Carmen Neamtu

Background/Objectives: Helicobacter pylori has been detected in the oral cavity as well as the stomach, but the gastric histopathology of periodontal patients with a positive oral urease test is rarely described. We set out to describe it. Methods: In a prospective cross-sectional convenience sample, 71 of 477 patients assessed at 13 referring clinics had clinically recorded periodontal disease, a positive salivary rapid urease test (an operational criterion that is not specific to the organism) and H. pylori identified histologically in a gastric biopsy. Neutrophilic activity, atrophy and intestinal metaplasia were recorded together with smoking, alcohol consumption, proton-pump inhibitor (PPI) use and previous eradication therapy. Only aggregate counts were available, so all comparisons are unadjusted. Results: Intestinal metaplasia was present in 74.6% and non-metaplastic atrophy in 53.5%; both were more frequent in men (metaplasia 93.0% versus 46.4%; odds ratio 13.29, 95% CI 3.57–49.40). Men also differed markedly from women in alcohol consumption (88.4% versus 10.7%) and previous eradication therapy (7.0% versus 85.7%). An exploratory compatibility analysis showed only that neither smoking nor PPI use could, on its own and under the model’s assumptions, account for the male excess; it establishes no causal relationship. Conclusions: In this small, selected cohort, gastric precancerous lesions were frequent. This study has no comparison group, rests on a non-specific oral test, and establishes no association; its findings are descriptive and hypothesis-generating.

Background/Objectives: Organised colorectal cancer screening is still being introduced in Romania, and the yield of opportunistic colonoscopy outside it is poorly documented. Our primary aim was to describe the histopathological spectrum and the yield of advanced neoplasia in an opportunistic colonoscopy service; a secondary, exploratory aim was to describe self-reported lifestyle items in a questionnaire subgroup. Methods: This study represents a retrospective cross-sectional analysis of consecutive colonoscopies (June 2023–June 2024) at a county hospital outside organised screening, restricted to patients from whom material reached histopathology; the comparison group therefore comprises patients whose sampled lesions were benign, not patients without neoplasia. Advanced neoplasia was defined histologically as adenocarcinoma or adenoma with high-grade dysplasia, without the 10 mm size criterion. A convenience subgroup self-completed a locally developed, unvalidated questionnaire before the procedure; its items were tested against advanced neoplasia and adenocarcinoma with false discovery rate correction. Results: Among 274 patients, 45 (16.4%) had adenocarcinoma, 139 (50.7%) adenoma and 72 (26.3%) advanced neoplasia; per examination (n = 978), detection was 4.6% for adenocarcinoma and 7.4% for advanced neoplasia. Forty-four of 45 carcinomas were graded as moderately differentiated, and no serrated lesion was separately reported. Age was associated with advanced neoplasia (OR 1.34 per decade, 95% CI 1.01–1.79). Questionnaire data were available for only 79 patients (28.8%), among whom adenocarcinoma was more frequent than among non-respondents (26.6% vs. 12.3%). In this subgroup, obesity was inversely (OR 0.07, 95% CI 0.02–0.28) and reported weight loss positively (OR 6.77, 2.26–20.30) associated with advanced neoplasia, and two coffee items were inversely associated; processed meat, dairy, aspirin and supplement use were not associated after correction. Conclusions: Opportunistic colonoscopy at this centre recovered a high proportion of carcinoma, consistent with symptom-driven presentation, and the reporting of serrated lesions and tumour grade requires standardisation. The questionnaire findings rest on a small, selected subgroup and are hypothesis-generating only. The inverse obesity association is most plausibly explained by selection of the comparison group and of respondents, and none of the associations identifies a risk factor.

Background/Objectives: Occupational contact dermatitis (OCD) is the most common work-related skin disease, accounting for roughly 90–95% of occupational dermatoses and falling predominantly on the hands. It is rarely dangerous yet imposes a substantial burden through impaired quality of life, lost productivity, and premature exit from affected trades. The COVID-19 pandemic intensified this burden among healthcare workers, in whom the pooled one-year prevalence of self-reported hand eczema reaches around 27%; meta-analytic data link the increased risk principally to frequent handwashing and wet work rather than to alcohol-based hand rub. Methods: This narrative review, which follows a non-systematic, thematically organised search strategy rather than PRISMA methodology, integrates current evidence on the epidemiology, pathophysiology, diagnosis, prevention, and management of OCD, with particular emphasis on the self-reinforcing cycle linking skin barrier disruption, microbiome dysbiosis, and antimicrobial-peptide dysregulation to inflammation. Results: We critically appraise the prevention evidence, foregrounding the low certainty of the existing trial base and the tension between the randomised trials of primary and secondary prevention, which have been null, and the encouraging but uncontrolled results of structured tertiary-prevention programmes. We summarise recent therapeutic advances, including topical delgocitinib, and situate the field within the World Health Organisation’s 2025 recognition of skin diseases as a global public health priority. Established evidence and hypotheses are kept separate throughout: we additionally advance, explicitly as a conjecture rather than as a demonstrated mechanism, a conceptual trans-kingdom dialogue model in which protease-generated LL-37 fragments may modulate staphylococcal quorum sensing, and each step of that model is labelled according to whether the supporting evidence is direct, extrapolated, or as yet untested. Conclusions: We argue that the prevention failure is less one of biology than of trial design and measurement, and outline the research needed to close the gap.

Peri-implantitis, a biofilm-driven inflammatory disease that causes progressive loss of the bone supporting dental implants, is common and difficult to treat: mechanical debridement cannot fully decontaminate the implant surface, and antibiotic adjuncts act non-selectively while promoting resistance. Antimicrobial peptides (AMPs) have emerged as a promising preventive strategy. As cationic, membrane-disrupting molecules they kill a broad spectrum of organisms with a low propensity to select for resistance, and as host-defense peptides they additionally modulate inflammation and promote epithelial and connective-tissue repair. This review examines AMP-functionalized titanium as a prospective strategy against peri-implantitis through a dermatological lens, drawing on the established roles of the cathelicidin LL-37 and the β-defensins in cutaneous and oral wound healing. We argue that the peri-implant transmucosal interface behaves as a healing epithelial barrier, so that a single class of host-defense peptides can address two goals usually pursued separately—suppressing the peri-implant biofilm and reinforcing the soft-tissue seal. Because peri-implant disease initiates at the transmucosal region, we give particular attention to the abutment or transmucosal collar as the primary sealing target, and we consider how the concept extends to zirconia and hybrid components. The evidence assembled here, however, is predominantly preclinical, derived from in vitro and animal studies, and does not yet demonstrate clinical prevention of peri-implantitis in patients. After surveying peri-implant epidemiology, microbiology, AMP biology, surface-engineering strategies, and the in vivo evidence, we appraise the translational barriers—stability, cytotoxicity, cost, regulation, and the absence of human trials—that remain. We conclude that biologically intelligent, multifunctional peptide coatings represent a rational direction for next-generation implant surfaces.

Background: The splenic artery exhibits considerable anatomical variability in its origin, course, and branching pattern, with important implications for upper abdominal surgery. However, existing evidence remains fragmented across anatomical, radiological, and clinical studies. Objective: This systematic review aimed to synthesise current evidence on anatomical variations in the splenic artery and evaluate their surgical implications in upper abdominal procedures. Methods: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and the Cochrane Library. Studies reporting anatomical variations in the splenic artery identified through cadaveric dissection, radiological imaging, or intraoperative findings were included. Data were extracted on origin, course, branching pattern, and accessory arteries, along with reported surgical implications. Methodological quality varied across study designs, with radiological and clinical studies generally demonstrating lower risk of bias than descriptive cadaveric investigations. Results: Seventeen studies involving 4301 subjects and specimens were included, encompassing cadaveric, radiological, and clinical investigations. The splenic artery most commonly originates from the celiac trunk, although less common origins from the abdominal aorta and the superior mesenteric artery have been reported. A suprapancreatic course was predominant, but retropancreatic and intrapancreatic variations were consistently documented. The artery frequently exhibited a tortuous configuration, and branching patterns were highly variable, with terminal bifurcation being most common. Segmental and polar arteries, as well as variations in gastric branches, were frequently observed. These vascular variations may influence operative complexity and increase the risk of intraoperative vascular injury, particularly during pancreatic, gastric, and splenic procedures. Conclusions: The splenic artery exhibits substantial anatomical variability with direct implications for surgical planning and outcomes. Preoperative vascular assessment using advanced imaging techniques may improve surgical safety in upper abdominal procedures.

Background: Colorectal cancer (CRC) prognosis, particularly in liver metastasis (CRLM), is influenced by histopathological and molecular factors. Methods: A narrative analysis of the specialized literature was conducted using databases such as PubMed, MEDLINE, Scopus, and Embase. The review focused on original articles published between 2005 and 2025. Results: Lymph node involvement is a critical prognostic factor, with lymph node-positive CRC correlating with increased risk of liver metastasis and significantly reduced survival rates. Poorly differentiated tumors (G3) exhibit a higher likelihood of metastasis, including liver involvement, and are associated with worse clinical outcomes. Vascular emboli and perineural invasion are indicative of hematogenous spread and higher metastatic potential, leading to poorer survival outcomes. Genetic mutations, such as KRAS, NRAS, and BRAF, are associated with therapy resistance, complicating treatment and highlighting the importance of personalized approaches. MSI-H and HER2 amplification further affect treatment response, with MSI-H tumors showing a favorable response to immunotherapy, while HER2-positive CRCs may benefit from targeted therapies. Tumor budding, high levels of which predict poor survival, is another key histopathological feature associated with aggressive metastatic behavior. Systemic inflammatory markers, such as the Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and C-Reactive Protein-to-Albumin Ratio (CAR), offer prognostic insights into CRLM patient survival. Conclusions: Histopathological features, molecular alterations, and immune microenvironment factors significantly impact the prognosis of CRC with liver metastasis. The integration of molecular profiling, immunotherapy, and targeted therapies offers promise for improving treatment outcomes. Personalized treatment strategies, incorporating these factors, are essential for overcoming therapy resistance and improving survival in CRLM patients.

Background: Venous resection during pancreatoduodenectomy is increasingly performed to achieve margin-negative resection in patients with pancreatic ductal adenocarcinoma involving the portomesenteric venous axis. However, its impact on oncologic and perioperative outcomes remains debated. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines. Comparative observational studies evaluating pancreatoduodenectomy with venous resection versus standard pancreatoduodenectomy were included. The primary outcome was overall survival (OS). Secondary outcomes included disease-free survival (DFS), R1 resection rate, and major postoperative morbidity. Secondary outcomes included R1 resection rate and major postoperative morbidity. Random-effects models were applied, and subgroup and sensitivity analyses were performed. Results: Nine studies were included in the quantitative synthesis. Venous resection was not associated with inferior overall survival compared with standard pancreatoduodenectomy (pooled HR = 1.01, 95% CI 0.94–1.09). Disease-free survival was significantly shorter in the venous resection group (pooled HR = 1.21, 95% CI 1.02–1.44), and venous resection was associated with a higher likelihood of R1 resection (pooled OR = 1.44, 95% CI 1.22–1.70). Major postoperative morbidity did not differ significantly between groups (pooled OR = 1.07, 95% CI 0.94–1.22). Subgroup analyses demonstrated inferior survival outcomes following segmental compared with tangential venous resection. Conclusions: Venous resection during pancreatoduodenectomy can be performed safely in experienced centers without compromising overall survival or increasing major postoperative morbidity. Shorter disease-free survival and higher R1 rates appear to reflect advanced local tumor biology rather than the vascular procedure itself. The extent of venous involvement plays a critical role in prognosis and should be considered in surgical decision-making and future study design.

Ragweed (Ambrosia artemisiifolia) represents a major and expanding source of aeroallergen exposure in Europe, with rising sensitization rates and substantial clinical impact. However, population-level data integrating airborne pollen exposure with detailed clinical sensitization patterns remain limited. We conducted a 5-year retrospective cross-sectional observational analysis of sensitization prevalence, complemented by a parallel temporal analysis of aerobiological data and symptom-driven healthcare presentation patterns (2020–2024) in Timisoara, Romania, including all patients undergoing first-time sensitization evaluation at a tertiary referral hospital. Sensitization was assessed using standardized skin prick testing to common aeroallergens and other allergen categories, while airborne ragweed pollen concentrations were monitored through a peri-urban network of real-time bio-particle analyzers. Statistical analyses included descriptive statistics, multivariable logistic regression, χ² tests for co-sensitization patterns, and comparative analyses of clinical manifestations across sensitization profiles. Among 4404 eligible patients, 50.7% were sensitized to at least one allergen. Ragweed sensitization was identified in 24.1% of patients, with a mean age of 31.1 years at diagnosis and no significant sex-related difference. Most ragweed-sensitized patients were polysensitized (71.5%), predominantly to other aeroallergens. Increasing age was independently associated with lower odds of polysensitization to other aeroallergens (adjusted OR = 0.97 per year, 95% CI: 0.96–0.98), while sex showed no independent association. Patients with ragweed sensitization alone and those cosensitized with aeroallergens exhibited similar prevalence of respiratory manifestations, whereas individuals with additional non-aeroallergen sensitization showed lower prevalence of rhinitis, conjunctivitis, and asthma but slightly higher rates of asthma exacerbations. Weekly diagnoses of ragweed sensitization demonstrated a pronounced seasonal peak between calendar weeks 33 and 38 (mid-August to late September), coinciding with peak airborne ragweed pollen concentrations. Ragweed sensitization therefore represents a substantial and seasonally driven healthcare burden in western Romania, characterized by frequent polysensitization, distinct clinical manifestation patterns across sensitization profiles, and close temporal alignment between airborne pollen exposure and clinical presentation. Integrating aerobiological monitoring with clinical surveillance may support targeted prevention strategies and improved patient management.

Background: Endometrial cancer (EC) represents one of the most prevalent gynecological malignancies worldwide, with increasing incidence rates attributed to rising obesity, metabolic syndrome, and demographic aging. Recent evidence suggests that dyslipidemia, including elevated triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and reduced high-density lipoprotein cholesterol (HDL-C), may have a significant role in the pathogenesis of EC through inflammatory, oxidative stress, and hormonal mechanisms. Objective: This meta-analysis aims to systematically evaluate the association between serum lipid biomarkers and endometrial cancer risk by synthesizing quantitative data from observational studies. Methods: We conducted a comprehensive search of five electronic databases (PubMed, Web of Science, Scopus, EMBASE, and Cochrane) to identify studies examining lipid biomarkers in patients with EC compared to healthy controls. After screening 639 articles and applying rigorous inclusion/exclusion criteria, six studies were selected for final analysis. The standardized mean differences (SMD) were calculated with 95% confidence intervals using random-effects and fixed-effects models, considering heterogeneity assessed by the I² statistic. Publication bias was evaluated using funnel plots and Egger’s regression test. Results: The meta-analysis revealed significantly elevated TG levels in EC patients compared to controls (SMD +0.87, 95% CI [+0.65, +1.10]), markedly reduced HDL-C levels (SMD −0.92, 95% CI [−1.15, −0.69]), and increased LDL-C levels (SMD +0.74, 95% CI [+0.50, +0.98]). The heterogeneity was moderate to substantial, with an I² ranging from 49% to 62%. Subgroup analyses demonstrated stronger associations in Type I EC and obese patients (BMI > 30 kg/m²). Conclusions: This meta-analysis establishes a significant association between dyslipidemia and endometrial cancer risk, with elevated triglycerides and LDL-C conferring increased risk while HDL-C appears protective. These findings support the integration of lipid profiling into EC risk assessment protocols and suggest the potential preventive value of lipid-modulating interventions. Further studies are needed to establish causality and evaluate therapeutic applications.

Background/Objectives: Colorectal cancer is a leading cause of cancer-related death worldwide, with rising incidence in younger adults. Unhealthy diets high in red and processed meat and low in fiber are key modifiable risk factors, highlighting the need for preventive nutritional strategies targeting CRC through dietary interventions. Methods: A one-day sample diet for colorectal cancer prevention, consisting of fiber-rich meals excluding red meat and incorporating whole grains, legumes, vegetables, fruits, nuts, and lean protein alternatives (such as fish and poultry), was developed. Its acceptability was assessed in a cross-sectional study using an online questionnaire among healthy Romanian adults aged 18–50, with a total of 395 included participants. Results: Of the 395 respondents meeting the inclusion criteria (aged 18–50, no cancer or chronic gastrointestinal disorders), 63.5% were females, predominantly urban (90.1%), and highly educated. Mean age was 32.4 years; mean BMI was 25.07 kg/m². The proposed colorectal cancer-preventive diet was rated as “quite attractive” and “very attractive” by 74.9% of participants. All meals received high ratings, with dinner and the first snack being most favored. Most respondents (77.2%) found the diet satisfying and the satiety level and energy adequate, and 90.4% were willing to adopt it at least a few times per week. Financial accessibility was affirmed by 77.2% of the respondents. However, 61.8% reported difficulty eliminating red meat consumption. Female participants rated the diet significantly more attractive than males did (p = 0.041). Willingness to adopt the diet strongly correlated with higher acceptability (p < 0.0001), while BMI and education level showed no significant effect. Conclusions: The proposed colorectal cancer-preventive diet was well accepted by Romanian adults aged 18–50, with higher receptivity among women and those with higher education; willingness to adopt the diet at least a few days per week was high, especially among those psychologically ready for dietary change, while key barriers included red meat reduction and perceived cost, underscoring the need for gender-sensitive, culturally adapted interventions and further research on long-term adherence and clinical impact.