Sepsis, a life-threatening condition arising from a dysregulated immune response to infection, is a significant health burden globally. Interleukin-6 (IL-6), an inflammatory cytokine produced by immune cells as a response to infection and tissue damage, plays a key role in the pathogenesis of sepsis. This systematic review and meta-analysis aimed to investigate the association of the baseline plasma levels of IL-6, and the dynamic change in these levels over a timespan of 96 h, with short-term mortality. A systematic literature search was conducted across multiple databases. Studies were included if they assessed the independent prognostic value of IL-6 in adult sepsis patients, used well-defined sepsis criteria, and reported at least one IL-6 measurement. Pooled effect estimates for the association between IL-6 and 28–30-day mortality were determined using logistic regression and AUROC analysis. Thirty-one studies, encompassing 4566 patients, were included. While baseline IL-6 levels and 96 h IL-6 clearance were not significantly associated with mortality risk (pooled OR 1.001, 95% CI 0.999–1.003 and 1.019, 95% CI 0.925–1.112, respectively), AUROC analysis indicated moderate-to-good discriminatory power for both baseline (0.701, 95% CI 0.660–0.742) and 96 h IL-6 clearance (0.828, 95% CI 0.736–0.919) in predicting 28-day mortality. While not a strong independent predictor, IL-6 demonstrates some discriminatory ability, suggesting its potential value in conjunction with other biomarkers.

Urinary tract infections (UTIs) remain a leading cause of healthcare-associated morbidity, particularly in patients with indwelling urinary catheters. This study aimed to compare catheter-associated (CAUTIs) and non-catheter-associated UTIs of the lower tract among hospitalized adults in Western Romania, identify potential predictors of prolonged hospital stay, and explore the interplay of inflammatory markers and clinical outcomes. We retrospectively examined 130 patients diagnosed with UTIs from 2020 to 2024. Demographic data, comorbidities, laboratory parameters (CRP, procalcitonin, fibrinogen, white blood cell counts), and microbiology results were assessed. Patients were divided into CAUTI (n = 72) and non-catheter UTI (n = 58) groups. CAUTI patients had a significantly longer mean hospital stay (13.9 ± 4.3 vs. 11.7 ± 3.8 days, p = 0.01). E. coli (29.2%), Klebsiella pneumoniae (18.5%), and mixed flora (11.5%) predominated overall, with Pseudomonas aeruginosa trending higher in CAUTIs (15.3% vs. 5.2%). Diabetic status correlated with higher CRP (54.7 ± 18.2 vs. 46.9 ± 15.7 mg/dL, p = 0.04) and increased intensive care unit (ICU) admission (23.5% vs. 9.4%, p = 0.03). In a subgroup of 65 patients, CRP demonstrated a moderate positive correlation with length of stay (r = 0.47, p = 0.02). Logistic regression indicated that CAUTI was associated with 2.3-fold higher odds of extended hospitalization (95% CI: 1.2–4.4, p = 0.02), adjusting for age, diabetes, and CRP levels. CAUTIs are linked to more resistant pathogens, longer hospitalizations, and potentially greater clinical complications. Diabetes further compounds risk, as reflected in higher inflammatory markers and ICU admissions.

Background/Objectives: Obstructive urosepsis mandates rapid source control, yet actionable time-to-decompression (TTD) thresholds and the influence of diversion route remain debated. This review synthesized evidence on TTD, early outcomes, and predictive biomarkers. Methods: Following PRISMA-2020, ten studies met eligibility: three large administrative cohorts and seven clinical series/trials comparing outcomes by TTD and/or initial decompression (retrograde stent [RUS] vs. percutaneous nephrostomy [PCN]) and reporting biomarkers. Results: Delays were consistently harmful. In a national cohort, a TTD of ≥ 2 days increased in-hospital mortality (adjusted OR, 1.29; 95% CI, 1.03–1.63). Another analysis showed mortality of 0.16% with ≤48 h vs. 0.47% when delayed (derived OR, 0.43; p = 0.044). Absence of decompression yielded the highest mortality (19.2% vs. 8.82%; OR, 2.6; 95% CI, 1.9–3.7). Septic shock remained frequent despite low crude mortality in clinical series: 20.8% and 33.3% across two cohorts. Post-decompression urosepsis occurred in 18.7% in a randomized study and was associated with pyonephrosis and higher procalcitonin (PCT). An ED cohort showed that earlier stenting reduced length of stay (≤6 h: 35.6 h vs. 71.6 h, p = 0.01; ≤10 h: 45.7 h vs. 82.4 h, p = 0.04). Modality effects were modest; one cohort reported higher ICU use with PCN vs. RUS (OR, 3.23; 95% CI, 1.24–8.41), likely reflecting confounding by indication. Conclusions: Across designs, timeliness—not device choice—was the dominant determinant of early outcomes. Biomarkers (notably, PCT) and imaging features can prioritize ultra-early decompression.

Background: The battle against HIV has led to the development of antiretroviral therapy (ART), including BIKTARVY^®, which combines three potent agents. However, concerns about gastrointestinal side effects during the early phases of treatment have emerged, potentially impacting patient adherence and outcomes. Materials and Methods: This retrospective cohort study, conducted over four years in Romania, examined 222 patients initiated on BIKTARVY^® therapy. Data were collected from electronic medical records, and stringent inclusion and exclusion criteria were applied to ensure data accuracy and relevance. Statistical analysis was performed to assess age-related patterns in gastrointestinal symptoms and their relation with significant weight loss. Results: This study revealed significant differences in the prevalence of gastrointestinal symptoms between age groups, with older patients experiencing more symptoms. Notably, diarrhea did not exhibit a statistically significant age-related difference. Furthermore, weight loss exceeding 5 kg was more common in older patients. Of the patients who continued BIKTARVY^® therapy, 84.9% showed an increase in CD4 cell counts, and most expressed satisfaction with treatment. Conclusion: Understanding age-related patterns and gastrointestinal side effects of BIKTARVY^® is crucial for optimizing HIV patient care. Future research should aim to corroborate and expand upon these findings, potentially leading to improved therapeutic approaches in the ongoing fight against HIV.

(1) Background: Since the advent of zidovudine in 1987, antiretroviral therapy has undergone significant evolution, marked by the introduction of 34 antiretroviral drugs and 24 fixed-dose combinations. Despite these advances, hepatotoxicity remains a formidable challenge, influencing morbidity, mortality, and treatment adherence in HIV-infected patients. This study aims to compare the hepatotoxic effects of latest-generation antiretroviral medications with those of older-generation therapies, assessing their long-term impact on liver health in HIV patients. (2) Methods: This retrospective study analyzed data from 304 HIV patients treated with either latest-generation or older-generation antiretroviral drugs over four years. Patients were monitored for hepatotoxicity through liver function tests at diagnosis, six months, and one-year post-treatment initiation. (3) Results: Initial and six-month liver function tests showed no significant differences between the two groups. However, at one-year post-treatment, patients on latest-generation antiretrovirals exhibited significant improvements in ALT, AST, and ALP levels, suggesting a better safety profile regarding hepatotoxicity. Additionally, a significantly lower incidence of splenomegaly was observed in patients treated with newer medications. (4) Conclusions: The findings suggest that the latest-generation antiretroviral medications may offer a safer profile in terms of hepatotoxicity compared to older therapies, with potential benefits for long-term liver health. This study underscores the importance of continuous monitoring and further research to optimize ART strategies, ensuring improved patient outcomes and quality of life for individuals living with HIV.

Background and Objectives: Early bedside tools that flag non-response in hospitalized adults with lower urinary tract infection (UTI) could align clinical care with antimicrobial stewardship. We evaluated REACT-UTI, a 72 h composite combining C-reactive protein (CRP) clearance ≥35%, defervescence (temperature < 37.5 °C), and ≥2-point symptom improvement, to predict early non-response and hospital length of stay (LOS), and we assessed modifiable processes of care. Methods: We conducted a prospective observational study of adults with culture-confirmed lower UTI (n = 126) admitted to a tertiary hospital in Timișoara (December 2023–August 2025). The primary outcome was 72 h early clinical response (ECR) defined by REACT-UTI. Multivariable logistic regression examined associations of catheter-associated UTI (CAUTI), time-to-effective therapy, baseline CRP, diabetes, early catheter removal/exchange (≤48 h), and early intravenous-to-oral switch (≤72 h) with non-response. Results: Overall, 76/126 patients (60.3%) achieved ECR. Non-responders more often had CAUTI, higher baseline CRP, longer time-to-effective therapy, ESBL or fluoroquinolone-resistant Enterobacterales, and longer LOS (14.1 vs. 9.8 days; p < 0.001). Adjusted models showed that CAUTI, delayed active therapy, higher baseline CRP, and diabetes increased the odds of non-response, whereas early catheter removal (adjusted odds ratio [aOR] 0.5, 95% confidence interval [CI] 0.3–0.9) and early IV-to-oral switch (aOR 0.4, 0.2–0.8) were protective. Greater CRP clearance correlated with shorter LOS (ρ = −0.52; p < 0.001). Conclusions: In this single-center setting with a high burden of antimicrobial resistance, REACT-UTI at 72 h identified patients at risk of early non-response and prolonged hospitalization and highlighted actionable levers—timely active therapy, catheter management, and early oral step-down. External validation in diverse settings is needed before broader implementation.