Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Oct 2020
ReviewOral anticoagulation in patients with active cancer and atrial fibrillation: current challenges.
Atrial fibrillation and cancer are common comorbidities. Given an increased risk of arterial thrombosis caused by the former and an increased risk of bleeding in patients with the latter, the management of anticoagulation in patients in whom they coexist is complex. ⋯ For each of these 9 challenges, the evidence available is presented, the author's personal practical advice is given and the most pressing need to move the field forward is stated. I conclude by emphasizing the need for high‑quality evidence and, more practically, by stressing 1) the importance of patient preference and values in the decision on whether and how to anticoagulate, and 2) the need for periodic reassessment of the benefits of anticoagulation with changes in cancer status and treatment plan.
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Pol. Arch. Med. Wewn. · Oct 2020
Age-related differences in vitamin D status in Polish centenarians compared with 65-year-olds.
Vitamin D status is known to change with age. However, little is known about vitamin D status in centenarians. ⋯ Considering lower 25(OH)D, 1,25(OH)D, and calcium concentrations in the majority of centenarians, as well as the negative correlation between vitamin D active metabolites and PTH, vitamin D and calcium should be systematically supplemented in the oldest of the elderly.
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Pol. Arch. Med. Wewn. · Oct 2020
Factors determining elective cardioversion preceded with transesophageal echocardiography: two cardiology centres' experiences.
Although guidelines endorse cardioversion after adequate non-vitamin K antagonist oral anticoagulant (NOAC) treatment without prior transesophageal echocardiography (TEE), the majority of patients still undergo this examination. ⋯ Transesophageal echocardiography before cardioversion was more frequently performed in patients with a history of CAD, bleeding, or thromboembolic events. Patients with paroxysmal AF and hypertension more often received cardioversion without prior TEE.