Background and Objectives: Hepatitis C virus (HCV) infection is a major global public health concern, particularly in hemodialysis (HD) patients. This study aims to evaluate the demographic, clinical, and laboratory characteristics of HCV-positive patients undergoing HD and assess the long-term impact of direct-acting antivirals (DAAs) on patient outcomes. Moreover, a narrative review aims to summarize the current knowledge regarding HCV treatment in HD patients. The search in the PubMed, Google Scholar, and Scopus databases identified 48 studies relevant to our topic, 18 regarding clinical history and 29 related to HCV treatment. Methods: A retrospective analysis was performed on 165 HD patients from Bihor County HD centers, Romania, between 2014 and 2024. The cohort was divided into two groups: 54 patients who tested positive for HCV and 111 controls who were HCV-negative. Data collected from GPs included demographic information, comorbidities, laboratory parameters, and psychological assessments. Outcomes were evaluated at over 5 years after DAA treatment. A literature review was conducted using PubMed and Google Scholar to identify relevant studies on HCV in HD patients from 1989 to 2024. Results: Laboratory results showed similar parameters across groups, except for lower serum cholesterol levels in the HCV-positive DAA-treated group vs. HCV-positive non-treated ones (155.607 mg% vs. 170.174 mg%, p = 0.040) and increased ALT levels when comparing the same groups (29.107 vs. 22.261, p = 0.027), whereas comorbidities did not differ significantly. The incidence of malignancies was significantly higher among HCV-positive compared to HCV-negative patients (20.3% vs. 8.1%, p = 0.023), mainly among those treated with DAAs, highlighted by the multivariate analysis. Cardiovascular disease remains the leading cause of mortality regardless of HCV status or the use of antiviral therapy. Psychological assessments revealed more severe depression in HCV-positive patients compared to their HCV-negative counterparts. Conclusions: HCV infection in the hemodialysis population typically follows a subclinical course. At over five years after DAA therapy, the results indicate a stabilization of the liver function and the absence of major complications. However, the incidence of malignancies remains high in HCV-positive patients.

Background and Objectives: Non-alcoholic fatty liver disease (NAFLD) is prevalent among obese individuals and can progress to non-alcoholic steatohepatitis (NASH). Bariatric surgery is known to induce significant weight loss and may improve NAFLD. This systematic review uniquely synthesizes current evidence on the effects of bariatric surgery on intrahepatic fat content, measured by magnetic resonance imaging proton density fat fraction (MRI-PDFF), and assesses study quality using the Newcastle–Ottawa Scale (NOS). Materials and Methods: The literature search was conducted across the PubMed, Scopus, and Web of Science databases up to October 2024, identifying 12 prospective cohort studies involving 613 patients who underwent bariatric surgery. Inclusion criteria included adult patients with NAFLD undergoing bariatric surgery, assessment of liver fat changes using MRI-PDFF before and after surgery, and studies reporting quantitative data on liver fat fraction and relevant clinical parameters. Data extraction focused on patient demographics, surgical procedures, specific weight loss outcomes (delta BMI), changes in intrahepatic fat content (delta MRI-PDFF), and quality assessment scores based on the NOS. Results: Significant reductions in intrahepatic fat content were observed across all studies, with delta MRI-PDFF reductions ranging from 6.9% to 14%. Weight loss outcomes varied, with excess weight loss percentages up to 81.3% and BMI reductions up to 12 kg/m². The quality assessment scores ranged from six to nine out of nine, indicating generally high-quality studies. Correlations were noted between the degree of weight loss and reduction in liver fat content. Several studies reported high rates of resolution of steatosis and NASH post-operatively. Conclusions: Bariatric surgery leads to significant reductions in intrahepatic fat content and improvements in NAFLD among obese patients. The degree of weight loss correlates with the reduction in liver fat. These findings underscore the clinical utility of bariatric surgery as a strategic intervention for managing NAFLD in obese individuals, potentially influencing clinical practice guidelines by integrating bariatric surgery as a viable treatment option for NAFLD-related hepatic conditions.

Background: This systematic review examines the efficacy of multiorgan resection (MOR) in treating locally advanced gastric cancer (LAGC), focusing on survival outcomes, postoperative morbidity, and mortality. Methods: We conducted a comprehensive search of studies in PubMed, Scopus, and Embase up to November 2023, based on the PRISMA guidelines. The inclusion criteria focused on clinical trials, observational studies, case–control studies, and qualitative research, involving patients of any age and gender diagnosed with LAGC undergoing MOR aimed at R0 resection, with secondary outcomes focusing on survival rates, postoperative outcomes, and the effects of adjuvant and neoadjuvant therapies. Exclusion criteria ruled out non-human studies, research not specifically focused on LAGC patients undergoing MOR, and studies lacking clear, quantifiable outcomes. The quality assessment was performed using the Newcastle–Ottawa Scale. The final analysis included twenty studies, involving a total of 2489 patients across a time span from 2001 to 2023. Results highlighted a significant variation in median survival times ranging from 10 to 27 months and R0 resection rates from 32.1% to 94.3%. Survival rates one-year post-R0 resection varied between 46.7% and 84.8%, with an adjusted weighted mean of 66.95%. Key predictors of reduced survival included esophageal invasion and peritoneal dissemination, the presence of more than six lymph nodes, and tumor sizes over 10 cm. Nevertheless, the meta-analysis revealed a significant heterogeneity (I² = 87%), indicating substantial variability across studies, that might be caused by differences in surgical techniques, patient demographics, and treatment settings which influence survival outcomes. Results: The review underlines the important role of achieving R0 resection status in improving survival outcomes, despite the high risks associated with MOR. Variability across studies suggests that local practice patterns and patient demographics significantly influence results. Conclusions: The findings emphasize the need for aggressive surgical strategies to improve survival in LAGC treatment, highlighting the importance of achieving curative resection despite inherent challenges.

Background: Hemodialysis (HD) patients are a highly vulnerable population with elevated mortality driven by comorbidities and dialysis-specific factors. While most studies focused on intra-pandemic outcomes, long-term effects remain underexplored. We aimed to evaluate 5-year mortality and the impact of COVID-19 vaccination in chronic HD patients. Methods: A retrospective study was conducted on 211 HD patients monitored between 2020 and 2024. Outcomes included overall and cardiovascular mortality, risk factors in COVID-19-positive patients, and vaccination impact. Logistic regression identified independent predictors. Results: The cohort had a mean age of 65.6 ± 13.3 years, with 55.9% males and mean dialysis vintage of 6.9 ± 5.5 years. Overall mortality reached 53.6%, while 38.4% were vaccinated. Predictors of all-cause mortality included age (OR = 1.078, p < 0.001), BMI (OR = 0.868, p < 0.001), hemoglobin (OR = 0.581, p < 0.001), phosphorus (OR = 1.351, p = 0.025), dialysis adequacy (OR = 0.138, p = 0.013), and ischemic cardiopathy (OR = 0.327, p = 0.009). In COVID-19-positive patients, mortality was associated with age (OR = 1.069, p = 0.002), low hemoglobin (OR = 0.642, p = 0.014), BMI (OR = 0.885, p = 0.009), CRP (OR = 1.015, p < 0.001), and coronary artery disease (OR = 5.68, p < 0.001). Cardiovascular disease was the leading cause of death (44.6% in COVID-19-positive vs. 73.3% in negatives, p = 0.006). Vaccination significantly reduced COVID-19-related mortality (OR = 0.023, p = 0.005) but did not influence overall or non-COVID mortality. Conclusions: Five-year mortality in HD patients remained high, mainly cardiovascular, and was strongly influenced by age, BMI, hemoglobin, dialysis adequacy, and comorbidities. COVID-19 vaccination substantially reduced COVID-related mortality but did not alter all-cause outcomes. These findings support vaccination and careful risk stratification in HD populations for future pandemics.

Background/Objectives: Sleeve gastrectomy (SG) is increasingly used to treat severe obesity in adolescents, but its effects on bone health during this critical period of bone accrual are not fully understood. This systematic review aims to evaluate the impact of SG on the bone mineral density (BMD), bone microarchitecture, marrow adipose tissue (MAT), and bone turnover markers in adolescents. Methods: A comprehensive literature search was conducted to identify studies assessing bone health outcomes in adolescents undergoing SG. Nine studies met the inclusion criteria, comprising prospective cohorts, observational cohorts, and one randomized controlled trial, with sample sizes ranging from 10 to 197 participants aged 13 to 25 years, and a total sample size of 597 individuals. Data were extracted and synthesized into tables summarizing changes in BMD, bone microarchitecture, MAT, and bone turnover markers. Results: SG in adolescents is associated with significant reductions in areal BMD at critical skeletal sites, particularly the femoral neck and total hip, with decreases ranging from −4.7% to −8.9%. Studies utilizing high-resolution peripheral quantitative computed tomography (HRpQCT) reported deteriorations in bone microarchitecture, including a decreased trabecular number, increased trabecular separation, and reduced cortical thickness. Two studies observed significant increases in MAT at the lumbar spine post-SG. Elevated bone turnover markers, particularly C-terminal cross-linking telopeptide (CTX), indicate increased bone resorption following SG. Conclusions: SG leads to negative effects on bone health in adolescents, including reductions in BMD, deterioration of the bone microarchitecture, increases in MAT, and elevated bone resorption markers. These findings highlight the need for careful monitoring of bone health and the development of strategies to mitigate bone loss in adolescents undergoing SG.

Leccinum is an ecologically significant and taxonomically complex genus of ectomycorrhizal fungi widely distributed across boreal, temperate, Mediterranean, and selected tropical regions. Despite its ecological, nutritional, and applied importance, no comprehensive review has previously synthesized global knowledge on this genus. This work provides the first integrative assessment of Leccinum research, combining a bibliometric analysis of 293 peer-reviewed publications with an in-depth qualitative synthesis of ecological, biochemical, and environmental findings. Bibliometric results show increasing scientific attention since the mid-20th century, with major contributions from Europe, Asia, and North America, and dominant research themes spanning taxonomy, ecology, chemistry, and environmental sciences. The literature review highlights substantial advances in phylogenetic understanding, species diversity, and host specificity. Leccinum forms ectomycorrhizal associations with over 60 woody host genera, underscoring its functional importance in forest ecosystems. Nutritionally, Leccinum species are rich in proteins, carbohydrates, minerals, bioactive polysaccharides, phenolic compounds, and umami-related peptides, with demonstrated antioxidant, immunomodulatory, and antitumor activities. At the same time, the genus exhibits notable bioaccumulation capacity for heavy metals (particularly Hg, Cd, and Pb) and radionuclides, making it both a valuable food source and a sensitive environmental bioindicator. Applications in biotechnology, environmental remediation, forest restoration, and functional food development are emerging but remain insufficiently explored. Identified research gaps include the need for global-scale phylogenomic frameworks, expanded geographic sampling, standardized biochemical analyses, and deeper investigation into physiological mechanisms and applied uses. This review provides the first holistic synthesis of Leccinum, offering an integrated perspective on its taxonomy, ecology, nutritional composition, environmental significance, and practical applications. The findings serve as a foundation for future mycological, ecological, and biotechnological research on this diverse and understudied fungal genus.