Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Nov 2024
The prevalence of hyperlipoproteinemia(a) in outpatient cardiology clinic patients of European ancestry: results from a STAR-Lp(a) cross-sectional study.
Elevated levels of lipoprotein(a) [Lp(a)] are independently associated with an increased risk of cardiovascular disease (CVD). ⋯ The observed prevalence of increased Lp(a) concentration among patients of European ancestry treated at outpatient cardiology clinics was 21.5%. Female sex, hypertension, atrial fibrillation, migraine, and concentrations of LDL‑C and HbA1c were independently related to the level of Lp(a) in this population.
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Pol. Arch. Med. Wewn. · Nov 2024
Meta AnalysisNeuropsychiatric adverse events in tenofovir disoproxil fumarate- and tenofovir alafenamide-based HIV therapy and prophylaxis: a systematic review and meta-analysis.
Tenofovir is integral to antiretroviral therapy (ART) and pre‑exposure prophylaxis (PrEP) for HIV; however, neuropsychiatric adverse events (NPAEs) associated with its use have not been systematically investigated. ⋯ Common occurrence of NPAEs in tenofovir‑based HIV multidrug regimens highlights the need to screen HIV patients for neuropsychiatric complications. The lack of effect of tenofovir, as compared with placebo, for most analyzable NPAEs suggests its favorable safety profile. However, a possible increase in the dizziness risk on tenofovir, and a potentially elevated risk of headache on tenofovir alafenamide- as compared with tenofovir disoproxil fumarate-based regimens in HIV therapy merit further investigation.
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Pol. Arch. Med. Wewn. · Nov 2024
ReviewHow to treat patients with thrombotic antiphospholipid syndrome in 2024?
Antiphospholipid syndrome (APS) encompasses a range of clinical conditions, particularly thrombotic or obstetrical manifestations, associated with the presence of antiphospholipid antibodies. Managing thrombotic APS in daily clinical practice can be challenging and requires thorough risk stratification and tailored treatment strategies. Primary prophylaxis focuses on correcting the traditional thrombotic risk factors and, in certain situations, may include low‑dose aspirin and / or prophylactic anticoagulants (eg, low‑molecular‑weight heparin). ⋯ In some cases, a combination of VKAs and low‑dose aspirin, increased doses of VKAs with an international normalized ratio target greater than 3, or a switch to therapeutic doses of low‑molecular‑weight heparin might be employed. The use of hydroxychloroquine is essential in patients with secondary systemic lupus erythematosus and may be considered in individuals with recurrent thrombosis. In other selected situations, the use of immunomodulatory agents can be considered.