The aim of this study was to assess the role of immunocyte-derived ratios (IDRs), such as the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR), as markers for the postoperative recovery of gastrointestinal function following colorectal cancer surgery. A retrospective analysis was conducted on a consecutive cohort of 260 patients who underwent radical colorectal cancer surgery within the timeframe spanning from January 2016 to December 2022. Data concerning the postoperative recovery of gastrointestinal function included the I-FEED score, time to pass flatus, toleration for liquids in the first 48 h, and the need for nasogastric tube reinsertion in the immediate postoperative period. A special emphasis was allocated towards the examination of IDRs and their interrelation with the postoperative gastrointestinal functional parameters. The I-FEED score exhibited a positive correlation with the NLR, SII, and PLR. The univariate analysis indicated that all IDRs, multiorgan resection, hemoglobin and protein levels, regional nodal extent of the tumor (N), and obesity significantly affected nasogastric tube reinsertion. The multivariate analysis showed that the SII and N1 stages were risk factors for nasogastric tube reinsertion after colorectal cancer surgery. The SII and multiorgan resection were the only classifiers that remained significant in the multivariable analysis for the toleration for liquids. In summation, certain preoperative IDRs, such as the SII, PLR, and NLR, may hold potential as predictive determinants for postoperative gastrointestinal functional recovery following colorectal cancer surgery.

Oxidative stress and chronic inflammation are tightly interconnected biological processes that play central roles in colorectal cancer (CRC) initiation, progression, and resistance to therapy. Understanding their reciprocal interactions may identify novel biomarkers and therapeutic targets with translational relevance. Methods: This systematic review with qualitative synthesis was conducted in accordance with the PRISMA 2020 guidelines. A comprehensive literature search of PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar was performed from January 2005 to June 2025. Eligible studies investigated mechanistic links between oxidative stress and inflammation in colorectal cancer, assessed oxidative or inflammatory biomarkers, or explored redox- and inflammation-targeted therapeutic strategies. Study selection and data extraction were performed systematically. Due to heterogeneity in study designs and outcomes, a qualitative synthesis was undertaken without meta-analysis. Results: Twenty-six studies met the inclusion criteria. Evidence consistently demonstrated that redox-sensitive pathways—including NF-κB, NRF2, and IL-6/JAK/STAT3—drive colorectal carcinogenesis by promoting genomic instability, immune evasion, angiogenesis, and therapy resistance. Biomarkers such as 8-hydroxy-2′-deoxyguanosine, malondialdehyde, F₂-isoprostanes, C-reactive protein, interleukin-6, and tumor necrosis factor-α were frequently associated with tumor stage, prognosis, and treatment response. Therapeutic strategies targeting oxidative stress and inflammation showed promising preclinical and early translational results, particularly in combination with chemotherapy or immunotherapy. Conclusion: Oxidative stress and inflammation constitute a synergistic axis that critically influences colorectal cancer biology. Although several biomarkers and redox-targeted interventions demonstrate translational potential, robust clinical validation is still required before routine implementation. Integrative strategies guided by biomarker profiling may represent a future direction for personalized CRC management. Most therapeutic approaches discussed are supported by preclinical and early translational evidence, and their clinical applicability remains to be validated.

Psoriatic arthritis (PsA) is a heterogenous systemic inflammatory disorder that affects peripheral joints and skin, but also causes inflammation at entheseal sites, digits (dactylitis) and the axial skeleton. Despite considerable advances, our understanding of the pathogenesis and management of PsA is hampered by its complex clinical expression. We enrolled patients who met the ClASsification for Psoriatic Arthritis (CASPAR) criteria for PsA (n = 17), and healthy controls (n = 13). The lipid profile, C-reactive protein (CRP) and Dickkopf-related protein 1 (DKK-1) circulating levels were measured for all subjects. For the patients with PsA, (1) the erosive character of the articular disease was assessed by a musculoskeletal ultrasound and (2) the cardiovascular risk was evaluated using the Systematic Coronary Risk Evaluation (SCORE) chart and the ultrasound measurement of the carotid intima-media thickness. A higher titer of serum DKK-1 was associated with the presence of erosions (p < 0.005) and the cIMT correlated with DKK-1 levels in patients with PsA (r = 0.6356, p = 0.0061). Additionally, we observed a positive correlation between increased cIMT and CRP (r = 0.5186, p = 0.0329). Our results suggest that DKK-1 could be used as an early biomarker for the erosive character of the articular disease and for the assessment of the cardiovascular risk in PsA patients.

Background: Incisional hernias are a frequent complication following ileostomy closure, with rates reaching 24%. Protective ileostomies are commonly performed in colorectal surgery, but their closure presents a significant risk for abdominal wall defects. Identifying risk factors for incisional hernias at the ileostomy site is crucial for improving patient outcomes. Methods: This retrospective study analyzed data from 95 patients who underwent loop ileostomy closure at two Romanian hospitals between 2018 and 2023. Patient demographics, surgical details, and follow-up data were reviewed. Incisional hernias were diagnosed through clinical examination or radiological imaging. Statistical analyses, including univariate and multivariate regression, were performed to identify independent risk factors. Results: The incidence of incisional hernias at the ileostomy site was 13.7% (13/95). Univariate analysis identified BMI (HR 30.08; p = 0.007), previous hernia (HR 7.99; p = 0.059), radiotherapy (HR 299.15; p = 0.029), and chemotherapy (HR 0.004; p = 0.026) as significant factors. Multivariate analysis confirmed BMI > 30 kg/m² (HR 12.27; p = 0.002) and prior hernia (HR 8.14; p = 0.007) as independent risk factors. Conclusions: Obesity and previous hernias significantly increase the risk of incisional hernias following ileostomy closure. Radiological follow-up enhances early detection, and further studies should explore the benefits of prophylactic mesh reinforcement. Optimizing patient selection and surgical technique may reduce postoperative hernia rates, improving long-term outcomes.

Introduction: Recurrent inguinal hernia remains a clinically relevant outcome that is difficult to quantify in the absence of national prospective registries. In Romania, structural differences between public and private hospitals may further influence recurrence-related care, access to minimally invasive surgery, and resource utilization. This study aimed to assess recurrence patterns after inguinal hernia repair at a national level, with emphasis on reinterventions, patient-related risk factors, and health system disparities. Methods: A nationwide retrospective cohort study was conducted using administrative DRG data from the Romanian National Health Insurance House. All adult patients undergoing inguinal hernia repair in 2019 were identified and followed for five years (2019–2023). Reintervention was used as a proxy for recurrence. Surgical approach, hospital sector, length of stay, reimbursement, patient migration, geographic distribution, and comorbidities were analyzed using descriptive statistics and multivariable logistic regression to explore factors associated with laparoscopic approach and reintervention. Results: Among the 18,185 patients who underwent inguinal hernia repair in 2019, reintervention rates during follow-up ranged from 0.58% to 4.88%, a variability that reflects inherent limitations of administrative coding. Most reinterventions occurred in the year of the index surgery, suggesting early technical failure. Public hospitals managed the majority of cases and disproportionately absorbed recurrent and clinically complex patients. Access to laparoscopic repair was uneven and concentrated in large academic centers. Length of hospital stay declined gradually in public hospitals but remained consistently shorter in private institutions, reflecting differences in patient selection and care pathways. Reimbursement by The National Health Insurance House was similar for open and laparoscopic procedures. Conclusions: Recurrent inguinal hernia care in Romania is shaped by system-level disparities extending beyond surgical technique. Further progress requires reimbursement reform, establishment of a national hernia registry, and expansion of laparoscopic training to ensure equitable access to high-quality hernia care.

Background/Objectives: Type 2 diabetes mellitus (T2DM) and atherogenic dyslipidemia have been implicated in colorectal cancer (CRC) development, but their prognostic relevance after cancer diagnosis remains unclear. This study aimed to evaluate the association between T2DM, lipid-derived atherogenic indices, and survival outcomes in patients with CRC. Methods: We conducted a retrospective cohort study including 240 CRC patients, of whom 60 had coexisting T2DM. Overall survival (OS) and disease-free survival (DFS) were analyzed using the Kaplan–Meier (KM) method and log-rank tests. In the absence of recurrence-specific data, DFS was defined as time to death or last follow-up. Lipid-related indices, including the atherogenic index of plasma (AIP), atherogenic coefficient (AC), remnant cholesterol (RC), non-high-density lipoprotein cholesterol (non-HDL-C), triglyceride–glucose (TyG) index, and triglyceride-to-HDL cholesterol ratio (TG/HDL-C), were evaluated by tertiles in KM analyses. Multivariable Cox proportional hazards models were constructed to assess the independent prognostic value of AIP, AC, and RC (entered separately as a continuous variable standardized to 1 standard deviation), adjusted for age, sex, adjuvant chemotherapy, radiotherapy, and T2DM status. Sensitivity analyses were performed in stage III–IV patients. Results: During follow-up, 28 deaths occurred. OS did not differ significantly between CRC patients and those with CRC coexisting with T2DM (log-rank p-values = 0.220). DFS analyses showed no significant differences across tertiles of any lipid-related index (all log-rank p-values > 0.05), with overlapping survival curves and no consistent dose–response patterns. In adjusted Cox models, AIP (hazard ratio [HR] per 1 SD = 0.71, 95% CI 0.48–1.06), AC (HR = 0.72, 95% CI 0.44–1.20), and RC (HR = 0.66, 95% CI 0.39–1.12) were not independently associated with DFS. Results were consistent in advanced-stage disease (stage III–IV). Conclusions: In this cohort of patients with CRC, neither T2DM nor lipid-derived indices reflecting atherogenic dyslipidemia and insulin resistance were independently associated with OS or DFS. These findings help refine the clinical interpretation of lipid-derived biomarkers in CRC, suggesting limited prognostic utility beyond established oncologic factors.