Background/Objectives: Ventilator-associated pneumonia (VAP) remains a critical challenge in ICU settings, often driven by the biofilm-mediated bacterial colonization of endotracheal tubes (ETTs). This study investigates antimicrobial resistance patterns and biofilm dynamics in ICU patients, focusing on microbial colonization and resistance trends in tracheal aspirates and endotracheal tube biofilms at a county emergency hospital in Romania. Methods: We conducted a longitudinal analysis of ICU patients requiring mechanical ventilation for more than 48 h. Tracheal aspirates and ETT biofilms were collected at three key time points: T1 (baseline), T2 (48 h post-intubation with ETT replacement), and T3 (92–100 h post-T2); these were analyzed using sonication and microbiological techniques to assess microbial colonization and antimicrobial resistance patterns. Results: In a total of 30 patients, bacteria from the ESKAPEE group (e.g., Klebsiella pneumoniae, Acinetobacter baumannii, Staphylococcus aureus) dominated the microbiota, increasing their prevalence over time. Resistance to carbapenems, colistin, and vancomycin was notably observed, particularly among K. pneumoniae and A. baumannii. Biofilm analysis revealed high persistence rates and the emergence of multidrug-resistant strains, underscoring the role of ETTs as reservoirs for resistant pathogens. The replacement of ETTs at T2 correlated with a shift in microbial composition and reduced biofilm-associated contamination. Conclusions: This study highlights the temporal evolution of antimicrobial resistance and biofilm-associated colonization in a limited number of ICU patients (30 patients). The findings support implementing routine ETT management strategies, including scheduled replacements and advanced biofilm-disruption techniques, to mitigate VAP risk and improve patient outcomes.

The escalation of global obesity is driving research to understand environmental influences on this process, particularly during vulnerable developmental stages such as childhood and adolescence. Efforts include the development of various structured data collection tools. We aimed to adapt a series of previously validated questionnaires from the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE), the Child Feeding Questionnaire, and elements from the World Health Organization Childhood Obesity Surveillance Initiative (COSI) in order to assess local lifestyle patterns among Romanian high school students and their families that may predispose them to obesity. To this goal, an expert committee was formed as part of a research partnership to oversee the questionnaire’s translation and adaptation. It consisted of education and school management specialists, clinical research professionals, language experts, and public health experts. The adapted questionnaires were then applied to 114 students enrolled in the 9th and 10th grades attending a high school situated in Sibiu, and their parents. The variables measured were investigated for correlations with overweight and obesity and, as a secondary objective, academic performance. The study revealed several critical findings, including suboptimal sleep durations and physical activity levels among students, a significant amount of screen time, and correlations between weight status and physical activity, sedentary time, and maternal weight status and education levels. The adapted questionnaires proved to be effective tools in capturing the multifaceted factors implicated in adolescent obesity, providing a foundation for targeted interventions and broader public health strategies to address this issue.

The impact of the school environment on childhood weight status has garnered significant attention in recent years. This study aimed to adapt and validate the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) School and Environment questionnaire in order to assess the potential obesogenic impact of school environments in Sibiu County, Romania. The ISCOLE questionnaire was chosen for its rigorous methodology. It was derived from a comprehensive study conducted across 12 countries which aimed to capture multifaceted influences on childhood weight while emphasizing educational settings in the collection of data. To guide the translation and adaptation of the questionnaire, a multidisciplinary committee was assembled which comprised experts in teaching and school administration to ensure target responder relevance, experts in clinical research to ensure methodological robustness, experts in language adaptation to preserve the original intent of the survey, and experts in public health to steer the interpretation of the results, with potential policy implications. The data were analyzed by distinguishing between urban and rural settings, and a two-step cluster analysis was implemented to identify potential intervention targets. To assess the validity of the adapted tool, the questionnaire’s construct validity and internal consistency were explored. A response rate of 71.2% of the approached schools in Sibiu County was achieved. Of the 84 responding school representatives, 37 (44%) were from a rural setting. The rural schools had significantly more limited access to gymnasiums, secured lockers, showers, and bicycle racks, and exhibited more serious problems regarding the inadequate disposal of garbage in the school vicinity. A two-step cluster analysis revealed distinct school categories, providing opportunities for public policy interventions. One of these primarily concerned rural schools with limited infrastructure but with proactive practices and policies which were termed “unable but willing”; on the opposing spectrum, the category “able but unwilling” mainly comprised urban schools which had available facilities but lacked local proactive initiatives. The findings emphasize the urgent need for targeted measures to bridge these discrepancies by investing in infrastructure in rural schools and promoting active school practices and policies in urban settings. The assessment of obesogenic school environments in Sibiu County provides a pilot model for broader applications due to the diverse school landscape and supportive local authorities. The results, which were achieved using low-cost methods, can guide future educational policies, health promotion initiatives, and preventive interventions.

Effective immunosuppressant pharmacotherapy is essential for successful organ transplantation. Background/Objectives: Generally, induction therapy includes basiliximab (BAS) or anti-thymocyte globulin (THY). However, other biological molecules have been used to accelerate firm immunosuppression. A reduced effectiveness of these induction agents increases the risk of graft rejection. This study aims to evaluate the ineffectiveness rate of biological molecules based on spontaneous reports uploaded to the EudraVigilance database. Methods: Specific topics related to the safety profiles of alemtuzumab, BAS, belatacept, and THY were analyzed. A total of 23 preferred terms describing drug resistance, drug ineffectiveness, and transplant rejection were used as the inclusion criteria. Descriptive and disproportionality analyses were performed. Results: Regarding the four molecules, 18,564 safety reports were communicated, with n = 5089 (27.4%) for THY and n = 3469 (18.7%) for BAS. Most adverse drug reactions (ADRs) for THY, BAS, and belatacept affected the adult male population. As expected, the majority of the ADRs were linked to infections, followed by general disorders. BAS presented higher probabilities of drug resistance and transplant rejection being reported among the four molecules. A higher probability of reporting drug ineffectiveness was noted for THY than for the other molecules. Conclusions: All the molecules showed small frequencies regarding resistance. As expected, transplant rejection was more frequently reported for all molecules (especially for BAS), accompanied by a notable variability in reporting frequencies. However, a causal relationship between the reported adverse reactions and drug efficacy cannot be established based on the present results. Further real-world evidence studies will enhance our understanding of the safety and efficacy of these drugs in transplant patients.

Background: Type 2 diabetes mellitus (T2DM) is common in patients with gastrointestinal malignancies, yet its relationship with functional status at cancer diagnosis remains poorly defined. Because both diabetes and cancer are characterized by systemic inflammatory activation, inflammation may be associated with the relationship between diabetes and functional impairment. Methods: We performed a retrospective observational study of 344 patients with colon or pancreatic cancer diagnosed between January 2019 and December 2025, including 172 patients with T2DM and 172 without diabetes, frequency-matched by tumor site. Clinical characteristics, The Eastern Cooperative Oncology Group—ECOG performance status (ECOG-PS) and laboratory parameters were assessed at diagnosis before oncological treatment. Associations between T2DM and ECOG-PS were examined using multinomial and ordinal logistic regression adjusted for age, cancer stage, tumor site, and sex. Multivariable linear regression was used to assess associations with log-transformed C-reactive protein (CRP) and lactate dehydrogenase (LDH). An exploratory analysis evaluated the indirect statistical association through a composite inflammatory score derived from standardized CRP, LDH, and neutrophil count values using 5000 bootstrap samples. Results: T2DM was independently associated with a higher ECOG-PS category in the ordinal model (OR = 1.78; 95% CI 1.14–2.76; p = 0.010). In the multinomial model, T2DM was associated with ECOG 2 versus ECOG 0 (OR = 2.84; 95% CI 1.22–6.63; p = 0.016), whereas the association with ECOG 1 versus ECOG 0 was not statistically significant. After multivariable adjustment, T2DM was associated with 56.4% higher CRP and 34.7% higher LDH levels. A significant indirect statistical association through the composite inflammatory score was observed (β = 0.147; 95% bootstrap CI 0.083–0.216; p < 0.001), whereas the direct association after inclusion of the inflammatory score was not significant (β = 0.020; 95% CI −0.119 to 0.158; p = 0.780). Conclusions: In this selected sample assessed cross-sectionally at cancer diagnosis, T2DM was associated with poorer ECOG performance status and higher systemic inflammatory markers. The observed indirect statistical association through the composite inflammatory score should be interpreted as exploratory because the concurrent assessment of inflammatory markers and ECOG-PS precludes temporal or causal inference. Prospective longitudinal studies are required to clarify these relationships.

Background: Differentiating benign from malignant pancreatic lesions requires integrating clinical, biochemical, and imaging data. We identified factors associated with malignancy and evaluated endoscopic ultrasound (EUS) alongside CT/MRI in pancreatic lesions with a reference diagnosis established by histopathology or clinical–radiological follow-up. Methods: In this single-center retrospective study (Sibiu, Romania; 2022–2025), all patients underwent EUS-guided FNA and CT and/or MRI. The reference standard was histopathology in 193 patients (82.1%) and clinical–radiological follow-up in 42 benign lesions (17.9%). Multivariable logistic regression identified factors associated with malignancy. EUS–CT/MRI agreement was assessed by concordance and Cohen’s kappa; diagnostic performance by sensitivity, specificity, predictive values, and Youden index. Results: Of 235 patients, 47 (20.0%) had malignant lesions. Age, ln-transformed CA 19-9, pancreatic duct dilation (OR 18.97; 95% CI 5.95–60.50), and lymphadenopathy were independently associated with malignancy (apparent AUC 0.956; optimism-corrected AUC 0.949 after internal bootstrap validation; no external validation). EUS visualized 46 lesions not detected on CT/MRI. Agreement was 95.8% for size category (κ = 0.905) and 87.8% for morphology (κ = 0.510). Sensitivity was 80.9% for both modalities; specificity 59.0% (EUS) and 51.6% (CT/MRI); Youden index 0.399 and 0.324. All 38 EUS-solid lesions were malignant (all adenocarcinoma) in this selected referral cohort. Conclusions: EUS detected additional lesions, but both modalities showed limited overall discrimination with comparable sensitivity. Findings support complementary use of EUS and CT/MRI within an integrated clinical assessment; the regression model requires validation. Predictive values apply to this selected referral cohort and may not be transferable to unselected populations.