Background: There is a strong correlation between systemic inflammation intensity and clinical presentation, disease progression, and survival during liver cirrhosis decompensation. This study aimed to evaluate the prognostic performance of blood-based biomarkers as meta-inflammation markers, including NLR, PLR, LMR, INPR, MPR, ALBI, FIB4, and APRI, in predicting hospital mortality in patients with acute decompensation of alcohol-related liver cirrhosis. Methods: Data from 411 patients with their first onset of acute decompensation were analyzed, forming two groups: deceased and survived during hospitalization. Generalized partial least squares regression analysis was applied to explore the effects of surrogate indicators on mortality rates, using mortality rate as the dependent variable. Root Mean Square Error, Akaike’s, and Bayesian information criteria determined that four components accounted for most of the variance. Results: Variables with significant negative contributions to the outcome prediction (ranked by standardized regression coefficients) were encephalopathy grade, total bilirubin, Child–Turcotte–Pugh score, MELD, NLR, MPV, FIB4, INR, PLR, and ALT. Coefficient sizes ranged from −0.63 to −0.09, with p-values from 0 to 0.018. Conclusions: NLR, PLR, and FIB4 significantly contribute to hospital mortality prediction in patients with acute decompensation of alcohol-related liver cirrhosis. Conversely, some variables used to predict liver disease severity, including INPR, APRI, LMR, and ALBI score, did not significantly contribute to hospital mortality prediction in this patient population.

Background/Objectives: Most cases of colorectal cancer (CRC) arise from adenomatous polyps. Identifying risk factors for colorectal adenoma (CRA) is critical for CRC prevention. Emerging evidence suggests a link between metabolic syndrome (MetS) and an elevated risk of CRA and CRC, potentially mediated by visceral obesity and adiponectin (APN). We aimed to evaluate the association between different markers of visceral obesity, serum APN, MetS, and the presence of CRA. Methods: A cross-sectional study was conducted at the University Clinical Center of Vojvodina, involving 120 patients, aged 40–75 years, who underwent colonoscopy between January 2022 and January 2023. Sixty patients with CRA were compared to 60 controls with normal colonoscopy findings. Visceral fat thickness (VFT) was measured using ultrasound (US), and bioelectrical impedance analysis (BIA) was used to assess visceral fat area (VFA). Serum APN levels, anthropometric measures, and MetS components were also evaluated. Results: Patients with CRA had significantly higher VFT measured by US (p < 0.05), but no significant differences were found in VFA measured by BIA, waist circumference (WC), or waist-to-hip ratio (WHR). MetS was significantly more prevalent in the CRA group (55% vs. 31.6%, p < 0.05), and logistic regression confirmed MetS as a significant predictor of CRA presence (OR = 2.6). Serum APN levels were inversely correlated with visceral fat measurements and MetS (p < 0.01), but no significant difference in APN levels was observed between patients with and without CRA. Conclusions: This study highlights the importance of VFT measured by US and the presence of MetS as significant factors associated with CRA.

The objectives of the paper: To evaluate inter atrial conduction time (ACT), intra left ACT, intra right ACT in relation to P wave dispersion in patients with different degree of arterial hypertension.

Background/Aim. Metabolic syndrome (MetS) is associated with an increased risk of developing colorectal cancer (CRC). However, data on its relationship with colorectal adenomas (CRA), the primary precancerous lesions, remain unclear and limited in certain regions. The aim of this study was to examine the characteristics and distribution of CRA in patients with and without MetS. Methods. A cross-sectional study was conducted, including 80 patients with CRA, of whom 40 had MetS (MetS group), and 40 did not meet the criteria for MetS (control group). Demographic data, risk factors for CRC (smoking, alcohol consumption, and family history of CRC), protective factors (use of acetylsalicylic acid and nonsteroidal anti-inflammatory drugs, physical activity), and polyp characteristics (size, number, localization, and degree of advancement) were collected and compared between the two groups. The diagnosis of CRA was established by histological examination of polyp specimens retrieved during colonoscopy. The diagnosis of MetS was made if three or more of the following criteria were present: increased waist circumference (? 94 cm for males, or ? 8 0 c m f or f emales); hypertriglyceridemia (? 1.7 mmol/L); reduced high-density lipoprotein cholesterol levels (< 1.0 mmol/L for males, or < 1.3 mmol/L for females); arterial hypertension (systolic blood pressure ? 130 mmHg, and/or diastolic blood pressure ? 85 mmHg); fasting hyperglycaemia (? 5.6 mmol/L). Results. The average age of the patients was 61 years. Males and females were equally present in both groups, as were all the common risk factors for CRA. There were no differences between the groups regarding adenoma size, number of detected adenomas, localization of adenomas, and the degree of histological advancement of the adenoma. Conclusion. No significant association was found between the presence of MetS and the characteristics and distribution of CRA in our study. Further studies with larger samples and biomarker analyses are needed to better understand the potential role of MetS-related factors in colorectal carcinogenesis.

Introduction. Purple urine bag syndrome is a condition where the urinary catheter bag turns purple as a result of the interaction between bacteria, urine and components of the urine bag. It appears in a certain group of patients with the following risk factors: urinary tract infection, older age, long-term indwelling urinary catheter, constipation, chronic kidney disease. Case Report. Two patients with purple urine bag syndrome are presented. The first patient, a 66-year-old man, was hospitalized due to decompensation of alcoholic liver cirrhosis. A urinary catheter was placed on admission, and on the fourteenth day of hospitalization, a purple discoloration of the urine in the urinary bag was noticed. Multidrug-resistant Proteus mirabilis and Enterococcus faecalis were isolated by microbiological analysis of urine. The second patient was a 92-year-old man, hospitalized for acute gastrointestinal bleeding in the form of hematochezia, with an indwelling urinary catheter and a history of a prostate cancer surgery. On the third hospital day, a purple content in the urinary catheter bag was detected and Klebsiella pneumoniae and Morganella morganii were confirmed by bacteriological analysis. Both patients were without clinical and laboratory signs of acute infection. In both cases, the urinary catheter was replaced and ceftriaxone was administered empirically. Conclusion. Current guidelines for purple urine bag syndrome recommend catheter replacement and empiric antibiotic therapy. In clinical practice, it is necessary to emphasize that urine sampling for bacteriological analysis is performed only after replacing the catheter, in order to establish the exact etiology of the syndrome and radical use of antibiotics.

Introduction. Between 20 - 60% of patients with chronic hepatitis C present with elevated serum ferritin and iron, as well as increased transferrin saturation, yet without a significant liver iron burden. The objective of this article was to summarize current knowledge on interactions between hepatitis C virus infection and iron metabolism. Case Report. A 34-year-old female patient positive for hepatitis C virus genotype 3, underwent therapy of chronic hepatitis C with pegylated interferon/ribavirin. The therapy was discontinued after four weeks due to leukopenia, anemia and significantly increased ferritin levels. Liver biopsy (Perl?s stain) revealed iron deposition predominantly in periportal hepatocytes. The therapy of chronic hepatitis C was continued by direct-acting (sofosbuvir/antiviral/velpatasvir) drugs. During the course of the therapy, the patient presented with normal complete blood count, ferritin of 150 ?g/l, and ferremia at upper limit of normal. Twelve weeks after the end of the therapy, the patient showed a sustained virologic response. The additional diagnostics of hereditary hemochromatosis has been performed, and therapeutic phlebotomy procedures were initiated. Conclusion. In patients with chronic hepatitis C and significantly elevated serum ferritin and iron, the diagnosis should be extended to hereditary hemochromatosis.