Background: Early prognostication of acute pancreatitis (AP) patients for those at high risk of complications during hospitalization can facilitate clinical decision-making. Sarcopenia has been proven to be a risk factor for poor prognosis in patients with AP. We aimed to evaluate the association between the muscle parameters measured in computed tomography (CT) and the clinical outcomes of hospitalized patients with AP. Methods: A total of 132 consecutive patients hospitalized between 1 January 2015 and 31 December 2021 for AP with a valid CT scan were analyzed. The first CT conducted during hospitalization was analyzed for psoas muscle area (PMA), index (PMI), and density (PMD) at the L3 vertebral level. The main adverse outcomes indicating a worse prognosis were the development of extrapancreatic complications, infections, ICU transfer, in-hospital mortality, and hospitalization length. Results: The lowest tertile of PMI, as a surrogate for sarcopenia, was significantly correlated with increased rates of extrapancreatic complications, infections, and longer hospitalizations. It was additionally correlated with a worse CT severity index. The results for PMA and PMD also showed worse outcomes, largely mirroring the results for PMI. Although in-hospital mortality was relatively low, none of the patients died in the highest tertile of PMI. A clear cutoff with sufficient predictive capability could not be found. Conclusions: A low psoas muscle index can serve as an additional potential predictive marker for more severe disease and worse outcomes in hospitalized acute pancreatitis patients. More studies are needed to determine its combination with existing prediction tools.

Purpose: This study was aimed at identifying biomarkers that could help exclude pulmonary embolism (PE) in patients aged 65 years and older, considering age-related challenges such as atypical clinical presentations and the presence of comorbidities. Methods: This single-center cohort study retrospectively collected data on 28 potential markers from patients aged 65 years and older who underwent computed tomography scans for PE diagnosis in emergency or internal wards over a 2.5-year period. Results: The study included 157 patients after exclusions, with 35 diagnosed with PE. Patients with PE exhibited higher D-dimer levels, lower platelet counts, and higher Padua scores. Six markers were selected based on likelihood ratio, each with an area under the curve above 0.7 and P-value below 0.05. Multiplying D-dimer levels with the Padua score (PaDd) improved specificity from 9% to 32% while maintaining 100% sensitivity in identifying PE. Further refinement by incorporating activated partial thromboplastin time (aPTT) into the Padua score multiplied by D-dimer (PaDd/aPTT) resulted in improved sensitivity and specificity. Conclusion: The Padua score multiplied by D-dimer is a simple yet effective tool that enhances specificity while maintaining high sensitivity, potentially reducing computed tomography utilization in elderly patients. Prospective, multicenter studies are needed to validate these findings and integrate them into routine clinical practice.

The objectives of our study were to determine the mortality rates, causes, and risk factors of people living with HIV in the modern antiretroviral therapy era, in a major HIV center in Israel. We retrospectively collected data from 1547 patients treated during 2001–2021. We used the Shapiro–Wilk test, Fisher’s exact test, Student’s t test, and chi-square to compare between patients who died and those who did not, and between patients who died from AIDS-related and non-AIDS-related causes. In total, 206 (13.3%) patients died. The causes of death were AIDS-defining diseases (33.5%), cardiovascular diseases (21.8%), non-AIDS infections (16%), and hepatic disorders (7%). The annual mortality rate was 1.31 ± 0.3%. Despite an increase in age (35 ± 13.2 in 2001, 49 ± 13.6 years in 2021; p < 0.001), the mortality rate decreased (2.12% during 2005–2008, 0.71% during 2018–2021; p = 0.0001). AIDS-defining diseases caused 75% of deaths during 2001–2002, and only 25% during 2019–2021. The proportion of cardiovascular deaths increased (8.3% in 2001–2003, 33.3% in 2019–2021; p < 0.001). Low CD4 and high viral load at diagnosis, male gender, non-MSM HIV acquisition (heterosexual transmission and people who inject drugs), and inability to achieve viral suppression because of non-compliance were risk factors for mortality. Mortality rates decreased during 2001–2021; however, the proportion of non-AIDS deaths increased. Early cardiovascular comorbidity screening and targeted adherence interventions in non-MSM populations and in patients with low CD4 are needed.