Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Oct 2019
ReviewUse of bedside ultrasound to assess fluid status: a literature review.
The assessment of a patient's body fluid status is a challenging task for modern clinicians. Ultrasonography has numerous advantages, the most important being reproducibility and bedside monitoring of the patient. The examination is quick and has a significant diagnostic value. ⋯ Ultrasound enables physicians to determine the baseline status of hydration and to monitor the patient during fluid therapy. Additionally, it allows an assessment of asymptomatic patients, patients who are well adapted to chronic oxygen deficiency, and those who develop pulmonary congestion secondary to congestive heart failure or chronic kidney disease. The development of a protocol for an ultrasound assessment of the volume status would significantly facilitate the everyday practice of internal medicine specialists.
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Pol. Arch. Med. Wewn. · Oct 2019
ReviewSmoking and cardiovascular diseases: paradox greater than expected?
Cardiovascular diseases, including acute coronary syndromes, are a major cause of death among tobacco smokers. Epidemiological studies have demonstrated that long‑term prognosis is worse in smokers with acute coronary syndromes than in nonsmokers. However, some studies have suggested that clopidogrel‑treated active smokers have better in‑hospital and short‑term follow‑up outcomes, a phenomenon regarded as the smoker's paradox. ⋯ More potent P2Y12 inhibitors may be considered in selected patients who stopped smoking after percutaneous coronary intervention. Further studies are required to determine the optimal antiplatelet strategy for stented patients who effectively quit smoking during clopidogrel treatment. The aim of this review is to discuss the risk of smoking and the potential elevated thrombotic risk related to smoking cessation.
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Pol. Arch. Med. Wewn. · Oct 2019
Comparative StudyImmunosuppressive treatment with everolimus in patients after liver transplant: 4 years of single-center experience.
Everolimus after liver transplant (LT) has been used to minimize the use of calcineurin inhibitors (CNIs), optimize renal function, and prevent recurre nce of hepatocellular carcinoma (HCC). ⋯ This study showed that switching from CNIs to everolimus after LT allowed a safe weaning of CNIs and an improvement in creatinine levels. In patients on everolimus monotherapy, we observed dyslipidemia as a dose‑dependent side effect of the drug as well as a lower risk of HCC recurrence.
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Pol. Arch. Med. Wewn. · Oct 2019
Paper-based training diaries for monitoring of performance progress due to long-term physical activity.
Training diaries are a common tool for training monitoring; however, their correlation with an effective performance gain is unclear. ⋯ Paper-based training diaries might serve as an additional tool in the monitoring of training progress. However, because of the discrepancy between reported training loads and objectively measured training progress, they are not suitable to replace a standard bicycle stress test for an exact determination of performance gain in hobby athletes. New devices, such as fitness trackers or watches, may present better alternatives in the future.