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

{"title":"Impact of chronic kidney disease on long-term outcomes after left main percutaneous coronary intervention: a propensity score-matched analysis with up to 10 years of follow-up.","authors":"Wojciech J Skorupski, Marek Grygier, Marta Kałużna-Oleksy, Sylwia Iwańczyk, Aleksander Araszkiewicz, Włodzimierz Skorupski, Przemysław Mitkowski, Małgorzata Pyda, Julia Kępska, Katarzyna Skorupska, Anna Nowicka, Maciej Lesiak","doi":"10.20452/pamw.17393","DOIUrl":"https://doi.org/10.20452/pamw.17393","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease (CKD) is a major determinant of adverse cardiovascular outcomes. Patients with CKD undergoing percutaneous coronary intervention (PCI) represent a particularly high-risk population; however, data on the long-term prognostic impact of CKD in patients treated with PCI for left main coronary artery disease (LM CAD) remain limited.</p><p><strong>Objectives: </strong>This study aimed to evaluate the long-term impact of CKD on outcomes after left main PCI.</p><p><strong>Patients and methods: </strong>This single-center, prospective registry study analyzed 1321 patients who underwent left main PCI. Propensity score matching based on age, sex, diabetes mellitus, left ventricular ejection fraction, and SYNTAX score was performed among patients treated between January 2015 and December 2020, yielding a matched cohort of 344 patients (177 with CKD and 177 without CKD). CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m².</p><p><strong>Results: </strong>During a median follow-up of 2199 days, CKD was associated with significantly higher all-cause mortality (HR 1.75, 95% CI 1.30-2.34; P <0.001), cardiac death (HR 2.10, 95% CI 1.33-3.33; P = 0.001), stroke and major adverse cardiovascular events rates. In contrast, no significant long-term differences were observed between CKD and non-CKD patients in the incidence of myocardial infarction. Procedural characteristics, periprocedural complications, and procedural success rates were comparable between groups.</p><p><strong>Conclusions: </strong>In patients undergoing PCI for LM CAD, CKD predicts worse long-term survival despite comparable procedural and ischemic outcomes. The excess mortality appears driven by systemic rather than revascularization-related factors, underscoring the need for intensified long-term multidisciplinary management in this high-risk population.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867548","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":"Intramural hematoma of the ascending aorta in a patient with granulomatosis with polyangiitis.","authors":"Joanna Kosałka-Węgiel, Karolina Jankowska, Krzysztof Wójcik, Magdalena Morytko, Robert Chrzan","doi":"10.20452/pamw.17324","DOIUrl":"10.20452/pamw.17324","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347016","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":"Direct medical costs in inflammatory arthritis: a single-center real-world analysis of cost drivers and impact of a national drug reimbursement program.","authors":"Magdalena Strach, Alen Brkic, Marcin Kaczor, Rafał Wójcik, Piotr Kuszmiersz, Tone Birkenes, Marcin Krzanowski, Roman Topór-Mądry, Glenn Haugeberg, Mariusz Korkosz","doi":"10.20452/pamw.17298","DOIUrl":"10.20452/pamw.17298","url":null,"abstract":"<p><strong>Introduction: </strong>The arrival of biologic and targeted synthetic disease‑modifying antirheumatic drugs (b/tsDMARDs) has transformed health care and improved outcomes in patients with rheumatic inflammatory diseases; however, the cost of these therapies remains considerable.</p><p><strong>Objectives: </strong>This study aimed to explore direct treatment costs of patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA), using real‑world data from a single tertiary center.</p><p><strong>Patients and methods: </strong>This retrospective study cross‑referenced data from a clinical registry and a health care expenses database covering the period from January 2021 to September 2023. The study included 593 patients with RA (50.6%), PsA (20.3%), and axSpA (29.1%). Direct medical costs were calculated from the public payer and the patient perspectives, encompassing fully reimbursed services and out‑of‑pocket expenses.</p><p><strong>Results: </strong>The average annual direct medical costs per patient were 4635 EUR for PsA, 3891 EUR for axSpA, and 3106 EUR for RA. The highest health care costs were driven by b/tsDMARDs, which accounted for 94.7% of total costs in PsA, 91.8% in axSpA, and 90.9% in RA. Tumor necrosis factor (TNF) inhibitor use was the highest in axSpA at 61.3% (37.6% biosimilars), whereas for RA it was at 58.3% (41.7% biosimilars), and for PsA at 34.2% (17.5% biosimilars). Anti‑interleukin (IL)-17/IL‑23 agents were used in 42.5% of the PsA and 36.9% of the axSpA patients, while anti‑IL‑6 in 48.7% of the RA patients.</p><p><strong>Conclusions: </strong>The direct cost of b/tsDMARDs varied substantially across diseases. Expenditure was the highest in PsA, largely owing to high drug prices and low uptake of biosimilar anti‑TNFs. These findings suggest that an outcome‑oriented strategy favoring more cost‑efficient therapeutic options, where clinically appropriate, may yield meaningful savings.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147949972","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":"Corrections: Erectile dysfunction and quality of life after myocardial infarction: a cross-sectional study with routine point-of-care penile Doppler ultrasonography.","authors":"","doi":"10.20452/pamw.17371","DOIUrl":"10.20452/pamw.17371","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":"136 7-8","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820036","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":"Practical tips for the use of automated insulin delivery systems in individuals with diabetes during minor procedures performed under sedation or anesthesia and during labor.","authors":"Beata Mianowska, Sebastian Seget, Andrzej Gawrecki, Katarzyna Cyganek, Przemysława Jarosz-Chobot, Anna Juza, Tomasz Klupa, Małgorzata Myśliwiec, Dominik Porada, Elektra Szymańska-Garbacz, Agnieszka Szadkowska","doi":"10.20452/pamw.17329","DOIUrl":"10.20452/pamw.17329","url":null,"abstract":"<p><p>Automated insulin delivery (AID) systems have become a standard of care in type 1 diabetes and are increasingly used across all age groups, including during pregnancy. As their utilization expands, clinicians more often encounter patients using AID systems in perioperative and peripartum settings. However, guidance regarding continuation of AID therapy during procedures under anesthesia / sedation or during labor remains limited. This document provides practical, consensus‑based recommendations for the use of AID systems during minor procedures, selected major surgeries, and throughout labor and delivery, aiming to support anesthesiologists, surgeons, and other procedural specialists as well as obstetric teams and diabetes specialists in clinical decision‑making. Eleven experts in pediatric and adult diabetology, each with extensive clinical experience in managing AID users in outpatient and inpatient settings, conducted a comprehensive literature review and synthesized available evidence with collective clinical experience. The authors outline criteria for continuation of AID therapy during procedures, including requirements related to the patient, procedural team, and type of procedure. Detailed perioperative algorithms are provided. Recommendations for labor emphasize adjustments of AID parameters, target glucose levels, and postpartum modifications. While AID system use may be continued during many minor procedures and selected major surgeries, intravenous insulin therapy remains preferable in situations associated with hemodynamic instability or high metabolic risk. With appropriate preparation and interdisciplinary coordination, continuation of AID therapy during selected procedures and childbirth can be safe and effective, reducing glycemic variability and treatment burden. As evidence remains limited, further clinical studies are urgently needed to validate and refine these recommendations.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354285","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":"Safety of oral bisphosphonates in patients with liver cirrhosis and esophageal varices: a population-based retrospective cohort study.","authors":"Abdellatif Zhalka, Rami Jabareen, Karem Awad, Fadi Abu Baker, Avital M Lang, Rawi Hazzan","doi":"10.20452/pamw.17352","DOIUrl":"10.20452/pamw.17352","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580909","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":"When targeted immunosuppression masks severe infection: Group B streptococcal meningitis on anti-interleukin-6 therapy.","authors":"Fiona Murphy, Aisling Brown","doi":"10.20452/pamw.17369","DOIUrl":"10.20452/pamw.17369","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":"136 7-8","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820027","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":"Fulminant liver failure following marathon run.","authors":"Maja Nowicka","doi":"10.20452/pamw.17360","DOIUrl":"10.20452/pamw.17360","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":"136 7-8","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820024","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 gut feeling: a rare cause of postprandial pain.","authors":"Ruth Airiel Ho, Yan Ru Tan","doi":"10.20452/pamw.17361","DOIUrl":"10.20452/pamw.17361","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":"136 7-8","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820011","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":"Spindle cell lipoma: a diagnostic pitfall of technetium-99m methoxyisobutyl isonitrile (MIBI) parathyroid scintigraphy.","authors":"Olgierd Chrabański, Magdalena Londzin-Olesik, Jacek Pająk, Beata Kos-Kudła, Anna Błach","doi":"10.20452/pamw.17322","DOIUrl":"10.20452/pamw.17322","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340878","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}