Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · May 2023
ReviewHow to predict recurrent venous thromboembolism and bleeding? A review of recent advances and their implications.
After the first venous thromboembolism (VTE), anticoagulant treatment duration should be based on the balance between the risk of recurrence and bleeding. However, this decision is challenging on the individual level. Prediction models that accurately estimate these risks may help selecting patients that would benefit from either short or indefinite anticoagulant treatment. ⋯ Notably, these models are rarely used in clinical practice and none of them is incorporated in current guidelines due to insufficient accuracy or insufficient validation. Moreover, evidence supporting the value of implementing these models is still lacking. Before these models can be used in routine care, further refinement may be required, and their added value and feasibility should be proven in both management and implementation studies.
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Pol. Arch. Med. Wewn. · May 2023
Potential benefits of one-time gastroscopy in searching for precancerous conditions.
Precancerous conditions for esophageal (EA) and gastric adenocarcinoma (GA) are Barrett's esophagus (BE) and atrophic gastritis (AG), respectively. Their surveillance is crucial for the detection of early lesions. ⋯ One‑time EGD in search for precancerous conditions could be potentially applicable in individuals between 40 and 69 years of age.
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Pol. Arch. Med. Wewn. · May 2023
Indirect insulin resistance markers are associated with non-alcoholic fatty liver disease in type 1 diabetes.
Insulin resistance (IR) in type 1 diabetes mellitus (T1DM) is associated with increased insulin dose requirements, poor glycemic control, and elevated risk of chronic complications. IR increases lipid synthesis and hepatic lipid content. Disruption in hepatic lipid accumulation and export leads to liver steatosis resulting in nonalcoholic liver disease (NAFLD). ⋯ In T1DM, NAFLD is more likely to be found in individuals with lower insulin sensitivity.