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

{"title":"Misfortune never comes singly: an unusual case of a patient with type 1 diabetes mellitus and widespread cardiac fibrosis with restrictive phenotype, mitral stenosis, and postcapillary pulmonary hypertension.","authors":"Maria Stec, Olaf Pachciński, Dominika Dziadosz, Paweł Bańka, Romuald Wojnicz, Katarzyna Mizia-Stec","doi":"10.20452/pamw.16879","DOIUrl":"10.20452/pamw.16879","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577125","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":"Application of the TRI-SCORE to predict long-term mortality in acute heart failure patients with moderate-to-severe tricuspid regurgitation.","authors":"Mehmet Rasih Sonsöz, Cemal Ozanalp, Orkun Canbolat, Ilyas Cetin, Gulden Guven, Yeliz Guler, Yelda Saltan Ozates","doi":"10.20452/pamw.16907","DOIUrl":"10.20452/pamw.16907","url":null,"abstract":"<p><strong>Introduction: </strong>Moderate‑to‑severe tricuspid regurgitation (TR) in the setting of acute heart failure (AHF) has been found to be associated with worse clinical outcomes. Recently, the TRI‑SCORE model was developed to predict clinical outcomes after isolated tricuspid surgery.</p><p><strong>Objectives: </strong>Our aim was to determine whether this score could aid in risk stratification of AHF patients with moderate‑to‑severe TR.</p><p><strong>Patients and methods: </strong>A total of 233 hospitalized patients with AHF and moderate‑to‑severe TR were included. We calculated the TRI‑SCORE for each patient, including the following parameters: age at least 70 years, New York Heart Association class at least III, right‑sided HF signs, daily furosemide dose at least 125 mg, glomerular filtration rate below 30 ml/min/1.73 m2, elevated total bilirubin concentration, left ventricular ejection fraction below 60%, and moderate-to-severe right ventricular dysfunction. The primary end point was all‑cause mortality during follow‑up.</p><p><strong>Results: </strong>The median (interquartile range [IQR]) age was 74 (65-84) years, 129 patients (55.4%) were women. During median (IQR) follow‑up of 8 (2-21) months, 135 patients (57.9%) reached the primary end point. The patients with the primary end point had a higher median (IQR) TRI‑SCORE value than those without (8 [6-9] vs 6 [4-7]; P <0.001). The multivariable Cox regression analysis showed that a 1‑point increase in the TRI‑SCORE was a significant indicator of all‑cause mortality (hazard ratio, 1.25; 95% CI, 1.14-1.38; P <0.001). The Kaplan-Meier analysis showed early divergence of low (0-3), intermediate (4-5), and high (≥6) TRI‑SCORE curves (log-rank; P <0.001).</p><p><strong>Conclusions: </strong>The AHF patients with moderate‑to‑severe TR have a poor prognosis during follow‑up. TRI‑SCORE can predict all‑cause mortality in these patients.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916145","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":"Prognostic significance of anti-gliadin and anti-F-actin immunoglobulin A antibodies in primary sclerosing cholangitis.","authors":"Ewa Wunsch, Małgorzata Milkiewicz, Gary L Norman, Alicja Łaba, Beata Kruk, Piotr Milkiewicz","doi":"10.20452/pamw.16910","DOIUrl":"10.20452/pamw.16910","url":null,"abstract":"<p><strong>Introduction: </strong>Primary sclerosing cholangitis (PSC) is a biliary disorder associated with a high risk of end‑stage liver disease and cholangiocarcinoma (CCA). Currently, prediction of unfavorable outcomes is hindered by a lack of valuable prognostic biomarkers.</p><p><strong>Objectives: </strong>The aim of the study was to assess the prevalence of autoantibodies in PSC and define their potential use as the predictors of the disease progress and CCA in a large, prospective cohort of PSC patients.</p><p><strong>Patients and methods: </strong>Enzyme‑linked immunosorbent assay was applied for detection of serum immunoglobulin (Ig) A anti‑gliadin antibodies at a concentration equal to or above 30 U and anti‑F‑actin antibodies at a concentration equal to or above 20 U in 624 patients with PSC and 305 healthy controls. Poor PSC outcomes were defined as liver transplantation or / and liver disease‑related death, that is, transplantation‑free survival, and CCA.</p><p><strong>Results: </strong>Anti‑gliadin and anti‑F‑actin IgA antibodies were more frequent in the PSC patients than in the healthy controls (P <0.001 for both). The autoantibodies were associated with laboratory indices of the liver disease severity, including the model of end‑stage liver disease score, and anti‑F‑actin was associated with cirrhosis (P <0.001). During a median (interquartile range) follow‑up of 18.5 (8-33) months, 17.2% patients were transplanted, 4.6% died due to their liver disease, and 5.2% were diagnosed with CCA. Associations between anti‑F‑actin and anti‑gliadin and a shorter transplantation‑free survival (P <0.001 for both) were found. In the multivariable Cox proportional hazards regression analysis anti‑gliadin was an independent predictor of poor survival. No association between the analyzed antibodies and the incidence of CCA was detected.</p><p><strong>Conclusions: </strong>Anti‑gliadin and anti‑F‑actin IgA identify the subgroup of PSC patients with a more severe disease and at a risk of shortened transplantation‑free survival.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916193","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":"Can we predict coronary artery disease in patients with heart failure with preserved ejection fraction based on echocardiographic parameters of diastolic dysfunction? A preliminary report.","authors":"Tomasz Urbanowicz, Ievgen Spasenenko, Marta Banaszkiewicz, Aleksandra Krasińska-Płachta, Zbigniew Krasiński, Beata Krasińska","doi":"10.20452/pamw.16930","DOIUrl":"10.20452/pamw.16930","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048463","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, efficacy, and changing trends in endoscopic ablation for dysplastic Barrett esophagus in Poland: a long-term multicenter retrospective analysis.","authors":"Marcin Romanczyk, Robert Klimkowski, Michal Kukla, Nastazja D Pilonis, Tomasz Romanczyk, Magda Gorecka, Magdalena Lesinska, Ewa Wronska, Jaroslaw Regula, Michal F Kaminski, Wladyslaw Januszewicz","doi":"10.20452/pamw.16912","DOIUrl":"10.20452/pamw.16912","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic ablation is the mainstay of treatment for dysplastic Barrett esophagus (BE), of which radiofrequency ablation (RFA) and argon plasma coagulation (APC) are the most widely available options.</p><p><strong>Objectives: </strong>We aimed to analyze the safety and outcomes of endoscopic ablation for BE at the Polish centers offering this procedure.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed data from 3 high‑volume endoscopy centers between 2002 and 2024. We included adult patients with confirmed BE who received at least 1 ablation session with either conventional / hybrid APC (APC/h‑APC) or RFA, followed by at least 1 endoscopic follow‑up. The outcomes included the rate of complete remission of intestinal metaplasia (CR‑IM) and dysplasia (CR‑D), and adverse event (AE) rate. Risk factors for treatment failure were analyzed using a multivariable logistic regression model.</p><p><strong>Results: </strong>We analyzed data from 191 patients, of which 160 were included (mean [SD] age, 59.4 [10.8] years; 79.4% men). The overall CR‑IM and CR‑D rates were 80% and 93.8%, respectively. We reported 49 minor AEs (30.6%), and 9 major AEs (5.6%), including 7 esophageal strictures (4.4%). In the early 2000s, APC was the only available ablation modality. However, since 2008, it has been gradually replaced by RFA. Notably, RFA was used for more severe BE cases and carried a higher risk of failed treatment than APC/h‑APC (odds ratio [OR], 7.48; P = 0.001). Other risk factors for treatment failure included the BE length (OR, 1.3; P = 0.002) and diabetes (OR, 7.48; P <0.001).</p><p><strong>Conclusions: </strong>Endoscopic ablation for BE is safely and effectively provided in Poland at a few expert centers. Patients with diabetes and long‑segment BE are at an increased risk for treatment failure.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916196","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 epidemiological situation of multidrug-resistant tuberculosis in Poland in the years 2018-2022.","authors":"Monika Kozińska, Dorota Filipczak, Magdalena Klatt, Jarosław Dziadek, Alina Minias, Daria Zygała-Pytlos, Tatiana Makarevich, Ewa Augustynowicz-Kopeć","doi":"10.20452/pamw.16904","DOIUrl":"10.20452/pamw.16904","url":null,"abstract":"<p><strong>Introduction: </strong>The presented analysis was conducted against the backdrop of the global pandemic and the Russian-Ukrainian war. The conflict on Poland's eastern border raised concerns about potential deterioration of the epidemiological situation in Poland due to the influx of immigrants from countries with a high incidence of multidrug‑resistant (MDR) tuberculosis (TB) and the Beijing genotype.</p><p><strong>Objectives: </strong>We aimed to assess the epidemiological situation of MDR‑TB in Poland from 2018 to 2022 and to analyze the prevalence of the Beijing genotype in both the Polish and immigrant populations.</p><p><strong>Patients and methods: </strong>The study group comprised 250 patients with bacteriologically confirmed MDR‑TB, diagnosed between 2018 and 2022. Microbiological, phenotypic, and molecular analyses were performed.</p><p><strong>Results: </strong>Significant changes were observed in the number of MDR‑TB cases, with a notable increase in registered cases after the outbreak of the war. One in 3 patients was infected with pre‑XDR strains, and 1 in 4 with XDR strains. A total of 40% of cases were resistant to fluoroquinolones, with higher resistance rates observed among Polish patients than the immigrants. MDR as well as MDR with resistance to second‑line injectable drugs were identified more often among the immigrants than the Polish population. The Beijing genotype dominated with 179 isolates (71.6%), identified with a similarly high frequency in both the immigrant and Polish populations.</p><p><strong>Conclusions: </strong>The war in Ukraine caused a massive influx of immigrants to Poland, many of whom were infected with MDR and Beijing strains of TB. There is a significant risk of an increase in the incidence of MDR‑TB in Poland in the future, as well as a potential for TB transmission between the immigrants and the native population.</p>","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916089","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":"Heart failure and tricuspid regurgitation: let the outcome lead.","authors":"Davide Stolfo","doi":"10.20452/pamw.16939","DOIUrl":"10.20452/pamw.16939","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":"135 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068707","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":"Macroprolactinoma and severe obesity: the chicken or the egg?","authors":"Magdalena J Woźniak, Monika Lenart-Lipińska, Jakub Gołacki, Beata Matyjaszek-Matuszek","doi":"10.20452/pamw.16943","DOIUrl":"https://doi.org/10.20452/pamw.16943","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068658","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":"Bone where it should not be: a case report of osseous metaplasia in the adrenal gland.","authors":"Szymon Suwała, Aisling Fitzgerald, Eoin Kavanagh, Adam Ostrowski, Izabela Neska-Długosz, Roman Junik","doi":"10.20452/pamw.16935","DOIUrl":"https://doi.org/10.20452/pamw.16935","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054050","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":"In search for cause of systolic murmur. A case study of MYH7 positive hypertrophic cardiomyopathy with right ventricular flow obstruction.","authors":"Renata Rajtar-Salwa, Michał Węgiel, Danuta Sorysz, Bernadeta Chyrchel, Stanisław Bartuś, Tomasz Rakowski","doi":"10.20452/pamw.16931","DOIUrl":"https://doi.org/10.20452/pamw.16931","url":null,"abstract":"","PeriodicalId":49680,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej-Polish Archives of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048469","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}