Systemic inflammatory response (SIR) indicators are an emerging category of serum biomarkers with significant potential as prognostic and predictive factors in various types of cancers The primary focus of our study was to determine the prognostic value of the lymphocyte-to-monocyte ratio (LMR), platelet-to-albumin ratio (PLR) and platelet-to-albumin ratio (PAR) in evaluating the response to neoadjuvant treatment for patients with rectal cancer. We included 99 consecutive patients with rectal cancer which were admitted for surgery in our institution after completing a standard neoadjuvant radio-chemotherapy regimen. Several hematologic parameters, including LMR, PAR and PLR, were calculated by collecting and analyzing blood samples preoperatively. Cases were divided into groups using ROC curve analysis to determine optimal cutoff values for each of the investigated parameters. Treatment response was assessed through histopathological analysis of the resected specimens. PLR values over 215.2 were correlated with the presence of lymph node metastasis. A similar correlation was observed between PAR values over 41.89 and lymph node positivity. A significant correlation was observed between the presence of tumor budding on histopathological analysis and high-PAR values. A statistically significant correlation between a high PLR and a good response to neoadjuvant treatment was determined. High PLR values may be associated with a more favorable treatment response to neoadjuvant radio-chemotherapy. A high PAR may be associated with unfavorable histopathological characteristics. Further studies on these readily available biomarkers are required in order to validate their clinical utility.

Background/Objectives: Alcoholic acute pancreatitis (AP) is a major cause of hospital admissions in Eastern Europe. However, data from secondary-care centers on the impact of the COVID-19 pandemic are limited. Methods: We retrospectively analyzed all adult AP admissions to a secondary-care hospital between March 2018 and March 2025. Cases were classified by etiology and grouped into pre-pandemic, pandemic, and post-pandemic periods. We compared demographic, clinical, severity, recurrence, outcome, resource use, and cost data between alcoholic and non-alcoholic AP. Results: Among 1096 patients (63.5% male; median age 55 years), alcohol was the leading etiology (40.1%), peaking during the pandemic. Alcoholic AP was more common in men, rural residents, and smokers, and less common in patients with obesity or diabetes. Recurrence was higher in alcoholic AP (21.8% vs. 15.9%; p = 0.015). Severe disease was more frequent in alcoholic than biliary AP (38.4% vs. 22.3%; p = 0.001). Overall mortality was 8.4%, declining after the pandemic (10.4% pre-pandemic vs. 6.5% post-pandemic). In multivariable Cox models, pleural effusion (HR 7.88; 95% CI 3.27–18.99) and age (HR 1.02; 95% CI 1.00–1.03) independently predicted mortality in the overall cohort. In alcoholic AP, pleural effusion was the only independent predictor (HR 13.19; 95% CI 2.48–70.08). In non-alcoholic AP, pleural effusion (HR 6.83; 95% CI 2.40–19.44) and signs of shock (HR 3.49; 95% CI 1.14–10.71) were independent predictors. Conclusions: Alcoholic AP was the most frequent etiology, with higher recurrence and severity than biliary AP, but alcoholic etiology itself did not predict mortality. Mortality drivers differed by etiology: pleural effusion in alcoholic AP, and pleural effusion plus signs of shock in non-alcoholic AP. ICU transfer was associated with death in descriptive analyses but was treated as a downstream mediator and not included in adjusted models.