Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Apr 2023
ReviewExtracellular vesicles in vascular pathophysiology: beyond their molecular content.
Extracellular vesicles (EVs) are released by all cells, both in physiological and pathological conditions. Their molecular charge and composition emerge as possible biomarkers, but EVs may also be considered for other clinical applications. This review discusses the role of other features of EVs, such as their lipid components or composition of glycans that form the EV corona and regulate EV biodistribution and uptake by target cells. The importance of EV electric charge has been discussed as a new insight into EV fate and destination.
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Pol. Arch. Med. Wewn. · Apr 2023
ReviewReflections on internal medicine in Poland on the occasion of the 100th anniversary of Polish Archives of Internal Medicine.
Dynamic development of medicine in the 20th and 21st centuries has only been possible due to its split into narrow specialties. The increasingly complicated and costly technologies used in clinical practice can only be mastered by small groups of highly‑ qualified specialists; however, diagnosis and treatment are not about matching a patient with the latest and most sophisticated technologies but about finding an optimal patient‑ oriented solution, as it is the human being as a whole that needs help. To achieve this goal, a close collaboration of different specialists is required, but the key role rests with a physician with good general internal medicine skills and the right motivation to act. ⋯ The task is further complicated by chronic underfunding of these wards. The aim of the present review is to reflect on the current state and prospects of Polish internal medicine as well as to attempt a definition of an internist and their role in the integration of different medical specialties. It also stresses the importance of a master in the teaching and practice of medicine and presents profiles of 4 eminent Polish internists.
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Post‑viral syndrome is a well‑known medical condition characterized by different levels of physical, cognitive, and emotional impairment that may persist with fluctuating severity after recovering from an acute viral infection. Unsurprisingly, COVID‑19 may also be accompanied by medium- and long‑term clinical sequelae after recovering from a SARS‑CoV‑2 infection. Although many clinical definitions have been provided, "long‑COVID" can be defined as a condition occurring in patients with a history of SARS‑CoV‑2 infection, developing 3 months from the symptoms onset, persisting for at least 2 months, and not explained by alternative diagnoses. ⋯ Long‑COVID primarily encompasses the presence of at least 1 symptom, such as fatigue, dyspnea, cognitive impairment / brain fog, postexertional malaise, memory issues, musculoskeletal pain / spasms, cough, sleep disturbances, tachycardia / palpitations, altered smell / taste perception, headache, chest pain, and depression. The most important demographic and clinical predictors to date are female sex, older age, cigarette smoking, pre‑existing medical conditions, lack of COVID‑19 vaccination, infection with pre‑Omicron SARS‑CoV‑2 variants, number of acute phase symptoms, viral load, severe / critical COVID‑19 illness, as well as invasive mechanical ventilation. Concerning the care for long‑COVID patients, the greatest challenge is the fact that this syndrome cannot be considered a single clinical entity, and thus it needs an integrated multidisciplinary management, specifically tailored to the type and severity of symptoms.
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Pol. Arch. Med. Wewn. · Apr 2023
Helping without harm: providing emotional support to health care workers in 2023.
Reflecting on the efforts to provide acute emotional support to health care workers (HCWs) before and after the COVID‑ 19 pandemic, 3 guiding principles are proposed for health care organizations, with the aim to support their workers by an efficient combination of disciplines and resources: 1) normalize the use of support resources for HCWs; 2) assess actual needs rather than act on assumptions; 3) reduce barriers for HCWs to get the support they need. Each of these principles is described in terms of their usefulness and potential for further developments that might provide better emotional support for HCW in the future.
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Pol. Arch. Med. Wewn. · Apr 2023
A journal as a mirror of continued progress in internal medicine. A century of Polish Archives of Internal Medicine.
Internal medicine emerged as a new medical specialty in the second half of the 19th century. It was based on a novel diagnostic and therapeutic paradigm, and included pathophysiologic interpretation of physical examination, laboratory tests, and imaging techniques, in contrast with previous descriptive approach to clinical problems. Professor Edward J. ⋯ Most of them had roots in the specialist sections of the Polish Society of Internal Medicine. The journal supported the newly founded societies by publication of issues focused on selected subspecialties. Despite the development of subspecialties, the role of internal medicine as a holistic discipline covering the diagnosis and therapy of many organs does not decrease.