Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Feb 2023
A deep learning model to identify fluid overload status in critically ill patients based on chest X-ray images.
Recent studies have highlighted adverse outcomes of fluid overload in critically ill patients. Therefore, its early recognition is essential for the management of these patients. ⋯ As CXR is routinely used in the intensive care unit, a simple, fast, low‑cost, and noninvasive DL model based on this modality can be regarded as an effective supplementary tool for identifying fluid overload, and should be widely adopted in the clinical setting, especially when invasive hemodynamic monitoring is not available.
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Pol. Arch. Med. Wewn. · Feb 2023
Genetic data protection as an indispensable element of genomic medicine development.
The immense progress in molecular biology observed in the last decades has led to a fundamental change in our understanding of the etiology of human diseases. Whole genome analyses, both DNA sequencing and microarray comparative genomic hybridization, allowed for identification of previously unknown diseases and syndromes. Therefore, in difficult‑to‑diagnose cases, clinical diagnosis is being replaced by molecular diagnosis (molecular dysmorphology, genomic medicine). ⋯ The respective legal acts and protective measures should take into account several different aspects. The present paper explores major benefits and risks associated with international sharing of vast databases of genetic material, and presents legal provisions applied in the European Union, the United States, and China. The latter part is based on the respective acts themselves, as well as on analyses and commentaries by other scholars.
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Pol. Arch. Med. Wewn. · Feb 2023
Iron status in chronic inflammatory disease: therapeutic implications.
Anemia of inflammation (AI) is a very frequent clinical condition affecting globally more than a billion people with chronic inflammatory disorders, such as chronic kidney disease, heart failure, and inflammatory bowel disease. It is usually associated with iron deficiency (ID), which imposes a severe additional burden on the recovery from the primary disease. The pathophysiology of iron dysregulation that may ultimately lead to absolute iron deficiency anemia (IDA) during inflammation is multifactorial and includes reduced iron absorption in the bowel, iron retention in macrophages of the reticuloendothelial system, reduction in circulatory half‑life of erythrocytes, inadequate production and activity of erythropoietin, and impaired proliferation and differentiation of erythroid progenitor cells. ⋯ Instead, intravenous iron preparations are a valuable option for patients with chronic inflammatory diseases, as they overcome reduced bowel absorption. Novel therapeutic approaches include downregulation of hepcidin synthesis and function, and stabilization of the hypoxia‑inducible factor via inhibition of prolyl hydroxylase domain. Several studies in vitro and in vivo are ongoing; however, the results in humans are still elusive.
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Pol. Arch. Med. Wewn. · Feb 2023
Pulmonary fibrosis in primary Sjögren's syndrome: computed tomography, clinical features, and associated clinical factors.
Interstitial lung disease (ILD) is common in patients with primary Sjögren syndrome (pSS). Pulmonary fibrosis significantly reduces the patient's quality of life. Therefore, better understanding of the characteristics of patients with pulmonary fibrosis is necessary. ⋯ The presence of dry cough and shortness of breath in the patients with pSS may indicate concomitant pulmonary fibrosis. High‑resolution chest CT can be used for better insights on the occurrence and severity of pulmonary fibrosis in these patients.