Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Nov 2019
ReviewThe interplay between muscle mass decline, obesity, and type 2 diabetes.
The world's population is progressively becoming older, and age‑related conditions are a major public health concern. A worrying phenomenon worldwide is the increasing obesity among aging societies, which occurs in parallel with a higher prevalence of sarcopenia in older populations. As a result of the combination of these 2 states, new medical conditions, such as sarcopenic obesity, have recently become a public health concern. ⋯ The mechanisms underlying sarcopenic obesity are multifactorial. There is an interplay between low‑grade inflammation, insulin resistance, hormonal changes, a sedentary lifestyle, eating habits, and aging. The aim of this review is to summarize the available data regarding the definition, epidemiology, and pathways that lead to sarcopenic obesity, as well as treatment strategies.
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Pol. Arch. Med. Wewn. · Oct 2019
ReviewUse of bedside ultrasound to assess fluid status: a literature review.
The assessment of a patient's body fluid status is a challenging task for modern clinicians. Ultrasonography has numerous advantages, the most important being reproducibility and bedside monitoring of the patient. The examination is quick and has a significant diagnostic value. ⋯ Ultrasound enables physicians to determine the baseline status of hydration and to monitor the patient during fluid therapy. Additionally, it allows an assessment of asymptomatic patients, patients who are well adapted to chronic oxygen deficiency, and those who develop pulmonary congestion secondary to congestive heart failure or chronic kidney disease. The development of a protocol for an ultrasound assessment of the volume status would significantly facilitate the everyday practice of internal medicine specialists.
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Pol. Arch. Med. Wewn. · Oct 2019
ReviewSmoking and cardiovascular diseases: paradox greater than expected?
Cardiovascular diseases, including acute coronary syndromes, are a major cause of death among tobacco smokers. Epidemiological studies have demonstrated that long‑term prognosis is worse in smokers with acute coronary syndromes than in nonsmokers. However, some studies have suggested that clopidogrel‑treated active smokers have better in‑hospital and short‑term follow‑up outcomes, a phenomenon regarded as the smoker's paradox. ⋯ More potent P2Y12 inhibitors may be considered in selected patients who stopped smoking after percutaneous coronary intervention. Further studies are required to determine the optimal antiplatelet strategy for stented patients who effectively quit smoking during clopidogrel treatment. The aim of this review is to discuss the risk of smoking and the potential elevated thrombotic risk related to smoking cessation.