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Deviations in laboratory tests assessing liver function in patients with COVID-19 are frequently observed. Their importance and pathogenesis are still debated. In our retrospective study, we analyzed liver-related parameters: aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyltransferase (GGT), total bilirubin (TBIL), albumin, comorbidities and other selected potential risk factors in patients admitted with SARS-CoV-2 infection to assess their prognostic value for intensive care unit admission, mechanical ventilation necessity and mortality. We compared the prognostic effectiveness of these parameters separately and in pairs to the neutrophil-to-lymphocyte ratio (NLR) as an independent risk factor of in-hospital mortality, using the Akaike Information Criterion (AIC). Data were collected from 2109 included patients. We created models using a sample with complete laboratory tests n = 401 and then applied them to the whole studied group excluding patients with missing singular variables. We estimated that albumin may be a better predictor of the COVID-19-severity course compared to NLR, irrespective of comorbidities (p < 0.001). Additionally, we determined that hypoalbuminemia in combination with AST (OR 1.003, p = 0.008) or TBIL (OR 1.657, p = 0.001) creates excellent prediction models for in-hospital mortality. In conclusion, the early evaluation of albumin levels and liver-related parameters may be indispensable tools for the early assessment of the clinical course of patients with COVID-19.

Background: Patients with heart failure represent a vulnerable population for COVID-19 and are prone to having worse prognoses and higher fatality rates. Still, the clinical course of the infection is dynamic, and complication occurrence in particular in patients with heart failure is fairly unpredictable. Considering that individual components of the C2HEST (C2: Coronary Artery Diseases (CAD)/Chronic obstructive pulmonary disease (COPD); H: Hypertension; E: Elderly (Age ≥ 75); S: Systolic HF; T: Thyroid disease) are parallel to COVID-19 mortality risk factors, we evaluate the predictive value of C2HEST score in patients with heart failure (HF) Material and Methods: The retrospective medical data analysis of 2184 COVID-19 patients hospitalized in the University Hospital in Wroclaw between February 2020 and June 2021 was the basis of the study. The measured outcomes included: in-hospital mortality, 3-month and 6-month all-cause-mortality, non-fatal end of hospitalization, and adverse in-hospital clinical events. Results: The heart failure cohort consists of 255 patients, while 1929 patients were assigned to the non-HF cohort. The in-hospital, 3-month, and 6-month mortality rates were highest in the HF cohort high-risk C2HEST stratum, reaching 38.61%, 53.96%, and 65.36%, respectively. In the non-HF cohort, in-hospital, 3-month, and 6-month mortalities were also highest in the high-risk C2HEST stratum and came to 26.39%, 52.78%, and 65.0%, respectively. An additional point in the C2HEST score increased the total death intensity in 10% of HF subjects (HR 1.100, 95% CI 0.968–1.250 p = 0.143) while in the non-HF cohort, the same value increased by 62.3% (HR 1.623, 95% CI 1.518–1.734 p < 0.0001). Conclusions: The C2HEST score risk in the HF cohort failed to show discriminatory performance in terms of mortality and other clinical adverse outcomes during hospitalization. C2HEST score in the non-HF cohort showed significantly better performance in terms of predicting in-hospital and 6-month mortality and other non-fatal clinical outcomes such as cardiovascular events (myocardial injury, acute heart failure, myocardial infarction, cardiogenic shock), pneumonia, sepsis, and acute renal injury.

Patients with heart failure represent a vulnerable population for COVID-19 and are prone to having worse prognoses and higher fatality rates. Still, the clinical course of the infection is dynamic, and complication occurrence in particular in patients with heart failure is fairly unpredictable. Considering that individual components of the CThe heart failure cohort consists of 255 patients, while 1929 patients were assigned to the non-HF cohort. The in-hospital, 3-month, and 6-month mortality rates were highest in the HF cohort high-risk CThe C

Occupational risk of blood-borne infections is investigated mostly among nurses and doctors, studies concerning non-clinical health personnel (nCHP) being rare. The analysis of the occupational exposure to the hepatitis B virus (HBV) infection and the history of vaccination against the HBV in the nCHP group has been the aim of the study.A retrospective analysis of 458 cases of the occupational exposure to biological agents was conducted: group I - doctors (N = 121, 28%), group II - nursing staff (N = 251, 55%), group III - nCHP (N = 86, 19%).In the group III the source was usually unknown (group: I - 0.83%, II - 11.16%, III - 86.05%, p0.001), and the proportion of individuals vaccinated against hepatitis B before the exposure was the lowest (group: I - 98.35%, II - 97.19%, III - 77.91%, p0.001). In this group most exposures resulted from injuries caused by needles/sharps deposited in waste sacks (60%) or anywhere outside of the medical waste container (5%). The possibility of the HBV infection risk during the exposure was found in 25 cases and was significantly more frequent in the group III. The qualification for the HBV post-exposure prophylaxis was also significantly more frequent in the group III.The exposure to the occupational risk of the HBV infection also concerns the non-clinical healthcare personnel. The non-clinical healthcare personnel comprises one of the main groups of the HBV post-exposure recipients. It is essential to determine the causes of the low hepatitis B vaccination coverage in the nCHP and consider introduction of mandatory vaccination in this group in Poland. Med Pr 2016;67(3):301-310.Narażenie zawodowe na zakażenia krwiopochodne bada się przede wszystkim u pielęgniarek i lekarzy, rzadko u innych grup zawodowych pracujących w placówkach opieki zdrowotnej. Celem badania była ocena ryzyka zawodowego narażenia na zakażenie wirusem zapalenia wątroby typu B (WZW B) i realizacji szczepień przeciw WZW B u pracowników pomocniczych zatrudnionych w Zespołach Opieki Zdrowotnej (ZOZ).Retrospektywną analizą objęto 458 osób eksponowanych zawodowo na materiał biologiczny: lekarzy – grupa I (N = 121, 28%), personel pielęgniarski – grupa II (N = 251, 55%) i personel pomocniczy – grupa III (N = 86, 19%).W grupie III pacjent będący źródłem zakażenia personelu (pacjent źródłowy) był najczęściej nieznany (grupa: I – 0,83%, II – 11,16%, III – 86,05%, p0,001), a odsetek wykonanych szczepień przedekspozycyjnych najniższy (grupa: I – 98,35%, II – 97,19%, III – 77,91%, p0,001). Badani z grupy III byli narażeni na zakażenie WZW B najczęściej poprzez skaleczenie/zakłucie ostrym narzędziem znajdującym się w worku ze śmieciami (60%) lub innych miejscach poza pojemnikiem na odpady medyczne (5%). Ryzyko zakażenia WZW B stwierdzono łącznie u 25 osób, jednak istotnie częściej występowało ono w grupie III. Także osoby z tej grupy badanej najczęściej kwalifikowano do profilaktyki poekspozycyjnej zakażenia WZW B.Pracownicy pomocniczy zatrudnieni w służbie zdrowia również są zawodowo narażeni na zakażenie WZW B. Stanowią oni jedną z głównych grup pacjentów, u których stosuje się profilaktykę poekspozycyjną zakażenia WZW B. Konieczna jest ocena przyczyn niższego odsetka szczepień przeciw WZW B u pracowników pomocniczych niż u lekarzy i personelu pielęgniarskiego i wprowadzenie obowiązku szczepień w tej grupie w Polsce. Med. Pr. 2016;67(3):301–310.

BACKGROUND The incidence of amyloidosis is difficult to determine because the disease is often undiagnosed or diagnosed incorrectly. In Polish studies, there are no statistics and analyses of the factors that may influence the development of amyloidosis in patients with multiple myeloma. OBJECTIVES The goal of this study was to estimate the incidence of AL amyloidosis in MM patients in Lower Silesia region. MATERIAL AND METHODS 70 patients treated at the Department of Hematology, Provincial Hospital in Legnica and the Department of Hematology, Blood Neoplasm and Bone Marrow Transplantation, Medical University in Wroclaw were enrolled in the survey. 37 patients were newly diagnosed, 33 had been treated for 2-34 months. The basis for the diagnosis of amyloidosis was the presence of green colored amyloid deposits in the polarized light microscope in the adipose tissue (received from abdominal fold and stained with Congo red). RESULTS Amyloidosis was diagnosed in 18 (25.7%) patients with MM, 9/9 F /M, aged 47-83 years. 6 (33%) pts with amyloidosis had newly diagnosed MM, in 12 (67%) progression of the disease was diagnosed. Amyloidosis occurred significantly more often (p = 0.048) in already treated patients. The odds ratio (OR) was 2.95. Amyloidosis occurred most frequently in patients with IgG myeloma (67%), (OR = 1.98), was more often found in patients with kappa light chain versus lambda, respectively 67% and 33%. The probability of amyloidosis in patients with clinical stage III was 1.5 times higher (p = 0.05) than in other stages (OR = 1.5), in persons with renal dysfunction was twice as high (OR = 2.4) compared to the renal competence group (p = 0.05). CONCLUSIONS AL amyloidosis in the course of MM occurs in Lower Silesia region with a comparable rate to other regions of the world. It is significantly more often diagnosed in patients with relapsed or refractory disease, in persons with clinical stage III and with renal failure.

Aim of the study The aim of the study was to analyze the incidence of adverse effects of antiretroviral therapy in patients receiving concomitant therapy with methadone substitution. Background With the advances in research on anti-retroviral drugs, we now have regiments with different mechanisms of action that can be combined to give an effective therapy that lengthens the life of HIV-infected people into old age. It should be emphasized, however, that anti-retroviral drugs, as other pharmacologically active substances, are characterized by adverse effects (AEs), significantly changing the quality of life for patients, as well as predisposing to the development of comorbidities. Their appearance can be triggered by administration of other therapy at the same time such as methadone in heroin addicts. Materials and methods The survey was conducted among 60 people, 21 of respondents were participants of methadone program. Results Based on the survey we found that among patients receiving methadone, compared to patients treated only with antiretroviral drugs, more often the following symptoms occurred: loss of appetite, constipation, cough, rhinitis, insomnia, libido and decreased hemoglobin level. Conclusion A study found that co-administration of methadone may increase the incidence of adverse effects, which in turn has a significant impact on patient quality of life. This issue has not been fully explained and requires further studies in a larger group of patients.

Background This study aimed to determine Polish patients’ experiences related to receipt of positive HIV test results and to understand changes in how this information was received over time. Material and methods Anonymous self-administered questionnaires were distributed to HIV-infected persons at support group meetings and at the Department of Infectious Diseases, Wroclaw Medical University. Patients diagnosed between 1988 and 1996 (before HAART era) (97 persons, 39.1%) were compared to those diagnosed between 1997 and 2008 (151 persons, 60.9%). Results Those tested between 1997 and 2008 were less likely to be tested without consent (25.8% versus 48.5%, p Conclusion Although there has been some improvement over time, the number of persons tested for HIV without consent remains high. Lack of informed consent and unprofessional communication of infection can cause significant delays in reporting to physicians, which is particularly dangerous in an era of combination antiretroviral therapy (cART).

Background. AL amyloidosis is an acquired systemic disease in which a pathologic amorphous substance produced as a result of abnormal protein metabolism is deposited in the extracellular space of various tissues. Objectives. The aim of the study was to investigate the relationship between the kappa and lambda serum free light chains (sFLCs) and the development of AL amyloidosis in patients suffering from multiple myeloma (MM). Material and Methods. The investigations included 70 MM patients, 40 females and 30 males, aged 28–83 years. In 37 persons, MM was had been diagnosed recently; 33 patients had been undergoing treatment. Amyloidosis was diagnosed in 18 patients (25.7%), including nine females, nine males; six had newly diagnosed disease. Fifteen patients developed kidney failure. The control group consisted of 10 healthy donors. The concentration of sFLC ls were determined using the immunonephelometric method and expressed in mg/L. Results. In 18 MM patients with amyloidosis the concentration of κ sFLCs ranged from 0.3 to 4780 (x = 854.5, SD = 1289), and was significantly higher (p = 0.039) than in the group without amyloidosis, where the range was from 0.3 to 426.0 (x = 68.9, SD = 98.1). The highest concentration of κ sFLCs was observed in the group of five patients with amyloidosis and renal failure. The concentration of λ sFLCs in patients with amyloidosis ranged from 0.5 to 41600 (x = 3035.7, SD = 9735) and was higher than in MM patients without amyloidosis, where it ranged from 0.5 to 834.0 (x = 79.3, SD = 193). In amyloidosis patients, the concentration of λ sFLCs was significantly higher (p = 0.05) in cases of renal failure as compared with the patients with normal renal function. Conclusions. The concentration of sFLCs is a strong indicator of amyloidosis development in MM patients (Adv Clin Exp Med 2014, 23, 4, 531–538).