Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Aug 2019
Assessment of patients with coronary artery disease who may benefit from the use of rivaroxaban in the real world: implementation of the COMPASS trial criteria in the TERCET registry population.
The positive outcomes of the COMPASS trial raise questions about the proportion of patients who could benefit from additional therapy with rivaroxaban in real‑world practice. ⋯ Less than one-third of the TERCET‑CAD population met the COMPASS criteria and could potentially benefit from low‑dose rivaroxaban therapy. Unfavorable clinical profiles and higher rates of adverse events in the TERCET registry compared with those in the COMPASS trial may predict greater benefits from the implementation of low‑dose rivaroxaban in the real‑world population.
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Pol. Arch. Med. Wewn. · Aug 2019
Estimation of 24-hour urinary sodium, potassium, and creatinine excretion in patients with hypertension: can spot urine measurements replace 24-hour urine collection?
Owing to inconvenience of a 24‑hour urine collection, diagnostic methods based on spot urine samples are becoming increasingly popular. Spot urine sodium measurements could replace 24‑hour urinary sodium (24hUNa) excretion, considered a surrogate measure of dietary sodium intake. Spot urine-based approaches to estimating 24hUNa and 24‑hour urinary potassium (24hUK) excretion are potentially useful in patients with hypertension, for example, to identify increased urinary potassium excretion in individuals with primary aldosteronism and high dietary sodium intake in those with resistant hypertension. ⋯ We also confirmed the general utility of the equations for estimating 24hUCr excretion in hypertensive individuals but with significant differences between various equations, the best formulas being Chronic Kidney Disease Epidemiology Collaboration (CKDEPI) and Rule. Compared with the combined PAHO/CKD‑EPI formula, the Tanaka and Kawasaki equations underestimated increased 24hUNa and 24hUK excretion. Thus, the combined PAHO/CKD‑EPI formula might be the best for identifying increased 24hUNa and 24hUK excretion in patients with hypertension.
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Pol. Arch. Med. Wewn. · Aug 2019
Gastroesophageal reflux disease and Barrett esophagus: an overview of evidence-based guidelines.
Gastroesophageal reflux disease is an extremely common condition worldwide, with the published prevalence rates varying from 2.5% in China to 51.2% in Greece. Its economic and morbidity burden is vast, and optimizing care for this condition carries huge financial and patient‑related benefits. The disease can be complicated by progression to Barrett esophagus (BE), a precancerous condition that affects approximately 2% of the population and remains undiagnosed in many individuals. ⋯ Areas for future development involve risk‑stratifying patients to surveillance, chemoprevention agents, and genetic biomarkers to help decide who will be at highest risk of malignant progression. Evidence supports the safety of proton pump inhibitors for symptom control in the medium term (ie, 9 years) and reducing the risk of progression of BE, while surgical options are cost‑effective treatments for certain patients. Barrett esophagus surveillance should be directed towards high‑risk groups, while those at lower risk may benefit from chemoprevention strategies.
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Pol. Arch. Med. Wewn. · Aug 2019
Changes in total and acylated ghrelin levels during mitotane treatment in patients with adrenocortical carcinoma.
Adrenocortical carcinoma (ACC) is a highly aggressive cancer with poor prognosis. Mitotane is the only approved drug for ACC treatment. Tolerability and efficacy of mitotane is variable. There is evidence that ghrelin may affect cancer development and the occurrence of side effects. ⋯ Plasma ghrelin levels are changed during mitotane treatment. These changes may be connected with side effects of mitotane.
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Pol. Arch. Med. Wewn. · Aug 2019
Efficacy of family history, genetic risk score, and physical activity in assessing the prevalence of type 2 diabetes.
Environmental and genetic factors play an important role in the development of type 2 diabetes (T2D). One of the most important lifestyle factors is a low level of physical activity (PA), but no studies have explicitly compared the amount of variation in diabetes prevalence explained by variation in PA compared with the amount explained by genetic variation. ⋯ We confirmed that PA is significantly associated with glucose homeostasis parameters and T2D prevalence, and that this association may be stronger in individuals who are more genetically predisposed to diabetes.