Background: Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) remains the most frequent and clinically significant complication of ERCP, with a multifactorial etiology involving patient- and procedure-related risk factors. Despite preventive measures such as NSAIDs and peri-procedural stenting, the incidence of PEP has not substantially declined. We aimed to assess clinical determinants of PEP in a large real-world cohort treated with standardized procedural protocols. Materials and Methods: This retrospective single-center study analyzed 806 patients who underwent ERCP between January 2019 and December 2021. All procedures were performed by a single operator under general anesthesia with standardized prophylaxis (diclofenac 100 mg per rectum and cefazolin 2 g intravenously). Patients with delayed ERCP (>48 h from admission) or active acute pancreatitis were excluded. Logistic regression was used to identify independent predictors of PEP, hospital stay, and in-hospital mortality. Results: PEP occurred in 60 patients (7.4%). Independent risk factors included stenosis of the papilla of Vater (OR = 2.45; p = 0.025), gallbladder stones (OR = 2.66; p = 0.001), prior acute pancreatitis (OR = 2.72; p = 0.005), and sphincterotomy (OR = 2.53; p = 0.016). PEP was associated with longer hospitalization (MD = 4.5 days; p < 0.001) and increased in-hospital mortality (6.7% vs. 1.7%; p = 0.032). Conclusion: Stenosis of the papilla, gallbladder stones, prior acute pancreatitis, and sphincterotomy independently increased the risk of PEP, whereas older age, previous ERCP, and pancreaticoduodenal tumors were associated with a reduced risk. Despite standardized prophylaxis, PEP remains a relevant clinical concern. Identification of high-risk patients and individualized procedural planning are essential to minimizing complications.

Zaburzenia psychosomatyczne to zaburzenia organiczne, w których etiopatogenezie znaczący udział mają czynniki psychospołeczne. W niniejszej pracy przeanalizowano wpływ depresji, zaburzeń snu, samopoczucia, zadowolenia z jakości życia, stosowania substancji uzależniających, sytuacji w miejscu pracy, sytuacji rodzinnej i stresu na występowanie migotania przedsionków, kołatania serca, omdleń, bólów w klatce piersiowej, a także choroby wieńcowej i niewydolności serca. Stwierdzono istnienie korelacji między zaburzeniami psychosomatycznymi a występowaniem wybranych schorzeń układu sercowo-naczyniowego. Pozwala to na wysunięcie wniosku, że podczas zbierania wywiadów u pacjentów kardiologicznych należy uwzględnić również czynniki mające potencjalnie negatywny wpływ na ich zdrowie psychiczne, będące jednocześ­nie czynnikami ryzyka wystąpienia lub zaostrzenia już istniejących chorób układu sercowo-naczyniowego.

Introduction: Measuring glomerular filtration rate (GFR) with the isotopic method is a gold standard. However, it is an elaborate and expensive procedure, so in everyday practice GFR is estimated with creatinine-based formulas. Despite the number of studies, it remains unclear which GFR estimating equation is the most accurate, especially in increasing elderly population. Aim: The aim of this study was to compare the commonly used formulas to assess which one of them should be used in elderly female non-diabetic patients suffering from chronic kidney disease (CKD) Material and methods: 336 non-diabetic females aged 70 and more were qualified to the study. On the basis of serum creatinine concentration, estimated GFR (eGFR) was estimated using various formulas. Results and discussion: The eGFR and CKD stages differ significantly depending on the used formula. The modification of diet in renal disease equation (MDRD) formula showed slightly, but still significantly, better correlation with creatinine concentration in serum than the CKD epidemiology collaboration equation. The Cockcroft-Gault equation formula was significantly inferior to above mentioned equations. The receiver operating characteristic curves showed that MDRD is the most sensitive equation and the differences between formulas compared in pairs were significant. Conclusions: Due to its highest correlation with creatinine and its highest sensitivity and specificity, the MDRD formula seems to be the most accurate equation to estimate GFR in elderly non-diabetic females.

Wprowadzenie: Zależność pomiędzy migotaniem przedsionków (AF) a przewlekłą chorobą nerek (CKD) jest dwukierunkowa. Obie choroby charakteryzują się dużą częstością występowania, zwiększającą się z wiekiem. Przewlekła choroba nerek, zwłaszcza przy współczynniku przesączania kłębuszkowego (GFR) poniżej 60 ml/min/1,73 m², jest uznanym niezależnym czynnikiem ryzyka AF. Jednak ich wzajemna relacja nie została jeszcze dokładnie zbadana u chorych w podeszłym wieku, szczególnie starszych kobiet. Cel pracy: Ocena, czy u kobiet w podeszłym wieku występuje zależność pomiędzy CKD a AF i czy jest ona dwukierunkowa. Materiał i metody: Dane pochodziły z grupy 336 kobiet w wieku od 70 do 84 lat leczonych ambulatoryjnie z powodu CKD. Wyniki: Spośród 336 pacjentek w wieku powyżej 70 lat leczonych ambulatoryjnie z powodu CKD (10,12% miało GFR < 60 ml/min/1,73 m²) włączonych do badania u 8,63% rozpoznano AF, u 21,3% cukrzycę, u 63,99% nadciś­nienie tętnicze, natomiast 4,46% przebyło zawał serca, a 2,68% udar mózgu. Nie wykazano żadnego związku pomiędzy CKD a AF zarówno ze względu na stopień CKD, jak i w analizie wieloczynnikowej. Migotanie przedsionków korelowało jedynie z cukrzycą oraz udarem mózgu, ale nie z parametrami funkcji nerek. Wnioski: Choroba przewlekła nerek u kobiet w podeszłym wieku nie wpływała na występowanie AF, co sugeruje inny patomechanizm AF w tej grupie. Potrzebne są dalsze badania w celu ustalenia, w jakim mechanizmie AF rozwija się w tej grupie, oraz wyznaczenia potencjalnych czynników ryzyka.

Ntroduction Microscopic polyangiitis (MPA) is an antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) that can affect any organ. Sometimes, untypical localization, together with an unusual clinical manifestation of tumour-resembling inflammatory changes, can cause a delay in diagnosis and proper treatment. Aim The aim of this study was to expose the case of very rare location of MPA manifestation. Case study In this paper, we present the case of inflammatory testicular tumour-like lesion that was a manifestation of MPA and mimicked testicular cancer. Results and discussion It is probably first desribed case of MPA mimicking testicular cancer. However, in the literature some others AAV manifestation in that location can be found. In these patients orchiectomy was recommended much more often than a testicular biopsy. Conclusions We conclude that in case of a patient with untypical features of a tumour, inflammatory processes, including vasculitis, should be taken into consideration in differential diagnosis.

Background/Objectives: Hospital length of stay (LOS) in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) may reflect baseline condition and underlying disease as well as procedure-related morbidity. We evaluated factors associated with prolonged hospital stay (PLOS) and the association of post-ERCP pancreatitis (PEP) with hospitalization duration. Methods: This retrospective single-center secondary analysis included 806 consecutive patients undergoing ERCP within 48 h of admission in 2019–2021. PLOS was defined as total LOS ≥ 12 days, corresponding to hospitalization above the 75th percentile. Modified Poisson regression estimated adjusted risk ratios (aRRs); LOS was also analyzed using negative binomial and median quantile regression. Sensitivity analyses used LOS > 7 and >14 days, a PLOS/death composite, and a PEP-excluded cohort. Results: Among 788 live discharges with complete LOS data, 176 (22.3%) met the PLOS criterion. In the primary Model A, emergency admission (aRR 3.01, 95% CI 2.01–4.51), cholangitis/postoperative indication (aRR 2.71, 95% CI 1.57–4.66), liver disease (aRR 1.85, 95% CI 1.10–3.12), and age (aRR 1.12 per 10 years, 95% CI 1.02–1.22) were associated with PLOS. PEP was associated with PLOS when added as a post-procedural exposure (aRR 2.34, 95% CI 1.67–3.29). Baseline associations were broadly preserved across sensitivity analyses. Conclusions: Prolonged hospitalization was associated mainly with acute clinical context, underlying disease, and patient characteristics. PEP was also associated with longer hospitalization, but this result should be interpreted cautiously because the historical PEP adjudication rule was not retained.