Polskie Archiwum Medycyny Wewnętrznej
-
Pol. Arch. Med. Wewn. · Feb 2019
Practice GuidelineUtilization of do-it-yourself artificial pancreas systems in the management of patients with type 1 diabetes: a position statement of the Pump School Education Initiative by Diabetes Poland.
Abstract
-
Pol. Arch. Med. Wewn. · Feb 2019
Platelet to red cell distribution width ratio for predicting clopidogrel efficacy in patients undergoing percutaneous coronary interventions: insights from the ONSIDE-TEST study.
INTRODUCTION Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel remains a cornerstone of pharmacotherapy after percutaneous coronary intervention (PCI). It has been demonstrated that even up to 30% of patients receiving DAPT have inadequate response to clopidogrel, namely, high on‑treatment platelet reactivity (HPR). The platelet to red cell distribution width (P‑RDW) ratio represents an indicator of cardiovascular risk and may be related to HPR. ⋯ Using a cut‑off level of 15.23, the P‑RDW ratio predicted HPR with a sensitivity of 69% and specificity of 75% (odds ratio, 6.67; 95% CI, 0.561-0.890; P = 0.02; are under the receiver operating characteristic curve, 0.723). CONCLUSIONS The P‑RDW ratio may serve as a supplementary tool for identification of patients at risk of HPR. Further studies are warranted to assess its role in planning DAPT among patients undergoing PCI.
-
Pol. Arch. Med. Wewn. · Feb 2019
Obstructive and nonobstructive coronary artery disease in long-lasting type 1 diabetes: a 7-year prospective cohort study.
INTRODUCTION It is widely believed that patients with diabetes are at increased risk of severe and premature coronary artery disease (CAD) when compared with nondiabetic individuals. OBJECTIVES The aim of the study was to evaluate the prevalence, 7‑year incidence, predictors, and outcomes of obstructive and nonobstructive CAD in patients with long‑lasting type 1 diabetes. PATIENTS AND METHODS We enrolled 2330 patients at a median age of 50 years and a median diabetes duration of 32 years. ⋯ CONCLUSIONS Nonobstructive CAD was the most frequent coronary complication in patients with type 1 diabetes. Both obstructive and nonobstructive CAD showed a similar incidence of nonfatal outcomes and selected predictors. Positive ETT/SPECT results were related to glycemic control only in patients with nonobstructive CAD.
-
Pol. Arch. Med. Wewn. · Feb 2019
Effect of short-term fluctuations in outdoor air pollution on the number of hospital admissions due to acute myocardial infarction among inhabitants of Kraków, Poland.
INTRODUCTION Air pollution is reaching alarming proportions worldwide; however, previous studies concerning the association between air pollution and myocardial infarction (MI) provided conflicting results. OBJECTIVES We evaluated a relationship between short‑term fluctuations in outdoor particulate matter (PM) and nitrogen dioxide (NO2) levels and the number of hospitalizations due to MI among the inhabitants of Kraków, Poland. PATIENTS AND METHODS Data on hospitalizations, daily pollutant concentrations, infections, and meteorological parameters were collected from December 2012 to September 2015. ⋯ CONCLUSIONS In all age groups, the short‑term elevation in PM2.5 levels was associated with an increased number of daily hospital admissions for MI, whereas for PM10 the effect was significant only with a simultaneous decrease in temperature. The effect of NO2 was observed only in older individuals and patients with pulmonary disorders. A negative clinical effect was more delayed in time in the case of exposure to PM than to NO2.
-
Pol. Arch. Med. Wewn. · Feb 2019
Case ReportsEsophagitis dissecans superficialis as the first manifestation of rectal adenocarcinoma.
Abstract