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

{"title":"Implementation of recommendations regarding pharmacotherapy optimization in patients with heart failure with reduced ejection fraction undergoing scheduled hospitalization: the HEROES study.","authors":"Agata Galas, Robert Morawiec, Agata Tymińska, Przemysław Leszek, Michał Tkaczyszyn, Adrian Stefański, Agnieszka Major, Dominika Klimczak-Tomaniak, Piotr Hamala, Katarzyna Byczkowska, Anna Furman-Niedziejko, Paweł Krzesiński","doi":"10.20452/pamw.17135","DOIUrl":"https://doi.org/10.20452/pamw.17135","url":null,"abstract":"<p><strong>Introduction: </strong>The optimization of pharmacotherapy to improve the prognosis of patients with heart failure (HF), guideline-directed medical therapy (GDMT) is one of the main goals of chronic care.</p><p><strong>Objectives: </strong>To assess the implementation of recommendations regarding GDMT optimization in HF patients undergoing scheduled hospitalization, with a particular emphasis on patients with reduced left ventricular ejection fraction (LVEF).</p><p><strong>Patients and methods: </strong>The analysis included 412 patients with known LVEF (mean [SD] age 66.7 [13.5] years; 297 men, 115 women) admitted for elective hospitalization, representing a subset of 1422 HEROES study participants. Recruitment across 41 Polish centers took place from April 2022 to May 2024.</p><p><strong>Results: </strong>The mean (SD) LVEF in the study group was 34.9 (14.4%). Patients with HF with reduced LVEF (HFrEF) constituted 69.7% (n = 287) of the whole group. In this subgroup, angiotensin receptor-neprilysin inhibitor (ARNI)/angiotensin-converting enzyme inhibitor (ACE-I ) / angiotensin receptor blocker (ARB) use increased from 81.5% of subjects at admission to 88.9% at discharge, beta-blocker use increased from 85.0% to 94.4%, mineralocorticoid receptor antagonist (MRA) use increased from 69.7% to 94.4%, and SGLT2i from 59.2% to 83.6%. ARNI / ACE-I / ARB therapy was optimized in 36.2% of the subjects, while the rates of optimization were 24.7%, 27.2%, and 24.4% for beta-blockers, MRA, and sodium glucose cotransporter-2inhibitor (SGLT2i), respectively. However, only 64 patients (22.3%) attained the 4-pillar GDMT of SGLT2i, ARNI/ACE-I/ARB, beta-blockers and MRA at doses ≥50%.</p><p><strong>Conclusions: </strong>In the Polish multicenter HEROES registry over 80% of patients with HFrEF were discharged on four-pillar GDMT. Nevertheless, the attainment of target high-dose GDMT remains suboptimal. These findings provide new insights into the variability of GDMT implementation at a national level and underline the need for strategies to improve dosing optimization.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287416","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":"A large mass in the left atrium: the importance of proper anticoagulation.","authors":"Elżbieta Ostrowska-Kaim, Joanna Pudło, Karolina Golińska-Grzybała, Małgorzata Konieczyńska, Andrzej Gackowski","doi":"10.20452/pamw.17132","DOIUrl":"https://doi.org/10.20452/pamw.17132","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240223","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":"Risk of hepatocellular carcinoma recurrence after liver transplantation and treatment of hepatitis C with direct-acting antivirals","authors":"Dorota Zarębska-Michaluk, Michał Brzdęk, Olga Tronina, Łukasz Laurans, Marta Wawrzynowicz-Syczewska, Dorota Dybowska, Anna Parfieniuk-Kowerda, Magdalena Tudrujek-Zdunek, Jolanta Białkowska-Warzecha, Ewa Janczewska, Natalia Mikołajczyk-Korniak, Robert Flisiak","doi":"10.20452/pamw.17131","DOIUrl":"10.20452/pamw.17131","url":null,"abstract":"<p><strong>Introduction: </strong>Data on the risk of hepatocellular carcinoma (HCC) recurrence in transplanted liver after direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV) infection are sparse and inconsistent.</p><p><strong>Objectives: </strong>This study aimed to evaluate the DAA treatment in patients after orthotopic liver transplantation (OLTx), and to assess the risk of HCC recurrence.</p><p><strong>Patients and methods: </strong>This real-world retrospective study included all consecutive patients with chronic hepatitis C who underwent liver transplantation for HCV-related HCC before DAA therapy.</p><p><strong>Results: </strong>The analyzed population consisted of 58 patients at a median age of 59 years; they were predominantly male (70.7%). The majority of patients had comorbidities (83%) and were infected with GT1b (86.2%). Less than half of the population was treatment-experienced. The median time from OLTx to DAA initiation was 19.5 months. Twelve patients had a diagnosis of cirrhosis at the start of DAA therapy, including four with decompensated cirrhosis. The treatment effectiveness was 98.2% with no differences according to the stage of fibrosis, the time since OLTx, and the type of DAA regimen used. During a median long-term follow-up of 8 years, three patients (5.4%) developed recurrence of HCC in the transplanted liver, one during therapy, one 12 weeks after treatment, and one two years after DAA therapy. All died from liver cancer dissemination.</p><p><strong>Conclusions: </strong>DAA therapy in patients who received antiviral treatment after OLTx for HCV-related HCC was highly effective, and the long-term HCC recurrence rate was 5.4%, which is lower than expected based on the natural history of the disease.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240271","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":"Positron emission tomography / computed-tomography-guided nodal triage in a lymphoma survivor undergoing en-bloc robot-assisted nephroureterectomy and cystectomy for distal ureteral carcinoma.","authors":"Rafał B Drobot, Artur A Antoniewicz","doi":"10.20452/pamw.17130","DOIUrl":"https://doi.org/10.20452/pamw.17130","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240249","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":"Epicardial fat: a non-invasive, non-contrast imaging biomarker for high-risk plaque monitoring in computed tomography.","authors":"Jan Henzel, Mariusz Kruk, Cezary Kępka, Magdalena Makarewicz-Wujec, Piotr Trochimiuk, Łukasz Wardziak, Hubert Krysztofiak, Piotr N Rudziński, Rafał Dąbrowski, Zofia Dzielińska, Marcin Demkow","doi":"10.20452/pamw.17129","DOIUrl":"https://doi.org/10.20452/pamw.17129","url":null,"abstract":"<p><strong>Introduction: </strong>Coronary computed tomography angiography (CCTA) is a viable method for monitoring vulnerable plaque, however, non-contrast calcium scoring (CAS) has a limited utility in this context. The search for novel non-contrast imaging biomarkers able to track high-risk plaque is necessary.</p><p><strong>Objectives: </strong>To investigate associations between low attenuation plaque (LAP) identified through CCTA and non-contrast CAS, pericardial adipose tissue (PAT), and epicardial adipose tissue (EAT) in patients with non-obstructive coronary atherosclerosis undergoing serial CCTA.</p><p><strong>Patients and methods: </strong>We analyzed data from 89 participants (40% women, 60 [7.7] years) of the dietary intervention to stop coronary atherosclerosis in the computed tomography study. CCTA was performed at baseline and repeated at mean follow-up of 66.8 (13.7) weeks. CAS and cardiac fat were measured in non-contrast reconstructions and analyzed in relation to contrast-derived LAP.</p><p><strong>Results: </strong>Mean decrease in LAP burden was 0.23 (1.0) % (P = 0.04), median decrease in PAT volume was 4.2 (-36.9; 8.3) cm³ (P <0.001), median decrease in EAT volume was 2.8 (-12.2; 6.7) cm³ (P = 0.01), and median increase in CAS was 21.2 (1.7; 71.7) Agatston units (P <0.001). Positive correlations were found between changes in LAP burden and both PAT and EAT volumes (r = 0.349, P = 0.001, and r = 0.490, P <0.001, respectively), but not with change in CAS. Multivariable linear regression analysis identified EAT as independent predictor of LAP regression (95% CI, 0.007; 0.032; P = 0.003).</p><p><strong>Conclusions: </strong>Pericardial and epicardial fat volumes and their dynamics are positively associated with LAP burden, while CAS is not. Monitoring EAT volume using non-contrast computed tomography may facilitate the assessment of high-risk plaque progression or regression, overcoming the limitations of CAS.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193687","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":"Circulating short-chain fatty acids and subclinical cardiovascular disease in type 2 diabetes mellitus.","authors":"Hui-Ju Tsai, Wei-Chung Tsai, Ping-Shaou Yu, Wei-Chun Hung, Wei-Wen Hung, Yi-Chun Tsai","doi":"10.20452/pamw.17128","DOIUrl":"https://doi.org/10.20452/pamw.17128","url":null,"abstract":"<p><strong>Introduction: </strong> Type 2 diabetes (T2D) is linked to a higher risk of cardiovascular disease (CVD). However, evidence on the impact of different short-chain fatty acids (SCFAs) on subclinical CVD is limited in patients with T2D.</p><p><strong>Objectives: </strong> This study was aimed to investigate the associations between circulating SCFA levels and subclinical CVD in patients with T2D.</p><p><strong>Patients and methods: </strong> This cross-sectional study enrolled 326 patients with T2D from November 2016 to June 2020. The levels of nine SCFAs including formate, acetate, propionate, butyrate, isobutyrate, methylbutyrate, valerate, isovalerate and methylvalerate in fasting serum were measured using liquid chromatography mass spectrometry. Cardiac structure and function were evaluated by echocardiography. Ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV), as a parameter of arterial stiffness, were measured. Multivariable linear and logistic model were adjusted for traditional risk factors including cholesterol and glycated hemoglobin (HbA1C).</p><p><strong>Results: </strong> The mean age of the patients was 63.5 (10.4) years and 56.4% were male. The median HbA1C level was 7.0%. The adjusted odd ratios of left ventricular hypertrophy were 2.39 and 2.60 for tertiles 3 of formate and isobutyrate compared with tertiles 1 of formate and isobutyrate, respectively. Higher circulating butyrate / isobutyrate ratio was significantly associated with decreased risk of diastolic dysfunction. An inverse relationship between circulating valerate level and arterial stiffness was found. Patients with the highest tertile of circulating butyrate level had lower risk of abnormal ABI.</p><p><strong>Conclusions: </strong> Our study demonstrates that serum SCFAs are potential biomarkers of the early stage of cardiovascular remodeling in patients with T2D.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193729","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":"Prevalence and clinical impact of vitamin C deficiency in patients hospitalized with community-acquired pneumonia.","authors":"Yogesh Sharma, Arduino A Mangoni, Richard Woodman, Rashmi Shahi, Chris Horwood, Campbell Thompson","doi":"10.20452/pamw.17067","DOIUrl":"10.20452/pamw.17067","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700151","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":"Revealing the epidemiology of pituitary adenomas in Poland.","authors":"Adrian F Daly","doi":"10.20452/pamw.17124","DOIUrl":"10.20452/pamw.17124","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":"135 9","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187292","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":"The risk of autoimmune disease development and exacerbation in patients receiving subcutaneous allergen immunotherapy: a cross-sectional study.","authors":"Dominika Ochab-Krupnik, Piotr Lacwik, Anna Mościcka, Beata Kręcisz, Maciej Kupczyk, Cezary Pałczyński","doi":"10.20452/pamw.17068","DOIUrl":"10.20452/pamw.17068","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709644","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":"Uncommon cause and treatment of acute pulmonary embolism.","authors":"Marta Kwiatkowska, Agnieszka Sawicka, Jerzy Leszczyński, Michał Sajdek, Piotr Sobieraj","doi":"10.20452/pamw.17039","DOIUrl":"10.20452/pamw.17039","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259222","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}