Articles: treatment.
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Pol. Arch. Med. Wewn. · Sep 2024
Heterogeneous and overlapping mechanisms of ischemia and non-obstructive coronary arteries: in-hospital results of the MOSAIC-COR registry.
Ischemia and nonobstructive coronary arteries (INOCA) remains a significant clinical issue. Recent guidelines underscore the importance of comprehensive coronary physiology assessment to make specific diagnoses and implement tailored treatment strategies. ⋯ The patients diagnosed with INOCA in the MOSAIC‑COR registry exhibit significant symptomatology and a high prevalence of typical cardiovascular risk factors. Myocardial ischemia in this population may be generated by various pathomechanisms that may overlap.
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Pol. Arch. Med. Wewn. · Sep 2024
Short- and long-term outcomes of mechanical thrombectomy in acute ischemic stroke patients with chronic kidney disease.
Chronic kidney disease (CKD) is a risk factor of acute ischemic stroke (AIS). Outcomes of treatment with mechanical thrombectomy (MT) in patients with CKD seem to be poorer than in the general population. Long‑term follow‑up studies are lacking. ⋯ MT outcomes in CKD patients are worse, especially in advanced stages of the disease, but CKD is not independently associated with poor prognosis. CKD alone should not be a contraindication for MT in otherwise eligible patients, although patients with impaired kidney function require more careful postprocedural monitoring.
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Pol. Arch. Med. Wewn. · Sep 2024
ReviewKidneys and commonly used medications: how to reduce risk of acute kidney injury in everyday practice?
Medications are a common cause of acute kidney injury (AKI). There are various mechanisms in which medications can induce AKI, and better understanding of their pathophysiology can aid in clinical recognition, treatment, and prevention of this condition. Hemodynamic‑mediated AKI is often associated with drugs that alter renal perfusion and its autoregulation. ⋯ Recognizing common medications associated with AKI is an important first step in reducing the risk of this condition. For each medication, understanding general and specific risk factors for AKI allows for early identification and timely discontinuation of offending agents. These measures can help mitigate the risk of AKI and promote renal recovery.
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The finding of mutations that activate epidermal growth factor receptor (EGFR) in people with lung adenocarcinoma resulted in the creation of a new class of biological treatments called tyrosine kinase inhibitors (TKI). These medications have changed how patients with EGFR mutations are clinically managed, nearly doubling their survival rate compared to standard chemotherapy. Though 1st and 2nd generation EGFR TKIs are initially highly effective, typically within 9-14 months all tumors with the mutation progress due to secondary resistance mutations involving alternative molecular pathways. In most cases (up to 60%), this is due to the T790M mutation emerging in the EGFR gene. ⋯ Of 85 patients with NSCLC with disease progression after TKI treatment, T790M mutations were detected during digital PCR in 30 of 85 patients, which is 35.2% of the sample, and with traditional real-time PCR, positive mutations came out only in 3 out of 85 patients.