Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Sep 2022
Multicenter Study Observational StudyDeep dive into achieving the therapeutic target: results from a prospective, 6-month, observational study nested in routine rheumatoid arthritis care.
Achieving remission or lowdisease activity (LDA) is an integral principle of treat‑to‑target (T2T) strategy in rheumatoid arthritis (RA). Prior studies have reported that achieving T2T therapeutic goals may be realistic only for a fraction of patients. Prospective, real‑world data on achieving target disease control in ambulatory care populations are limited for Central and Eastern European countries. ⋯ A combination of clinical characteristics and provider treatment decisions shapes the "profile" of a patient failing to achieve T2T goals. Low‑dose steroid equivalent, never smoking, and lower body mass index appear as individual characteristics independently associated with achieving LDA / remission at 3 and 6 months.
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Pol. Arch. Med. Wewn. · Sep 2022
ReviewRecent advances in the diagnosis and management of autoimmune hepatitis.
Autoimmune hepatitis (AIH) is an acute or chronic inflammatory disease of the liver caused by an immune response of unknown origin. It affects people from all ethnic groups irrespective of age or sex. AIH is characterized by hyperglobulinemia, presence of circulating autoantibodies, and liver inflammation. ⋯ Most patients initially respond to first‑ line treatment, which consists of corticosteroids combined with azathioprine or mycophenolate mofetil. However, insufficient response to the treatment and intolerance due to side effects are common, so a significant proportion of patients require second- and / or third‑ line therapies. Herein, we review the challenges and recent advances in AIH diagnosis and management.
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Pol. Arch. Med. Wewn. · Sep 2022
Elevated urinary Kidney Injury Molecule 1 (KIM-1) at discharge strongly predicts early mortality following an episode of acute decompensated heart failure.
Hospitalization for acute decompensation of heart failure (ADHF) is a frequent event associated with long‑term adverse effects. Prognosis is even worse if acute kidney injury (AKI) occurs during hospitalization. ⋯ Discharge urinary KIM‑1 was a strong and independent predictor of mortality, particularly during the most vulnerable period shortly after hospitalization. Admission serum NGAL was inferior to conventional renal function parameters in predicting AKI during ADHF.
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Pol. Arch. Med. Wewn. · Sep 2022
Clinical characteristics and antiviral therapy in patients infected with hepatitis C virus in the interferon‑free era.
The highly effective and safe interferon (IFN)-free options were a breakthrough in the treatment of patients infected with hepatitis C virus (HCV). ⋯ The median age of HCV‑infected patients decreased over the years. They were less burdened with comorbidities and comedications, more likely to be treatment‑naïve, and had less advanced liver disease. The genotype‑specific regimens, predominantly used at the beginning of the IFN‑free era, were superseded by the pangenotypic regimens.