpox outbreak among men who have sex with men in Kraków, Poland; June-November 2022.","authors":"Aleksandra Raczyńska, Martyna Lara, Anna Kalinowska-Nowak, Paweł Skwara, Aleksander Garlicki, Monika Bociąga-Jasik","doi":"10.20452/pamw.16859","DOIUrl":"10.20452/pamw.16859","url":null,"abstract":"<p><strong>Introduction: </strong>Mpox is a zoonotic disease caused by mpox virus. Sporadic cases reported before 2022 were almost universally linked to a direct contact with animals or travel to endemic regions of Africa. However, in 2022, a significant shift occurred in human‑to‑human transmission, leading to a global outbreak in 117 countries. In Poland, 217 cases of mpox were reported.</p><p><strong>Objectives: </strong>The aim of this study was to evaluate the epidemiology, clinical presentation, laboratory findings, and coinfections with sexually transmitted pathogens among patients with mpox.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed all mpox cases diagnosed at the University Hospital in Kraków between June 2022 and November 2022.</p><p><strong>Results: </strong>Forty‑five patients at a median (interquartile range) age of 34 (19-48) years were diagnosed with mpox. Most of them (n = 44; 98%) were men, 42 (93%) identified themselves as men who have sex with men (MSM). Twenty‑two of the patients (49%) had previously been diagnosed with HIV. Together with mpox diagnosis, new cases of sexually transmitted infections (STIs) were identified. Specifically, 4 patients (9%) were newly diagnosed with HIV, 5 with syphilis, 4 with Chlamydia trachomatis infection, 3 with Neisseria gonorrhoeae infection, and 2 with Ureaplasma urealyticum infection; in this group, 4 patients (33%) had more than 1 sexually transmitted coinfection.</p><p><strong>Conclusions: </strong>The 2022 mpox outbreak in Kraków primarily affected MSM and was transmitted through sexual contact. Health care professionals should be aware of emerging STIs. Educational initiatives should emphasize the importance of vaccinations, safe sexual practices, and regular testing.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330990","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":"End-stage kidney disease treated with hemodialysis in a patient with Hutchinson-Gilford progeria syndrome.","authors":"Sławomir Badurek, Paweł Stróżecki, Joanna Zawadzka","doi":"10.20452/pamw.16833","DOIUrl":"10.20452/pamw.16833","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074349","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":"Intraindividual variability of lipoprotein(a) in the middle-aged population: the impact of smoking.","authors":"Aleksandra M Gołąb, Małgorzata Konieczyńska, Michał Ząbczyk, Anetta Undas, Joanna Natorska","doi":"10.20452/pamw.16889","DOIUrl":"10.20452/pamw.16889","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669700","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":"Measurement of lipoprotein(a) levels in real-world clinical and laboratory settings: a single-center experience.","authors":"Joanna Ochotnicka, Magdalena Spryńca, Elżbieta Pociask, Anetta Undas, Ewa Wypasek","doi":"10.20452/pamw.16891","DOIUrl":"10.20452/pamw.16891","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":"134 11","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741199","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":"Kikuchi-Fujimoto disease: rare but worth remembering.","authors":"Maciej Dubaj, Karol Bigosiński, Aneta Szudy-Szczyrek, Justyna Szumiło, Marek Hus","doi":"10.20452/pamw.16830","DOIUrl":"10.20452/pamw.16830","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019317","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":"Coexistence of dilated cardiomyopathy with pre-existing testicular cancer in a young man: successful treatment ensured by interdisciplinary cooperation.","authors":"Natalia Wiligórska, Paweł Wiechno, Wojciech Michalski, Artur Antoniewicz, Ilona Michałowska, Anna Konopka","doi":"10.20452/pamw.16827","DOIUrl":"10.20452/pamw.16827","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005659","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":"Neuropsychiatric adverse events in tenofovir disoproxil fumarate- and tenofovir alafenamide-based HIV therapy and prophylaxis: a systematic review and meta‑analysis.","authors":"Marlen Gräfe, Marie S Schäfer, Christoph Leithner, Kristina Allers, Thomas Schneider, Engi E A Algharably, Reinhold Kreutz, Thomas G Riemer","doi":"10.20452/pamw.16861","DOIUrl":"10.20452/pamw.16861","url":null,"abstract":"<p><strong>Introduction: </strong>Tenofovir is integral to antiretroviral therapy (ART) and pre‑exposure prophylaxis (PrEP) for HIV; however, neuropsychiatric adverse events (NPAEs) associated with its use have not been systematically investigated.</p><p><strong>Objectives: </strong>This systematic review aimed to characterize common NPAEs occurring during tenofovir‑based ART and PrEP, and to assess the specific role of tenofovir in their emergence.</p><p><strong>Patients and methods: </strong>Four literature databases and 3 trial registries were searched up to December 31, 2023 for randomized controlled trials reporting NPAEs in treatment‑naive adults receiving tenofovir‑based ART or PrEP. Meta‑analyses were conducted to compare tenofovir (with / without emtricitabine) with placebo and tenofovir alafenamide-based with tenofovir disoproxil fumarate-based regimens.</p><p><strong>Results: </strong>A total of 69 trials (62 on ART, 7 on PrEP) including 29 340 patients on tenofovir‑based therapies identified headache, dizziness, insomnia, and depression as common NPAEs, especially in HIV studies. Meta‑analyses of tenofovir (with / without emtricitabine) vs placebo only indicated an increased risk of dizziness (odds ratio [OR], 1.32; 95% CI, 1.09-1.59; P = 0.004). Comparisons between tenofovir alafenamide and disoproxil fumarate did not show significant differences in NPAE risks, although sensitivity analyses suggested a higher risk of headache with tenofovir alafenamide in HIV studies (OR, 1.24; 95% CI, 1.01-1.52; P = 0.04).</p><p><strong>Conclusions: </strong>Common occurrence of NPAEs in tenofovir‑based HIV multidrug regimens highlights the need to screen HIV patients for neuropsychiatric complications. The lack of effect of tenofovir, as compared with placebo, for most analyzable NPAEs suggests its favorable safety profile. However, a possible increase in the dizziness risk on tenofovir, and a potentially elevated risk of headache on tenofovir alafenamide- as compared with tenofovir disoproxil fumarate-based regimens in HIV therapy merit further investigation.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479089","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}