Background: Colorectal cancer affects a large number of patients worldwide, with numerous factors being involved in its etiopathogenesis and chronic inflammation playing an essential role in tumor development. In this study, we analyzed and compared several markers of inflammation that are relatively easy to obtain for a rapid and accurate diagnosis and prognosis. Methods: This study included 219 patients diagnosed with colorectal cancer, analyzing the inflammation scores derived from their blood cells and inflammatory circulating proteins. These inflammatory markers are neutrophil-to-lymphocyte ratio—NLR; platelet-to-lymphocyte ratio—PLR; lymphocyte-to-monocyte ratio—LMR; systemic immune inflammation index—SII; systemic inflammatory response index—SIRI; aggregate index of systemic inflammation—AISI; derived neutrophil-to-lymphocyte ratio—dNLR; C-reactive protein-to-albumin ratio—CAR; and fibrinogen-to-albumin ratio—FAR. In the analysis of patients with colorectal cancer, we have also introduced two new recently developed inflammatory markers: the cumulative inflammatory index (IIC) and the ratio between the mean corpuscular volume and lymphocytes (MCVL). This study aimed to correlate the inflammatory markers’ levels with the colorectal cancer diagnostic stage, the tumor and clinical characteristics of the colorectal cancer patients, and 36 months’ survival time and to evaluate the diagnostic and prognostic capacity and accuracy of these inflammatory markers in this type of cancer. Results: We showed that the levels of the analyzed inflammation markers correlate with the TNM stage, the tumor pathological differentiation grade, the age and gender of the patients, and overall survival, with their increased levels being associated with a lower survival rate. Conclusions: The analyzed markers, which are easy to perform right from the patient’s admission, can be helpful both in diagnosis and, mostly, in prognosis, sustaining the role of inflammation in cancer. By comparing them, we showed which one can be useful for increased sensitivity and specificity in the diagnosis and prognosis of colorectal cancer patients.

Background: Colorectal cancer is a major health problem that still causes many deaths worldwide. Neuropeptides, such as substance P and calcitonin gene-related peptide, play the neurotransmitter and neurohormone roles that increase tumor invasiveness and metastasis potential. This study aimed to see whether these neuropeptides and their receptors—neurokinin 1 receptor and calcitonin receptor-like receptor—correlate with the diagnosis stage, tumor differentiation grade, and different patient characteristics in colorectal cancer and also to compare them. Methods: We performed serum analyses of substance P and CGRP levels in patients with colorectal cancer and also the immunohistochemical analysis of their receptors in colorectal tumors and then correlated them with the disease stage and with different tumor characteristics. Results: We demonstrated that both substance P and calcitonin gene-related peptide had increased levels in colorectal cancer and that their levels correlated with the stage of the disease and with the tumor differentiation grade. We also demonstrated the correlation of NK-1R and CRLR higher immunohistochemical scores with advanced and poorly differentiated tumors. Conclusions: This study demonstrates that the neuropeptides SP and CGRP and their receptors NK-1R and CRLR could play a role in the pathogenesis of colorectal cancer, and they could be used as diagnostic and prognostic markers and could represent potential therapeutic targets.

Objectives: The aim of the study was to assess the diagnosis and evolution of low anterior rectal resection syndrome (LARS) in patients admitted to a tertiary surgical center in Romania. Materials and Methods: From 120 patients initially included in the analysis, after applying the exclusion criteria, we selected 102 patients diagnosed and operated on for neoplasm of the upper, middle, and lower rectum for which resection and excision (partial or total) of mesorectum was associated. All the patients we treated in the general surgery department of the County Emergency Hospital of Craiova within a time frame of 5 years (1 October 2017–1 September 2022), and all experienced at least one symptom associated with LARS. The group included 68 men and 34 women aged between 35 and 88, who were followed-up for at least 2 years. Patients with progression of neoplastic disease, with advanced neurological disease, and those who died less than 2 years after surgery were excluded. Results: The overall incidence varied by gender, site of the tumor (requiring a certain type of surgery), and anastomotic complications, and it was directly proportional to the time interval between resection and restoration of continuity of digestion. Conclusions: Obesity, size of the remaining rectum, total excision of the mesorectum, anastomotic complications, and prolonged ileostomy time are cofactors in the etiology of LARS. The LARS score decreased in most patients during the 2-year follow-up, although there were a small number of patients in whom the decrease was insignificant. The persistence of major LARS at 6 months after surgery may predict the need for a definitive colostomy.

Currently, worldwide, the coronavirus disease 2019 (COVID-19) pandemic, which first appeared in Wuhan, China, in December 2019, is capsizing the medical system and turning the attention of the entire healthcare system through the many aspects it presents, both from a pathophysiological and from a semiological view, insufficiently studied aspects. With a high rate of morbidity and mortality, the COVID-19 pandemic was initially observed as a pathology leading to a severe acute respiratory syndrome, but over time gastrointestinal and hepatic manifestations have been reported. The study includes an analysis of 21 patients in the stage of the clinical disease of COVID-19 or in the stage of recovery, hospitalized in the Departments of General Surgery II or Gastroenterology, Emergency Clinical County Hospital of Craiova, Romania, with predominantly digestive symptoms, with the clinical expression of infectious enterocolitis, although stool culture was negative for pathogenic bacteria. The evolution of patients was influenced by the appearance of peritonitis through colonic necrosis or remission of clinical symptoms under empirical therapy.

Background: Staphylococcus aureus — particularly methicillin-resistant S. aureus (MRSA) — remains one of the leading causes of skin and soft tissue infections (SSTIs) worldwide. Patients with renal edema, including those with nephrotic syndrome and chronic kidney disease (CKD), represent a population of increased susceptibility due to combined barrier dysfunction, immune impairment, and altered pharmacokinetics. Despite its substantial clinical relevance, the mechanistic relationship between renal edema and cutaneous staphylococcal infection has received limited integrative attention. Objectives: This narrative review aims to: (1) examine the pathophysiological mechanisms through which renal edema predisposes to cutaneous S. aureus infection; (2) characterize the virulence mechanisms that facilitate bacterial persistence and invasion in the renal host; (3) describe the clinical spectrum of SSTIs in this population; (4) evaluate current and emerging therapeutic strategies adapted to renal dysfunction; and (5) discuss the management challenges of severe S. aureus infection in critically ill renal patients. Methods: Search terms included combinations of Staphylococcus aureus, MRSA, skin and soft tissue infections, renal edema, nephrotic syndrome, chronic kidney disease, ICU, vancomycin pharmacokinetics, augmented renal clearance, and anti-virulence therapy. Priority was given to clinical guidelines, systematic reviews, translational studies, and landmark investigations relevant to the pathophysiology and management of cutaneous staphylococcal infection in renal disease. Results: Three converging pathophysiological axes appear to underlie the increased susceptibility of patients with renal edema to cutaneous S. aureus infection: (1) mechanical barrier disruption caused by edema-associated skin tension, blistering, fissuring, and proteinaceous exudate; (2) nephrotic and uremic immunodeficiency, including urinary immunoglobulin loss, neutrophil dysfunction mediated by protein-bound uremic retention solutes (PBURS), complement depletion, and T-cell dysregulation; and (3) lymphatic dysfunction impairing regional immune surveillance and antigen clearance. S. aureus exploits these abnormalities through adhesins, toxin-mediated tissue injury, biofilm formation, and coordinated immune evasion pathways regulated in part by the ArlRS/MgrA cascade. In critically ill patients, management is further complicated by major pharmacokinetic variability, including augmented renal clearance, expanded volume of distribution, and extracorporeal renal support, necessitating individualized dosing strategies and AUC/MIC-guided vancomycin monitoring. Emerging anti-virulence approaches targeting alpha-toxin, quorum-sensing systems, and immune evasion pathways represent promising adjunctive therapeutic strategies. Conclusions: Renal edema creates a biologically permissive environment for cutaneous S. aureus infection through the interaction of barrier dysfunction, immune impairment, and altered antimicrobial pharmacokinetics. Optimal management requires early recognition, renal-adapted antimicrobial therapy, therapeutic drug monitoring, source control, and multidisciplinary care. Continued development of anti-virulence and immunomodulatory therapies may further improve outcomes in this vulnerable patient population.

Background and Objectives: Necrotizing fasciitis (NF) is characterized by rapid and aggressive infection of the subcutaneous tissue and fascia, and a high risk of death in case of delay in diagnosis and treatment. Materials and Methods: This 7-year retrospective study (May 2017–May 2024) evaluated 38 patients with upper- and lower-limb NF admitted to the surgery clinic at the County Emergency Hospital in Craiova, Romania. Results: 21.8% of the confirmed NF cases were monomicrobial; Gram-positive strains were predominant, but Gram-negative strains were also involved. The mortality rate was 28.9%; acute kidney injury appears as the only independent risk factor associated with mortality, although in univariate analysis, septic shock and high NLR and INR values were also factors associated with mortality. An increased resistance rate to antibiotics was recorded, with a 32.7% MDR rate; moderate to high resistance to piperacillin + tazobactam, most cephalosporins, most carbapenems (for Gram-negative strains), and quinolones was noted. Conclusions: Multidisciplinary management, comprising intensive medical support, prompt targeted antibiotic therapy, and immediate surgical intervention, was critical for achieving favorable patient outcomes. Increasing antibiotic resistance may alter the prognosis in patients with NF.