Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Jul 2010
ReviewEuropean Society of Cardiology 2009 guidelines for preoperative cardiac risk assessment and perioperative cardiac management in noncardiac surgery: key messages for clinical practice.
Patients undergoing noncardiac surgery are at risk of adverse perioperative and long-term outcome. When considering a patient for noncardiac surgery, a careful preoperative clinical risk evaluation and subsequent risk-reduction strategies are essential to reduce postoperative complications. To assist physicians with decision making, clinical guidelines are developed. ⋯ By translating the best available scientific evidence into specific recommendations, guidelines can serve as a useful tool to achieve effective and efficient patient care. In 2009, the first European Society of Cardiology guidelines on perioperative care were developed. This decisionmaking process integrates clinical markers, early coronary evaluation, functional capacity, and the type of surgery involved.
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Pol. Arch. Med. Wewn. · Jun 2010
Clinical presentation, treatment, and long-term outcomes in patients with takotsubo cardiomyopathy. Experience of a single cardiology center.
Takotsubo cardiomyopathy (TTC) is a rare transient cardiomyopathy mimicking acute coronary syndrome (ACS). ⋯ TTC is observed mainly in postmenopausal women. Clinical presentation of TTC is almost indistinguishable from ACS, but its course is milder and the outcomes are better.
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Pol. Arch. Med. Wewn. · May 2010
Management of dyspnea in patients with advanced lung or heart disease: practical guidance from the American college of chest physicians consensus statement.
Patients with advanced lung or heart disease are not generally being treated consistently and effectively for relief of dyspnea. ⋯ There was consensus that: patients with advanced lung or heart disease should be asked about the intensity and distress of their breathlessness; pursed-lips breathing, relaxation, oxygen for those with hypoxemia, noninvasive positive pressure ventilation, and oral/parental opioids can provide relief of dyspnea; therapies should be started with the understanding that the patient and clinician will reassess whether the specific treatments are relieving dyspnea without causing adverse effects; and it is important to communicate about palliative and end-of-life care.
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Pol. Arch. Med. Wewn. · Jan 2010
Randomized Controlled TrialThe influence of simvastatin on selected inflammatory markers in patients with chronic obstructive pulmonary disease.
There is growing evidence that chronic obstructive pulmonary disease (COPD) is a risk factor for coronary heart disease. Simvastatin is a hypolipemic drug with proven efficacy in the prevention of cardiovascular diseases. Observational studies showed that statins may be useful in the reduction of mortality from COPD. Experimental studies on animals showed anti-inflammatory effects of statins on the lung tissue. ⋯ In COPD patients, a 3-month treatment with simvastatin does not reduce circulating inflammatory markers.