Hepatocellular carcinoma (HCC) is the third leading cause of cancer death worldwide. The STAT4 rs7574865 genetic variant has been associated with an increased risk of developing HCC in Asian populations. However, this association has not been studied in Latin America and is poorly assessed in European populations. This case-control study investigated the association between STAT4 rs7574865 and HCC risk in these populations. We evaluated DNA samples from seven medical institutions across six Latin American countries and one Dutch institution in 1060 individuals (344 HCC and 716 controls). STAT4 rs7574865 SNP was genotyped using TaqMan-genotyping assay and analyzed using logistic regression. We found no significant association between the homozygous risk allele (G) of STAT4 and HCC development in either population, with odds ratios (OR) for GG versus TT of 0.85 (CI: 0.48–1.52, p = 0.58) and 0.81 (CI: 0.34–1.93, p = 0.67) for Latin Americans and Europeans respectively. No correlation was found between the risk allele and HCC based on underlying liver disease. However, we found that Latin Americans of European ancestry were more likely to carry the risk allele. Our results suggest that the STAT4 SNP rs7574865 does not influence the risk of developing HCC in Latin American or European populations, highlighting the importance of evaluating genetic risk factors in various ethnic groups and understanding the possible influence of ancestry on the genetic basis of disease.

Pancreatic pseudocyst formation is a common complication of chronic pancreatitis. Rarely, a fistula develops between the pseudocyst and the portal venous system. We present a case of a 50-year-old man who was found to have a pancreatic pseudocyst-superior mesenteric vein fistula after being evaluated for several months of abdominal pain and weight loss. The patient was treated with endoscopic stenting of the pancreatic duct along with early enteral nutrition and suppressive antibiotics, which resulted in improvement in his condition. This case report highlights clinical presentation and the complexity of treatment of this rare diagnosis.

Hepatitis E virus (HEV) is a significant yet understudied cause of viral hepatitis among liver transplant (LT) recipients in Central and South-eastern Europe. We conducted a combined cross-sectional and prospective cohort study to determine the seroprevalence, incidence, and risk factors of HEV infection in Croatian LT recipients. A total of 766 adult LT recipients were analyzed for anti-HEV IgG and HEV RNA. Additionally, 152 patients listed for LT were followed prospectively with sampling before and up to 12 months after transplantation. Anti-HEV IgG seroprevalence in the cross-sectional cohort was 19.8%, with no active infections detected via HEV RNA. In the prospective cohort, baseline seroprevalence was 20.4%, declining post-transplant, while 3.9% of initially seronegative patients seroconverted without detectable HEV RNA. Older age and non-tertiary level of education were associated with seropositivity, while dietary and animal contact factors were not. These findings indicate a moderately high level of prior HEV exposure among Croatian LT recipients, comparable to some European regions, but a low incidence of post-transplant infection and no evidence of chronic HEV infection. Our results suggest that despite frequent exposure, clinically significant HEV infection is uncommon in this immunosuppressed population.

Background: Helicopter Emergency Medical Services (HEMS) provide rapid transport and advanced medical care for critically ill or injured patients, especially in hard-to-reach areas. In March 2024, HEMS services were introduced in Croatia, with Dubrava University Hospital serving as the primary receiving center for the Zagreb region. This article presents an analysis of the implementation of HEMS in the northwest part of Croatia from the perspective of a receiving hospital. Methods: A retrospective observational analysis was conducted on patients transported by HEMS to Dubrava University Hospital from March to September 2024. Data on patient demographics, transport times, medical interventions, and outcomes were collected and analyzed. Results: Out of 41 patients transported by HEMS during the study period, 4 were immediately referred to other specialized centers. The median transport time was 24 minutes. Out of the 37 admitted patients, 14 (38%) were admitted for surgical management, 16 patients (43%) were admitted for medical and neurological management, 7 (19%) were discharged on the same day after workup and observation in the ED. Conclusion: Introducing HEMS in the Zagreb region has enhanced rapid medical care for critically ill patients, especially polytraumatized patients. Further studies are required to optimize patient flow and improve patient outcomes.