Background: Prostate cancer remains one of the most frequently diagnosed malignancies in men, where early detection is key to curative treatment. Conventional biopsy techniques can miss small or focal lesions, especially in cases with persistently elevated prostate-specific antigen (PSA) levels and uncertain imaging, risking delayed diagnosis. Case Report: We present the case of a 69-year-old male who initially presented in 2022 with lower urinary tract symptoms and an elevated PSA level of 26.17ng/ml. He was diagnosed with acute prostatitis and responded favourably to targeted treatment. Over the following two years, his PSA levels remained in the “gray zone” (7.24-8.68ng/ml), raising continued clinical suspicion despite normal findings on digital rectal examination (DRE), PIRADS 3 lesions on serial multiparametric magnetic resonance imaging (mpMRI), and two previous transperineal prostate biopsies, including a saturation biopsy-both with benign histopathology. In July 2025, the patient presented for the first time to our center. A new mpMRI again showed a PIRADS 3 lesion in the transitional zone of the right prostatic lobe. Given the persistent suspicion and previous negative results, a transperineal cognitive fusion-guided biopsy was performed, combining MRI-targeted and systematic sampling. Histopathological evaluation identified a 0.55 mm focus of acinar adenocarcinoma with a Gleason score of 7 (3+4). Conclusion: This case illustrates how cognitive fusion-guided biopsy can detect clinically significant prostate cancer in patients who have undergone prior negative standard biopsies. The technique improves diagnostic detection rates and represents a valuable, accessible alternative for centers without computer-assisted fusion platforms.

Prostate cancer is the most common malignancy in men, and systematic ultrasound-guided biopsy remains the diagnostic gold standard. The transrectal (TR) route, while widely used, carries an increased risk of infectious and haemorrhagic complications. The transperineal (TP) biopsy approach has been developed to reduce these risks while maintaining comparable diagnostic accuracy. This study aimed to compare cancer detection rates, histopathological patterns, and complication rates between TP and TR prostate biopsies. Methods: A retrospective analysis was conducted on 310 patients who underwent prostate biopsy between January 2023 and January 2024. Patients were divided into TP (n=178) and TR (n=132) groups. Clinically significant prostate cancer (csPCa) was defined as Gleason score ≥7 or ISUP grade ≥2. Data regarding detection rates, ISUP distribution, complications, and age were compared using the Chi-square test. Age distribution and ISUP grade across age decades were evaluated to exclude age-related bias. Results: The overall cancer detection rate was significantly higher in the TP group (60.67%) than in the TR group (49.24%) (p=0.045), while csPCa detection did not differ significantly (TP 49.44% vs TR 43.94%, p=0.20). High-grade (ISUP 5) tumours were more frequent in the TR group (41.5% vs 25.0%, p=0.034). Complications were significantly more common after TR biopsy (15.2% vs 6.7%, p=0.027), with infections and rectal bleeding occurring only in TR cases. Patient age distribution was similar between groups (χ²=4.49, p=0.213), and ISUP grade distribution by age decade showed no significant differences (all p>0.05). No non-prostatic pathology was identified in either cohort. Conclusions: Transperineal prostate biopsy demonstrated a higher overall detection rate and significantly fewer complications compared to the transrectal approach, while maintaining equivalent detection of clinically significant prostate cancer. The absence of age-related or histological bias confirms that the lower complication rate of TP biopsy is attributable to the procedural route rather than patient-related factors.

Background and Objectives: Multiparametric MRI (mpMRI) has improved prostate cancer (PCa) detection, but the added value of cognitive fusion (CF) over systematic biopsy (SB) remains debated. This prospective study evaluated the diagnostic performance of SB, CF, and their combined use in patients with Prostate Imaging and Reporting Data System (PI-RADS) ≥3 lesions. Materials and Methods: A total of 282 patients underwent mpMRI followed by both SB and CF biopsy. Results: PCa was diagnosed in 154 patients. SB detected 112 cancers (24 ISUP 1 (International Society of Urological Pathology), 88 ISUP ≥ 2), and CF detected 135 cancers (16 ISUP 1, 119 ISUP ≥ 2), while the combined approach detected all 154 cancers (9 ISUP 1, 145 ISUP ≥ 2). CF identified 42 cancers missed by SB, whereas SB identified 19 cancers not detected by CF. CF upgraded 38 patients from low-risk to intermediate-risk (23)/high-risk (15) categories, while SB underestimated disease severity in 41 cases. No major biopsy-related complications were recorded. Conclusions: CF biopsy outperformed SB in detecting clinically significant PCa and improved risk stratification, while the combined approach provided the highest overall diagnostic performance, supporting its use in contemporary PCa assessment.

Background/Objectives: Understanding vaccination intentions before health education can help identify locally relevant concerns. This study examined self-reported awareness of a combined human papillomavirus (HPV) statement, vaccination intention, and associated informational and attitudinal factors in a workplace health-education project in Dolj County, Romania. Materials and Methods: A cross-sectional analysis included 1747 questionnaires voluntarily completed by female employees before educational discussions from 28 October to December 2025. Categorical associations were examined using Pearson’s chi-square test, Cramér’s V, and false-discovery-rate adjustment. Hierarchical binary logistic regression examined favourable intention among unvaccinated respondents; a multinomial model separated favourable intention, indecision, and no intention. Results: Among valid responses, 81.02% answered ‘Yes’ to the combined Q1 awareness statement, 26.06% expressed favourable vaccination intention, 47.65% were undecided, and 5.21% reported previous vaccination. Among undecided respondents or those with no intention, fear of adverse reactions was the most frequently selected reservation (49.37%). Awareness, younger age, and trusted information source were associated with favourable intention. Adding willingness to vaccinate one’s child and to recommend vaccination to a friend was interpreted as attitudinal concordance rather than independent predictive information. Conclusions: High self-reported awareness of the combined Q1 statement coexisted with substantial indecision and low self-reported previous vaccination in this self-selected workplace sample. The findings identify topics for age-appropriate communication and prospective evaluation, not evidence that the educational sessions changed attitudes or increased vaccination. Interpretation is constrained by age-dependent access and the possible priming effect of Q1; closely related attitude measures should not be interpreted causally.

Background/Objectives: Medication-taking behaviour during pregnancy may be associated with treatment-related beliefs, emotional concerns, information sources, and clinician–patient communication. We examined these cross-sectional associations and the preliminary measurement properties of the Pregnancy Medication Adherence Model (PMAM). Methods: This cross-sectional study included 355 pregnant women with prescribed treatment recruited from nine general practices in Dolj County, Romania. Q25 was analysed on its five-category scale and using an operational threshold of ≥4. Internal consistency, principal component analysis, an ordinal exploratory factor analysis based on polychoric correlations, regression modelling, and review-stage sensitivity analyses addressing criterion overlap were performed. Results: Overall, 255 participants (71.8%) scored ≥4 on Q25. The four multi-item domains had Cronbach’s α values of 0.897–0.935. Parallel analysis and principal-axis factoring with oblique rotation supported four factors; salient loadings were 0.797–0.925 and no secondary loading reached 0.30. In the original adjusted binary model, cognitive understanding, emotional reassurance, clinician–patient communication, and lower endorsement of information-seeking and social-influence items were associated with Q25 ≥ 4. After Q23 was removed from the communication score and Q19 and Q24 were omitted, these four associations persisted (adjusted ORs 1.90–2.55). Conclusions: The findings identify concurrent associations between medication-related perceptions and a single self-reported treatment-behaviour item. PMAM remains an exploratory framework; external psychometric evaluation and prospective assessment against defined medication-specific adherence and clinical outcomes are required before clinical use.