Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Jun 2023
ReviewDecoding the role of fatty acids and their metabolites in lung fibrosis.
Idiopathic pulmonary fibrosis (IPF) is a progressive and life‑threatening interstitial lung disease of familial or sporadic onset. The incidence and prevalence of IPF range from 0.09 to 1.3 and from 0.33 to 4.51 per 10 000 people, respectively. IPF has a poor prognosis, and death usually occurs within 2 to 5 years following the diagnosis due to secondary respiratory failure. ⋯ In addition, they have been associated with the development of a profibrotic phenotype of epithelial cells, macrophages, and fibroblasts / myofibroblasts contributing to their (trans)differentiation and production of the disease‑relevant mediators. Furthermore, strategies focusing on the correction of FA profiles in experimental models of lung fibrosis brought advances in understanding tissue scarring processes and contributed to the transition of new molecules into clinical development. This review highlights the role of FAs and their metabolites in IPF and provides evidence for therapeutic potential of lipidome manipulations in the treatment of this disease.
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Pol. Arch. Med. Wewn. · Jun 2023
Comparison of the population of Polish patients participating in the TRANSITION study with the international population: a post-hoc analysis.
Heart failure (HF) patients discharged from a hospital are at a high risk of death and rehospitalization. Scarce data are available on the use of sacubitril / valsartan in this population in Poland. ⋯ Sacubitril / valsartan can be used safely in the early period after an episode of acute HF both in the Polish and non‑Polish patients with HFrEF, and the likelihood to achieve the maximum dose is the same despite significant differences between the studied populations.
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Pol. Arch. Med. Wewn. · Jun 2023
Targeted sequencing of a gene panel in patients with Familial Hypercholesterolemia from Southern Poland.
Familial hypercholesterolemia (FH) is an autosomal dominant monogenic lipid metabolism disorder characterized by a significantly elevated level of low‑density lipoprotein (LDL) cholesterol and leading to premature ischemic heart disease. FH is caused by mutations in the LDLR, APOB, and PCSK9 genes; however, these mutations account for only about 40% of FH cases. In order to obtain a genetic diagnosis of FH, sequencing of other genes involved in the lipid metabolism might be useful. ⋯ NGS is a useful and reliable method to detect new variants in genes related to FH. In addition, the results enable the detection of FH phenocopies and introduction of appropriate treatment.
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Pol. Arch. Med. Wewn. · Jun 2023
Role of metformin in the management of type 2 diabetes: recent advances.
Metformin is one of the oldest antidiabetic medications, commonly used in the management of type 2 diabetes. Its mechanism of action is based on reducing glucose production in the liver, decreasing insulin resistance, and increasing insulin sensitivity. The drug has been studied extensively and has been shown to be effective in lowering blood glucose levels without increasing the risk of hypoglycemia. ⋯ According to current guidelines, metformin can be used as the first‑line agent in the management of diabetes; however, in individuals with type 2 diabetes who would benefit from cardio‑renal protection, newer agents, such as sodium‑glucose cotransporter‑2 inhibitors and glucagon‑like peptide‑1 receptor agonists, are favored as the first‑line therapy. The novel classes of antidiabetic medications have demonstrated significant positive effects on glycemia with added benefits in patients with obesity, renal disease, heart failure, and cardiovascular disease. The emergence of these more effective agents has significantly altered the way diabetes is managed, thus prompting re‑evaluation of metformin as the initial therapy for all patients with diabetes.