Background/Objectives: Multi-organ failure (MOF) often complicates advanced heart failure (HF), contributing to a poor prognosis. The Model of End-Stage Liver Disease 3.0 (MELD-3.0) scale incorporates liver and kidney function parameters. This study aims to evaluate the prognostic significance of the MELD-3.0 score in patients with advanced HF who have undergone heart transplantation (HTx). Methods: The MELD-3.0 score was computed using the average values of the international normalized ratio and bilirubin, creatinine, sodium, and albumin levels during a hospital stay following HTx. The average MELD-3.0 scores from the period of 1 month preceding HTx and 1 week after HTx were analyzed. The primary endpoint of the study was the 6-month total mortality, and the secondary endpoint was ICU hospitalization time after HTx. Results: The analysis included 106 patients undergoing HTx, with a median age of 53 years (44–63), 81% of whom were male. Within 6 months post-HTx, 17 patients (16%) died; those patients had a higher 1-week post-HTx MELD-3.0 score of 18.3 (14.5–22.7) in comparison to survivors, whose average score was 13.9 (9.5–16.4), p < 0.01. There was no difference in MELD 3.0 score in the pre-HTx period: 16.6 (11.4–17.8) vs. 12.3 (8.6–17.1), p = 0.36. The post-HTx MELD-3.0 score independently predicted death: RR 1.17 (95% CI 1.05–1.30), p < 0.01. A Receiver Operating Characteristic (ROC) determined the cut-off value of the MELD-3.0 score as 17.3 (AUC = 0.83; sensitivity—67%; specificity—86%). Survivors with scores above this value had a longer ICU hospitalization time: 7 (5.0–11.0) vs. 12 (8–20) days (p = 0.01). Conclusions: The post-HTx MELD-3.0 score serves as an independent predictor of an unfavorable prognosis in patients with advanced HF undergoing HTx. The evaluation of MELD-3.0 scores provides additional prognostic information in this population.

Background: Multi-organ failure (MOF) is a common complication of advanced heart failure (HF), significantly influencing patient prognosis. This study aimed to assess and compare the impact of orthotopic heart transplantation (HTx) and left ventricular assist device (LVAD) implantation on the severity of MOF, as measured by the model for end-stage liver disease excluding INR (MELD-XI) score. Methods: Data from 1 month before to 1 year after HTx or LVAD implantation were analysed. The MELD-XI score was calculated using average bilirubin and creatinine values. Comparative assessments of MELD-XI scores were performed within the HTx and LVAD groups at various time points pre- and post-procedure. Results: The analysis included 107 HTx patients and 30 LVAD patients. The median MELD-XI score 1 month pre-procedure was 11.7 (9.4–16.7) in all patients. There were no significant differences in MELD-XI scores between the groups at 3-, 6-, and 12-month follow-ups. However, a significant difference was observed 1 month post-procedure [HTx: 14.8 (9.4–17.7) vs. LVAD: 11.2 (7.3–14.9), p = 0.02]. In the LVAD group, a significant decrease in MELD-XI score was noted for 3 months post-procedure compared to 1 month pre-procedure (p < 0.001), whereas at 6- and 12-month follow-ups the score did not differ from pre-procedural scores. In the HTx group, significant decreases in MELD-XI scores were observed from 3 months, 6 months, and 1 year post-procedure compared to 1 month pre-procedure (p < 0.002). Conclusions: The MELD-XI scale reveals different MOF trajectories between HTx and LVAD recipients. Both interventions lead to early improvements in liver and kidney function, with sustained benefits in HTx patients, highlighting the distinct impacts on organ function.

Background: Autism spectrum disorder (ASD) is traditionally considered a neurodevelopmental condition typically identified in early childhood. However, a substantial proportion of individuals receive their first diagnosis only in adolescence or adulthood, which may affect mental health, access to support, and overall quality of life. Objective: This review examines late diagnosis of ASD in adults and summarizes current evidence on factors contributing to diagnostic delay, including camouflaging behaviours, psychiatric comorbidities, and suicidality. Methodology: A literature search was conducted using PubMed and Google Scholar to identify studies published between 2000 and 2025. Search terms included combinations of “autism,” “adult diagnosis,” “diagnostic delay,” “camouflaging,” “psychiatric comorbidity,” and “suicide.” Studies focusing on adult populations, diagnostic pathways, and mental health outcomes were prioritized. In total, 36 publications were included. Due to methodological heterogeneity across studies, findings were synthesized narratively. Results: Definitions of late ASD diagnosis vary across studies, with inconsistent age thresholds. Many adults diagnosed with ASD report prior psychiatric diagnoses, although registry data indicate that a substantial proportion had no documented psychiatric conditions during childhood. Camouflaging behaviours, particularly among women, may contribute to delayed recognition and are associated with increased psychological distress. Adults with ASD show elevated rates of depression and anxiety, with lifetime prevalence of depressive disorders reaching 30–40% in some studies. Population-based research also indicates increased risk of suicidality. Conclusions: Late identification of ASD in adulthood is associated with complex diagnostic pathways and a high prevalence of psychiatric comorbidity. Improving awareness of adult autism among clinicians may contribute to earlier recognition and more appropriate support for affected individuals. Further research is needed to refine diagnostic tools and to better understand long-term mental health outcomes in people diagnosed with ASD later in life.

Objective: This review aims to compare surgical and conservative treatment methods for degenerative meniscus injuries. Methods: A literature search was conducted in PubMed, Scopus, Web of Science, and the Cochrane Library to identify randomized controlled trials published from 2012 onwards. Eligible studies evaluated adult patients with degenerative meniscal tears confirmed by magnetic resonance imaging or radiographs, comparing surgical interventions with non-operative treatments. Results: Evidence from high-quality trials indicates that conservative approaches are comparable to surgical interventions in improving long-term patient-reported outcomes. While arthroscopic partial meniscectomy (APM) yields significant initial clinical improvements, it offers no meaningful long-term advantage over structured physical therapy. Placebo-controlled trials demonstrate that the perceived therapeutic benefits of APM are predominantly due to the non-specific effects of the surgical act itself rather than the removal of damaged tissue. Conversely, APM exposes the knee to accelerated degenerative changes, including an increased risk of radiographic osteoarthritis progression and a five-fold higher likelihood of ultimately requiring a total knee replacement. Furthermore, patients who crossover from physical therapy to delayed surgery due to unsatisfactory results do not achieve superior functional outcomes compared to those who remain in conservative management. Conclusion: Current clinical guidelines advocate for at least three months of structured physical therapy as the primary, first-line treatment for degenerative meniscal lesions. Adopting a conservative approach maximizes patient benefit, prioritizes the preservation of the meniscus, and supports long-term joint longevity.

Introduction and purpose: Perioperative nutritional care has become an increasingly important component of colorectal cancer (CRC) surgery, particularly in patients with malnutrition, sarcopenia, frailty, or increased metabolic vulnerability. This systematic review aimed to evaluate the effectiveness and safety of perioperative nutritional interventions in CRC surgery and to determine whether their clinical benefit is uniform or mainly concentrated in high-risk patients. Material and methods: A systematic review of randomized controlled trials was conducted in accordance with PRISMA guidelines. PubMed/MEDLINE, Cochrane Library, and Scopus were searched through March 12, 2026. Eligible studies included adult patients undergoing elective CRC surgery and evaluated carbohydrate loading, early oral feeding, oral nutritional supplementation, immunonutrition, or multimodal prehabilitation including a nutritional component. Primary outcomes were postoperative complications and length of hospital stay; secondary outcomes included infectious complications, anastomotic leakage, recovery parameters, metabolic response, patient-reported outcomes, and safety. Results: Twenty-one randomized controlled trials were included. Early oral feeding and carbohydrate loading were mainly associated with improved postoperative recovery, gastrointestinal function, and patient-reported well-being, whereas their effects on major clinical endpoints were less consistent. Oral nutritional supplementation and targeted nutritional support appeared most beneficial in malnourished or nutritionally at-risk patients. Immunonutrition showed the clearest signal for reduced infectious morbidity and attenuation of perioperative inflammatory response. Multimodal prehabilitation improved functional recovery and appeared particularly relevant in frail or high-risk patients. Across intervention types, safety profiles were generally acceptable. Conclusions: Perioperative nutritional interventions may provide clinically meaningful benefits in CRC surgery, but their effects are not uniform across all patients. Current evidence supports a risk-stratified approach, with the greatest benefit observed in patients with increased nutritional or physiological vulnerability.

Background: Gallstone disease is a chronic condition characterized by the formation of calculi within the biliary tract. It represents a common health issue, particularly among obese populations or those with type 2 diabetes. An increasing number of clinical evidence suggests a potential association between an elevated risk of gallstone development and the chronic use of GLP-1 receptor agonists. Objective: The aim of this study was to analyze the impact of GLP-1 receptor agonist therapy on the risk of biliary complications, with particular emphasis on gallstone disease. Selected clinical studies and meta-analyses were reviewed, and the mechanisms of gallstone formation, as well as their clinical implications for patient management and therapy selection, were evaluated. Methods: We analyzed the effects of GLP-1 receptor agonists on gallstone development, gallbladder function, gastrointestinal hormonal regulation, and the impact of rapid weight loss, based on widely available randomized clinical trials and meta-analyses. Results: GLP-1 receptor agonists are associated with an increased risk of gallstone formation, primarily due to the promotion of rapid weight loss, as well as their effects on gastrointestinal hormonal regulation and gallbladder function, particularly in obese individuals and those with type 2 diabetes. Conclusions: Chronic therapy with GLP-1 receptor agonists constitutes a risk factor for the development of gallstone disease. However, further long-term clinical studies in larger populations are needed to clarify the underlying mechanisms of this association.