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
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
Epidemiology of inflammatory bowel disease in Poland 2009-2020: nationwide data.
The epidemiology of inflammatory bowel disease (IBD) in Poland has been recognized to only a limited extent. ⋯ The prevalence and incidence of IBD in Poland are presented, with time trends showing a substantial increase in the disease burden over the years 2009-2020.
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Pol. Arch. Med. Wewn. · May 2022
Meta AnalysisMortality in critically ill COVID-19 patients with fungal infections: a comprehensive systematic review and meta-analysis.
Patients with COVID‑19 may develop concomitant viral, bacterial, or fungal infections. Such patients are at a higher risk of death, especially from a critical illness. Although much attention has been recently given to fungal infections that may have devastating consequences, data on this issue are scarce. ⋯ In critically ill patients with COVID‑ 19, CAPA is rather common and significantly increases mortality. The evidence regarding other fungal infections is weaker, with CAC occurring less frequently but also impacting mortality. Therefore, clinical awareness and screening are needed, followed by personalized antifungal therapy stewardship, which is strongly recommended in order to improve the patients' prognosis.
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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.