Background: Ultrasonography is essential for diagnosing endometrial pathologies, such as hyperplasia, polyps, and endometrial cancer. The International Endometrial Tumor Analysis (IETA) group provides guidelines for using ultrasound to assess endometrial thickness, texture, and irregularities, aiding in the diagnosis of these conditions. The aim of this study was to evaluate the utility of various endometrial morphological features, as assessed by gray-scale ultrasound, and endometrial vascular features, as assessed by power Doppler ultrasound, in differentiating benign and malignant endometrial pathologies. A secondary objective was to compare the effectiveness of these ultrasound techniques in assessing myometrial invasion. Methods: A total of 162 women, both pre- and postmenopausal, with or without abnormal vaginal bleeding were enrolled in a prospective study. All participants underwent transvaginal gray-scale and color Doppler ultrasound examinations, conducted by examiners with over 15 years of experience in gynecological ultrasonography. Endometrial morphology and vascularity characteristics were evaluated based on the IETA group criteria, which include parameters such as endometrial uniformity, echogenicity, the three-layer pattern, regularity of the endometrial–myometrial border, Doppler color score, and vascular pattern (single dominant vessel with or without branching, multiple vessels with focal or multifocal origin, scattered vessels, color splashes, and circular flow). Sonographic findings were compared with histopathological results for comprehensive assessment. Results: The mean age of the study population was 56.46 ± 10.84 years, with a range from 36 to 88 years. Approximately 53.08% of the subjects were postmenopausal. The mean endometrial thickness, as measured by transvaginal ultrasonography, was 18.02 ± 10.94 mm with a range of 5 to 64 mm (p = 0.028), and it was found to be a significant predictor of endometrial malignancy. The AUC for the ROC analysis was 0.682 (95% CI: 0.452–0.912), with a cut-off threshold of 26 mm, yielding a sensitivity of 62.5% and a specificity of 89%. Vascularization was absent in 68.4% of patients with polyps. Among the cases with submucosal myomas, 80% exhibited a circular flow pattern. Malignant lesions were identified in 22.84% of the cases. Subjective ultrasound assessment of myometrial invasion, categorized as <50% or ≥50%, corresponded in all cases with the histopathological evaluation, demonstrating the effectiveness of ultrasound in evaluating myometrial invasion in endometrial cancer. Conclusions: In this study, cystic atrophic endometrium was identified as the most prevalent cause of postmenopausal bleeding. The most significant ultrasound parameters for predicting malignancy included heterogeneous endometrial echogenicity, increased endometrial thickness, and the presence of multiple vessels with multifocal origins or scattered vascular patterns. Additionally, color Doppler blood flow mapping was demonstrated to be an effective diagnostic tool for the differential diagnosis of benign intrauterine focal lesions.

Urinary tract infections (UTIs) are a common pathology worldwide, frequently associated with kidney stones. We aimed to determine how artificial intelligence (AI) could assist and enhance human medical activities in this field. We performed a search in PubMed using different sets of keywords. When using the keywords “AI, artificial intelligence, urinary tract infections, Escherichia coli (E. coli)”, we identified 16 papers, 12 of which fulfilled our research criteria. When using the keywords “urolithiasis, AI, artificial intelligence”, we identified 72 results, 30 of which were suitable for analysis. We identified that AI/machine learning can be used to detect Gram-negative bacilli involved in UTIs in a fast and accurate way and to detect antibiotic-resistant genes in E. coli. The most frequent AI applications for urolithiasis can be summarized into three categories: The first category relates to patient follow-up, trying to improve physical and medical conditions after specific urologic surgical procedures. The second refers to urinary stone disease (USD), focused on stone evaluation, using different AI and machine learning systems, regarding the stone’s composition in terms of uric acid, its dimensions, its volume, and its speed of detection. The third category comprises the comparison of the ChatGPT-4, Bing AI, Grok, Claude, and Perplexity chatbots in different applications for urolithiasis. ChatGPT-4 has received the most positive evaluations. In conclusion, the impressive number of papers published on different applications of AI in UTIs and urology suggest that machine learning will be exploited effectively in the near future to optimize patient follow-up, diagnosis, and treatment.

Accurate lymph node staging is crucial for both prognosis (in the event of early-stage disease) and treatment (for local control of disease) in patients with breast cancer. Sentinel lymph node biopsy (SLNB) has been studied in numerous international trials, showing that it allows about 70% of axillary lymph node dissection (ALND) to be avoided and thus significantly reduces the morbidity associated with ALND. SLNB represents a necessary step in the diagnostic algorithm for breast neoplasms because the surgical treatment for breast cancer has become progressively less invasive. We present a case of a 70-year-old woman with multicentric breast cancer (MBC) treated by surgery at “Cuza Vodă” Women’s University Hospital, Iassy, Romania. In this case, only the ultrasonography established the diagnosis of left MBC with certainty. Conclusion: The detection of sentinel lymph nodes (SLNs) for MBC must be indicated. In this type of cancer, SLNB is accurate and practical, with sufficient quality control and interdisciplinary collaboration between surgical, nuclear medicine, and pathology units. Lymphoscintigraphy allows the patient to avoid axillary clearance surgery if the sentinel node is negative for metastatic disease. The variability of Ki67, PR, HER2, and ER status supports the idea that all individual foci should be tested in MBC cases to provide the best management and prognosis.

Placental morbid adherence is a known risk factor for postpartum hemorrhage. The incidence of abnormal placental attachment has been increasing over the past few decades, mainly due to rising rates of cesarean deliveries, advanced maternal age, and the use of assisted reproductive technologies. Cesarean section is a significant risk factor for placenta increta, as it disrupts the normal architecture of the uterine wall, making it more difficult for the placenta to detach after delivery. We present the case of a woman who underwent a cesarean section at 28 weeks due to anterior placenta previa, accompanied by hemorrhage and rupture of membranes. Following the delivery, she experienced normal postoperative bleeding and was discharged home after five days. However, six weeks later, she presented with heavy bleeding, leading to the decision to perform a total hysterectomy. The levels of HCG were found to be low. The pathological examination of the specimens confirmed a diagnosis of placenta increta, as it revealed notable placental proliferation, necrotic villi, and placental invasion near the uterine serosa. Notably, we did not find any similar cases documented in the literature. Patients experiencing prolonged vaginal bleeding after childbirth and diagnosed with placenta accreta should be closely monitored through ultrasound examinations; abnormal proliferation of the placenta can occur, and prompt detection is crucial for appropriate management.

Background/Objectives: Endometrial B-cell lymphoma 6 (BCL6) overexpression has been proposed as a marker of progesterone resistance, occult endometriosis, and endometrial dysfunction in infertile women. Its possible association with reproductive outcomes and its potential role in guiding management before embryo transfer have attracted increasing interest. However, the prognostic and clinical significance of BCL6 across infertility settings remains incompletely defined. We systematically reviewed the literature on endometrial BCL6 expression and reproductive outcomes in infertile women. Methods: This systematic review was conducted according to a prospectively registered PROSPERO protocol. Studies evaluating endometrial BCL6 expression on biopsy in infertile women were eligible if they reported reproductive outcomes or clinically relevant comparative data. Two prespecified questions were addressed: whether high or abnormal BCL6 expression is associated with poorer reproductive outcomes than low or normal expression, and whether treatment before embryo transfer improves outcomes in BCL6-positive women. Thirteen studies were included in the review. Because the included studies differed substantially in infertility phenotype, embryo context, hormonal preparation, biopsy timing, and outcome reporting, findings were synthesized narratively. Results: The available evidence suggests that abnormal or elevated endometrial BCL6 expression may be associated with poorer reproductive outcomes in some infertility populations, particularly in women with unexplained infertility undergoing IVF, although this pattern was less evident in selected euploid embryo transfer cohorts. Treatment-oriented studies suggested a possible benefit of pre-transfer medical suppression or surgical management in some BCL6-positive women, but findings were variable across studies. Supportive non-comparative and mechanistic studies further indicated that interpretation of BCL6 is influenced by hormonal preparation, endometrial context, and whether BCL6 is considered in isolation or within a broader biological or multimarker framework. Interpretation of the available evidence was constrained by the limited number of comparative studies, observational study designs, variability in clinical populations, and incomplete standardization of reproductive outcome reporting. Conclusions: Endometrial BCL6 appears biologically and clinically relevant as a marker of endometrial dysfunction in selected infertility settings, but current evidence is insufficient to support routine stand-alone clinical use or strong treatment recommendations. Its apparent prognostic and clinical utility varies across patient populations and reproductive settings. Larger prospective comparative studies with harmonized biopsy protocols, standardized outcome reporting, and independent external validation are needed to clarify the role of BCL6 in reproductive medicine.

The aim of this study was to assess whether baseline the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), the systemic immune-inflammation index (SII), and C-reactive protein (CRP) could predict postoperative outcomes in systemically healthy patients receiving dental implants. A retrospective analysis of 116 systemically healthy adults receiving dental implants was conducted. To minimise confounding, individuals over 50 years old, smokers, and those with systemic diseases, stage III/IV periodontitis, or current medication use were excluded. Periodontal status was classified as clinically healthy or stable. Baseline CRP and complete blood count-derived indices (NLR, PLR, SII) were recorded preoperatively. The primary outcome was osseointegration (proper versus impaired). Implant success was 95.7% (n = 111), with early implant failure occurring in 4.3% (n = 5). Females exhibited higher PLR values than males (p = 0.041), and SII was higher in periodontally stable patients compared to clinically healthy ones (p = 0.036). In systemically healthy patients, routine preoperative screening based on NLR, PLR, and CRP did not improve prediction of early implant failure, whereas SII demonstrated good, statistically significant discrimination (p = 0.015). These findings emphasise the need for further research to clarify the predictive value of blood inflammatory biomarkers.