The COVID-19 pandemic has led to the confrontation of the health system with the need to identify solutions for providing medical care to a very large number of patients. The main objective of our study was to describe the measures taken to provide optimal medical care to patients who presented themselves in one of the large emergency hospitals of Romania in the fourth wave of the COVID-19 pandemic. Material and Methods: We conducted a retrospective, observational study on a group of 1417 patients. The statistical analysis was performed using R. Results: The average length of stay of patients in the emergency departments was approximately 2.6 h, increasing to up to 15 days in some more severe cases. For rapid antigen tests, the highest positivity rate for SARS-CoV-2 was identified in patients aged >75 years (53%). Among the identified risk factors associated with the need for mechanical ventilation were advanced age (α < 0.001) and lack of vaccination against SARS-CoV-2 (α < 0.001). Discussion and conclusions: A method of saving the Romanian health system in full hospital bed occupancy conditions in the wards proved to be the provision of medical care in emergency departments.

Background: Caustic ingestion represents a severe clinical emergency, leading to variable and often unpredictable outcomes. The severity depends on the nature of the corrosive agent, the amount ingested, and the timing of management. Summary: This review provides an updated overview of post-caustic esophagitis, integrating epidemiology, pathophysiology, clinical spectrum, diagnostic strategies, and management principles. Special emphasis is placed on complications such as strictures, fistulas, and long-term nutritional consequences. To illustrate practical aspects, we present two recent cases managed in our department, reflecting the contrasting patterns of acid and alkali injury. A brief reference to our previously published retrospective analysis of 188 patients referred to Clinical Emergency Hospital of Bucharest between January 2003–January 2004 complements this clinical perspective. Conclusions: Post-caustic esophagitis remains a major therapeutic challenge. Early endoscopic assessment, individualized management, and multidisciplinary follow-up are crucial to improving patient outcomes. Preventive strategies and public education are equally essential to reduce the incidence of this life-threatening condition.

The global trend of increasing mushroom consumption, combined with traditional practices in Romania and other Eastern European countries of collecting and consuming “wild mushrooms”, may contribute to the rising incidence of emergency presentations due to inedible mushroom poisoning. This study aims to identify the clinical features of mushroom poisoning by retrospectively analyzing 47 cases presented to the Emergency Department of the Bucharest Emergency Hospital between 2023 and 2024. The methodology consists of a retrospective cohort study including all patients presented to the Emergency Department of the Bucharest Emergency Hospital with symptoms following mushroom ingestion between 2023 and 2024 totaling 47 cases. Conclusions: In this cohort, most cases of wild/forest mushroom poisoning (76.59%) were diagnosed during autumn, particularly in September and October. The distribution of cases was uniform with respect to both gender and urban versus rural residence. A significant proportion of patients (74.46%) required hospitalization for surveillance and/or specific treatment. The predominant clinical presentation consisted of gastrointestinal symptoms, observed in 97.87% of cases.

Background and Clinical Significance: Percutaneous vertebroplasty is an effective procedure for patients with osteoporosis and fractures. However, notable side effects may occur. Cement leakage into the vascular system may be incidental, with effects ranging from asymptomatic to life-threatening conditions. The treatment of extravasation of the cement and pulmonary embolism does not have definitive guidelines and requires specific treatment for every patient, ranging from basic anticoagulation to surgical procedures. Cement embolisms without periprocedural complications—such as cardiac perforation or massive pulmonary embolism—are often stable. However, symptomatic presentations with hemodynamic instability can occur. We report a clinically significant case of symptomatic cement pulmonary embolism resulting in shock. Case Presentation: A 68-year-old female patient with osteoporosis and a history of cement vertebroplasty two weeks prior to admission for vertebral compression fracture arrived with a three-day history of left leg swelling and shortness of breath. Vital signs revealed hypotension and the lab tests showed elevated lactate and D-dimer, mild leucocystosis, normal PCT and a threefold increase in CRP. The ultrasound confirmed complete thrombosis of the left external iliac and common femoral vein. The thoraco-abdominal CT demonstrated the extravasation of the cement from vertebroplasty to the inferior vena cava, lumbar veins, coupled with multiple cement structures in the segmental lobar pulmonary arteries. The echocardiography showed preserved right ventricular function. The management included intravenous fluids, anticoagulation and norepinephrine. Conclusions: This case underlines that cement pulmonary embolism following vertebroplasty, while typically undetected, can result in significant hemodynamic compromise even in the absence of right heart failure, potentially mediated by an inflammatory response. Importantly, it highlights the possibility of delayed clinical deterioration, with instability manifesting two weeks post-procedure—distinct from the more commonly observed immediate peri-procedural complications or other stable delayed presentation.