Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine最新文献_第5页

Unexplained microcytic anemia with hepatic and cerebral iron deposition: a diagnostic challenge. 不明原因的小细胞性贫血伴肝和脑铁沉积：一个诊断挑战。

IF 4.7 4区医学

Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine Pub Date : 2025-09-05 DOI: 10.20452/pamw.17108

Paweł Wiliński, Artur Kośnik, Tomasz Wróbel, Agnieszka Antos, Tomasz Litwin, Joanna Raszeja-Wyszomirska

引用次数: 0

Primary extraosseous Ewing's sarcoma/primitive neuroectodermal tumor of head and neck in an adult. 成人头颈部原发性骨外尤文氏肉瘤/原始神经外胚层肿瘤1例。

IF 4.7 4区医学

Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine Pub Date : 2025-09-05 DOI: 10.20452/pamw.17110

Piotr Majewski, Barbara Trepka-Sirek, Iwona Niedzielska

引用次数: 0

How to treat arterial hypertension effectively in elderly subjects? 如何有效治疗老年高血压？

IF 4.7 4区医学

Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine Pub Date : 2025-09-03 DOI: 10.20452/pamw.17109

Francesco Fantin, Anna Giani, Elena Zoico, Mauro Zamboni

{"title":"How to treat arterial hypertension effectively in elderly subjects?","authors":"Francesco Fantin, Anna Giani, Elena Zoico, Mauro Zamboni","doi":"10.20452/pamw.17109","DOIUrl":"https://doi.org/10.20452/pamw.17109","url":null,"abstract":"Hypertension is the most common cardiovascular risk factor in older adults, significantly contributing to morbidity and mortality. Its prevalence rises with age and is strongly associated with vascular aging, isolated systolic hypertension, and comorbidities such as cognitive impairment and chronic kidney disease. However, treatment in older adults-especially those with frailty-requires a careful balance between benefit and potential harm. This review aims to provide an updated synthesis of pathophysiological mechanisms, epidemiological trends, diagnostic considerations, and evidence-based therapeutic approaches to arterial hypertension in older adults. Emphasis is placed on tailoring treatment strategies according to frailty and functional status. We conducted a narrative review of major international guidelines (ESC, ESH), clinical trials, and real-world studies addressing hypertension in aging populations. Special focus was given to randomized controlled trials and observational studies stratified by frailty. Evidence supports blood pressure lowering in fit older adults, as demonstrated in trials such as HYVET, SPRINT-SENIOR, and STEP, which showed significant reductions in cardiovascular events and mortality. Conversely, studies like PARTAGE, OPTiMiSE, and DANTE highlight the risks of overtreatment in frail or institutionalized patients, including hypotension, falls, and increased mortality. The presence of orthostatic hypotension, impaired renal function, and polypharmacy further complicates management. In conclusion hypertension management in the elderly should follow a personalized approach based on a comprehensive geriatric assessment and frailty evaluation; patient-centered goals are essential to guide treatment intensity, aiming to protect cardiovascular health without compromising safety, cognition, or functional independence. Future studies must include frailer populations to better inform clinical decisions.","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994199","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}

引用次数: 0

Epidemiology of venous thromboembolism: implications for clinical practice. 静脉血栓栓塞的流行病学：对临床实践的影响。

IF 4.7 4区医学

Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine Pub Date : 2025-09-01 DOI: 10.20452/pamw.17105

Peter Marschang, Grigoris Gerotziafas, Matija Kozak, Benilde Cosmi, Mariella Catalano, Agata Stanek

{"title":"Epidemiology of venous thromboembolism: implications for clinical practice.","authors":"Peter Marschang, Grigoris Gerotziafas, Matija Kozak, Benilde Cosmi, Mariella Catalano, Agata Stanek","doi":"10.20452/pamw.17105","DOIUrl":"https://doi.org/10.20452/pamw.17105","url":null,"abstract":"Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common disorder with annual incident rates of 150 (95% confidence interval (CI) 131-169) / 100 000 (VTE), 90 (95% CI 72-109) / 100 000 (DVT) and 67 (95% CI 54-80) / 100 000 (PE), respectively in Western countries. Of note, reported VTE incidences are approximately 7-fold lower in East Asia. VTE incidence increases with age and is comparable between sexes, although men exhibit a higher risk of recurrence. Incidence rates of PE, but not of DVT, have been increasing in the last decades, reflecting changes in diagnostic workup and risk factors. VTE has a significant impact on mortality, and it is estimated that death from PE, which includes sudden death from undiagnosed, untreated PE may be responsible for approximately 3-4 of all deaths. But also diagnosed, treated VTE still carries a substantial risk with case fatality rates up to 10% in contemporary cohorts. Even when conservative calculations are applied, VTE deaths equal approximately 26 (95% CI 19-32) / 100 000 and rank-at least in Europe and North America-at the 3rd place for cardiovascular diseases and at the 5th place for death from all causes. In this article, we summarize the current state of knowledge and recent data on the epidemiology of VTE with a particular focus on mortality from PE and clinical implications.","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976438","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}

引用次数: 0

Citrulline and propionic acid levels are decreased in metabolic depression: results of a cross-sectional study. 代谢抑郁症患者瓜氨酸和丙酸水平降低：一项横断面研究的结果。

IF 4.7 4区医学

Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine Pub Date : 2025-09-01 DOI: 10.20452/pamw.17106

Oliwia Gawlik-Kotelnicka, Joanna Grzelczyk, Aleksandra Margulska, Grażyna Budryn, Jakub Wasiak, Dominik Strzelecki

引用次数: 0

Argyria: clinical features which should be remembered. 银屑病：应记住的临床特征。

IF 4.7 4区医学

Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine Pub Date : 2025-08-29 DOI: 10.20452/pamw.17127

Justyna Putek, Przemysław Pacan, Tomasz Kaczmarski, Jacek C Szepietowski

引用次数: 0

The gut as a mediator of environmental harm: unveiling microbial pathways in climate-related disease. 肠道作为环境危害的中介：揭示气候相关疾病的微生物途径。

IF 4.7 4区医学

Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine Pub Date : 2025-08-26 DOI: 10.20452/pamw.17100

Wojciech Marlicz, George Koulaouzidis, Dafni Charispoulou, Maria Marlicz, Anastasios Koulaouzidis

引用次数: 0

Cryptococcosis in an immunocompromised patient: diagnosis and therapeutic success. 隐球菌皮肤传奇：揭开诊断和治疗的胜利。

IF 4.7 4区医学

Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine Pub Date : 2025-08-26 Epub Date: 2025-06-04 DOI: 10.20452/pamw.17028

Daniel Nolberczak, Joanna Narbutt, Marta Matych, Kamil Grabowski, Natalia Bień, Aleksandra Lesiak

引用次数: 0

Pulmonary vein isolation with radiofrequency ablation and pulsed-field ablation: follow-up with real-world data. 肺静脉隔离与射频消融和脉冲场消融：与真实世界数据的随访。

IF 4.7 4区医学

Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine Pub Date : 2025-08-26 Epub Date: 2025-07-04 DOI: 10.20452/pamw.17062

Bartosz Krzowski, Julia Dźwinacka, Michał Peller, Michał Marchel, Cezary Maciejewski, Grzegorz Opolski, Marcin Grabowski, Paweł Balsam, Piotr Lodziński

{"title":"Pulmonary vein isolation with radiofrequency ablation and pulsed-field ablation: follow-up with real-world data.","authors":"Bartosz Krzowski, Julia Dźwinacka, Michał Peller, Michał Marchel, Cezary Maciejewski, Grzegorz Opolski, Marcin Grabowski, Paweł Balsam, Piotr Lodziński","doi":"10.20452/pamw.17062","DOIUrl":"10.20452/pamw.17062","url":null,"abstract":"Introduction: Currently, the treatment of atrial fibrillation (AF) focuses on restoring sinus rhythm with pulmonary vein isolation (PVI). Pulsed‑field ablation (PFA) is a novel, promising method that requires greater support of real‑world data.Objectives: Our aim was to assess the rate of arrhythmia recurrence in patients who underwent PVI with either radiofrequency (RF) energy or PFA.Patients and methods: This retrospective analysis included 210 patients with paroxysmal (76.2%) or persistent AF undergoing PVI at a university hospital. The study group consisted of 108 patients who underwent PFA using the Farawave catheter. RF ablations were performed in 102 patients using a very‑high‑power, short‑duration or index‑guided ablation. The primary end point was no recurrence of arrhythmia.Results: There were no significant baseline differences in patient characteristics. Procedural times were shorter with PFA (55 min) than RF (115 min; P <0.001), while fluoroscopy exposure duration was longer (PFA, 1100 s; RF, 159 s; P <0.001). In the patients who underwent PFA under deep sedation, remifentanil dose was lower than in the RF group under conscious sedation (PFA, 0.2 mg; RF, 0.5 mg; P <0.001). The efficacy of both methods did not differ in the recurrence rate of atrial arrhythmias during the blanking period (PFA, 32.7%; RF, 28.7%; P = 0.55) and afterward (PFA, 34.6%; RF, 33.7%; P >0.99). The overall frequency of adverse events was similar in both groups.Conclusions: Regardless of the selected method, the efficacy of the procedures remains comparable. There was no significant difference in postoperative adverse events between the groups.","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561766","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}

引用次数: 0

Anomaly of the left main coronary artery originating from the right coronary sinus in a 65-year-old man. 65岁男性左冠状动脉主干起源于右冠状动脉窦的异常。

IF 4.7 4区医学

Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine Pub Date : 2025-08-26 Epub Date: 2025-06-05 DOI: 10.20452/pamw.17029

Małgorzata Zalewska-Adamiec, Hanna Bachórzewska-Gajewska, Sławomir Dobrzycki

引用次数: 0