{"title":"110th Anniversary of the Polish Society of Internal Medicine. Foundation of the Polish Society of Internal Medicine.","authors":"E. Kucharz","doi":"10.20452/pamw.3755","DOIUrl":"https://doi.org/10.20452/pamw.3755","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"9 1","pages":"963-966"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90157012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Treatment of asthma: predicting the future of atopic disease treatment Dr. Paul O'Byrne in an interview with Dr. Roman Jaeschke: part 2.","authors":"P. O'Byrne, R. Jaeschke","doi":"10.20452/pamw.3763","DOIUrl":"https://doi.org/10.20452/pamw.3763","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"6 1 1","pages":"1031-1032"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78482109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"VTE treatment in 201 6 and future challenges Dr. Mark Crowther in an interview with Dr. Roman Jaeschke: part 3.","authors":"M. Crowther, R. Jaeschke","doi":"10.20452/pamw.3780","DOIUrl":"https://doi.org/10.20452/pamw.3780","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"1 1","pages":"1026-1027"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79904066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Internal medicine: an indispensable field of medicine.","authors":"K. Mizia-Stec","doi":"10.20452/pamw.3745","DOIUrl":"https://doi.org/10.20452/pamw.3745","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"40 1","pages":"1066-1067"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74710738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Which anticoagulants should be used for patients with atrial fibrillation and cancer? In the management of patients with atrial fibrillation (AF) and can‐ cer, VKAs or NOACs can be used for stroke pre‐ vention. However, the effectiveness and safety of treatment with NOACs in this specific group of patients are poorly documented because these pa‐ tients have not been included in large randomized clinical trials on the use of NOACs in AF. How‐ ever, clinical practice shows that NOACs are well tolerated by most cancer patients in good general condition, receiving outpatient cancer treatment, and with low ‐to ‐moderate bleeding risk, and not taking antifungal drugs or cyclosporine. In every‐ day practice, however, LMWH are mostly used in patients with venous thromboembolism (VTE), and not with AF, except when such management is planned only for a short time and because of invasive procedures, nausea, vomiting, or diar‐ rhea, and other complications of an underlying disease. The effectiveness of LMWH (particular‐ ly at prophylactic or moderate doses) in AF, es‐ pecially in high ‐risk patients is unknown; how‐ ever, in high ‐risk cancer inpatients with elevat‐ ed risk of bleeding LMWH should be considered. Anticoagulation strategy should be individualized in cancer patients especially if both bleeding and thrombosis risks are high.
{"title":"Long-term anticoagulation in questions and answers.","authors":"A. Undas","doi":"10.20452/pamw.3773","DOIUrl":"https://doi.org/10.20452/pamw.3773","url":null,"abstract":"Which anticoagulants should be used for patients with atrial fibrillation and cancer? In the management of patients with atrial fibrillation (AF) and can‐ cer, VKAs or NOACs can be used for stroke pre‐ vention. However, the effectiveness and safety of treatment with NOACs in this specific group of patients are poorly documented because these pa‐ tients have not been included in large randomized clinical trials on the use of NOACs in AF. How‐ ever, clinical practice shows that NOACs are well tolerated by most cancer patients in good general condition, receiving outpatient cancer treatment, and with low ‐to ‐moderate bleeding risk, and not taking antifungal drugs or cyclosporine. In every‐ day practice, however, LMWH are mostly used in patients with venous thromboembolism (VTE), and not with AF, except when such management is planned only for a short time and because of invasive procedures, nausea, vomiting, or diar‐ rhea, and other complications of an underlying disease. The effectiveness of LMWH (particular‐ ly at prophylactic or moderate doses) in AF, es‐ pecially in high ‐risk patients is unknown; how‐ ever, in high ‐risk cancer inpatients with elevat‐ ed risk of bleeding LMWH should be considered. Anticoagulation strategy should be individualized in cancer patients especially if both bleeding and thrombosis risks are high.","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"12 1","pages":"1036-1039"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82096374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Roik, D. Wretowski, K. Irzyk, Andrzej Łabyk, O. Dzikowska-Diduch, P. Pruszczyk
{"title":"Familial chronic thromboembolic pulmonary hypertension in a mother and a son: successful treatment with refined balloon pulmonary angioplasty.","authors":"M. Roik, D. Wretowski, K. Irzyk, Andrzej Łabyk, O. Dzikowska-Diduch, P. Pruszczyk","doi":"10.20452/pamw.3723","DOIUrl":"https://doi.org/10.20452/pamw.3723","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"118 1","pages":"1014-1016"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90259741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Brajer-Luftmann, Agata Nowicka, M. Kaczmarek, M. Grabicki, B. Kuźnar-Kamińska, Barbara Bromińska, J. Sikora, H. Batura-Gabryel
INTRODUCTION Myeloid‑derived suppressor cells (MDSCs) have the potent ability to suppress T‑cell function, and are important in the regulation of chronic inflammation and carcinogenesis. MDSCs may influence local and systemic inflammation and carcinogenesis in COPD; however, their presence in bronchoalveolar lavage fluid (BALF) and peripheral blood (PB) or their relationship with clinical parameters in COPD has not been studied yet. OBJECTIVES The aim of the study was to assess MDSCs in BALF and PB and to analyze the relationship between MDSCs and clinical parameters in COPD. PATIENTS AND METHODS The study included 64 patients with stable COPD. The clinical parameters of the patients were studied, and MDSCs were assessed using monoclonal antibodies directly conjugated with fluorochromes in flow cytometry. RESULTS The percentage of MDSCs in BALF was lower than that in PB (0.63 ±0.90 vs 3.94 ±0.38). In BALF, MDSCs (% of mononuclear cells) correlated with forced expiratory volume in 1 second (rs = -0.30, P = 0.0185), residual volume/total lung capacity (rs = 0.32, P = 0.0148), PaO2 (rs = -0.45, P = 0.0002), arterial oxygen saturation (SaO2; rs = -0.41, P = 0.0008), and diffusion capacity of carbon dioxide (rs = -0.32, P = 0.0211). There was a significant negative correlation between MDSCs (% of all leukocytes) and arterial oxygen pressure (rs = -0.42, P = 0.0006) and SaO2 (rs = -0.37, P = 0.0027). No correlations were found in PB. CONCLUSIONS MDSCs are present in human lung microenvironment and may be involved in local inflammation in COPD. Future studies should focus on a detailed assessment of MDSCs in local and systemic inflammation in COPD.
髓源性抑制细胞(Myeloid derived suppressor cells, MDSCs)具有抑制T细胞功能的强大能力，在慢性炎症和癌变的调控中发挥着重要作用。MDSCs可能影响慢性阻塞性肺病的局部和全身炎症和癌变;然而，目前尚未研究它们在COPD患者支气管肺泡灌洗液(BALF)和外周血(PB)中的存在及其与临床参数的关系。本研究的目的是评估BALF和PB中的MDSCs，并分析MDSCs与COPD临床参数之间的关系。患者和方法本研究纳入64例稳定期COPD患者。研究患者的临床参数，并利用流式细胞术中荧光染料直接偶联的单克隆抗体对MDSCs进行评估。结果BALF中MDSCs的比例低于PB(0.63±0.90 vs 3.94±0.38)。在BALF中，MDSCs(占单个核细胞的百分比)与1秒用力呼气量(rs = -0.30, P = 0.0185)、残气量/总肺活量(rs = 0.32, P = 0.0148)、PaO2 (rs = -0.45, P = 0.0002)、动脉血氧饱和度(SaO2;rs = -0.41, P = 0.0008)和二氧化碳扩散能力(rs = -0.32, P = 0.0211)。MDSCs(占全部白细胞的百分比)与动脉血氧压(rs = -0.42, P = 0.0006)、SaO2 (rs = -0.37, P = 0.0027)呈显著负相关。PB无相关性。结论:MDSCs存在于人肺微环境中，可能参与慢性阻塞性肺疾病的局部炎症。未来的研究应侧重于详细评估MDSCs在COPD患者局部和全身性炎症中的作用。
{"title":"Myeloid‑derived suppressor cells in bronchoalveolar lavage fluid in patients with chronic obstructive pulmonary disease.","authors":"B. Brajer-Luftmann, Agata Nowicka, M. Kaczmarek, M. Grabicki, B. Kuźnar-Kamińska, Barbara Bromińska, J. Sikora, H. Batura-Gabryel","doi":"10.20452/pamw.3718","DOIUrl":"https://doi.org/10.20452/pamw.3718","url":null,"abstract":"INTRODUCTION Myeloid‑derived suppressor cells (MDSCs) have the potent ability to suppress T‑cell function, and are important in the regulation of chronic inflammation and carcinogenesis. MDSCs may influence local and systemic inflammation and carcinogenesis in COPD; however, their presence in bronchoalveolar lavage fluid (BALF) and peripheral blood (PB) or their relationship with clinical parameters in COPD has not been studied yet. OBJECTIVES The aim of the study was to assess MDSCs in BALF and PB and to analyze the relationship between MDSCs and clinical parameters in COPD. PATIENTS AND METHODS The study included 64 patients with stable COPD. The clinical parameters of the patients were studied, and MDSCs were assessed using monoclonal antibodies directly conjugated with fluorochromes in flow cytometry. RESULTS The percentage of MDSCs in BALF was lower than that in PB (0.63 ±0.90 vs 3.94 ±0.38). In BALF, MDSCs (% of mononuclear cells) correlated with forced expiratory volume in 1 second (rs = -0.30, P = 0.0185), residual volume/total lung capacity (rs = 0.32, P = 0.0148), PaO2 (rs = -0.45, P = 0.0002), arterial oxygen saturation (SaO2; rs = -0.41, P = 0.0008), and diffusion capacity of carbon dioxide (rs = -0.32, P = 0.0211). There was a significant negative correlation between MDSCs (% of all leukocytes) and arterial oxygen pressure (rs = -0.42, P = 0.0006) and SaO2 (rs = -0.37, P = 0.0027). No correlations were found in PB. CONCLUSIONS MDSCs are present in human lung microenvironment and may be involved in local inflammation in COPD. Future studies should focus on a detailed assessment of MDSCs in local and systemic inflammation in COPD.","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"36 10 1","pages":"980-988"},"PeriodicalIF":0.0,"publicationDate":"2016-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80177433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Plonska-Gosciniak, J. Kasprzak, T. Kukulski, K. Mizia-Stec, E. Nowalany-Kozielska, Z. Gąsior, K. Wita, W. Sinkiewicz, H. Szwed, P. Gościniak, Ł. Chrzanowski
INTRODUCTION The response to Cardiac Resynchronisation Therapy (CRT) varies significantly, resulting in lack of improvement among the substantial patients proportion. OBJECTIVES To identify mechanical dyssynchrony indices with combination of myocardial viability characteristics for predicting long-term response to CRT. PATIENTS AND METHODS ViaCRT was a multicentre study coordinated by the Working Group on Echocardiography of Polish Cardiac Society. 127 patients with heart failure were assessed prospectively. Cardiac dyssynchrony indices and low-dose dobutamine response were determined by echocardiography prior to CRT. Improvement in Wall Motion Score Index (WMSI) or LVEF exceeding 20% at peak stress identified preserved contractile reserve. RESULTS After 12 months there was significantly different survival between subsets with and without viability characterised by WMSI decrease, corresponding to 1 (4.4%) and 20 (19.4%) fatal events respectively (p=0.048). The predictive value of LVEF gain at Dobutamine Stress Echocardiography (DSE) study was only significant at 6 months, with all-cause death occurring in 1 (1.6%) and 7 (12.1%) of patients with viable and non-viable myocardium respectively (p=0.029). Multivariate regression analysis identified the presence of septal flash and interventricular dyssynchrony as independent indices with the ability to predict echocardiographic response alone at 12 months. CONCLUSIONS The study demonstrated a significant relationship between left ventricular contractile reserve at DSE and long-term all-cause mortality following CRT device implantation. Conversely, the presence of septal flash and interventricular dyssynchrony but not myocardial viability were predictive of the response to resynchronisation. The results indicate that interference of multiple different mechanisms may be responsible for the general effect following CRT.
{"title":"Role of low‑dose dobutamine echocardiography in predicting response to biventricular pacing. Results from the multicenter Viability in Cardiac Resynchronisation Therapy (ViaCRT) study.","authors":"E. Plonska-Gosciniak, J. Kasprzak, T. Kukulski, K. Mizia-Stec, E. Nowalany-Kozielska, Z. Gąsior, K. Wita, W. Sinkiewicz, H. Szwed, P. Gościniak, Ł. Chrzanowski","doi":"10.20452/pamw.3715","DOIUrl":"https://doi.org/10.20452/pamw.3715","url":null,"abstract":"INTRODUCTION The response to Cardiac Resynchronisation Therapy (CRT) varies significantly, resulting in lack of improvement among the substantial patients proportion. OBJECTIVES To identify mechanical dyssynchrony indices with combination of myocardial viability characteristics for predicting long-term response to CRT. PATIENTS AND METHODS ViaCRT was a multicentre study coordinated by the Working Group on Echocardiography of Polish Cardiac Society. 127 patients with heart failure were assessed prospectively. Cardiac dyssynchrony indices and low-dose dobutamine response were determined by echocardiography prior to CRT. Improvement in Wall Motion Score Index (WMSI) or LVEF exceeding 20% at peak stress identified preserved contractile reserve. RESULTS After 12 months there was significantly different survival between subsets with and without viability characterised by WMSI decrease, corresponding to 1 (4.4%) and 20 (19.4%) fatal events respectively (p=0.048). The predictive value of LVEF gain at Dobutamine Stress Echocardiography (DSE) study was only significant at 6 months, with all-cause death occurring in 1 (1.6%) and 7 (12.1%) of patients with viable and non-viable myocardium respectively (p=0.029). Multivariate regression analysis identified the presence of septal flash and interventricular dyssynchrony as independent indices with the ability to predict echocardiographic response alone at 12 months. CONCLUSIONS The study demonstrated a significant relationship between left ventricular contractile reserve at DSE and long-term all-cause mortality following CRT device implantation. Conversely, the presence of septal flash and interventricular dyssynchrony but not myocardial viability were predictive of the response to resynchronisation. The results indicate that interference of multiple different mechanisms may be responsible for the general effect following CRT.","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"61 1","pages":"989-994"},"PeriodicalIF":0.0,"publicationDate":"2016-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86007768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Fedak, M. Kużniewski, A. Fugiel, E. Wieczorek-Surdacka, B. Przepiórkowska-Hoyer, P. Jasik, P. Miarka, P. Dumnicka, M. Kapusta, B. Solnica, W. Sułowicz
INTRODUCTION Urinary uromodulin excretion has been associated with kidney diseases. However, serum uromodulin concentrations have not been extensively studied in patients with chronic kidney disease (CKD), and the results of published studies are inconsistent. OBJECTIVES The aims of the study were to evaluate serum uromodulin concentrations in patients with CKD and to assess the utility of serum uromodulin measurements for diagnosing CKD stages. PATIENTS AND METHODS This observational study included 170 patients with CKD stages 1 to 5, not treated by renal replacement therapy, and 30 healthy individuals. The serum levels of creatinine, cystatin C, and uromodulin were measured, and estimated glomerular filtration rate (eGFR) was calculated according to the 2012 CKD Epidemiology Collaboration cystatin‑creatinine equation. RESULTS Among patients with CKD, serum uromodulin concentrations were significantly lower than in controls, and were strongly negatively correlated with renal retention markers (ie, serum creatinine and cystatin C) and strongly positively correlated with eGFR. An inverse, hyperbolic relationship between serum creatinine and uromodulin levels was analogous to the well‑known association between serum creatinine concentrations and eGFR. A receiver‑operating characteristic curve analysis showed a high diagnostic accuracy of the measurement of serum uromodulin concentrations in the assessment of CKD stages. CONCLUSIONS Serum uromodulin concentrations are closely correlated with eGFR, which is the recommended measure of renal function. As uromodulin is produced exclusively by renal tubular cells, the assessment of uromodulin levels in patients with CKD may be an alternative method for evaluating the number of functioning nephrons.
{"title":"Serum uromodulin concentrations correlate with glomerular filtration rate in patients with chronic kidney disease.","authors":"D. Fedak, M. Kużniewski, A. Fugiel, E. Wieczorek-Surdacka, B. Przepiórkowska-Hoyer, P. Jasik, P. Miarka, P. Dumnicka, M. Kapusta, B. Solnica, W. Sułowicz","doi":"10.20452/pamw.3712","DOIUrl":"https://doi.org/10.20452/pamw.3712","url":null,"abstract":"INTRODUCTION Urinary uromodulin excretion has been associated with kidney diseases. However, serum uromodulin concentrations have not been extensively studied in patients with chronic kidney disease (CKD), and the results of published studies are inconsistent. OBJECTIVES The aims of the study were to evaluate serum uromodulin concentrations in patients with CKD and to assess the utility of serum uromodulin measurements for diagnosing CKD stages. PATIENTS AND METHODS This observational study included 170 patients with CKD stages 1 to 5, not treated by renal replacement therapy, and 30 healthy individuals. The serum levels of creatinine, cystatin C, and uromodulin were measured, and estimated glomerular filtration rate (eGFR) was calculated according to the 2012 CKD Epidemiology Collaboration cystatin‑creatinine equation. RESULTS Among patients with CKD, serum uromodulin concentrations were significantly lower than in controls, and were strongly negatively correlated with renal retention markers (ie, serum creatinine and cystatin C) and strongly positively correlated with eGFR. An inverse, hyperbolic relationship between serum creatinine and uromodulin levels was analogous to the well‑known association between serum creatinine concentrations and eGFR. A receiver‑operating characteristic curve analysis showed a high diagnostic accuracy of the measurement of serum uromodulin concentrations in the assessment of CKD stages. CONCLUSIONS Serum uromodulin concentrations are closely correlated with eGFR, which is the recommended measure of renal function. As uromodulin is produced exclusively by renal tubular cells, the assessment of uromodulin levels in patients with CKD may be an alternative method for evaluating the number of functioning nephrons.","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":" 1","pages":"995-1004"},"PeriodicalIF":0.0,"publicationDate":"2016-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91416080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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