Background: Systemic inflammation through neutrophil-mediated injury, lymphocyte depletion, and monocyte-driven fibrosis plays a central pathophysiological role in heart failure (HF) progression. We investigated the diagnostic and prognostic utility of contemporary inflammatory indices, particularly the Systemic Inflammatory Response Index (SIRI) and Naples Prognostic Score (NPS). Methods: This retrospective cohort study enrolled 926 participants (500 HF patients, 426 controls). Multiple inflammatory indices (e.g., SIRI, Prognostic Nutritional Index (PNI)) and prognostic scores (e.g., NPS) were calculated from routine hematological and biochemical parameters. Primary outcomes were HF diagnosis discrimination and 3-month and 24-month all-cause mortality. Receiver operating characteristic (ROC) curve analysis, Kaplan–Meier survival curves, and Cox proportional hazards regression were performed. Results: HF patients demonstrated significantly elevated inflammatory burden: SIRI (3.26 vs. 1.06, p < 0.001) and NPS (2.00 vs. 1.43, p < 0.001). For HF diagnosis, SIRI exhibited superior discriminative performance (AUC = 0.893; 95% confidence interval (CI): 0.871–0.912), substantially exceeding all other indices (p < 0.001). For long-term mortality prediction, SIRI maintained the highest accuracy (AUC = 0.677), followed by PNI (AUC = 0.639) and NPS (AUC = 0.613). Kaplan–Meier analysis revealed progressive survival deterioration across NPS categories: 24-month mortality increased from 5.9% (NPS = 0) to 23.0% (NPS = 4), p = 0.002. Multivariable Cox regression confirmed independent prognostic value: SIRI >1.86 (HR = 2.232; 95% CI: 1.280–3.892; p = 0.005) and NPS > 2 (HR = 1.403; 95% CI: 1.180–1.668; p < 0.0001). Conclusions: SIRI and NPS represent powerful, readily accessible prognostic tools capturing distinct but complementary pathophysiological domains in HF. These indices offer substantial clinical utility for risk identification and treatment decisions, particularly in resource-limited settings. Future studies should validate these cut-offs and evaluate biomarker-guided therapeutic strategies.

Early identification of patients at risk for severe acute pancreatitis (AP) remains a major clinical challenge. Although several clinical scores and inflammatory markers are used for risk stratification, their predictive performance is variable. ABO and Rh blood groups are fixed biological characteristics that have been associated with inflammatory and thrombotic conditions; however, their potential role in predicting the clinical course of acute pancreatitis remains unclear. This retrospective observational study included 512 patients hospitalized with a diagnosis of acute pancreatitis between January 2018 and May 2025. Diagnosis and disease severity were classified according to the Revised Atlanta Classification. ABO and Rh blood group information, along with demographic, laboratory, and clinical data, was obtained from the institutional hospital database. Patients were categorized as having mild or non-mild acute pancreatitis, the latter comprising moderately severe and severe disease. Statistical analyses were performed using the Chi-square test and the Mann–Whitney U test. Non-mild acute pancreatitis was observed in 17.8% of patients. The frequency of non-mild disease was significantly higher among individuals with blood group O compared with other ABO blood groups (24.5% vs 14.3%, P = .033). No significant association was identified between Rh factor and disease severity ( P = .88). Male sex, obesity (body mass index ≥ 30 kg/m ² ), and elevated C-reactive protein levels (>150 mg/L) at admission were significantly associated with a more severe disease course. Leukocyte count, hematocrit, and peak C-reactive protein levels were higher in the non-mild group, whereas amylase and lipase levels did not differ significantly between severity categories. Blood group O was associated with a higher prevalence of non-mild acute pancreatitis in this cohort. While ABO blood group alone should not be considered a standalone prognostic marker, its integration with established clinical and inflammatory parameters may contribute to early risk stratification. Further multicenter prospective studies are warranted to clarify the role of ABO blood groups in the clinical course of acute pancreatitis.

Background: Human papillomavirus-induced disruption of the anogenital mucosal barrier may increase susceptibility to other sexually transmitted infections (STIs), and guidelines recommend STI screening in patients with anogenital warts (AGW). We aimed to determine the seroprevalence of concomitant STIs in patients with AGW over a five-year period and to perform an exploratory assessment of associated demographic factors. Methods: In this retrospective, cross-sectional study, all consecutive patients clinically diagnosed with AGW between December 2020 and October 2025 (n = 779) were evaluated. Serological results for HBsAg, anti-HBs, anti-HCV, anti-HIV, and syphilis (treponemal and non-treponemal) were obtained. Seroprevalence was estimated with Wilson 95% confidence intervals (CIs) using the number of patients actually tested as the denominator. Patterns of multiple reactive serological markers were described, and the relationship between age and seropositivity was examined using a Cochran–Armitage trend test. Associations of demographic factors with concomitant STI seropositivity were explored using Fisher’s exact test with Woolf logit CIs and a complementary Firth penalized logistic regression; given the small number of events, these analyses were considered exploratory and hypothesis-generating. Results: Among 779 patients (585 [75%] male; mean age, 35.80 ± 12.32 years), the overall seroprevalence of concomitant STIs was 2.4% (19/779; 95% CI, 1.6–3.8). Seroprevalence was 1.4% for HBsAg, 0.9% for anti-HCV, 0.2% for anti-HIV, and 1.6% for treponemal antibodies, while anti-HBs immunity was present in 53.5% of patients. Two patients (10.5% of seropositive cases) had more than one concomitant STI. Seropositivity increased from 0.7% in patients aged 17–24 years to 3.5% in those aged ≥45 years, although the trend was not statistically significant (p = 0.13). Anti-HBs negativity was associated with concomitant STI seropositivity (OR = 5.63; 95% CI, 1.60–19.83; p = 0.003); this association was attenuated and no longer statistically significant after excluding HBV markers (OR = 2.73; 95% CI, 0.70–10.69; p = 0.200). A complete-case analysis restricted to patients with a fully defined testing panel yielded a similar prevalence estimate (2.8%; 95% CI, 1.7–4.5). Conclusions: The seroprevalence of the tested markers in patients with AGW was low but non-negligible and increased with age, while the subgroup of markers more consistent with current infection was less common. Anti-HBs negativity was associated with the composite outcome, but a sensitivity analysis showed this was largely attributable to its expected link with HBV status. These findings support guideline-recommended serological screening—including hepatitis B vaccination assessment—in all patients with AGW, and should be regarded as hypothesis-generating given the limited number of seropositive cases.

Background and Objectives: While percutaneous endoscopic gastrostomy (PEG) is a standard procedure for long-term enteral nutrition, the impact of precise intragastric tube localization on complications remains underexplored. This study aimed to determine whether proximal versus distal placement is a significant determinant of PEG-related complications and to identify associated risk factors. Materials and Methods: This retrospective study evaluated the medical records of 268 adult patients who underwent PEG for the first time at a single center between June 2022 and January 2025. Patients were divided into two groups based on the intragastric position of the PEG tube: Group A (proximal placement) and Group B (distal placement), defined anatomically in relation to the incisura angularis. The complication rate was 30.6% in patients with distally placed PEG tubes, compared to 14.1% in those with proximal placement. Demographic characteristics, PEG indications, body mass index (BMI), comorbidities, and anticoagulant use were recorded. Complications were classified as early (≤7 days) or late (8 days–6 months), and by severity as minor or major. Results: The complication rate was 30.6% in patients with distally placed PEG tubes, compared to 14.1% in those with proximal placement (p = 0.004), corresponding to an odds ratio of 2.7 (95% CI: 1.4–5.2). Both early and late complications, as well as minor and major events, were more frequently observed in the distal group. Patients with a low BMI and male patients demonstrated significantly higher co mplication rates (p = 0.0001 and p = 0.003). Five patients (1.8%) died due to PEG-related complications. Conclusions: PEG tubes positioned in the distal stomach carry a significantly higher risk of complications compared to proximal placement. These findings suggest that proximal intragastric positioning should be prioritized whenever feasible during PEG insertion to improve patient safety.

Background/Objectives: Acyclovir, valacyclovir, and famciclovir are widely used antiviral agents, but comparative data on neuropsychiatric adverse event reporting are limited. This study’s aim was to compare neuropsychiatric adverse event reporting among acyclovir, valacyclovir, and famciclovir and to evaluate the influence of demographic and temporal factors. Methods: A retrospective pharmacovigilance analysis was conducted using the FDA Adverse Event Reporting System (FAERS, Q4 2003–Q3 2025). Unique reports in which acyclovir, valacyclovir, or famciclovir was the primary suspect drug were analyzed. Disproportionality was assessed using the reporting odds ratio (ROR), proportional reporting ratio (PRR), and information component (IC). Between-drug differences in the proportion of neuropsychiatric reports were examined using multivariable logistic regression adjusted for age, sex, region (with Japan as a separate category), and reporting year, together with overlap and inverse probability weighting and sensitivity analyses. A narrow clinical phenotype (encephalopathy/neurotoxicity, altered consciousness/delirium, hallucination/psychosis, and seizure) was the primary outcome, and a broad System Organ Class (SOC)-based definition was a secondary outcome. Results: Of 16,071 unique primary-suspect reports (acyclovir, 6641; valacyclovir, 8980; famciclovir, 450), 4942 (30.8%) contained at least one nervous system or psychiatric Preferred Term (broad definition), and 2471 (15.4%) contained the narrow phenotype. All three drugs showed strong disproportionality signals for encephalopathy-related terms (e.g., toxic encephalopathy ROR 71.63 for acyclovir and 123.39 for valacyclovir; neurotoxicity ROR 55.74 and 48.57, respectively). For the primary narrow phenotype, reporting did not differ between valacyclovir and acyclovir (aOR 1.06, 95% CI 0.96–1.17) and was not higher for famciclovir (aOR 0.72, 95% CI 0.54–0.96; adjusted p = 0.055). Only with the secondary broad definition was the adjusted proportion of neuropsychiatric reports higher for valacyclovir (aOR 1.15, 95% CI 1.07–1.24) and famciclovir (aOR 1.41, 95% CI 1.14–1.75) than for acyclovir. The valacyclovir difference was confined to reports from Japan (aOR 1.88, 95% CI 1.52–2.33) and was absent elsewhere (aOR 1.06, 95% CI 0.98–1.15; interaction p < 0.001), whereas the famciclovir excess reflected non-specific terms such as dizziness and headache. Older age was independently associated with neuropsychiatric reporting (narrow phenotype: aOR 2.52, 95% CI 2.24–2.82). Conclusions: Acyclovir, valacyclovir, and famciclovir share a consistent, encephalopathy-dominated neuropsychiatric reporting signal in FAERS. Apparent between-drug differences depended on the case definition and on reports from Japan and should not be interpreted as differences in neurotoxic risk. Clinical vigilance for encephalopathy is warranted with all three agents, particularly in older patients, while recognizing that FAERS data cannot establish causality or absolute risk.