Metabolic and bariatric surgery (MBS) is an effective intervention for patients with severe obesity and metabolic comorbidities, particularly when non-surgical weight loss methods prove insufficient. MBS has shown significant potential for improving quality of life and metabolic health outcomes in individuals with obesity, yet it carries inherent risks. Although these procedures offer a multifaceted approach to obesity treatment and its clinical advantages are well-documented, the limited understanding of its long-term outcomes and the role of multidisciplinary care pose challenges. With an emphasis on quality-of-life enhancements and the handling of postoperative difficulties, the present narrative review seeks to compile the most recent findings on MBS while emphasizing the value of an integrated approach to maximize patient outcomes. Effective MBS and patients’ management require a collaborative team approach, involving surgeons, dietitians, psychologists, pharmacists, and other healthcare providers to address not only physiological but also psychosocial patient needs. Comparative studies demonstrate the efficacy of various MBS methods, including Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy that may considerably decrease morbidity and mortality in individuals with obesity. Future studies should target long-term patient treatment, and decision making should be aided by knowledge of obesity, comorbidity recurrence rates, and permanence of benefits.

Acute pancreatitis (AP) is among the most frequent gastroenterology emergencies, with hospital admission rates on the rise in recent decades. However, a specific treatment for this condition is still lacking. Mitochondrial damage induced by oxidative stress is regarded as the key event in the pathophysiology and initiation of cellular damage in AP. In the early stages of AP, the oxidant–antioxidant balance changes rapidly, and there are significant data regarding the reduced serum levels of antioxidants, with this event being correlated with the clinical severity of pancreatitis. Therefore, addressing oxidative stress could represent a potential therapeutic target in AP. In this comprehensive review, we aimed to provide an update on current evidence regarding clinical and experimental data on antioxidant use in AP, focusing on human studies investigating the effects of single and combined antioxidant supplementation. Although a multitude of animal studies demonstrated that antioxidant therapy has beneficial effects in experimental AP by reducing oxidative injury, inflammatory markers, and ameliorating histological outcomes, human trials showed predominantly conflicting results, with some studies suggesting benefit while others showed no effect, or even potential harm, when antioxidants were administered in high doses or in combination. Moreover, some antioxidants with beneficial results in experimental settings did not show the same efficacy when translated to human studies, which may be a consequence of either inappropriate dosage, route of administration and duration of therapy, or altered pharmacodynamics in vivo. In conclusion, oxidative stress plays a key role in the pathophysiology of AP by enhancing acinar cell injury, inflammation, and systemic complications. Future studies should be centered on optimized dosing strategies, early administration protocols, targeted patient selection, and delivery methods of proper pharmaceutical forms.

Honey quality and authenticity are influenced by floral origin, processing, and storage, with implications for composition and sensory appeal. This study offers a comparative assessment of eight monofloral honey samples, representing five botanical varieties: acacia, linden, rapeseed, lavender, and thyme. For acacia, linden, and rapeseed, both producer-sourced and commercial honeys were analyzed, while lavender and thyme samples were available only from local beekeepers. The botanical origin of each sample was confirmed using morphological markers of pollen grains. Physicochemical characterization included acidity, pH, moisture content, refractive index, hydroxymethyl furfural (HMF), proline concentration, and carbohydrate profiling by HPLC-RID. Acacia honey exhibited the lowest acidity and HMF levels, alongside the highest fructose/glucose (F/G) ratios, indicating superior freshness, lower crystallization risk, and a sweeter flavor profile. In contrast, rapeseed honey showed elevated glucose levels and the lowest F/G ratio, confirming its tendency to crystallize rapidly. All samples recorded proline concentrations well above the quality threshold (180 mg/kg), supporting their authenticity and proper maturation. The estimated glycemic index (eGI) varied between 43.91 and 62.68 and was strongly inversely correlated with the F/G ratio (r = −0.98, p < 0.001). Sensory evaluation highlighted acacia honey from producers as the most appreciated across visual, tactile, and flavor attributes. Correlation analyses further revealed consistent links between sugar composition and both physical and sensory properties. Overall, the findings reinforce the value of integrated analytical and sensory profiling in assessing honey quality and authenticity.

Background and Clinical Significance: As a common inflammatory skin disorder, acne vulgaris is classically associated with sebum overproduction, follicular hyper keratinization, and Cutibacterium acnes proliferation. Emerging evidence suggests a link between severe or treatment-resistant acne and metabolic syndrome, characterized by central obesity, insulin resistance, dyslipidemia, and hypertension. This case series aims to explore the clinical overlap between acne and metabolic dysfunction and highlight the relevance of multidisciplinary evaluation. Case Presentation: Three patients with severe acne vulgaris and coexisting metabolic abnormalities were evaluated at a dermatology clinic in Oradea, Romania, between 2023 and 2024. Each patient underwent dermatologic examination, laboratory testing for metabolic and hormonal parameters, and individualized treatment. Management strategies included topical/systemic acne therapies combined with metabolic interventions (lifestyle modifications, metformin (in two cases), and lipid-lowering agents). Case 1 (female, 23) had obesity, insulin resistance, dyslipidemia, and polycystic ovary syndrome (PCOS). Case 2 (male, 19) presented with central obesity and atherogenic dyslipidemia. Case 3 (male, 18) showed insulin resistance, overweight status, and elevated inflammatory markers. All three showed suboptimal response to standard acne treatment. Adjunct metabolic management resulted in partial improvement within 3 months. One patient required isotretinoin after metabolic stabilization. Conclusions: These cases underscore the interplay between acne and metabolic dysfunction. Insulin resistance and systemic inflammation may contribute to therapeutic resistance in acne. Early recognition of metabolic syndrome features in patients with severe acne may improve treatment outcomes. Dermatologists should consider metabolic screening to guide comprehensive, multidisciplinary care.

Background: Hepatitis B (HBV) and C (HCV) virus coinfections remain major contributors to liver-related morbidity and mortality among people living with HIV (PLWH). This study aimed to assess the prevalence of HBV and/or HCV coinfections in a Romanian HIV cohort and to evaluate their impact on immunological, virological, and liver function parameters under antiretroviral therapy (ART). Methods: We retrospectively analyzed 462 HIV-infected patients (2018–2021) from the National Institute of Infectious Diseases, Bucharest, stratified into four groups: HIV mono-infection (n = 176), HIV/HBV (n = 114), HIV/HCV (n = 97), and HIV/HBV/HCV (n = 75) coinfections. Immunological (CD4 count, CD8 count, and CD4/CD8 ratio), virological (HIV-1 RNA), and hepatic parameters (ALT, AST, GGT, bilirubin, amylase, and lipase) were compared. Results: No significant differences were observed between groups regarding the immune recovery (mean CD4 count p = 0.89, HIV-RNA suppression p = 0.78). However, liver and pancreatic parameters showed statistically significant deterioration in the coinfected groups. ALT (p < 0.001), GGT (p = 0.009), total bilirubin (p = 0.011), amylase (p = 0.010), and lipase (p < 0.001) were significantly higher in the triple-infection (HIV/HBV/HCV) group compared to HIV mono-infected patients. Coinfection was also associated with a longer duration of illness (p = 0.002) and therapy (p = 0.021) and with a higher number of ART regimens used (p = 0.013). Conclusions: While HIV suppression and immune recovery were not significantly impaired by HBV/HCV coinfections, liver and pancreatic injuries were significantly more prevalent and severe in coinfected patients. Regular monitoring of hepatic function and integrated management strategies are recommended to minimize liver-related complications in this population.

This exploratory study assessed the influence of botanical origin and acquisition source on the phenolic profile and antioxidant properties of selected Romanian monofloral honeys. Eight samples were analyzed, representing five floral types: acacia, linden, rapeseed, lavender, and thyme. For acacia, linden, and rapeseed, both commercial and locally sourced honeys were included. Analytical techniques included total phenolic content (TPC, Folin–Ciocalteu), antioxidant assays (DPPH, ABTS, FRAP), color intensity (ABS₄₅₀), and phenolic compound profiling via HPLC-DAD-ESI⁺. TPC ranged from 179.26 ± 23.57 to 586.67 ± 18.33 mg GAE/100 g, with thyme and linden honeys presenting the highest values. Seventeen phenolic compounds were tentatively identified; gallic acid was predominant in thyme honey (127 mg/100 g), and linden honey contained high levels of rutin (70 mg/100 g) and galangin-glucoside. Antioxidant capacity varied notably by floral origin, with thyme and linden outperforming acacia samples. Significant correlations were found between total phenolics and ABTS (r = 0.86), and between ABS₄₅₀ and FRAP (r = 0.86). DPPH kinetics followed zero-order behavior (R² > 0.98). Principal component analysis (PC1 + PC2 = 88%) enabled preliminary separation by botanical origin. While based on a limited sample set, findings support the relevance of combining chromatographic, kinetic, and multivariate tools for exploratory honey characterization.