Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Mar 2022
ReviewMedical referral criteria for palliative care in adults: a scoping review.
Palliative care (PC) is focused on the relief of serious suffering due to severe illness. The Polish health care reimbursement system limits the access to PC to a so-called "basket" of recipients with life‑limiting incurable diseases (mainly cancer), not responding to disease‑modifying therapy. This scoping literature review was aimed to define the criteria of medical referral for PC in the context of the interpretation of the terms life‑limiting illness and disease‑modifying therapy, which may aid in increasing the number of appropriate referrals and patients receiving optimal treatment. ⋯ Equally important as limited survival prognosis is the presence of severe, complex, and persistent symptoms or problems occurring despite optimal treatment and general care. Based on the reviewed literature, the national reimbursement program should be urgently extended to cover more patients who are eligible and could benefit from specialist PC. Additionally, the importance of general PC should be universally acknowledged.
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Pol. Arch. Med. Wewn. · Mar 2022
Airway remodeling assessed by quantitative computed tomography at various stages of asthma severity defined according to Global Initiative for Asthma report: a single-center study.
In asthma, airway remodeling is defined as structural changes of the airways. The association between remodeling and asthma severity is still unclear, and there are limited data on the intensity of airway remodeling in various stages of the disease as defined in the Global Initiative for Asthma (GINA) asthma severity classification. Computed tomography (CT) and postprocessing applications are effective tools to assess the intensity of airway remodeling. ⋯ Our findings indicated similar values of CT morphological measures of airway remodeling in all asthma severity groups as defined by the GINA guidelines.