Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Jul 2009
Randomized Controlled TrialThe efficacy and safety of glucose control algorithms in intensive care: a pilot study of the Survival Using Glucose Algorithm Regulation (SUGAR) trial.
The benefits, harms and feasibility of intensive insulin therapy in critically ill patients remain unclear. Several single center studies have attempted to demonstrate the benefit of intensive insulin therapy in critically ill patients with variable results. ⋯ This pilot trial of intensive insulin therapy identified numerous challenges that helped in the preparation of an international multicenter randomized trial of intensive insulin therapy to evaluate benefits and harms.
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Pol. Arch. Med. Wewn. · Jun 2009
Review Meta AnalysisNoninvasive positive pressure ventilation: effect on mortality in acute cardiogenic pulmonary edema: a pragmatic meta-analysis.
In contrast to a series of recent meta-analyses (MAs), the 3CPO (Three Interventions in Cardiogenic Pulmonary Oedema) randomized controlled trial (RCT) reported in 2008 did not find a significant mortality benefit of noninvasive positive pressure ventilation (NPPV) in acute cardiogenic pulmonary edema (ACPE). ⋯ An analysis of the existing RCT data, inclusive of the 3CPO trial, predicts a continued and significant mortality benefit of NPPV in ACPE.
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Pol. Arch. Med. Wewn. · Apr 2009
Case ReportsDyspnea as a dominant clinical manifestation in a patient with takotsubo cardiomyopathy treated for chronic obstructive pulmonary disease and hyperthyroidism.
This paper discusses the case of a female patient treated for chronic obstructive pulmonary disease and hyperthyroidism, who also had takotsubo cardiomyopathy with dyspnea at rest as a dominant clinical manifestation.
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Pol. Arch. Med. Wewn. · Mar 2009
ReviewFibromyalgia: pathogenetic, diagnostic and therapeutic concerns.
Musculoskeletal pains are one of the most common complaints reported by patients. In 1972, Smythe described the generalized pain and tenderness on palpation at specific points and, 4 years later, the term fibromyalgia was introduced for determining the disease syndrome. The etiology and pathogenesis of fibromyalgia are still unknown. ⋯ The effectiveness of locally used agents is also being emphasized. Fibromyalgia has become a serious social problem in the well developed countries in the recent years. Therefore, of importance are efforts to appropriately diagnose fibromyalgia and to implement its appropriate treatment that resolves disease symptoms in a possibly maximum degree.
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Pol. Arch. Med. Wewn. · Jan 2009
Review Practice Guideline[Polish guidelines for the prevention and treatment of venous thromboembolism: 2009 update].
The overall objective of the Polish guidelines for the prevention and treatment of venous thromboembolism is to increase patient benefit and safety by appropriate prevention and treatment of deep vein thrombosis and pulmonary embolism as well as proper management of the complications associated with antithrombotic and thrombolytic therapy. These guidelines apply to adult trauma, cancer, surgical, and medical patients as well as those at increased risk of venous thromboembolism. Specific recommendations have been formulated for pregnant women, patients requiring surgery while receiving long-term oral anticoagulant treatment, and patients undergoing regional anesthesia and/or analgesia. ⋯ For each recommendation we explicitly assessed its relevance and applicability in the context of health care system in Poland. We adapted recommendations when necessary, explicitly stating the rationale for modification and judgements about the values and preferences we assumed. We developed original recommendations on the use of new oral anticoagulants that have recently become available, following the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.