Stanisław Głuszek

Background/Objectives: Research indicates a bidirectional association between obesity and depression. The co-occurrence of both disorders has serious clinical implications. The aim of this study was to assess the prevalence of self-reported depressive symptoms (DS) in a group of men and women with obesity and to identify the health factors, sociodemographic factors and lifestyle elements associated with the severity of DS among these persons. Methods: The participants in the study were a group of 3742 persons aged 42–65 years with a BMI ≥ 30.0 kg/m². A multivariate negative binomial regression analysis was performed in order to determine the expected number of DS. Results: Almost 28% of the participants with obesity showed at least four DS. The factors with the strongest associations with the number of DS were experiencing stressful events over the past year (IRR = 1.28, 95% CI: 1.23–1.33, p < 0.001), gender (IRR = 0.82, 95% CI: 0.79–0.85, p < 0.001) and multimorbidity (IRR = 1.10, 95% CI: 1.06–1.14, p < 0.001). The prevalence of DS was also associated with some socioeconomic factors (place of residence, education and marital status) and lifestyle factors (smoking, TV-viewing time, sleep duration and regular participation in organised groups or associations). Conclusions: Further longitudinal and intervention studies are necessary in order to better understand the factors related to the prevalence of DS in persons with obesity.

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.

Introduction: A patient’s voice, after thyroidectomy uncomplicated by recurrent laryngeal nerve damage, may undergo both objective and subjective changes. The intensity and duration of these changes are unclear.Aim: To perform a subjective and acoustic analysis of the voice in patients after thyroidectomy uncomplicated by recurrent laryngeal nerve damage.Materials and methods: A prospective study was performed at an endocrinological surgery clinic in Poland between 2018 and 2019. The study included 70 patients who had undergone thyroidectomy due to a noncancerous goiter. The Voice Handicap Index was used for a subjective assessment of the voice. An acoustic analysis was performed using the DiagnoScope Specjalista software, designed for a comprehensive assessment of the voice. A three-stage laryngologic examination was performed.Results: The mean age of the participants was 53 years (71% women and 29% men). Most of the patients (80.0%) subjectively assessed their vocal impairment as minor, 18.6% as moderate, and 1.4% as severe. The patients assessed the physical state of their voice as the worst. The short-term parameters obtained through an acoustic analysis differed significantly between the subsequent measurements and were worst on the second day after the operation. The changes subsided six months after the operation. Similarly, a significant improvement in the long-term parameters was observed six months after the operation; specifically, the phonation time (15.11 vs 12.64 vs 16.14) and the performance index (7.91 vs 6.50 vs 9.04). No significant changes were observed between each measurement in terms of the no phonation index, voice breaks coefficient, and the F0 modulation index.Conclusions: Voice impairment after thyroidectomy is frequent, according to a subjective assessment, and has been confirmed by an acoustic analysis of the short- and long-term parameters of the voice. These changes usually subside six months after the operation. Some patients require speech therapy to normalise their voice emission technique.

Purpose: To evaluate the clinical associations of admission non-contrast CT morphology in acute pancreatitis within a real-world emergency workflow. Materials and methods: This retrospective observational cohort study included 264 consecutive adult patients admitted with acute pancreatitis to two surgical centers between 2019 and 2024. Patients were categorized according to the first imaging modality obtained at admission into an ultrasound-first (US-first) or computed tomography–first (CT-first) pathway. Baseline characteristics and in-hospital outcomes were compared between pathways. In the CT-first subgroup, all examinations were performed without intravenous contrast, and morphologic severity was assessed using the Balthazar classification. Associations between CT morphology and clinical outcomes were evaluated using univariable analyses. Results: Of the 264 patients, 143 (54.2%) were managed within a US-first pathway and 121 (45.8%) underwent CT as the initial imaging modality. Baseline demographic and etiologic characteristics were comparable between pathways. Patients in the CT-first pathway demonstrated numerically higher rates of adverse clinical outcomes at admission, including a longer length of hospital stay (median 8 vs. 6 days; p = 0.01) and numerically higher rates of severe acute pancreatitis and in-hospital mortality. Within the CT-first cohort, non-contrast CT morphology demonstrated heterogeneous inflammatory severity. Higher Balthazar grades were associated with stepwise numerical increases in rates of severe disease, complications, and length of hospital stay. When dichotomized, advanced morphologic severity (Balthazar grades D–E) showed higher odds of adverse outcomes compared with grades A–C, although these associations did not reach statistical significance. Conclusion: In routine emergency practice, selection of ultrasound-first or CT-first imaging pathways appears largely driven by triage and organizational factors rather than predefined imaging strategies. In patients undergoing non-contrast CT at admission, higher Balthazar grades demonstrated consistent numerical gradients toward more severe clinical courses; however, these associations did not reach statistical significance. Early non-contrast CT morphology should therefore be interpreted as contextual inflammatory assessment rather than a standalone prognostic tool.

Total reflection X-ray fluorescence (TXRF) analysis was used to determine element concentrations in blood serum samples of patients receiving parenteral nutrition. The concentrations of elements were measured in the serum samples two times, namely in the first day (measurement I) of the treatment and on the seventh day (measurement II) after nutrient supplementation. For comparison purposes, also serum samples of 50 patients without nutritional disorders, admitted to a planned cholecystectomy (surgical procedure of the gall bladder removal), were analyzed and treated as the control group. Descriptive statistics of measured concentrations of P, S, Cl, K, Ca, Cr, Fe, Cu, Zn, Se, and Br were determined both for the studied and control groups. Statistical analysis of the results concentrates on verifying the type of element concentration distributions. Next, the comparison of element concentration between groups of women and men was done. Parenteral nutrition resulted in a significant increase in supplemented Se and a decrease in Cu concentrations between measurement I and II. Parametric as well as nonparametric approaches were applied to verify the hypothesis. Additionally, it was found out that for some elements differences between the studied and control groups can be observed (P, S, Ca, Fe, Cu, Zn, Se, Br). The analyses were also performed taking into account the gender of the patients. Correlation coefficients were calculated for the studied and control groups as regards the determined elements. It was observed that in all groups positive correlations were obtained between S and Ca, and for Zn and Se. In studied and control groups a negative correlation between Ca and Cr was obtained. This paper discusses also prediction of trace element concentrations following seven days of parenteral nutrition therapy, based on the knowledge of various anthropometric, biochemical and immunological parameters describing the patient’s condition. The procedure is discussed for Br concentration.

This document presents a comprehensive overview of the management of postinflammatory pancreatic and peripancreatic fluid collections, with a particular emphasis on endoscopic treatment, developed by a team of experts based on the latest clinical and scientific evidence. The guidelines present a detailed scheme of treatment of patients with local complications of acute pancreatitis in the form of postinflammatory pancreatic and peripancreatic fluid collections.

Pancreatic ductal adenocarcinoma (PDAC) is a tumor characterized by a very poor prognosis and increasing global incidence. Environmental factors have been identified among the various causes of pancreatic cancer, while about 10–15% of presenting patients show a genetic predisposition towards the disease. This paper presents the current insight into the etiology and pathogenesis of cancer, as well as the principles of diagnosis and treatment of the disease. Neoadjuvant and complementary systemic treatment, as well as the principles of palliative treatment, are widely discussed. Advances in the radicalization of surgical treatment, the new options to treat post-operative complications, as well as advances in chemotherapy for pancreatic cancer have hitherto failed to dramatically improve the prognosis, even at the local stage. A breakthrough in pancreatic cancer research is still awaited.

Background: Many factors associated with constipation have not been sufficiently investigated. The aim of this study was to assess the factors associated with constipation, defined as low stool frequency, in a community-dwelling adult population. Methods: A cross-sectional study was carried out between 2010 and 2012 among adults who live in the Kielce District of Poland. The participants comprised 11,488 persons aged 37–66 years. Data on depressive symptoms, eating frequency, physical activity and smoking, as well as sociodemographic data, were collected using face-to-face interviews. Constipation was defined as < 3 defecations per week. Dietary patterns (DPs) were identified using a factor analysis. Associations between DPs and the likelihood of constipation were assessed using a logistic regression analysis. Results: The factors associated with constipation were moderate and severe depressive symptoms, regular use of antidepressants, a sedentary lifestyle and past smoking (in women) (all p < 0.05). The likelihood of constipation was significantly decreased by male sex and obesity, as well as by a diet belonging to the highest terciles of the ‘Carbohydrates’, ‘Vegetables and Meat’ and ‘Healthy’ DPs (all p < 0.05). For the ‘Unhealthy’ DP, a high level of physical activity (Q4 vs. Q1 of MVPA) decreased the likelihood of constipation (OR = 0.75; 95%CI: 0.57–0.99). Conclusions: Preventing the onset or reoccurrence of depression by improving one’s mental resistance, reducing the risk factors for depression and promoting a healthy lifestyle, primarily a diet high in vegetables and a limited sitting time, reduces the risk of constipation. Further longitudinal studies are needed to better understand which factors are associated with the occurrence of constipation.

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.

Obesity is a recognized risk factor for gastrointestinal diseases and is also suspected of aggravating intestinal reflux, causing intestinal atrophy and metaplasia, and an increased risk of carcinogenesis. This study aimed to evaluate the prevalence of upper gastrointestinal pathologies in patients undergoing esophagogastroduodenoscopy procedures, including their relationship to patient body mass index (BMI) values. This retrospective analysis included 368 consecutive outpatients examined by a single physician from March 1, 2023 to February 29, 2024. The analysis was based on the results of endoscopic and histopathological examinations in the patient group. We collected their baseline characteristics. The assessment of endoscopy results included the Campylobacter-like organism screening, status of erosive esophagitis, degree of endoscopic signs of gastroesophageal reflux disease as assessed during endoscope withdrawal, status of Z-line displacement as per the Prague classification, degree of Z-line displacement relative to the diaphragmatic branches, and nature of the gastric lake contents. Histopathological assessment focused on the presence of chronic inflammation and the features of active inflammatory processes, foveolar hyperplasia, gastric mucosal atrophy, intestinal metaplasia, and Barrett esophagus. A correlation was observed between the BMI and the prevalence of esophageal hiatal hernia, particularly in relation to large hernias. Interestingly, an inverse relationship was shown regarding the incidence of intestinal reflux. Although biliary reflux and Helicobacter pylori infection increased the incidence of intestinal metaplasia in gastric mucosa and Barrett esophagus, these findings were not statistically significant. Furthermore, concomitant thyroid diseases were associated with a higher incidence of biliary reflux and Barrett esophagus. Although BMI correlated with a higher prevalence of large esophageal hiatal hernias, an inverse association was observed with intestinal reflux. Additionally, thyroid diseases were linked to higher incidences of biliary reflux and Barrett esophagus.