Background/Objectives: Ischemic heart disease (IHD) is a major cause of morbidity and mortality worldwide, and it is frequently associated with depression, which can negatively impact both clinical outcomes and quality of life. The relationship between IHD and depression is complex, with gender differences influencing the severity of depression and willingness to seek psychological support. This study aims to evaluate the prevalence and severity of depression in IHD patients using the Depression Assessment in Ischemic Heart Disease Questionnaire (DA-IHDQ) and to explore gender differences in depression severity and help-seeking behavior. Methods: This cross-sectional study involved 103 patients diagnosed with IHD (62 males, 41 females), with data collected from two general practice clinics in Arad, Romania, between November 2023 and November 2024. Participants completed the DA-IHDQ, a self-developed questionnaire designed to screen for depression in IHD patients. The questionnaire categorizes depression severity into four grades: minimal to no depression, mild depression, moderate depression, and severe depression. The study also assessed participants’ interest in receiving psychological support. Descriptive and inferential statistical analyses were performed, and the psychometric properties of DA-IHDQ, including its reliability (Cronbach’s α = 0.957) and diagnostic accuracy (sensitivity = 90.0%, specificity = 98.8%), were evaluated. Results: Mild depression was the most common grade in both male and female IHD patients, while severe depression was the least prevalent. Males had a higher overall frequency of depression, with more cases of mild depression, whereas females had a higher proportion of moderate and severe depression. Additionally, males demonstrated significantly lower interest in psychological or psychiatric help, while females showed greater willingness to seek mental health support. The DA-IHDQ exhibited strong internal consistency and high diagnostic accuracy in identifying depressive symptoms in IHD patients. The DA-IHDQ exhibited strong internal consistency and high diagnostic accuracy in identifying depressive symptoms in IHD patients. Conclusions: The findings highlight the high prevalence of depression in IHD patients and the gender disparities in mental health engagement, emphasizing the need for targeted psychological interventions. The DA-IHDQ demonstrated strong psychometric properties and could serve as an effective screening tool for depression in IHD care. The DA-IHDQ demonstrated strong psychometric properties and could serve as an effective screening tool for depression in IHD care. Future research should explore the barriers to help-seeking among male IHD patients and develop gender-sensitive strategies to improve access to mental health services.

Background/Objectives: Hypersensitivity pneumonitis (HP), a subtype of interstitial lung disease (ILD), is often misdiagnosed as idiopathic pulmonary fibrosis (IPF), particularly when the causative antigen cannot be identified. Typically resulting from chronic exposure to inhaled organic particles smaller than 5 microns, HP presents a diagnostic challenge. This report outlines a case of fibrotic HP initially misclassified as asthma. No triggering antigen was identified despite extensive investigation. The disease progressed despite corticosteroid, immunosuppressive, and antifibrotic therapy, ultimately leading to an advanced fibrotic stage and requiring lung transplantation. This clinical course is rare and infrequently reported, particularly in cases requiring lung transplantation without an identifiable causative antigen. Such progression is uncommon and underreported, especially in patients initially misclassified as having asthma. Methods: Medical records of 24 patients diagnosed with HP were reviewed. Only one case demonstrated progression to fibrotic HP; this case was selected for detailed analysis. Results: Clinical and functional deterioration occurred despite standard therapy. Given the advanced stage of fibrosis and treatment resistance, lung transplantation was deemed the next appropriate therapeutic option. Conclusions: HP remains underdiagnosed due to difficulties in identifying the causative antigen and overlapping features with other ILDs. Early and accurate differentiation from IPF is essential, particularly in progressive fibrotic forms unresponsive to conventional therapies.

Background/Objectives: Adolescent pregnancy is associated with an increased risk of adverse neonatal outcomes, including low birth weight, preterm birth, and impaired neonatal adaptation. While maternal age is a well-established determinant, the independent role of parity in this population remains uncertain. This study aimed to assess the association between parity and neonatal outcomes in adolescent mothers. Methods: We conducted a retrospective cohort study including 751 singleton live-birth deliveries to adolescent mothers aged <18 years at a Romanian secondary-care hospital. The unit of analysis was the delivery episode recorded in the institutional birth registry. Mothers were classified according to parity at the time of the index delivery as primiparous or multiparous. Neonatal outcomes included low birth weight (<2500 g), preterm birth (<37 weeks), Apgar score < 7 at 5 min, and a composite adverse neonatal outcome. Multivariable logistic regression models were used to evaluate the association between parity and neonatal outcomes, adjusting for maternal age (<15 vs. ≥15 years), gestational age, and mode of delivery, as appropriate. Results: A total of 751 singleton live-birth delivery episodes were included; 609 (81.1%) occurred in primiparous adolescents and 142 (18.9%) in multiparous adolescents. Parity was not significantly associated with preterm birth (aOR 0.86, 95% CI 0.48–1.56, p = 0.622), Apgar score < 7 at 5 min, or the composite adverse neonatal outcome. Maternal age < 15 years and gestational age were independently associated with Apgar score < 7 at 5 min. Multiparity was associated with lower odds of low birth weight (aOR 0.40, 95% CI 0.17–0.92, p = 0.031). Conclusions: Parity was not independently associated with most neonatal outcomes in adolescent pregnancies. Multiparity was associated with lower odds of low birth weight, but this finding should be interpreted cautiously because residual confounding cannot be excluded.

Background/Objectives: Psychiatric inpatient care varies substantially in its clinical goals, resource demands, and financial implications. Acute units focus on short-term crisis stabilization, whereas chronic units provide prolonged supervision for patients with persistent functional impairment. Limited evidence exists from Eastern Europe on how these differing service models impact both hospital costs and clinical outcomes such as early rehospitalization. This study aimed to compare the economic and operational performance of Acute versus Chronic Psychiatry and to identify predictors of 30-day readmission following acute psychiatric hospitalization. Methods: This retrospective observational study analyzed routinely collected data from a Romanian public hospital. All adult admissions to Acute and Chronic Psychiatry recorded between 1 January 2024 and 31 December 2024 were included. Standardized financial indicators were derived from administrative data, while clinical variables and readmission outcomes were extracted from electronic medical records. Between-group comparisons of economic and operational indicators were performed using t-tests. Multivariable logistic regression was used to determine independent predictors of 30-day readmission in Acute Psychiatry, reporting adjusted odds ratios (aOR) with 95% confidence intervals (CI). Model performance was evaluated with area under the curve (AUC), Hosmer–Lemeshow tests, and Nagelkerke R². Results: Acute Psychiatry demonstrated significantly higher mean cost per bed-day (798.76 vs. 373.75 lei; p < 0.001), but a lower mean cost per patient due to shorter hospitalization (10.17 vs. 53.32 days). A total of 188 acute patients (13.7%) were readmitted within 30 days. No early readmissions occurred in Chronic Psychiatry, consistent with its long-stay care model. Independent predictors of readmission included psychotic disorder diagnosis (aOR = 1.62, 95% CI: 1.18–2.23), multiple prior admissions (aOR = 1.35, 95% CI: 1.18–1.54), shorter length of stay (LOS) (aOR = 0.88 per 5-day increase, p = 0.006), and absence of a post-discharge plan (aOR = 0.54, 95% CI: 0.39–0.76). Model discrimination was acceptable (AUC = 0.74). Conclusions: Acute and chronic psychiatric services differ markedly in cost structures and care pathways. Early rehospitalization is a clinically relevant outcome within acute psychiatric care and is influenced by both patient-level and continuity-of-care factors. Enhancing discharge coordination, expanding continuity-of-care strategies, and optimizing resource allocation toward community-based support may reduce early rehospitalizations while improving hospital cost-efficiency.

Background and Objectives: Adolescent pregnancy is traditionally associated with increased obstetric risk, particularly among very young adolescents. Romania continues to report one of the highest adolescent birth rates in the European Union, yet age-stratified clinical data on obstetric outcomes among minors remain limited. This study aimed to evaluate maternal and intrapartum outcomes among underage mothers (<18 years), stratified by age (<15, 15–16, and 17 years), and to identify predictors of adverse obstetric outcomes. Materials and Methods: We conducted a retrospective cohort study of all live births and stillbirths among mothers aged 12–17 years recorded between 2020 and 2024 at a secondary maternity hospital in Romania. Data were extracted from standardized obstetric and neonatal records. Primary outcomes included preterm birth (<37 weeks), cesarean delivery, and intrapartum complications. Group comparisons were performed using non-parametric tests and the χ² test. Multivariable logistic regression models were used to assess independent associations between maternal age and obstetric outcomes. Results: The cohort comprised 763 adolescent mothers aged 12–17 years. No significant differences were observed across age groups in gestational age at birth, preterm birth rate, fetal presentation, or mode of delivery. In multivariable analyses, younger maternal age was not independently associated with preterm birth (adjusted odds ratios [aORs] 0.87–1.21) or cesarean delivery (aORs 0.74–1.08). Obstetric factors, such as non-cephalic presentation and characteristics of membrane rupture, were the main predictors of adverse outcomes. Temporal analyses demonstrated stable outcome patterns across the study period, with no significant interaction between maternal age and year of delivery. Conclusions: In this tertiary-care cohort, very young maternal age (<15 years) was not associated with poorer obstetric outcomes compared with older adolescents. These findings suggest that standardized antenatal surveillance and intrapartum management may mitigate age-related obstetric risk among underage mothers. Further population-based studies are warranted to contextualize these results within broader healthcare access and social determinants of adolescent pregnancy. Cesarean section rates were high across all groups (~50%), with no significant differences by maternal age.

Background and Clinical Significance: Extrapulmonary tuberculosis (TB) remains a diagnostic challenge, particularly when affecting rare sites such as the oral cavity and digestive tract. We report the case of a 55-year-old woman with disseminated (miliary) tuberculosis presenting with atypical oral lesions initially suspected to represent a malignant tumor. Case Presentation: The patient had a history of recurrent depressive disorder, cognitive impairment, sleep disturbances, and nicotine/alcohol dependence. She presented with painful ulcerations of the oral cavity, dysphagia, odynophagia, and glossodynia. Otolaryngologic examination revealed reduced tongue mobility and an ulceroinfiltrative lesion involving the floor of the mouth and the lower alveolar ridge. Fibroscopic evaluation confirmed infiltrative ulcerative lesions, and biopsy samples were obtained. Histopathologic examination revealed a chronic necrotizing granulomatous inflammation with multinucleated giant cells, consistent with a mycobacterial infection. Further investigations confirmed disseminated (miliary) tuberculosis with oral and digestive involvement. Antituberculous therapy was initiated; however, despite temporary stabilization, the patient’s condition progressively worsened and the outcome was fatal. Conclusions: Oral and digestive tuberculosis, although rare, should be considered in the differential diagnosis of ulceroinfiltrative lesions of the oral cavity, particularly in patients with systemic symptoms or risk factors for TB. Early histopathologic confirmation and initiation of specific therapy are essential for favorable outcomes and prevention of misdiagnosis as malignant disease.