{"title":"SPRINT trial and blood pressure treatment. Dr. Gordon Guyatt in an interview with Dr. Roman Jaeschke.","authors":"G. Guyatt, R. Jaeschke","doi":"10.20452/pamw.3614","DOIUrl":"https://doi.org/10.20452/pamw.3614","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"5 2 1","pages":"806-807"},"PeriodicalIF":0.0,"publicationDate":"2016-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89045290","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":"Periprocedural risk of bleeding and thrombosis: to bridge or not to bridge. Dr. James Douketis in an interview with Dr. Roman Jaeschke: part 2.","authors":"J. Douketis, R. Jaeschke","doi":"10.20452/pamw.3610","DOIUrl":"https://doi.org/10.20452/pamw.3610","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"56 1","pages":"801-802"},"PeriodicalIF":0.0,"publicationDate":"2016-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78717731","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":"Cigarette smoking: number one enemy for Graves ophthalmopathy.","authors":"L. Bartalena, E. Piantanida","doi":"10.20452/pamw.3592","DOIUrl":"https://doi.org/10.20452/pamw.3592","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"79 1","pages":"725-726"},"PeriodicalIF":0.0,"publicationDate":"2016-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76639218","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}
Is of combination with furosemide and torasemide justified in patients with heart failure?
心衰患者联合呋塞米和托拉塞米是否合理?
{"title":"Heart failure in questions and answers.","authors":"E. Konduracka","doi":"10.20452/pamw.3618","DOIUrl":"https://doi.org/10.20452/pamw.3618","url":null,"abstract":"Is of combination with furosemide and torasemide justified in patients with heart failure?","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"49 1","pages":"809-810"},"PeriodicalIF":0.0,"publicationDate":"2016-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76908959","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}
789 with a reduced left ventricular ejection fraction (40%), moderate mitral valve insufficiency, and moderate ‐to ‐severe tricuspid valve insufficiency. In the parasternal long ‐axis view (FIGURE 1C and 1D) and the apical 5 ‐chamber view (FIGURE 1E–1G), an accessory structure was found in the region of the left ventricular outflow tract. Localization A 40 ‐year ‐old patient with no known medical history presented with progressive exertional dyspnea. A 12 ‐lead electrocardiogram showed a first ‐degree atrioventricular block and signs of left ventricular hypertrophy. Transthoracic echocardiography revealed dilation and global hypokinesis of the left ventricle (FIGURE 1A and 1B) CLINICAL IMAGE
{"title":"Huge interventricular septal aneurysm diagnosed in vivo in an adult.","authors":"B. Kusz, M. Mizia, W. Wróbel, K. Mizia-Stec","doi":"10.20452/pamw.3600","DOIUrl":"https://doi.org/10.20452/pamw.3600","url":null,"abstract":"789 with a reduced left ventricular ejection fraction (40%), moderate mitral valve insufficiency, and moderate ‐to ‐severe tricuspid valve insufficiency. In the parasternal long ‐axis view (FIGURE 1C and 1D) and the apical 5 ‐chamber view (FIGURE 1E–1G), an accessory structure was found in the region of the left ventricular outflow tract. Localization A 40 ‐year ‐old patient with no known medical history presented with progressive exertional dyspnea. A 12 ‐lead electrocardiogram showed a first ‐degree atrioventricular block and signs of left ventricular hypertrophy. Transthoracic echocardiography revealed dilation and global hypokinesis of the left ventricle (FIGURE 1A and 1B) CLINICAL IMAGE","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"18 1","pages":"789-790"},"PeriodicalIF":0.0,"publicationDate":"2016-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89053362","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 as the queen of medical sciences: an underestimated specialization in Poland.","authors":"D. Zozulinska-Ziolkiewicz","doi":"10.20452/pamw.3634","DOIUrl":"https://doi.org/10.20452/pamw.3634","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"62 1","pages":"827-828"},"PeriodicalIF":0.0,"publicationDate":"2016-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83934104","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}
1 significant difference between the 3 study groups in the primary outcome at discharge from the hos‐ pital, or the secondary outcome of favourable neu‐ rologic status at discharge. The authors of the study concluded that “Over‐ all, neither amiodarone nor lidocaine resulted in a significantly higher rate of survival or favor‐ able neurologic outcome than the rate with pla‐ cebo among patients with out ‐of ‐hospital cardiac arrest due to initial shock ‐refractory ventricular fibrillation or pulseless ventricular tachycardia.”4 However, this statement may be misleading. Here the devil is, as usual, in the details. First, the overall lack of statistical significance brings an issue of clinical interpretation of that very concept. The 3.2% absolute difference in sur‐ vival to discharge between amiodarone and pla‐ cebo (and 2.6% between lidocaine and placebo) is nonsignificant (P values of 0.08 and 0.16, re‐ spectively). However, if this is a real difference, it is very likely of clinical importance. Similarly, a 2.2% absolute difference in favorable neurolog‐ ical outcome in favor of amiodarone versus place‐ bo (nonsignificant) was observed. In this sense, lack of proof of a significant difference should not be interpreted as proof of a lack of such differ‐ ence. Of note, looking at the absolute numbers, the improvement in survival rate was accompa‐ nied by a nonsignificant 1% absolute increase in survival of people with severe or very severe neu‐ rological disability. Second and more importantly, there was a dif‐ ference in survival among the predefined sub‐ group of those who suffered witnessed cardiac ar‐ rest (and, presumably, received faster interven‐ tion): the survival rate was higher with amioda‐ rone (27.7%) or lidocaine (27.8%) than with pla‐ cebo (22.7%). The absolute risk difference (this time statistically significant) is likely larger than, for example, any medication intervention used in the short to medium term in acute coronary syndrome, or for several years in hypertension or hyperlipidemia. This difference was yet larg‐ er if the arrest was witnessed by emergency ser‐ vices personnel: survival to discharge was 38.6% among amiodarone ‐treated patients versus 23.3% To the Editor Cardiac arrest is an event of such speed and intensity that predetermined man‐ agement guided by algorithms is likely needed to provide a meaningful chance of survival. Cur‐ rent European and North American guidelines call for immediate and effective cardiopulmonary re‐ suscitation (CPR) and rapid delivery of defibril‐ lation for shockable rhythms (ie, ventricular fi‐ brillation [VF], pulseless ventricular tachycardia [pVT]).1,2 Definitive airway management follows closely. The use of drugs in cardiac arrest, howev‐ er, remains controversial. Epinephrine remains recommended, while vasopressin has been removed from the guide‐ lines as single vasoactive therapy in cardiac ar‐ rest. The use of antiarrhythmic drugs (ie, amio‐ darone or lidocaine) for VF/pVT is r
{"title":"Do not consider amiodarone, give it! Comment on antiarrhythmic drugs for shock‑refractory ventricular fibrillation or pulseless ventricular tachycardia.","authors":"Andrew Gibson, R. Jaeschke","doi":"10.20452/pamw.3602","DOIUrl":"https://doi.org/10.20452/pamw.3602","url":null,"abstract":"1 significant difference between the 3 study groups in the primary outcome at discharge from the hos‐ pital, or the secondary outcome of favourable neu‐ rologic status at discharge. The authors of the study concluded that “Over‐ all, neither amiodarone nor lidocaine resulted in a significantly higher rate of survival or favor‐ able neurologic outcome than the rate with pla‐ cebo among patients with out ‐of ‐hospital cardiac arrest due to initial shock ‐refractory ventricular fibrillation or pulseless ventricular tachycardia.”4 However, this statement may be misleading. Here the devil is, as usual, in the details. First, the overall lack of statistical significance brings an issue of clinical interpretation of that very concept. The 3.2% absolute difference in sur‐ vival to discharge between amiodarone and pla‐ cebo (and 2.6% between lidocaine and placebo) is nonsignificant (P values of 0.08 and 0.16, re‐ spectively). However, if this is a real difference, it is very likely of clinical importance. Similarly, a 2.2% absolute difference in favorable neurolog‐ ical outcome in favor of amiodarone versus place‐ bo (nonsignificant) was observed. In this sense, lack of proof of a significant difference should not be interpreted as proof of a lack of such differ‐ ence. Of note, looking at the absolute numbers, the improvement in survival rate was accompa‐ nied by a nonsignificant 1% absolute increase in survival of people with severe or very severe neu‐ rological disability. Second and more importantly, there was a dif‐ ference in survival among the predefined sub‐ group of those who suffered witnessed cardiac ar‐ rest (and, presumably, received faster interven‐ tion): the survival rate was higher with amioda‐ rone (27.7%) or lidocaine (27.8%) than with pla‐ cebo (22.7%). The absolute risk difference (this time statistically significant) is likely larger than, for example, any medication intervention used in the short to medium term in acute coronary syndrome, or for several years in hypertension or hyperlipidemia. This difference was yet larg‐ er if the arrest was witnessed by emergency ser‐ vices personnel: survival to discharge was 38.6% among amiodarone ‐treated patients versus 23.3% To the Editor Cardiac arrest is an event of such speed and intensity that predetermined man‐ agement guided by algorithms is likely needed to provide a meaningful chance of survival. Cur‐ rent European and North American guidelines call for immediate and effective cardiopulmonary re‐ suscitation (CPR) and rapid delivery of defibril‐ lation for shockable rhythms (ie, ventricular fi‐ brillation [VF], pulseless ventricular tachycardia [pVT]).1,2 Definitive airway management follows closely. The use of drugs in cardiac arrest, howev‐ er, remains controversial. Epinephrine remains recommended, while vasopressin has been removed from the guide‐ lines as single vasoactive therapy in cardiac ar‐ rest. The use of antiarrhythmic drugs (ie, amio‐ darone or lidocaine) for VF/pVT is r","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"40 1","pages":"791-792"},"PeriodicalIF":0.0,"publicationDate":"2016-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73263105","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":"Prepregnancy care: improvements for some women but not for all!","authors":"H. Murphy","doi":"10.20452/pamw.3596","DOIUrl":"https://doi.org/10.20452/pamw.3596","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"2 1","pages":"729-730"},"PeriodicalIF":0.0,"publicationDate":"2016-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73317460","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":"Resuscitation in sepsis in 2016. What's new? Dr. Waleed Alhazzani in an interview with Dr. Roman Jaeschke: part 1.","authors":"W. Alhazzani, R. Jaeschke","doi":"10.20452/pamw.3604","DOIUrl":"https://doi.org/10.20452/pamw.3604","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"55 1","pages":"794-795"},"PeriodicalIF":0.0,"publicationDate":"2016-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80205649","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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