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

{"title":"Changing patterns of nicotine product use in the urban population: sociodemographic differences and increasing use of e-cigarettes and heated tobacco products.","authors":"Magdalena Chlabicz, Marcin Warpechowski, Paweł Sowa, Marlena Dubatówka, Alexander Teumer, Karol A Kamiński","doi":"10.20452/pamw.17418","DOIUrl":"https://doi.org/10.20452/pamw.17418","url":null,"abstract":"<p><strong>Introduction: </strong>Cigarette smoking remains a leading cause of preventable death, while e-cigarettes and heated tobacco products (HTPs) are gaining popularity. Population-based data are essential for tobacco control policy.</p><p><strong>Objectives: </strong>This study aimed to assess the prevalence and sociodemographic differences in conventional cigarette, e-cigarette, and HTP use in an urban Polish population.</p><p><strong>Patients and methods: </strong>A total of 3527 participants aged 20-79 years from the population-based Bialystok PLUS study were examined between 2018 and 2025; 3407 participants (96.6%) with complete data were analyzed. Data were collected using standardized questionnaires. Groups were compared with analysis of variance and χ² tests (Bonferroni-adjusted); temporal trends were assessed with modified Poisson regression.</p><p><strong>Results: </strong>Mean age was 49.2 years and 55.8% were women; 22.7% used any nicotine product. Exclusive use was 14.3% for cigarettes, 2.8% for e-cigarettes, and 1.3% for HTPs; 4.3% used 2 or 3 products. Including dual and triple use, 18.4% used cigarettes, 5.3% e-cigarettes, and 4.1% HTPs. Overall use was stable (prevalence ratio [PR] per study year, 1.02; 95% CI, 0.98-1.06), but exclusive cigarette smoking fell (PR, 0.91; 95% CI, 0.87-0.96) and exclusive e-cigarette use rose (PR, 1.33; 95% CI, 1.13-1.57). Nicotine use was associated with male sex, younger age, lower education, and unmarried status; non-combustible product users were younger, better educated, and more often in paid employment.</p><p><strong>Conclusions: </strong>In this urban population, overall nicotine use remained stable while cigarette smoking declined, and use of newer products and poly-use increased. Prevention strategies should address evolving poly-use, particularly among younger adults; these single-city findings may not apply nationwide.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117588","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 factors for pulmonary mortality in patients with obstructive sleep apnea: a competing risk analysis integrating Cox regression, random survival forests, and unsupervised clustering.","authors":"Wojciech Kuczyński, Karol Pierzchała, Zuzanna Boczar, Aleksandra Kudrycka, Piotr Białasiewicz","doi":"10.20452/pamw.17417","DOIUrl":"https://doi.org/10.20452/pamw.17417","url":null,"abstract":"<p><strong>Introduction: </strong>Obstructive sleep apnea (OSA) is associated with increased all-cause mortality, yet the specific determinants of pulmonary mortality in this population remain poorly characterized.</p><p><strong>Objectives: </strong>To identify independent risk factors for pulmonary-specific death in OSA patients using complementary statistical and machine-learning approaches within a competing risk framework.</p><p><strong>Patients and methods: </strong>We analyzed 4368 patients consecutively referred to a tertiary sleep center (assessed between January 2005 and December 2025), including 2304 with moderate-to-severe OSA (apnea-hypopnea index ≥15 events/h). Pulmonary mortality (International Classification of Diseases, Tenth Revision, J codes) was modeled using cause-specific Cox regression and Fine-Gray subdistribution hazard models. A random survival forest (RSF) competing risk model quantified variable importance, and Gower-distance hierarchical clustering identified phenotypes.</p><p><strong>Results: </strong>Over a median (interquartile range) follow-up of 8.6 (6.7-12.5) years (range, 0.04-20 years), 101 pulmonary deaths occurred. In multivariable cause-specific Cox models, age (hazard ratio [HR], 1.11; 95% CI, 1.09-1.13), nocturnal desaturation (HR, 3.09; 95% CI, 1.88-5.09), active smoking (HR, 2.13; 95% CI, 1.37-3.30), body mass index (HR, 1.06; 95% CI, 1.02-1.10), and male sex (HR, 1.61; 95% CI, 1.01-2.56) were independent predictors. Fine-Gray models yielded concordant results. The RSF achieved a C-index of 0.84. Clustering identified 4 phenotypes; the highest-risk cluster reached a 20-year cumulative pulmonary mortality approaching 8%.</p><p><strong>Conclusions: </strong>Nocturnal hypoxemic burden, active smoking, age, body mass index, and cardiometabolic comorbidities are the principal correlates of pulmonary mortality in OSA. To our knowledge, this is the first large-scale competing-risk analysis dedicated specifically to pulmonary mortality in OSA, integrating cause-specific Cox, Fine-Gray, RSF, and clustering in a single cohort. Machine-learning-based stratification identifies clinically distinct phenotypes that may guide personalized intervention; these findings are hypothesis-generating and require prospective validation.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117532","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":"Association of serum chromogranin A and carcinoembryonic antigen with prevalent metastatic disease in pancreatic neuroendocrine neoplasms.","authors":"Violetta Rosiek, Ksenia Janas, Beata Kos-Kudła","doi":"10.20452/pamw.17416","DOIUrl":"https://doi.org/10.20452/pamw.17416","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117546","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":"Right atrial mass in metastatic melanoma: a cardio-oncology challenge.","authors":"Justyna Jachimowska, Zuzanna Synowiec, Sławomir Katarzyński, Anna Olasińska-Wiśniewska","doi":"10.20452/pamw.17413","DOIUrl":"https://doi.org/10.20452/pamw.17413","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117529","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":"Dapsone-controlled leukocytoclastic vasculitis during continued infliximab therapy for Crohn disease.","authors":"Kacper K Zagaja, Dagmara S Mahadea, Katarzyna Waszak, Kamila Stawczyk-Eder, Agnieszka Dobrowolska, Liliana Łykowska-Szuber","doi":"10.20452/pamw.17412","DOIUrl":"https://doi.org/10.20452/pamw.17412","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117561","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":"Carotid plaque burden in the adult Polish urban population and its association with body fat distribution.","authors":"Wojciech Łaguna, Małgorzata Chlabicz, Marlena Dubatówka, Jacek Jamiołkowski, Natalia Zieleniewska, Zofia Stachurska, Anna Lisowska, Anna Szpakowicz, Adam Łukasiewicz, Karol A Kamiński","doi":"10.20452/pamw.17414","DOIUrl":"https://doi.org/10.20452/pamw.17414","url":null,"abstract":"<p><strong>Introduction: </strong>Carotid plaques (CP) reflect systemic atherosclerotic burden and may predict cardiovascular (CV) events.</p><p><strong>Objectives: </strong>The aim of the study was to assess CP burden in a general adult urban population and its associations with fat distribution with adjustment for known CV risk factors.</p><p><strong>Patients and methods: </strong>Overall, 3321 participants from the Bialystok PLUS study (Poland) with a complete carotid ultrasound examination and clinical dataset were included, with a median (IQR) age of 49.0 (37.0-62.0) years. Plaques were assessed on ultrasound of 8 extracranial carotid segments. CP presence was defined as at least one plaque-positive segment, and CP burden was quantified as the number of plaque-positive segments across both sides (range, 0-8). Dual-energy X-ray absorptiometry was used to assess body composition.</p><p><strong>Results: </strong>Most participants had no CP (60.1%), whereas CP in 1, 2, 3, 4, and ≥5 segments were observed in 14.1%, 14.8%, 6.0%, 3.3%, and 1.6% of participants, respectively. Plaques were unevenly distributed across carotid segments, clustering at the bifurcation (right 30.1%, left 30.0%). A more central fat pattern was associated with a higher CP burden in women, whereas a more peripheral gynoid fat distribution was associated with a lower burden in men. After adjustment for selected CV risk factors, fat-distribution measures showed modest associations with CP burden in sex-stratified analyses. However, formal interaction tests did not provide statistically significant evidence of heterogeneity by sex.</p><p><strong>Conclusions: </strong>Age and established CV risk factors were the primary determinants of CP burden; however, selected fat-distribution measures showed additional but modest covariate-adjusted associations.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117518","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":"Upper-lobe pulmonary sequestration presenting as a fissural mass.","authors":"Jerry Chin-Wei Chien, Wing P Chan","doi":"10.20452/pamw.17411","DOIUrl":"https://doi.org/10.20452/pamw.17411","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117595","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":"Spatial heterogeneity and temporal dynamics of continuous adventitious lung sounds during asthma exacerbations.","authors":"Jędrzej Kociński, Tomasz Grzywalski, Honorata Hafke-Dys, Anna Pastusiak, Adam Biniakowski, Barbara Kuźnar-Kamińska","doi":"10.20452/pamw.17375","DOIUrl":"https://doi.org/10.20452/pamw.17375","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":"136 9","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117578","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":"Cardiovascular-kidney-metabolic syndrome staging in an internal medicine ward: an opportunity for risk stratification and intervention.","authors":"Dimitrios Patoulias, Kyriaki Vafeidou, Theocharis Koufakis, Konstantinos Stavropoulos, Michael Doumas","doi":"10.20452/pamw.17403","DOIUrl":"https://doi.org/10.20452/pamw.17403","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076419","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":"Cardiovascular-kidney-metabolic syndrome staging in an internal medicine ward: an opportunity for risk stratification and intervention.","authors":"Dimitrios Patoulias, Kyriaki Vafeidou, Theocharis Koufakis, Konstantinos Stavropoulos, Michael Doumas","doi":"10.20452/pamw.17403","DOIUrl":"https://doi.org/10.20452/pamw.17403","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":"136 9","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117557","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}