The COVID-19 pandemic affected over 130 million individuals during more than one year. Due to the overload of health-care services, a great number of people were treated as outpatients, many of them subsequently developing post-acute COVID-19 syndrome. Our study was conducted on 150 subjects without a history of cardiovascular diseases, treated as outpatients for a mild/moderate form of COVID-19 4 to 12 weeks prior to study inclusion, and who were diagnosed with post-acute COVID-19 and attended a cardiology evaluation with transthoracic echocardiography (TTE) for persisting symptoms. We detected various cardiac abnormalities in 38 subjects (25.33%), including pulmonary hypertension (9.33%), impaired left ventricular performance (8.66%), diastolic dysfunction (14%) and/or evidence of pericarditis (10%). We highlighted statistically significant correlations between the intensity of symptoms and quality of life scores with the severity of initial pulmonary injury, the number of weeks since COVID-19 and with TTE parameters characterizing the systolic and diastolic performance and pulmonary hypertension (p < 0.001). (Post-acute COVID-19 is a complex syndrome characterized by various symptoms, the intensity of which seem to be related to the severity and the time elapsed since the acute infection, and with persisting cardiac abnormalities.

Background: Endoscopic retrograde cholangiopancreatography (ERCP) represents a major pivotal point in gastrointestinal endoscopy. Little is known about acute kidney injury (AKI) post-ERCP. This study analyses the incidence, risk factors, and prognosis of post-ERCP AKI. Methods: A total of 396 patients were prospectively studied. AKI was defined by an increase in serum creatinine (SCr) ≥ 0.3 mg/dL or by an increase in SCr ≥ 50% in the first 48 h post-ERCP. Logistic regression analysis was used to identify the predictors of AKI and in-hospital mortality. A two-tailed p value < 0.05 was considered significant. Results: One hundred and three patients (26%) developed post-ERCP AKI. Estimated glomerular filtration rate (adjusted odds ratio (aOR) = 0.95, 95% confidence interval (CI): 0.94–0.96, p < 0.001), nonrenal Charlson Comorbidity Index (Aor = 1.19, 95% CI: 1.05–1.35, p = 0.006), choledocholithiasis (aOR = 4.05, 95% CI: 1.98–8.29, p < 0.001), and bilirubin (aOR = 1.1, 95% CI: 1.05–1.15, p < 0.001) were associated with post-ERCP AKI. Post-ERCP AKI was associated with longer hospital stay (p < 0.001) and with increased in-hospital mortality (7.76% versus 0.36%, p < 0.001). Moderate-to-severe (stage 2 and 3) AKI was independently associated with in-hospital mortality (aOR = 6.43, 95% CI: 1.48–27.88, p < 0.013). Conclusions: Post-ERCP AKI represented an important complication associated with longer hospital stay. Moderate-to-severe post-ERCP AKI was an independent risk factor for in-hospital mortality.

Background/Objectives: To date, delirium is considered one of the most frequent acute neuropsychiatric syndromes among hospitalized populations, although there is a lack of data regarding its frequency and predictors in nephrological patients. The aims of this study were to investigate the prevalence of and the risk factors for delirium and to evaluate the association between delirium and short-term clinical outcomes, including the length of stay (LOS) and in-hospital mortality rate among patients from the nephrology unit of a tertiary university hospital in Eastern Europe. Method: A cohort of 942 patients admitted between January 2023 and December 2023 were enrolled in a prospective observational study. Delirium was diagnosed by a psychiatrist during hospitalization. The endpoint was defined as hospital death or hospital discharge. Results: In the studied group, the median age was 65 years, and 519 (55.09%) patients were males. The prevalence of delirium was 5.41% (51/942 patients). The patients with delirium had a significantly longer LOS (11.96 days vs. 8.86 days, p = 0.007) and a significantly higher in-hospital mortality rate (47.05% vs. 14.36%, p < 0.001) compared to the patients without delirium. The independent predictors of delirium were as follows: age (OR = 1.029; 95%CI: 1.002–1.056; p = 0.034), history of stroke (OR = 3.493; 95%CI: 1.849–6.598; p < 0.001), alcohol abuse (OR = 4.728; 95%CI: 1.968–11.359; p = 0.001), and AKI stages 2 and 3 (OR = 2.175; 95%CI: 1.152–4.105; p = 0.017). From a time-to-event analysis, delirium was associated with increased mortality (HR = 2.77; 95%CI: [1.79 to 4.29]; p < 0.001). Moreover, delirium was independently associated with increased in-hospital mortality (OR = 1.666; 95%CI: 1.069–2.597; p =0.024). Conclusions: Among nephrological patients, age, alcohol abuse, history of stroke, and AKI stages 2 and 3 were independent risk factors for delirium. Delirium significantly increased the LOS and in-hospital mortality.

Background: IgG4-RD is an autoimmune fibro-inflammatory condition with chronic evolution and systemic involvement. The incidence is not clearly established. IgG4-RD can easily mimic other pathologic conditions, such as tumors and infections; therefore, affected patients are frequently misdiagnosed and sometimes undertreated. The disease can affect multiple organs and needs a multidisciplinary therapeutic approach. Sometimes, the lack of diagnosis is a result of the high cost of dedicated serological analyses, as well as patient non-compliance. Methods: This review summarizes the current state of knowledge regarding the diagnosis and treatment of IgG4-RD, together with the authors’ practical experience. Results: The diagnosis of IgG4-RD has no specific clinical, paraclinical, or imaging aspects. This condition can mimic any other disease in the affected organ. Frequently, a diagnosis will result from the exclusion of other diseases and even the analysis of a patient’s reaction to a dedicated treatment. Spontaneous remission is rarely observed, and recurrence is common . Most patients have a favorable response to glucocorticoid therapy, but there is a need for maintenance treatment due to the risk of recurrence. Conclusions: IgG4-RD is an underdiagnosed and undertreated condition due to the lack of specific clinical, paraclinical, and imaging changes, the cost-related limitations of dedicated laboratory analyses, and patient non-compliance. If, in the case of patients with fibro-inflammatory changes in one or more structures, the diagnosis of IgG4-RD is excluded, even by elimination, the complications of its occurrence are prevented. This approach is cost-effective, as it prevents complications that require acute and long-term supportive treatment.