Polskie Archiwum Medycyny Wewnętrznej
-
Pol. Arch. Med. Wewn. · Nov 2020
ReviewNonalcoholic fatty liver disease and the risk of metabolic comorbidities: how to manage in clinical practice.
Nonalcoholic fatty liver disease (NAFLD) is a clinical condition that encompasses various forms of liver damage not caused by chronic alcohol consumption. In the absence of other etiologies, it ranges from steatosis to nonalcoholic steatohepatitis and cirrhosis. The prevalence of NAFLD has considerably increased over the last years owing to the current lifestyle (unhealthy diet and sedentarism). ⋯ Nowadays, we are in a race to find the first drug able to stop the incidence of NAFLD and reverse the disease in patients at more advanced stages. Meanwhile, the management of the NAFLD metabolic overload, including weight loss, cardiovascular protection, insulin sensitization, and lipid reduction, is the only strategy to improve hepatic and extrahepatic outcomes. In this review, we aimed to describe the management of the main metabolic disorders related to NAFLD, such as type 2 diabetes, arterial hypertension, and dyslipidemia.
-
Pol. Arch. Med. Wewn. · Nov 2020
Meta AnalysisAssessment of the risk of incident heart failure in osteoporosis patients: a systematic review and meta-analysis of eligible cohort studies.
A relation between cardiovascular diseases and bone health is increasingly reported. However, the association between osteoporosis and incident heart failure (HF) has not been yet determined. ⋯ Osteoporosis was associated with a modest but significantly increased risk of incident HF. Considering the limited number and quality of available studies, future high‑quality data are required to further demonstrate the association between osteoporosis and incident HF.
-
Pol. Arch. Med. Wewn. · Nov 2020
Simple clinical scores to predict blood pressure and renal function response to renal artery stenting for atherosclerotic renal artery stenosis.
There are no systematic tools to predict blood pressure (BP) or renal function (RF) improvement after stent‑assisted percutaneous transluminal angioplasty (PTA) for atherosclerotic renal artery stenosis (ARAS). ⋯ Models of favorable BP and RF response may improve patient selection for ARAS‑PTA. Further insights are expected from prospective validation.
-
Pol. Arch. Med. Wewn. · Nov 2020
Isolated subsegmental pulmonary embolism (ISSPE): current therapeutic challenges.
The advent of computed tomography pulmonary angiography allowed better visualization of peripheral vessels, thereby increasing rates of subsegmental pulmonary embolism (SSPE), but there are minimal changes in mortality. The true clinical significance of SSPE and isolated SSPE (ISSPE) remains unclear. ⋯ It is possible that ISSPE could represent a subset of a more benign disease and be not clinically relevant among patients with PE. There is a therapeutic dilemma in patients with small PE: should anticoagulation be used or not in all cases? As there are limited data to guide the appropriate management of ISSPE, this short review addresses the controversy over the therapeutic challenges in SSPE and ISSPE.