Alexandru-Romulus Hut

Background and Objectives: Alcohol misuse, depressive symptoms, maladaptive coping, and impaired health-related quality of life (HRQoL) are clinically relevant in head-and-neck cancer, but their interrelationships are not fully captured by clinical stage alone. This multicenter study examined these domains at first admission and explored whether data-driven psychosocial phenotypes could complement stage-based stratification. Materials and Methods: In this multicenter cross-sectional study conducted at participating ENT/oncology centers in Timișoara and Oradea, Romania, during May 2024–October 2026, 64 adults with head-and-neck cancer completed the Alcohol Use Disorders Identification Test (AUDIT), Patient Health Questionnaire-9 (PHQ-9), EuroQol five-dimension questionnaire (EQ-5D), and Coping Orientation to Problems Experienced (COPE). Patients were compared by stage (I–III vs. IV). We also examined correlations, modeled poor HRQoL (EQ-5D health sum ≤ 9), derived COPE factor scores, identified psychosocial profiles by unsupervised clustering, and explored an indirect-association framework linking AUDIT, PHQ-9, and EQ-5D problem severity. Results: Stage IV disease was associated with greater tumor burden but not with worse psychosocial scores. Overall, 18.8% met criteria for possible alcohol dependence (AUDIT ≥ 20), and PHQ-9 scores correlated with poorer EQ-5D health status (ρ = −0.275; p = 0.028). Three psychosocial profiles showed significant differences in alcohol-risk burden, depressive symptoms, and coping signatures. The exploratory indirect-effect analysis did not support a statistically significant PHQ-9-mediated association between AUDIT and EQ-5D problem severity (indirect effect 0.002; 95% CI −0.018 to 0.022). Conclusions: Alcohol-related risk and depression-associated HRQoL burden were common and were not meaningfully explained by stage alone. Exploratory phenotype-based stratification may help identify patients who could benefit from earlier supportive-care triage.

Background and Objectives: Circulating microRNAs may provide minimally invasive biomarkers for laryngeal squamous cell carcinoma (LSCC), but clinically interpretable data for miR-99a-5p and miR-1246 remain limited. We compared circulating levels of these two miRNAs between LSCC patients and controls and explored stage-associated differences within the cancer cohort. Methods: This single-center case–control study was conducted in Timișoara, Romania. Circulating miRNAs were quantified by RT-qPCR. Expression was summarized as ΔCt [Ct(target) − Ct(miR-16)] and as the relative expression (2^−ΔΔCt) using the control group as a calibrator. Group comparisons used Mann–Whitney U tests, associations used Spearman correlation, and the diagnostic performance was assessed by ROC analysis and multivariable logistic regression. Results: Fourteen controls were compared with cancer patients with available miRNA measurements (miR-99a-5p, n = 53; miR-1246, n = 49). miR-99a-5p showed significantly higher ΔCt values in cancer patients than in the controls (5.308 [IQR 4.139–6.864] vs. 3.184 [2.142–3.708], p < 0.001), corresponding to a lower relative expression (fold-change 0.200 [0.068–0.449], p < 0.001). miR-1246 did not differ significantly between cancer and controls (p = 0.09). Within the cancer cohort, advanced-stage disease showed a lower relative miR-1246 expression than early-stage disease (ΔCt 5.820 [4.502–6.972] vs. 4.233 [3.109–5.372], p = 0.01; fold-change 0.363 vs. 1.091, p = 0.01), while miR-99a-5p showed a non-significant difference in the same direction (p = 0.052). miR-99a-5p discriminated cancer patients from the controls with an AUC of 0.842 (95% CI 0.744–0.931), sensitivity of 77.4%, and specificity of 92.9% at ΔCt = 4.018. In multivariable analysis, ΔCt(miR-99a-5p) remained independently associated with cancer status (OR 1.89, 95% CI 1.19–3.00; p = 0.007). Conclusions: Circulating miR-99a-5p showed the strongest diagnostic signal in LSCC, whereas miR-1246 appeared more informative for stage-associated biological stratification.

Background/Objectives: Laryngeal cancer (LC), predominantly squamous cell carcinoma (SCC), represents a considerable health burden worldwide. Tumour subsite heterogeneity (supraglottic, glottic, subglottic) influences clinical behavior and outcomes. This review synthesizes current knowledge on epidemiology, risk factors, diagnostics, histological variants, biomarkers, treatment modalities, and survival. Results: This narrative review synthesizes current literature on the epidemiology, risk factors, diagnosis, histological variants, biomarkers, and prognosis of LC. The review highlights the critical influence of tumour sites (supraglottic, glottic, subglottic) on metastatic patterns and survival. Key risk factors of LC include tobacco and alcohol use, human papillomavirus (HPV) infection, and occupational exposures. The diagnostic process encompasses clinical examination, endoscopy, biopsy, and imaging. Several biomarkers that aid in diagnosis, treatment plan determination, and prognosis prediction have been established. These biomarkers include long noncoding RNAs, cell cycle regulators, apoptosis regulators, oncogenes, tumour suppressor genes, growth factor pathway components, angiogenic factors, structural proteins, sex hormone receptors, and immunological markers. Current treatment modalities range from organ-preserving surgery and radiotherapy to combined chemoradiotherapy and total laryngectomy. Finally, survival data are presented and stratified by stage and subsite. Conclusions: The review underscores the need for a multidisciplinary approach to LC management, integrating clinical, pathological, and molecular information to optimize patient outcomes.

Background and Objectives: The aim of this study was to identify specific rhino- and oropharyngeal microbiological pathogens as well as associated comorbidities that favor SARS-CoV-2 infection and corelate them. Materials and Methods: This prospective clinical study enrolled 61 patients (28 COVID-19-positive and 33 controls) who were tested for other comorbidities and co-existence of associated oral pathogenic microbiota. Results: A total of 247 bacterial isolates were identified in the bacterial cultures in both groups. Viral hepatitis type A was more prevalent in the COVID-19-positive group (p = 0.026), as was the presence of oral candidiasis (p = 0.006). In the control group, a moderate direct relationship was observed between the Beta hemolytic streptococcus group G and dermatitis, and strong direct relationships were observed between the Beta hemolytic streptococcus group G and external otitis, Streptococcus pyogenes and dental alveolitis, and Streptococcus pyogenes and chronic lymphocytic leukemia. In the test group, strong direct relationships were observed between Hemophilus influenzae and pulmonary thromboembolism; Staphylococcus aureus and autoimmune thyroiditis; post-viral immunosuppression, chronic coronary syndrome, and hypernatremia; Beta hemolytic streptococcus group C and rheumatoid polyneuropathy; Beta hemolytic streptococcus group G and hyperkalemia, hypothyroidism, secondary anemia, and splenomegaly; and active oral candidiasis and SARS-CoV-2 viral pneumonia. The following relationships were strong, but inverse: Beta hemolytic streptococcus group G and acute respiratory failure, and active oral candidiasis and SARS-CoV-2 viral bronchopneumonia. Conclusions: Briefly, COVID-19-positive patients have the predisposition to build up associated comorbidities and coinfections, which can be the expression of the immune burden that this virus generates to the host.