Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · May 2020
ReviewAddressing multiple gastroenterological aspects of coronavirus disease 2019.
The outbreak of the coronavirus disease 2019 (COVID‑19) pandemic has become the biggest challenge for the whole human community since many years. It seems that the proper identification of all people infected with severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is the best strategy to limit the transmission. However, in a significant proportion of patients, there are no clinical manifestations of the disease, and symptoms may be very mild or atypical. ⋯ Patients with new‑onset diarrhea, abdominal pain, nausea, and vomiting without any other evident etiological factors should be tested for SARS‑CoV‑2 infection. Gastroenterologists and members of other medical specialties should also remember that the current epidemiological situation has changed diagnostic and therapeutic algorithms in the management of several gastrointestinal and liver disorders. This review article summarizes the currently available data on multiple gastroenterological aspects of COVID‑19 and provides information on practical recommendations and position statements of the most prominent associations in the field of gastroenterology, which appeared in response to the emergence of the pandemic.
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Pol. Arch. Med. Wewn. · May 2020
Etiology and bacterial susceptibility to antibiotics in patients with recurrent lower urinary tract infections.
Recurrent urinary tract infections (UTIs) are a frequent health problem and a common reason for treatment resistance. ⋯ The most frequently occurring bacteria causing recurrent lower UTI are characterized by significant resistance to the antimicrobial therapy recommended as the first‑ line treatment: fluoroquinolones and trimethoprim / sulfamethoxazole. It seems that the first choice in the treatment of lower UTIs should be: fosfomycin, nitrofurantoin, or cefuroxime.
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Pol. Arch. Med. Wewn. · May 2020
ReviewHow can an internal medicine specialist save a patient with hemophagocytic lymphohistiocytosis (HLH)?
Hemophagocytic lymphohistiocytosis (HLH; also, hemophagocytic syndrome) occurs when an inflammatory reaction cannot stop on its own but continues to self‑ accelerate with positive feedback loops. If not interrupted, this pathomechanism leads to death. HLH in adults is usually diagnosed based on the HLH‑2004 criteria, but its confirmation should not stop the diagnostic process. ⋯ Prompt diagnosis and treatment, frequently made by an internal medicine specialist, is life‑saving. The aim of this review is to raise HLH awareness among internal medicine specialists and to provide advice on HLH management tailored for this group of physicians. Suggested approach is based on the latest recommendations by the Histiocyte Society and include novel insights from the authors' experience.
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Pol. Arch. Med. Wewn. · May 2020
Clinical characteristics and short-term outcomes of patients with coronavirus disease 2019: a retrospective single-center experience of a designated hospital in Poland.
Since the first reported case of coronavirus disease 2019 (COVID‑19) in Poland, the worldwide pandemic has spread throughout the country, leading to many hospital admissions. There has been an urgent need to determine clinical characteristics of Polish patients with laboratory‑confirmed severe acute respiratory syndrome coronavirus 2 (SARS‑CoV 2) infection in the clinical setting. ⋯ Polish patients with COVID‑19 have similar characteristics and risk factors for adverse outcomes to those observed in countries in which outbreaks occurred earlier. Significantly higher mortality in patients transferred from other centers warrants special attention and transfer policy should be verified.
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Pol. Arch. Med. Wewn. · May 2020
Impact of disseminated tumor cells in the bone marrow on survival and disease progression in patients with left-sided colorectal cancer.
Disseminated tumor cells (DTCs) are a subset of circulating tumor cells that migrate to the bone marrow. Colorectal cancer is a heterogeneous disease depending on the site of the primary tumor. ⋯ The presence of DTCs in the bone marrow is not associated with primary tumor characteristics and seems to reduce metastasis formation in left‑sided colorectal cancer. There is also a trend for improved overall survival in DTC‑positive patients. These results are intriguing and warrant further confirmation.