Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Mar 2022
Secondary prevention of coronary heart disease in Poland: does gender matter? Results from POLASPIRE survey.
Adherence to health‑promoting behaviors intended to mitigate modifiable risk factors plays an important role in secondary cardiovascular prevention. ⋯ The prevalence of cardiovascular risk factors in patients with CHD is high, especially in women. Therapeutic goals are met infrequently in both sexes. This situation calls for widening the access to educational programs and paying greater attention to their proper implementation.
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Pol. Arch. Med. Wewn. · Mar 2022
Hashimoto thyroiditis: an evidence-based guide: etiology, diagnosis and treatment.
Hashimoto thyroiditis (HT) is a common autoimmune disorder, affecting women 7-10 times more often than men, that develops because of genetic susceptibility, Xchromosome inactivation patterns modulated by environmental factors as well as microbiome composition, and leads to an imbalance in self‑tolerance mechanisms. The consequential thyroid infiltration by lymphocytes, potentiated by antibody‑mediated autoimmune response through the antibodies against thyroid peroxidase (TPOAbs), leads to a destruction of thyrocytes. The presence of TPOAbs is associated with a 2 to 4‑fold increase in the risk of recurrent miscarriages and preterm birth in pregnant women. ⋯ The dose of levothyroxine (LT4) used for treatment is based on the degree of preserved thyroid functionality and lean body mass, and usually ranges from 1.4 to 1.8 mcg/kg/day. There is insufficient evidence to recommend for or against therapy with triiodothyronine (T3), apart from in pregnancy when only levothyroxine is indicated, as T3 does not sufficiently cross fetal blood‑brain barrier. HT is associated with 1.6 times higher risk of papillary thyroid cancer and 60 times higher risk of thyroid lymphoma than in general the population.
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Pol. Arch. Med. Wewn. · Mar 2022
Management of SARS-CoV-2 infection: recommendations of the Polish Association of Epidemiologists and Infectiologists as of February 23, 2022.
The first Polish recommendations regarding the management of patients with COVID-19 were published by the Polish Society of Epidemiologists and Infectiologists (PTEiLChZ) on March 31, 2020, and the last annex was dated November 12, 2021. The ongoing state of pandemic, the emergence of new variants of the virus, and the availability of new drugs necessitate their updating. ⋯ Anakinra, an antagonist of interleukin 1 receptors, has been added as a treatment option in advanced stages of the disease, and the recommended daily dose of glucocorticosteroids used in the most severe forms of COVID-19 has been increased. Information on vaccination and pre-exposure prophylaxis in specific populations has also been updated.
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Pol. Arch. Med. Wewn. · Mar 2022
Exploring the relationship between trans fatty acids and body fat distribution.
The importance of fat distribution is well established. Nevertheless, the mechanism by which fat is distributed throughout the trunk and limbs remains unclear. ⋯ Our study demonstrated that increased TFA concentration was associated with fat deposition predominantly in the trunk rather than in the limbs. Further research is needed to investigate the role of TFA in different body fat distributions.
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Pol. Arch. Med. Wewn. · Mar 2022
The Th17/Treg imbalance in patients with primary hyperaldosteronism and resistant hypertension.
Inflammation plays a pivotal role in blood pressure regulation. Data on experimental models of hypertension and hypertensive patients reflect the imbalance between T regulatory (Treg) and Th17 effector cells (Th17). ⋯ Elevated 24 h SBP in PHA was associated with the increased numbers of CD4+IL‑17 and CD4+CD25+FOXP3+ T cells.