Transarterial chemoembolization (TACE) is used as a bridging treatment in liver transplant candidates with hepatocellular carcinoma (HCC). Alpha-fetoprotein (AFP) is the main tumor marker used for HCC surveillance. The aim of this study was to assess the potential of using the AFP change after the first TACE in the prediction of complete tumor necrosis. The study comprised 101 patients with HCC who underwent liver transplantation (LT) after TACE in the period between January 2011 and December 2020. The ΔAFP was defined as the difference between the AFP value before the first TACE and AFP either before the second TACE or the LT. The receiver operator characteristics (ROC) curves were used to identify an optimal cut-off value. Complete tumor necrosis was found in 26.1% (18 of 69) and 6.3% (2 of 32) of patients with an initial AFP level under and over 100 ng/mL, respectively (p = 0.020). The optimal cut-off value of ΔAFP for the prediction of complete necrosis was a decline of ≥10.2 ng/mL and ≥340.5 ng/mL in the corresponding subgroups. Complete tumor necrosis rates were: 62.5% (5 of 8) in patients with an initial AFP < 100 ng/mL and decline of ≥10.2 ng/mL; 21.3% (13 of 61) in patients with an initial AFP < 100 ng/mL and decline of 100 ng/mL and decline of ≥340.5 ng/mL; and null in 20 patients with an initial AFP > 100 ng/mL and decline of <340.5 ng/mL, respectively (p = 0.003). The simple scoring system, based on the initial AFP and AFP decline after the first treatment, distinguished between a high, intermediate and low probability of complete necrosis, with an area under the ROC curve of 0.699 (95% confidence intervals 0.577 to 0.821, p = 0.001). Combining the initial AFP with its change after the first treatment enables early identification of the efficacy of TACE.

Background: Malignant and benign neuroendocrine tumors (NET) share many histopathological features. Liver transplantation (LT) is one of the liver-directed therapies for neuroendocrine liver metastases (NELM). The aim of this study was to determine the outcomes of patients undergoing LT for NELM. Material/Methods: This was a retrospective study that included 19 patients who underwent LT for unresectable NELM between December 1989 and December 2022 in the Department of General, Transplant, and Liver Surgery of the Medical University of Warsaw. Kaplan-Meier estimator and Cox proportional hazards regression were used for statistical analyses.Results: The primary tumor was located most frequently in the pancreas. The median follow-up was 72.5 months. The overall survival (OS) was 94.7%, 88.0%, 88.0%, 70.4%, and 49.3% after 1, 3, 5, 10, and 15 years, respectively. Accordingly, the recurrence-free survival (RFS) rates were 93.8%, 72.9%, 64.8%, 27.8%, and 27.8% after 1, 3, 5, 10, and 15 years, respectively. Ki-67 index >= 5% was found as a risk factor for both worse OS (hazard ratio (HR) 7.13, 95% confidence intervals (95% CI) 1.32-38.63, P=0.023) and RFS (HR 13.68, 95% CI 1.54-121.52, P=0.019). Recipient age >= 55 years was a risk factor for worse RFS (P=0.046, HR 5.47, 95% CI 1.03-29.08). Multivariable analysis revealed Ki-67 >= 5% as the sole independent factor for worse OS (HR 13.78, 95% CI 1.48-128.56, P=0.021).Conclusions: Patients with unresectable NELM achieve great OS and satisfying RFS after LT. The risk factors associated with worse outcomes are attributed to primary tumor aggressiveness.

Background: Dialysis adequacy (Kt/V) remains an essential marker of hemodialysis quality; however, it does not fully capture patients’ overall well-being. Growing evidence underscores the need for a more holistic, patient-centered approach that integrates clinical efficiency with factors affecting daily functioning and quality of life (QoL). Objectives: This study aimed to identify the key determinants of health-related quality of life (HRQoL) among Polish patients undergoing hemodialysis. Methods: Seventy hemodialysis patients from a single center completed the KDQOL-36 questionnaire and provided demographic and clinical data. Statistical analyses included Pearson’s and Spearman’s correlations, as well as multiple linear regression, to determine predictors of HRQoL. Results: The mean (SD) KDQOL summary score was 60.9 (17.3). Pain (B = −15.9, p < 0.001) and the need for additional dialysis sessions (B = −10.2, p = 0.008) were the strongest independent predictors of poorer HRQoL, collectively accounting for 28.6% of variance. Longer dialysis-related transportation time (r = −0.238, p = 0.03) and longer hemodialysis vintage (r = −0.254, p = 0.03) were also significantly associated with lower HRQoL, while dialysis adequacy showed no significant effect. Conclusions: Pain, additional dialysis sessions, and longer dialysis-related transportation time are key, modifiable contributors to reduced HRQoL in Polish hemodialysis patients. These findings underscore the importance of a patient-centered approach that supplements clinical measures with interventions targeting comfort, education, and accessibility. Incorporating structured pain management and improved transport into routine nephrology practice can meaningfully improve patient QoL.

Przewlekła choroba nerek to zespół nieprawidłowości w zakresie czynności lub budowy nerek, utrzymujących się powyżej 3 miesięcy, występujących w jednostkach chorobowych o różnej etiologii. Klasyfikacja przewlekłej choroby nerek opiera się na dwóch podstawowych kategoriach. Pierwsza z nich – G – odnosi się do wartości przesączania kłębuszkowego, przy czym zwykle posługuje się jego szacowaną wartością, wyliczoną za pomocą wzoru CKD-EPI. Druga wartość –A – dotyczy ilości albuminy wydalanej z moczem. Ustalenie etiologii zaburzeń jest ważne, ponieważ ukierunkowane leczenie może spowolnić naturalny postęp choroby i opóźnić wejście w ostatnie, piąte stadium, zwane schyłkową niewydolnością nerek, które wiąże się z koniecznością wdrożenia leczenia nerkozastępczego. W pracy przedstawiono przypadek 50-letniej pacjentki z przewlekłą chorobą nerek w stadium G5 A3, z licznymi obciążeniami, między innymi nieoptymalnie leczoną łuszczycą, dną moczanową, nawracającymi zakażeniami układu moczowego oraz zmianami o charakterze żółtakoziarniniakowego odmiedniczkowego zapalenia prawej nerki i przewlekłym wodonerczem w wywiadzie.

Introduction: Tinnitus is the perception of sound in the absence of external stimuli, often experienced as ringing or buzzing. While many individuals habituate to tinnitus, others develop chronic tinnitus (CT), which can severely affect emotional well-being. Psychological mechanisms such as anxiety and maladaptive coping are known contributors to tinnitus distress, yet the protective role of mindfulness and self-compassion remains underexplored. This study examined the associations between tinnitus distress, anxiety, depression, mindfulness, and self-compassion in a clinical sample. It further investigated whether mindfulness and self-compassion mediate the relationship between tinnitus distress and anxiety. Methods: Ninety-two adults (mean age = 42.6 years; 64.1% female) with tinnitus lasting at least 2 months completed an online survey. Measures included the Tinnitus Functional Index, Hospital Anxiety and Depression Scale, Cognitive and Affective Mindfulness Scale-Revised, and Self-Compassion Scale-Short-Form. Correlational and mediation analyses were conducted using PROCESS. Results: Tinnitus distress was strongly correlated with anxiety (r = 0.484, p < 0.001) and moderately with depression (r = 0.304, p < 0.01). Both mindfulness and self-compassion were negatively associated with tinnitus distress and anxiety. Mediation analyses showed that self-compassion (β = 0.145, 95% CI [0.053, 0.252]) and mindfulness (β = 0.167, 95% CI [0.071, 0.272]) partially mediated the relationship between tinnitus distress and anxiety. Discussion: These findings support the role of mindfulness and self-compassion as protective factors in tinnitus-related anxiety. Interventions targeting these traits may help reduce emotional suffering in individuals with CT but require further evaluation. Longitudinal studies are recommended to confirm causal pathways.

Zespół nerczycowy to zespół objawów, charakteryzujący się przede wszystkim dobową utratą białka z moczem powyżej 3,5 grama, który może być wywołany przez szereg jednostek chorobowych. Przedstawiony przypadek 88-letniego pacjenta z zespołem nerczycowym obrazuje wyzwania związane z procesem diagnostycznym oraz leczeniem tego zespołu przy licznych obciążeniach i zaawansowanym wieku pacjenta. Mimo przeciwwskazań do wykonania biopsji nerki i braku jej wyniku, wdrożono leczenie, które pozwoliło na uzyskanie niepełnej, lecz znaczącej remisji w postaci istotnego zmniejszenia białkomoczu, obniżenia stężenia kreatyniny i uzyskania wartości przesączania kłębuszkowego na satysfakcjonującym poziomie. Opisany przypadek podkreśla konieczność leczenia zespołu nerczycowego u pacjentów w bardzo zaawansowanym wieku oraz pokazuje, że skuteczna terapia jest możliwa pomimo trudności diagnostycznych wynikających z przeciwwskazań do wykonania biopsji nerki.