Jan Kochanowski University

To characterize switching among GLP-1 receptor agonists (GLP-1 RAs) in a large private-sector cohort in Poland and to quantify therapy- and patient-level associations with switching while accounting for switching opportunity and calendar-time dynamics. We conducted a retrospective analysis of GLP-1 RA prescription records from the LUX MED network (2018–2025). Switching was defined as any change in agent between consecutive prescriptions. Patients with more than one prescription were included (n = 42,423). The primary analysis used a transition-level discrete-time hazard model in which each prescription-to-prescription interval contributed one observation, and the outcome was switching at that interval. Current-therapy contrasts were reported relative to subcutaneous semaglutide. Sensitivity analyses examined alternative temporal parameterizations and additional adjustment for elapsed time. Overall, 29.7

The propagation of nonlinear energy density waves in a hot Quark-Gluon Plasma is investigated within the framework of relativistic magnetohydrodynamics with nonextensive statistics. Using the reductive perturbation technique, we derive a Burgers-type evolution equation for energy density perturbations in a medium subject to strong external magnetic fields. The thermodynamic coefficients are evaluated using the MIT bag model equation of state incorporating Tsallis nonextensive distributions and Landau-level quantization. Our analysis reveals that magnetic fields significantly enhance wave localization by suppressing nonlinear steepening and dissipation. The degree of stabilization is controlled by the interplay among field strength, background temperature, and nonextensive parameter q. While increased temperature promotes wave delocalization, stronger magnetic confinement and higher nonextensivity parameter counteract this effect, preserving waveform coherence. Interacting effects of magnetic fields, fluctuations, and nonlinear wave dynamics in extreme QCD matter may shed light on the evolution of perturbations in heavy-ion collisions.

To evaluate the clinical associations of admission non-contrast CT morphology in acute pancreatitis within a real-world emergency workflow. 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. Of the 264 patients, 143 (54.2

Aim: The aim of this study was to compare the effectiveness of physiotherapy combined with massage and kinesiotherapy versus massage and kinesiotherapy alone in patients with lumbosacral pain syndromes, based on changes in VAS and Laitinen scale scores. Materials and Methods: A total of 30 patients aged 34-68 years with pain syndromes in the lumbosacral spine in the course of spinal osteoarthritis and lumbosacral discopathy were evaluated. They underwent physical therapy as follows: Group I (n=15) underwent physiotherapy, therapeutic massage + kinesiotherapy; Group II (n=15) underwent massage and kinesiotherapy. In Group I, physiotherapy included lasertherapy, ultrasound therapy, and electrotherapy. The study patients were examined at a physiotherapy laboratory in Ostrowiec & Sacute;wi & eogon;tokrzyski. The patients were examined twice, before the start of rehabilitation and after rehabilitation, over a 2-week outpatient treatment period. The study used a VAS for pain, the Laitinen scale (modified), and BMI. Results: The treatment used in the study contributed to a reduction in pain in both study groups, with a significantly higher improvement seen in Group I. The severity and frequency of pain significantly decreased in Group I compared to Group II. A greater reduction in total Laitinen scores was also observed in the Group I. The treatment used in the study contributed to a reduction in physical activity limitation as assessed by the Laitinen scale in both study groups. No statistically significant correlation was found between age and VAS scores; however, age was positively correlated with baseline Laitinen scores and inversely correlated with post-treatment changes in Laitinen scores. Conclusions: Physiotherapy combined with massage and kinesiotherapy was associated with greater improvement in pain intensity and symptom severity compared to massage and kinesiotherapy alone. Physical therapy and rehabilitation are a fundamental part of treatment in spinal pain syndromes.

Acute postoperative abdominal wall failure with recurrent evisceration is a rare but severe complication following emergency laparotomy. Progressive lateral wall contracture and loss of medial compliance may render repeated primary closures ineffective. We describe the salvage management of a frail 66-year-old male with three episodes of recurrent postoperative evisceration after emergency laparotomy for an incarcerated inguinal hernia with ischemic small bowel. Bilateral transversus abdominis release (TAR) combined with retromuscular polypropylene mesh placement was performed, along with intraoperative botulinum toxin A (BTA) injection into the lateral abdominal wall. Transversus abdominis release restored medial compliance and allowed for anatomical midline reconstruction with wide retromuscular mesh overlap. Intraoperative BTA was used as a protective adjunct to decrease lateral muscle tension during early healing—not to facilitate closure. The patient’s postoperative course was uneventful with regard to abdominal wall integrity. At 6‑month follow-up, there was no recurrence, bulging, or chronic pain. This case highlights the technical viability of combining anatomical reconstruction with functional modulation as a salvage strategy in highly selected patients with acute abdominal wall failure when repeated primary closure is unlikely to succeed and preoperative chemical component separation is not feasible. This observation is hypothesis generating only and should not be generalized beyond similar exceptional cases.