Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Jan 2022
Performance of plastic stents used for benign and malignant biliary strictures; experience of single high-volume endoscopy unit.
Endoscopic plastic biliary stenting has been used for more than 30 years as a temporary or definitive treatment of benign and malignant neoplasms. These stents are commonly available, inexpensive, and easy to implant. ⋯ The patency of plastic stents depends on the underlying disease. In patients with benign biliary disease, stent replacement is recommended after about 3.5 months. In patients with cancer, the timing of stent replacement should be guided by survival prognosis and location of stricture.
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Pol. Arch. Med. Wewn. · Jan 2022
The health risks of dual use of electronic and combustible cigarettes: exposure to acrylamide and glycidamide.
A combustible cigarette is a significant source of acrylamide, which is associated with numerous adverse effects. Electronic cigarette (e‑cigarette) is an emerging smoking device with uncertain health effects. OBJECTIVES The aim of the study was to explore the exposure risks of acrylamide (AA) by measuring biomarkers, hemoglobinadducts of AA (HbAA) and of glycidamide (HbGA), in serum samples of the general adult population with regard to different smoking status (smoking vs nonsmoking). ⋯ E‑cigarette users are exposed to AA, and users of both combustible and e‑cigarettes have highest measures of HbAA and HbGA. Aside from the adverse effects caused by e‑cigarette smoking, coexposure risks of combustible cigarettes and e‑cigarettes need to be communicated to the public. Further studies are warranted to aid in health promotion.
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Pol. Arch. Med. Wewn. · Jan 2022
Endosonographic predictors of malignancy in a left adrenal gland in lung cancer patients - a comparison of EUS-b, CT and PET-CT.
Patients with resectable lung cancer require invasive evaluation of the enlarged left adrenal gland (LAG). Few studies showed the utility of endoscopic ultrasound using ultrasound bronchoscope (EUS‑B) in LAG assessment. Moreover, little is known on the combination of computed tomography (CT), positron emission tomography-computed tomography (PET‑CT), and EUS‑B for predicting left adrenal metastasis. ⋯ Hypoechogenicity and loss of sea‑gull shape on EUS‑B are the most reliable predictors of left adrenal metastasis. The combination of CT, PET‑CT, and EUS‑B improves the noninvasive diagnosis of left adrenal metastases in lung cancer patients.
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Pol. Arch. Med. Wewn. · Jan 2022
Rapid pharmacological cardioversion of recent-onset atrial fibrillation using antazoline in elderly patients.
There is insufficient evidence on the efficacy and safety of pharmacological cardioversion of recent‑onset atrial fibrillation (AF) in elderly patients. Antazoline has been shown to be effective and safe in various patient populations. ⋯ Intravenous antazoline seems to be effective and safe for pharmacological cardioversion of recent‑onset AF in elderly patients in the emergency setting.
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While bronchiectasis is an old condition, it is only in the last decade that there have been major strides in our understanding of this disease and its treatment. Recent evidence has shown that the "vicious cycle" hypothesis remains valid. This, and the concept of "treatable traits," provide useful frameworks on which to base the management of this condition. ⋯ While airway clearance strategies remain the mainstay of therapy, other treatments including nebulized hypertonic saline and inhaled antibiotic treatment are discussed. Greater emphasis is being placed on immune‑modulatory therapies, not just long‑term macrolide therapy but other more innovative strategies. The role of surgical lung resection in the management of this condition is also discussed.