Background/Objectives: Multidrug-resistant (MDR) nosocomial infections remain a major challenge in intensive care units (ICUs), where delays in diagnosis and suboptimal antimicrobial therapy significantly impact outcomes. This narrative review synthesizes international literature and local epidemiological data from Western Romania to examine the role of rapid molecular diagnostics in the management of MDR infections and their integration with prevention and antimicrobial stewardship (AMS) strategies. Methods: Evidence was collected through a narrative literature review using PubMed, WHO, and ECDC sources published between 2010 and 2025. Key terms included “rapid molecular diagnostics,” “sepsis,” “ICU,” “UNYVERO,” “GeneXpert,” “BioFire,” and “carbapenem resistance.” Studies were selected based on clinical relevance to rapid diagnostics and MDR pathogens; no PRISMA-based systematic methodology was applied. Results: Diagnostic performance varies by platform and clinical syndrome. UNYVERO Hospitalized Pneumonia panel demonstrates a sensitivity range of 88.8–91.4% and specificity of 94.9–99.5% in respiratory infections, with a turnaround time of approximately 4–5 h. The GeneXpert Carba-R assay identifies major carbapenemases within 45–60 min with reported sensitivity 96–100% and specificity of 93–99%. BioFire^® Pneumonia and Blood Culture Identification panels similarly provide rapid syndromic results within 1 h, enabling earlier optimization of antimicrobial therapy. Local ICU data from Western Romania identified a substantial burden of carbapenem-resistant Acinetobacter baumannii, underscoring the need for rapid resistance detection to guide therapy. Conclusions: Rapid molecular diagnostics, when integrated with prevention bundles and AMS programs, facilitate earlier targeted therapy, support responsible antimicrobial use, and improve clinical decision-making in MDR infections. Their value is amplified in settings with high resistance prevalence. Wider implementation, combined with surveillance and access to novel antimicrobials, is essential to improve outcomes in critically ill patients.

Exosome-derived microRNAs (miRNAs) have been proposed as minimally invasive biomarkers for laryngeal squamous- cell carcinoma (LSCC). Because oral and maxillofacial surgeons are integral to head-and-neck oncologic and reconstructive pathways, such liquid-biopsy signals could support perioperative decision-making (selection for organ-preserving surgery), margin surveillance, and reconstructive planning. We conducted a preregistered, protocol-driven search of PubMed/MEDLINE, Web of Science, and Scopus from inception to 1 June 2025. Given the very small number of clinically comparable diagnostic studies, discordant index tests/thresholds, and high heterogeneity, we did not perform quantitative pooling or publication-bias testing. Instead, we undertook a narrative synthesis and constructed an evidence map; risk of bias tools (QUADAS-2; ROBINS-I) were applied descriptively to inform qualitative confidence. Nine studies were formally analysed based on eligibility to the study topic. Two serum-based case–control investigations (111 LSCC, 80 controls) reported areas under the ROC curve of 0.876 (miR-21 + HOTAIR) and 0.797 (miR-941), with corresponding sensitivities of 94% and 82%. Seven mechanistic papers showed that vesicular cargos—including miR-1246, circPVT1, and LINC02191—drive STAT3-dependent M2 polarisation, NOTCH1-mediated stemness, Rap1b-VEGFR2 angiogenesis, and glycolytic re-programming, producing 1.6–2.6-fold increases in invasion, tube formation, or xenograft growth. Only three studies fulfilled MISEV-2018 characterisation criteria, and none incorporated external validation. This narrative review and evidence map identifies promising but preliminary diagnostic signals and biologically plausible mechanisms for exosomal miRNAs in LSCC; however, the evidence is sparse, single-region, methodologically inconsistent, and at high risk of bias. Findings do not support clinical implementation at this stage. Priorities include harmonised EV workflows, prespecified thresholds, and prospective, multi-centre validation.

(1) Background: Respiratory allergens, particularly ragweed (RW) pollen and house dust mites (HDMs), are major triggers of respiratory inflammation and allergic diseases. This study investigated the impact of single- versus combined-allergen exposure on the barrier function of normal human bronchial epithelial (NHBE) cells cultured at the air–liquid interface (ALI). (2) Methods: NHBE cells were exposed to RW pollen extract (200 µg/mL), HDM extract (200 µg/mL) and their combination at varying concentrations (200 µg/mL, 100 µg/mL, 50 µg/mL, 25 µg/mL). Additional groups included a mixture of Amb a 1, Amb a 11 and Amb a 12 (100 mg/mL) and combinations of Der p 1 with the ragweed allergens (50 mg/mL, 100 µg/mL). Transepithelial electrical resistance (TEER) was recorded over 72 hours to assess barrier integrity, and immunofluorescence (IF) staining for zonula occludens-1 (ZO-1) was performed to evaluate tight junction alterations. (3) Results: TEER measurements showed a significant reduction in epithelial barrier integrity following allergen exposure, with the most pronounced disruption observed with the combined exposure to RW and HDM groups. IF staining confirmed extensive tight junction damage, highlighting their synergistic impact. (4) Conclusions: These findings emphasize the importance of assessing cumulative allergen effects, as combined exposure may exacerbate epithelial dysfunction and represent a key aspect in the management of allergic rhinitis and asthma.

Background and Objectives: Laryngeal cancer imposes a disproportionate burden on speech, airway protection and long-term quality of life. Contemporary population-based data for Central and Eastern Europe remain scarce, and the post-pandemic trajectory is uncertain. Materials and Methods: We performed a nationwide, retrospective ecological time-series study using Romanian mortality registers and hospital-discharge files for 2017–2023. Crude and age-standardised mortality rates (ASMRs) were calculated, county-level indirect standardisation and spatial autocorrelation assessed and joinpoint regression quantified temporal trends. Forecasts to 2040 combined Holt–Winters/ARIMA models with Elliott-wave heuristics anchored to Fibonacci retracements. Results: In 2023, 798 laryngeal cancer deaths yielded a crude mortality of 3.65/100,000 (95% CI 3.41–3.91). Male mortality (7.07/100,000) exceeded female mortality 18-fold. Rural residents experienced a higher rate than urban counterparts (4.26 vs. 3.04/100,000), a difference unchanged after indirect age standardisation. National ASMR fell by 3.7% annually (p < 0.01), yet five counties formed a high-risk corridor (standardised mortality ratios 1.59–1.82); Moran’s I = 0.27 (p < 0.01) indicated significant spatial clustering. Pandemic-era surgical throughput collapsed by 48%, generating a backlog projected to persist beyond 2030. Ensemble forecasting anticipates a doubling of discharges and mortality between 2034 and 2037 unless smoking prevalence falls by ≥30% and radon exposure is curtailed. Conclusions: Although overall laryngeal cancer mortality in Romania is declining, the pace lags behind Western Europe and is threatened by geographic inequities and pandemic-related care delays. Aggressive tobacco control, radon-remediation policies and expansion of surgical and radiotherapeutic capacity are required to avert a forecasted surge in the next decade.

Background and Objectives: Lacrimal sac/nasolacrimal duct (LS/NLD) tumors may present as primary acquired nasolacrimal duct obstruction (PANDO), raising debate over routine versus selective dacryocystorhinostomy (DCR) biopsy. We systematically reviewed (i) biopsy yields in routine versus selective strategies, (ii) clinical/imaging red flags for neoplasia, and (iii) outcomes of malignant LS/NLD tumors. Materials and Methods: Following a preregistered PRISMA 2020-compliant protocol, we searched PubMed/MEDLINE, Web of Science, and Scopus (1970–2025) for adult cohorts reporting histopathology, imaging, or oncologic outcomes in PANDO/DCR or LS/NLD tumors. Eligible designs included comparative, cohort, cross-sectional, and diagnostic accuracy studies with histology as a reference. Results: Across 16 cohorts, routine DCR series reported “any specific pathology” in 0–7.91% of specimens and malignant yields generally ≤0.73%. In Anderson, 7.91% of 316 patients had significant pathology and 4.43% neoplasia, with 2.53% unsuspected pre-/intra-operatively. Selective biopsy or tumor-enriched cohorts showed higher malignant burdens; pooled modern data yielded ~72.8% squamous cell carcinoma and ~21.4% lymphoma among malignancies. Imaging red flags included bone erosion (50% malignant vs. 11% benign) and infiltrative patterns (63% vs. 0%), while sac masses were present in 88% of tumors in one recent series. In LSSCC-only cohorts, contemporary multimodal therapy achieved 5-year overall survival of 87.6% and progression-free survival of 76.3%. Conclusions: Malignancy is rare in unselected PANDO but clinically significant when present. A tiered strategy combining bedside red flags, targeted CT/MRI, and selective biopsy appears to balance oncologic safety with resource stewardship and supports histology-directed epithelial versus lymphoma care pathways.

We examined whether baseline artificial intelligence (AI) economic literacy was associated with sustained use of oncology AI tools. This prospective cohort included 96 oncology and critical care professionals at two centres in Timișoara, Romania, followed for 12 months after institutional roll-out. Participants were classified by AI Economic Literacy Index (AIELI) scores as high (≥14) or low (<14). Sustained use required log-verified activity in at least two of the final three months. Analyses included regression, inverse probability of treatment weighting and exploratory indirect-association analysis through return-on-investment (ROI) confidence. Among 91 completers, sustained use occurred in 29/53 high-literacy participants (54.7%) and 7/38 low-literacy participants (18.4%; risk ratio 2.97, 95% confidence interval 1.46–6.06). The weighted risk ratio was 2.24 (1.15–4.34), and the profession-stratified risk ratio was 2.80 (1.36–5.76). Median time to first use was 5.8 months in the high-literacy group and was not reached in the low-literacy group. Nine participants (eight high-literacy, one low-literacy) had recorded use before the baseline assessment; in a delayed-entry analysis restricted to the 87 participants unused at assessment, the crude hazard ratio for subsequent first use was 2.98 (1.62–5.48) and the crude risk ratio for sustained use after excluding prior users was 3.01 (1.36–6.64); the corresponding covariate-adjusted estimates were less precise (hazard ratio 1.81, 0.89–3.69; risk ratio 2.19, 0.99–4.86) and their confidence intervals included the null. Roll-out-based time-to-first-use comparisons are descriptive because they include events preceding measurement. Sustained use increased across literacy bands. An indirect association through ROI confidence was observed but was not interpretable as causal mediation. Higher baseline economic literacy was associated with earlier and more sustained recorded AI-tool use, although opportunity for use differed by profession, and the adjusted timing-corrected estimates leave the independent contribution of literacy uncertain. Larger multicentre studies should evaluate whether literacy training improves adoption and whether adoption translates into clinical or economic benefit.