Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Dec 2021
Current applications and outcomes of venoarterial extracorporeal membrane oxygenation based on six years of experience. Risk factors for in-hospital mortality. A single-center retrospective study.
Data regarding venoarterial extracorporeal membrane oxygenation (VA ECMO) as a temporary circulatory support in cardiogenic shock (CS) for Central Europe are scarce. ⋯ The study showed survival benefit, despite frequent complications. The protocol focusing on proper candidate selection and timing can positively impact patient survival. Additional risk reduction can be achieved with a further increase of the team experience with ECMO.
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Pol. Arch. Med. Wewn. · Dec 2021
Thyroid nodules with indeterminate cytopathology: a constant challenge in everyday practice. The effectiveness of clinical decisions using diagnostic tools available in Poland.
A crucial issue in the management of thyroid nodules is an accurate estimation of their malignancy risk. The key tool for risk stratification is fine-needle aspiration biopsy. Unfortunately, approximately 20% of biopsy results are indeterminate. The malignancy risk assigned to these categories does not allow unequivocal further management. ⋯ The majority of Polish patients with thyroid nodules assigned to Bethesda III and IV cytological categories are overtreated based on the use of diagnostic tools currently available in Poland.
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Pol. Arch. Med. Wewn. · Dec 2021
Sarcopenia and cachexia in chronic diseases: from mechanisms to treatment.
Two main manifestations of wasting disorders in chronic disease are cachexia and sarcopenia. Due to shared pathological features, including impairments in systemic inflammatory responses, neurohormonal activity, and metabolic systems, the 2 disorders can present with similar symptoms (tissue depletion, dyspnea, anorexia, asthenia, fatigue, and impaired physical performance). Wasting disorders are associated with reduced quality of life and increased mortality. ⋯ In the past decade, intensive research has focused on new therapeutic strategies within a multimodal approach, which embraces nutritional support, physical activity, and targeted pharmacological therapy. Despite some initial promising therapeutic results for selected novel agents, guideline-recommended pharmacotherapy is not yet available for cachexia or sarcopenia. More research is needed to better understand these wasting disorders and learn how to treat them.