It has been demonstrated that fibrin clots generated from plasma samples obtained from patients with prior thromboembolic events are denser and less susceptible to lysis. Such a prothrombotic fibrin clot phenotype has been suggested as a new risk factor for venous thromboembolism, but its prognostic value is unclear. To assess whether abnormal clot properties can predict recurrent deep-vein thrombosis (DVT), we studied 320 consecutive patients aged 18 to 70 years following the first-ever DVT. Plasma clot properties were evaluated after 3 months of anticoagulant treatment since the index event. A mean duration of anticoagulation was 10 months (range, 4-20). Recurrent DVT was observed in 77 patients (25%; 6.6%/year) during a median follow-up of 44 months. Recurrences of DVT were associated with faster formation (-9% lag phase) of denser fibrin networks (-12% fibrin clot permeability [K_s]) and 4% higher maximum absorbance of plasma clots (ΔAbs), that displayed impaired fibrinolytic degradation (+25% prolonged clot lysis time [CLT]) and 5% slower rate of increase in D-dimer levels during clot degradation (D-D_rate, all p<0.05). Proximal DVT alone, higher C-reactive protein, D-dimer, peak thrombin, lower K_s, shorter lag phase, decreased D-D_rate and prolonged CLT were independent predictors of recurrences (all p96 min) were at the highest risk of recurrent DVT (OR, 15.8; 95% CI, 7.5-33.5). Kaplan-Meier curves showed that reduced K_s and prolonged CLT predicted recurrent DVT. We demonstrated that unfavourably altered clot properties may predict recurrent DVT after anticoagulation withdrawal. Key points Formation of more compact plasma fibrin clots associated with impaired susceptibility to lysis predisposes to recurrent DVT. Determination of plasma clot phenotype prior to anticoagulation withdrawal might help identify patients at elevated risk of DVT recurrence.

Post-thrombotic syndrome (PTS) is a common complication of deep vein thrombosis (DVT). Little is known about the involvement of adipokines in the pathogenesis of DVT. We evaluated whether adipokines can predict PTS. In a prospective cohort study, 320 DVT patients aged 70 years or less were enrolled. Serum adiponectin, leptin and resistin levels were measured three months since the index first-ever DVT. After 2 years’ follow-up PTS was diagnosed in 83 of 309 available patients (26.9%) who had 13.9% lower adiponectin and 16% higher leptin levels compared with the remainder (both p < 0.0001). No PTS-associated differences in C-reactive protein, fibrinogen, D-dimer, plasminogen activator inhibitor-1 and resistin were observed. The multivariable logistic regression adjusted for age, sex, obesity and tissue plasminogen activator (tPa) showed that lower adiponectin (odds ratio [OR], 0.42; 95% confidence interval [CI], 0.31–0.56) and higher leptin levels (OR, 1.49; 95% CI, 1.31–1.69) are independent predictors for PTS. Obesity-stratified logistic regression analysis confirmed that lower adiponectin (OR, 0.49; 95% CI, 0.38–0.64) and higher leptin (OR, 1.41; 95% Cl, 1.25–1.58) levels predicted PTS. Our findings showed that lower adiponectin and higher leptin measured 3 months after DVT, regardless of obesity, can independently predict PTS, which suggests novel links between adipokines and thrombosis.

Background: The aim of this study was to compare tumour stage, treatment modalities, post-treatment complications, and survival among patients with sinonasal malignancies (SMs) before, during, and after the COVID-19 pandemic. Methods: This retrospective, two-centre study included 139 patients with SMs who were hospitalised before the COVID-19 pandemic (group 1), during the pandemic (group 2), and after the pandemic (group 3). Results: The study included 32, 41, and 66 patients in groups 1, 2, and 3, respectively. No significant differences were observed between the groups in terms of age, sex, recurrence rate, or the proportion of patients treated surgically. Complications were more common in group 1 than in group 2 (46.88% vs. 24.39%, p = 0.045). Intracranial tumour extension was observed more frequently in group 1 than in group 3 (51.61% vs. 27.27%, p = 0.024). The use of photon radiotherapy (RT) decreased from group 1 to group 3, whereas the use of proton RT increased and became predominant in group 3 (19.4%, 64.1%, and 95.2% in groups 1, 2, and 3, respectively). Group 3 had a higher proportion of T3 tumours than group 1 (33.3% vs. 6.3%) but a lower proportion of T4b tumours (31.8% vs. 56.3%, p = 0.009). Most patients had advanced disease (stage III–IV) in all groups. Kaplan–Meier survival analysis demonstrated a statistically significant improvement in survival in group 3 compared with group 1 (log-rank test, p = 0.048). Conclusions: The observed improvement is more likely attributable to shifts in tumour stage distribution and changes in treatment strategies than to any direct effect of the COVID-19 pandemic. Future research should evaluate longer post-COVID-19 periods, as potential negative effects may emerge later.

The COVID-19 pandemic severely restricted global access to healthcare, including for patients with laryngeal cancer (LC). To compare laryngeal cancer stage distribution (TNM classification), surgical treatment patterns (types of surgery and perioperative complications), and timelines before vs 1 year after the COVID-19 pandemic declaration. We conducted a retrospective, single-center, cross-sectional study at a tertiary care center in Poland. The analysis included 110 patients hospitalized for laryngeal cancer during 2 six-month intervals: October 2019-March 2020 (prepandemic, group 1) and October 2021-March 2022 (post-pandemic, group 2). Group 1 included 49 patients, and group 2 included 61. Baseline characteristics were similar between groups, with males comprising 96.9% of group 1 and 83.6% of group 2. Admissions via the fast-track cancer pathway increased from 33.3% in group 1 to 52.5% in group 2. Although a higher proportion of patients in group 2 were classified as stage IVB by TNM, the difference was not statistically significant. Surgical treatment patterns were largely consistent across groups, except for a decrease in total laryngectomy from 18.4% in group 1 to 3.3% in group 2. Moderately differentiated tumors (G2) were more common in group 1 (66.7%) than in group 2 (35%). High concordance was observed between clinical and pathological staging for tumor size (79.1%) and regional lymph node metastasis (87.5%). Future research should extend the post-COVID-19 observation period, as pandemic-related adverse effects on cancer diagnosis and outcomes may not fully manifest until several years later.