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

{"title":"The impact of angiotensin receptor-neprilysin inhibitor on clinical status and hemodynamic parameters in patients with pulmonary hypertension due to heart failure with preserved left ventricular ejection fraction: a case series analysis.","authors":"Małgorzata Niemiec, Marek Grabka, Rafał Niemiec, Artur Filipecki, Mateusz Polak, Katarzyna Mizia-Stec","doi":"10.20452/pamw.17120","DOIUrl":"https://doi.org/10.20452/pamw.17120","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066196","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 prevalence of metabolic syndrome in a Polish population-based study: a comparison of previous and updated diagnostic criteria.","authors":"Natalia Zieleniewska, Jacek Jamiołkowski, Paweł Sowa, Małgorzata Kazberuk, Urszula Roszkowska, Małgorzata Chlabicz, Irina Kowalska, Karol Kamiński","doi":"10.20452/pamw.17118","DOIUrl":"https://doi.org/10.20452/pamw.17118","url":null,"abstract":"<p><strong>Introduction: </strong> Metabolic syndrome (MetS) is a growing global health concern characterized by adiposity, elevated blood pressure, and lipid and glucose metabolism abnormalities-that synergistically increase cardiovascular (CV) risk. The newly introduced concept of cardio-kidney-metabolic (CKM) syndrome aims to capture the continuum of metabolic dysfunction and its direct link to CV risk.</p><p><strong>Objectives: </strong> To assess the prevalence of MetS and CKM, compare traditional and updated MetS definitions, examine their diagnostic concordance, and explore associations with CV risk.</p><p><strong>Patients and methods: </strong> We analyzed 2110 adults (mean age (SD) 49.3 (15.3); 44.4% male) from the population-based Białystok PLUS cohort. MetS was defined using the 2009 and updated 2022 criteria. CKM staging was applied, and CV risk was estimated using SCORE2 and SCORE2-OP. Anthropometric, biochemical, and imaging data were assessed. Receiver operating characteristics analyses were performed to evaluate diagnostic utility.</p><p><strong>Results: </strong> MetS was diagnosed in 22.1% using both definitions; 5.1% met only the 2022 and 13.1% only the 2009 criteria. Individuals fulfilling both definitions had higher age, body mass index (BMI), and adiposity. BMI (AUC = 0.941, 95% CI 0.931-0.951) and waist circumference (AUC = 0.912, 95% CI 0.900-0.924) showed the highest diagnostic accuracy under the 2022 criteria. CV risk and subclinical atherosclerosis were most prevalent in those meeting both definitions. CKM stage ≥2 was present in 55.3%, with increasing prevalence of higher CV risk observed across stages.</p><p><strong>Conclusions: </strong> MetS and CKM are highly prevalent, yet their diagnostic overlap is limited. CKM staging captures high-risk individuals beyond MetS criteria, underscoring its broader utility for integrated cardiometabolic risk assessment.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066261","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":"Changes in the prevalence of heart failure phenotypes over time and their association with patients' prognosis.","authors":"Agnieszka Doryńska, Anna Drohomirecka, Roman Topór-Mądry, Hubert Łazarczyk, Tomasz Zieliński, Tomasz M Rywik","doi":"10.20452/pamw.17119","DOIUrl":"https://doi.org/10.20452/pamw.17119","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence and phenotypic frequency of heart failure (HF) vary across populations, yet little is known about how these phenotypes change over time and how such changes affect patient outcomes.</p><p><strong>Objectives: </strong>To evaluate temporal trends in HF phenotype prevalence and their associations with patients' characteristics and prognosis.</p><p><strong>Patients and methods: </strong> We retrospectively analyzed data from 2597 patients hospitalized with HF between January 2014 and May 2019. Patients were categorized into tertiles according to their time of hospital admission and stratified by HF phenotype: HFrEF, HFmrEF, and HFpEF. We assessed changes in phenotype prevalence, clinical characteristics, and survival. Data were obtained from hospital records and the National Health Fund. The endpoint was all-cause mortality or censoring on May 25, 2023.</p><p><strong>Results: </strong>  A 27% decrease in the prevalence of HFrEF and an increase in HFmrEF and HFpEF (53% and 92%, respectively) were observed between the first and third tertile. There was a progressive increase in the proportion of older patients, women, and comorbidities, particularly hypertension, atrial fibrillation, diabetes, and cancer. 5-year survival improved across tertiles for all HF patients (48.4% to 60.2%, P <0.001), with significant gains observed in HFrEF (45.7% to 57.0%, P <0.001). After adjusting for confounders, the later tertiles remained independent predictors of better survival compared to the first tertile.</p><p><strong>Conclusions: </strong> The proportion of HFpEF and HFmrEF patients has increased recently and this shift was paralleled by a growing proportion of elderly and female patients and a rising burden of comorbidities. However overall survival has improved, particularly among HFrEF patients.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041927","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":"Therapeutic use of cannabis and cannabinoids: benefits and risks.","authors":"Xiadi Zhai, Pooja R Sarkar, Kevin P Hill","doi":"10.20452/pamw.17117","DOIUrl":"https://doi.org/10.20452/pamw.17117","url":null,"abstract":"<p><p>The international popularity of cannabis and the shifting legal landscape have propelled conversations around medical and recreational use to the forefront of public discussion. Clinicians face increased questions from patients, though there is a lack of clear medical consensus on several conditions for which cannabis is commonly used. As of 2025, key indications for cannabis and cannabinoid use are nausea and vomiting induced by chemotherapy, loss of appetite induced by HIV / AIDS, Dravet syndrome, Lenox Gastaut syndrome, seizures associated with tuberous sclerosis, and multiple sclerosis spasticity. However, cannabis and cannabinoids are used to treat additional conditions, which we discuss in this update of Hill and Palastro's 2017 review of medical cannabis. We review current evidence for cannabis and cannabinoid treatment of chronic non-cancer pain, insomnia, psychiatric and neurologic disorders. We also consider current inconclusive evidence for cannabis to treat opioid use disorder and neurological disorders. Risks associated with cannabis and cannabinoid use include addiction, decreased neurocognitive function, particularly in adolescents, cannabinoid hyperemesis syndrome, psychosis, perinatal complications, cardiovascular, pulmonary and physical injury risks such as falls and motor vehicle accidents. As public and clinical interest in cannabis grows, clinicians must evaluate potential harms alongside benefits relevant to the medical condition for which cannabis is being considered. Anecdotal experiences and commercial claims, whether positive or negative, and however compelling, must be eschewed in favor of research findings and fact to guide clinical decision-making.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042105","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":"Oxidative stress markers associate with hypofibrinolysis in atrial fibrillation.","authors":"Patrycja Mołek-Dziadosz, Joanna Natorska, Paweł T Matusik, Michał Ząbczyk, Aleksander Siniarski","doi":"10.20452/pamw.17116","DOIUrl":"https://doi.org/10.20452/pamw.17116","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042084","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":"18F-prostate-specific membrane antigen-1007 positron emission tomography / computed tomography detects occult leptomeningeal metastases in poorly differentiated thyroid carcinoma misdiagnosed as vascular mimicry on magnetic resonance imaging.","authors":"Min Liu, Yan Sun, Li Cai, Zhiying Xu, Weilong Li","doi":"10.20452/pamw.17112","DOIUrl":"https://doi.org/10.20452/pamw.17112","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041950","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":"Impella-supported coronary intervention: overcoming access challenges.","authors":"Filip Waśniewski, Łukasz Kruszyna, Włodzimierz Skorupski, Mikołaj Derewońko, Marta Kałużna-Oleksy","doi":"10.20452/pamw.17113","DOIUrl":"https://doi.org/10.20452/pamw.17113","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042050","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":"Endothelial function in patients with rheumatoid arthritis without classical cardiovascular risk factors is determined by subclinical lipid disturbances and compensatory vascular adaptation.","authors":"Jaroslaw Nowakowski, Brygida Marczyk, Marzena Frołow, Mariusz Korkosz, Stefan Chlopicki","doi":"10.20452/pamw.17114","DOIUrl":"https://doi.org/10.20452/pamw.17114","url":null,"abstract":"<p><strong>Introduction: </strong> Endothelial dysfunction has been reported in rheumatoid arthritis (RA) patients without classical cardiovascular risk factors, but findings remain inconsistent.</p><p><strong>Objectives: </strong> To assess whether endothelial function is impaired in RA with moderate inflammatory burden in the absence of established cardiovascular risk factors.</p><p><strong>Patients and methods: </strong> This cross-sectional study was conducted in 64 patients with RA without classical CV risk factors and 60 healthy age- and sex-matched controls. Endothelial function was evaluated in the brachial artery by flow-mediated dilation (FMD), in peripheral and skin microcirculation by peripheral arterial tonometry (RH-PAT), and flow-mediated skin fluorescence (FMSF), respectively.</p><p><strong>Results: </strong> There were no significant differences in endothelial function parameters between patients with RA and healthy controls. However, patients with RA had increased augmentation index: 3.0 (-9.0-10.0) vs -6.5 (-16.0-2.0), P = 0.003. 29 patients with RA that displayed lowered FMD (<7%) had higher total cholesterol (5.09 mmol/l [0.85] vs 4.47 [0.77], P = 0.005) and higher low-density lipoprotein cholesterol (LDL-C: 2.92 mmol/l [0.86] vs 2.42 [0.75], P = 0.02). Surprisingly, a subgroup with FMD >7% had higher C-reactive protein (CRP) (1.11, [1.0-8.46] vs 1.0 [1.0-1.0], P = 0.03) in contrast to patients with FMD <7%. Furthermore, microvascular responses measured by FMSF techniques (RHR%) were augmented in patients with higher LDL-C levels as compared with the group of RA with lower LDL-C level.</p><p><strong>Conclusions: </strong> RA, even with a moderate inflammatory burden, may facilitate the detrimental effect of lipoproteins on macrovascular endothelial function. Interestingly, compensatory vascular responses were detected that may precede overt vascular dysfunction. Their monitoring may be useful in endothelial-guided therapy.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024699","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":"Predictors of one-year interstitial lung disease progression in patients with interstitial pneumonia with autoimmune features: a single-center, prospective study.","authors":"Ewa Miądlikowska, Joanna Miłkowska-Dymanowska, Adam J Białas, Joanna S Makowska, Anna Lewandowska-Polak, Piotr Łacwik, Wojciech J Piotrowski","doi":"10.20452/pamw.17115","DOIUrl":"https://doi.org/10.20452/pamw.17115","url":null,"abstract":"<p><strong>Introduction: </strong>Interstitial pneumonia with autoimmune features (IPAF) describes a rare condition characterized by interstitial lung disease (ILD) with autoimmune manifestations in the absence of defined autoimmune rheumatic diseases (AIRD). Although the classification was established in 2015, prospective data on disease progression remain limited.</p><p><strong>Objectives: </strong>To identify predictors of ILD progression in IPAF patients using three criteria: 1) progressive pulmonary fibrosis (PPF), 2) INBUILD criteria, 3) absolute FVC decline ≥10%. A secondary aim was to compare bronchoalveolar lavage fluid (BALF) cellular profiles between IPAF and AIRD-ILD and explore their prognostic value.</p><p><strong>Patients and methods: </strong>Between March 2021 and November 2022, 69 patients were prospectively recruited: 31 with IPAF and 38 with AIRD-ILD. Clinical, laboratory, radiological, pulmonary function and BALF data were analyzed. Univariable and multivariable logistic regression were used to assess one-year progression predictors.</p><p><strong>Results: </strong>Among IPAF patients, 43.3% met PPF criteria, 36.7% met INBUILD and 22.2% had FVC decline ≥10%. PPF-defined progression was more frequent in IPAF than AIRD-ILD (43.3% vs. 19.35%, p = 0.04). Predictors of progression per PPF criteria included elevated peripheral blood neutrophil count (OR = 1.89, 95% CI: 1.08-3.31; p = 0.03) and usual interstitial pneumonia pattern on HRCT (OR = 43.8, 95% CI: 1.52-1260; p = 0.03). BALF lymphocyte count was not associated with progression (OR = 1.10, p = 0.07). For INBUILD criteria, predictors were peripheral blood neutrophil count (OR = 2.06, 95% CI: 1.19-3.59; p = 0.01) and honeycombing (OR = 69.1, 95% CI:2.16-2220; p = 0.02). Antinuclear antibody titer had no impact on IPAF progression.</p><p><strong>Conclusions: </strong>Fibrotic HRCT features (UIP, honeycombing) and peripheral neutrophilia were predictors of ILD short-term progression in IPAF.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024715","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":"Intramuscular hematomas as a first presentation of angiosarcoma.","authors":"Monika Pietras, Anna Hawrot-Kawecka, Ewelina Szymańska, Mirosława Janowska, Agata Stanek","doi":"10.20452/pamw.17111","DOIUrl":"https://doi.org/10.20452/pamw.17111","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024712","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}