Polskie Archiwum Medycyny Wewnętrznej
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Obscure gastrointestinal (GI) bleeding (OGIB) is defined as small bowel bleeding of unknown etiology after negative endoscopic evaluation including esophagogastroduodenoscopy and colonoscopy with endoscopic evaluation of the terminal ileum. The presentation of OGIB may be either overt or occult. The former refers to persistent or recurrent visible GI bleeding (eg, melena and / or hematochezia, and rarely hematemesis), while the latter indicates the presence of persistently positive results of fecal oc-cult blood testing, iron deficiency anemia, or both, without evidence of visible GI bleeding. This review focuses exclusively on obscure‑overt GI bleeding and presents entities that should be considered as part of the differential diagnosis in patients with this type of bleeding, as well as details the role of endoscopic and radiographic techniques in the evaluation and treatment.
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Pol. Arch. Med. Wewn. · May 2022
The association between the acquisition of antibodies against Lyme disease and the risk of atrial arrhythmias.
The impact of antibodies against Borrelia burgdorferi (BB) on the occurrence of cardiac arrhythmias in patients without typical symptoms of Lyme disease (LD) is largely unknown. ⋯ Our data indicated an association between the exposure to Borrelia infection and the risk for AF and other AAs in the patients with elevated levels of NT‑proBNP, suggesting the need for a more efficacious diagnostic approach to patients with SAs, especially in LD‑endemic regions.
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Pol. Arch. Med. Wewn. · May 2022
ReviewBenefits and limitations of statin use in primary cardiovascular prevention: recent advances.
The status of low‑density lipoprotein (LDL) cholesterol is strong as an essential cause of atherosclerotic vascular disease (ASCVD) and primary target of lipid lowering. Drugs affecting primarily LDL choles-terol through an increase of LDL receptor expression are the backbone of current therapy, and generic statins are generally safe, effective, and inexpensive drugs serving this purpose. Statins are indicated for practically all patients in secondary prevention, whereas treatment in primary prevention (healthy individuals) is based on a calculated 10‑year risk of ASCVD. ⋯ More information about the benefits and risks of statins in primary prevention in older people (>70 years of age) will be provided by ongoing randomized and controlled trials (STAREE and PREVENTABLE). In this narrative review, I shall present recent advances in the use of statins in younger and older healthy people, and discuss their benefits and potential risks. I also raise a question whether with the current evidence base, most people in affluent societies would benefit from taking statins.
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Pol. Arch. Med. Wewn. · May 2022
Left atrial appendage thrombus in patients referred to electrical cardioversion for atrial fibrillation: a prospective single-center study.
Left atrial appendage thrombus (LAAT) is a risk factor for stroke; however, the actual health risk associated with LAAT in patients with atrial fibrillation (AF) on chronic anticoagulation is unknown. ⋯ The presence of LAAT had no practical value for predicting stroke, thromboembolic events, or death in patients with AF and on chronic anticoagulation.
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Pol. Arch. Med. Wewn. · May 2022
Validation of the Polish version of Severe Respiratory Insufficiency Questionnaire.
Improvement in the quality of life (QoL) is an essential outcome in patients with chronic respiratory failure (CRF). However, its reliable and comparative assessment is difficult in this highly heterogeneous group of patients. Severe Respiratory Insufficiency Questionnaire (SRI) has shown to have high psychometric properties to measure specific health-related QoL in patients with CRF due to different pathologies. ⋯ Our study demonstrated that the Polish version of the SRI is valid, reliable, and reproducible and may be used in research involving CRF.