Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Jan 2020
CommentEmphysema affects the number and characteristics of solitary pulmonary nodules identified by chest low-dose computed tomography. A study on screenees with high-risk lung cancer recruited in Upper Silesia.
Chest low-dose computed tomography (LDCT) has recently been proved effective in lung cancer screening. ⋯ Emphysema was more frequently associated with multiple SPNs of different morphology among elderly patients with a higher number of smoking pack‑years.
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Pol. Arch. Med. Wewn. · Jan 2020
ReviewBleeding in anticoagulated patients with atrial fibrillation: practical considerations.
Major bleeding (especially intracranial hemorrhage) is the most feared adverse event observed in patients with atrial fibrillation (AF) receiving oral anticoagulation. Clinical risk factor-based scores have modest ability to predict major or clinically relevant bleeds, and blood biomarkers are increasingly implemented to improve bleeding prognostication in patients with AF on life‑long anticoagulation. To improve the safety of anticoagulation in the era of non-vitamin K antagonist oral anticoagulants (NOACs, or direct oral anticoagulants [DOACs], including dabigatran, rivaroxaban, apixaban, and edoxaban), specific demographic, clinical, and laboratory variables should be considered. The current review summarizes practical challenges in the management of oral anticoagulation with emphasis on the risk assessment tools, elderly or underweight patients, cancer patients, impact of chronic kidney disease, liver cirrhosis, and thrombocytopenia in the context of bleeding risk in patients with AF.
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Pol. Arch. Med. Wewn. · Jan 2020
Primary nonadherence to medication and its drivers in Poland: findings from the electronic prescription pilot analysis.
Primary nonadherence to medication occurs when a patient does not fill a prescription and often leads to suboptimal patient outcomes, lost productivity, and increased net costs. Pilot introduction of electronic prescriptions (e‑prescriptions) in Poland took place in 2018, enabling nationwide assessment of primary nonadherence. ⋯ A high percentage of prescriptions issued in Poland are never filled. E‑prescriptions allow the identification and analysis of drivers of this phenomenon. Our findings may help designing national health and medicine policies.