A total of 300 research participants—200 consecutive patients diagnosed with dyslipidemia (100 statin (+), treated for at least five years, and 100 statin (−)) and 100 healthy controls—were included in this observational study. The aim of the study was to deliver insights into the relationship between the long-term use of statins for dyslipidemia and gallstone disease (GSD), as well as insights into the background particularities of the gut microbiota. All study participants underwent clinical examination, laboratory workups, stool microbiology/stool 16S r RNA, next-generation sequencing, and abdominal ultrasound/CT exams. Results: The research participants presented with similarities related to age, gender, and location. Patients displayed comparable heredity for GSs, metabolic issues, and related co-morbidities. Gut dysbiosis (DB) was present in 54% of the statin (−) patients vs. 35% of the statin (+) patients (p = 0.0070). GSs were present in 14% of patients in the statin (−) group vs. 5% of patients in the statin (+) group (p = 0.0304). Severe dysbiosis, with a significant reduction in biodiversity, an increase in LPS (+) bacteria, and a notable decrease in mucin-degrading bacteria, mucosa-protective bacteria, and butyrate-producing bacteria were observed in the statin (−) group. Strong positive correlations between GSD and diabetes/impaired glucose tolerance (r = 0.3368, p = 0.0006), obesity (r = 0.3923, p < 0.0001), nonalcoholic fatty liver disease (r = 0.3219, p = 0.0011), and DB (r = 0.7343, p < 0.0001), as well as significant negative correlations between GSD and alcohol use (r = −0.2305, p = 0.0211), were observed. The multiple regression equation demonstrated that only DB (95% CI: 0.3163 to 0.5670; p < 0.0001) and obesity (95% CI: 0.01431 to 0.2578; p = 0.0289) were independent risk factors predicting GSD in the group of patients treated with statins. Conclusion: The long-term use of statins in dyslipidemic patients was associated with a low risk of developing GSs. The gut microbiota associated with a long-term use of statins in dyslipidemic patients was characterized by a low risk of developing an imbalance of various functional bacteria and alterations in the metabolic microbiota. DB and obesity were found to be independent risk factors predicting GSD in statin (+) patients.

Sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) is a rare liver vascular condition, potentially life-threatening, with clinical signs of portal hypertension, frequently reported in relation to bone marrow transplantation and possibly in non-transplantation-related chemotherapy. We report the case of a 65-year-old female patient who insidiously developed fatigue, mild tenderness of the right upper abdominal quadrant, hepato-splenomegaly and slight weight gain consecutive to ascites development, as well as persistent elevation of transaminases and mild thrombocytopenia. To note, she had a previous history of colorectal cancer (CRC) with liver metastases and several courses of chemotherapy. Abdominal duplex and elastography measurements made the diagnosis of cirrhosis improbable. A lot of lab work-ups were performed in order to rule out several diseases and conditions. Further, transjugular access was used to perform the measurement of the hepatic venous pressure gradient and liver biopsy that confirmed SOS/VOD. In late 2023, she was diagnosed with endometrial adenocarcinoma, requiring chemotherapy again. At present, the liver condition is stationary, but the prognosis is, however, uncertain. In conclusion, we presented the atypical case of a female patient who developed portal hypertension syndrome associated with the late onset of SOS/VOD, after 5-fluorouracil and oxaliplatin chemotherapy for CRC and liver metastases, subsequently diagnosed with endometrial adenocarcinoma, which posed many diagnostic and therapeutic challenges. Given the potentially bad outcome, an early diagnosis of SOS/VOD in patients receiving drugs of risk is important not only to stratify further risk, but also to initiate an appropriate therapy in order to improve the prognosis.

Background and objectives: Immune thrombocytopenic purpura (ITP) is a rare hematological disorder characterized by an autoimmune-mediated decline in platelet count in peripheral blood. Over the years, its treatment has evolved, leading to a decline in the role of splenectomy, which was previously used as a second-line therapy. This study aims to evaluate the effects of spleen removal on the progression of the disease, regardless of the surgical procedure, by presenting a single-center experience. Materials and Methods: We retrospectively reviewed the medical records of all ITP patients who underwent splenectomy and were admitted to the Hematology Clinic of Timișoara Emergency City Hospital between January 1988 and June 2024. A total of 217 ITP patients who underwent splenectomy were identified over a 37-year period. Demographic data, postoperative complications, and responses to splenectomy were analyzed over a median follow-up period of 93.86 ± 104.25 months, ranging from 6 to 423 months. Results: Among the 217 patients included in the study, 155 (71.42%) were female and 62 (28.58%) were male, with a mean age of 38.47 ± 16.12 years. During the follow-up period, a significant decrease in the number of splenectomies was observed (p < 0.001). The overall morbidity rate was 14.28%. The overall response rate after splenectomy was 85.71%, with 158 patients (72.81%) achieving a complete response and 28 (12.90%) achieving a partial response. However, 28 (15.05%) of the responsive patients experienced relapse during follow-up and required additional medical therapy. Analyzing the association between comorbidities and relapse after splenectomy, the presence of diabetes (OR = 6.90, 95% CI: 2.87–16.58), hepatic diseases (OR = 64.60, 95% CI: 19.60–212.91), immune thyroid disorders (OR = 8.37, 95% CI: 2.09–33.46), and obesity (OR = 10.22, 95% CI: 3.41–30.60) were identified as risk factors for relapse using univariate analysis. Conclusions: Splenectomy remains the treatment with the best long-term outcomes compared to other therapies. However, concerns about early and late complications following splenectomy, along with advancements in modern ITP treatments, have led to a significant decline in the number of splenectomies performed. In univariate analyses, female gender, age over 40, and the presence of diabetes, hepatic diseases, obesity, or immune thyroid disorders were found to be risk factors for relapse following splenectomy. In the logistic regression analysis adjusted for age and sex, obesity and steatosis were significantly associated with an increased risk of relapse after splenectomy in women over 40 years of age.

Immune thrombocytopenia (ITP) is an autoimmune disorder often triggered by prior viral infections. Although there is considerable evidence suggesting platelets act as passive bystanders during viral illnesses, they are increasingly recognised as active participants in their interactions with viruses. Our descriptive observational retrospective study, conducted at a tertiary hospital in Romania, aimed to evaluate the impact of viral infections on the incidence and outcomes of ITP. This cohort study focused on newly diagnosed ITP cases over a 10-year period, comparing two patient groups: the first group (I-306 patients) from the viral outbreak period (2020–2024) and the second (II-213 patients) from an epidemic-free period (2015–2019). Despite non-pharmacological measures implemented to prevent respiratory infection spread, the number (p = 0.05) and incidence (p = 0.001) of newly diagnosed ITP cases in hospitalised children increased significantly, mainly associated with severe acute respiratory syndrome coronavirus 2 (r = 0.967, p = 0.007), Epstein–Barr virus (r = 0.974, p = 0.004), and influenza (r = 0.901, p = 0.037), with mild thrombocytopenia (p = 0.028). The severity and persistence or chronicity of ITP remained unchanged. The rise in newly diagnosed ITP cases, even without increased severity or chronic evolution, may impose a substantial burden of medical and non-medical costs, highlighting the need for preventive measures during risky viral infection outbreaks.

Background: Non-Hodgkin lymphoma (NHL) involving the ear, nose, and throat (ENT) region encompasses several established lymphoma entities with heterogeneous anatomical presentations. This study describes the clinicopathological features of a selected institutional cohort. Methods: We conducted a single-center retrospective case series of adult patients with NHL documented in institutional records during 2019–2021. Extranodal ENT-organ involvement was distinguished from cervical nodal disease without documented ENT-organ infiltration. Clinical, pathological, staging, treatment, and available follow-up information were reviewed descriptively. Results: Nineteen distinct patients were included (twelve in 2019, three in 2020, four in 2021). The median recorded age was 64 years, and 10 patients (52.6%) were male. Fourteen patients (73.7%) had extranodal ENT-organ involvement, and five (26.3%) had cervical nodal involvement only. The palatine tonsil was the most frequent index site (42.1%). Follicular lymphoma and mantle cell lymphoma were each recorded in four patients (21.1%). All final pathological diagnoses were recorded as B-cell lymphoma entities, although individual immunophenotypic findings were incomplete. Conclusions: This single-center retrospective case series highlights the anatomical and histopathological heterogeneity of NHL involving ENT-region structures. Larger multicenter studies with standardized clinicopathological assessment and longitudinal follow-up are needed to further characterize these presentations and their clinical outcomes.