Background and Objectives: Anastomotic leakage (AL) remains one of the most feared complications following colorectal resection, yet the relationship between cumulative surgeon experience and AL risk remains inconclusive in the literature. Most available evidence originates from high-volume or specialized centers, with limited data from mid-volume Central and Eastern European settings. This study aimed to evaluate the association between cumulative surgeon experience, operative time, and AL risk in a selected sample of colorectal resections with primary anastomosis for both benign and malignant indications, excluding right colectomies, abdominoperineal resections, TaTME, Hartmann’s procedures, and stoma-protected anastomoses, within a single-center multi-surgeon setting over a seven-year period. Materials and Methods: This retrospective observational study included 315 consecutive adult patients who underwent left-sided or segmental colorectal resection with primary anastomosis for both benign and malignant indications (excluding right colectomy, abdominoperineal resection, TaTME, Hartmann’s procedure, and stoma-protected cases) at Békés County Central Hospital, Gyula, Hungary, between January 2018 and December 2024. AL was defined according to ISREC criteria, with only clinically relevant grade B or C leaks recorded as events. The main exposure was cumulative surgeon experience (log2-transformed). The primary analysis used a multivariable generalized estimating equation (GEE) model clustered by surgeon, adjusted for operative time, surgical approach, conversion, wound infection, and resected segment. Eight surgeons participated, with cumulative experience ranging from 50 to 600 cases. Results: Among the 315 patients included, the median age was 68 years, with a male predominance (61.0%); most cases involved malignant pathology (82.9%) and at least one comorbidity (73.3%). The rectosigmoid was the most frequently resected segment (49.8%), and an open approach was used in 58.7% of cases. The overall AL incidence was 7.94% (25/315), with a median onset at postoperative day 5. In the multivariable GEE model, cumulative surgeon experience was not significantly associated with AL risk (OR per doubling 1.12; 95% CI 0.73–1.72; p = 0.597), nor was operative time (OR per 10 min 1.03; p = 0.294). Wound infection was the only variable significantly associated with AL (OR 3.48; 95% CI 1.06–11.44; p = 0.042), although its temporal relationship with AL could not be established from the available data. AL rates by experience category were 8.9%, 7.5%, and 7.9% for surgeons with <100, 100–199, and ≥200 cases, respectively (p = 0.913). AL was associated with a significantly prolonged hospital stay (median 17 vs. 7 days, p < 0.001) regardless of surgical approach. Conclusions: Cumulative surgeon experience was not independently associated with AL risk in the selected sample of colorectal resections with primary anastomosis in this single-center, mid-volume setting. Wound infection emerged as the only variable significantly associated with AL, although its temporal relationship with AL could not be determined and several established confounders, including anastomotic height, BMI, ASA class, and emergency status, were unavailable for adjustment. Considerable inter-surgeon variability was observed irrespective of case volume. These findings highlight the complexity of AL risk and the need for prospective multicenter studies with comprehensive risk adjustment.

Background/Objectives: Colorectal cancer (CRC) disproportionately affects Romania, where mortality exceeds the EU average and screening uptake remains low. Diet is among the most modifiable CRC risk factors, yet no validated instrument for assessing nutritional knowledge, attitudes, and practices (KAP) related to CRC prevention exists for the Romanian population. We developed and pilot-tested the EduNutriCRC questionnaire and characterised the corresponding nutritional KAP profile of Romanian adults. Methods: In a cross-sectional pilot study (April–May 2026), a convenience sample of 301 Romanian adults aged 18–74 years completed the 51-item self-administered questionnaire. The instrument was evaluated for internal consistency and dimensional structure (exploratory factor analysis), with non-parametric tests used for group comparisons. Results: The composite knowledge score (C1–C9; maximum 9) was 6.12 ± 2.25 with wide item-level variation. Internal consistency was acceptable, and the Attitudes subscale resolved into two factors (Motivation & Self-Efficacy and Perceived Barriers). Screening engagement was critically low (92.4% never tested; 81.7% unaware of the national programme). Although 64.1% expressed willingness to change their diet, 46.2% reported consuming processed meat at least weekly. Motivation & Self-Efficacy, but not the knowledge score, was inversely correlated with risk-food consumption (ρ = −0.39, p < 0.001). Conclusions: EduNutriCRC demonstrated acceptable psychometric properties at the pilot stage. The study identified prevalent nutritional misconceptions, a marked knowledge–behaviour gap, low screening awareness, and a structural mismatch between information sources used and those trusted. Attitudes and self-efficacy, rather than factual knowledge, were the more proximal correlates of dietary behaviour, supporting the development of self-efficacy-focused, culturally adapted educational interventions for CRC prevention in Romania, with EduNutriCRC serving as a baseline and monitoring instrument.

Background/Objectives: Modifiable lifestyle factors are established determinants of venous thromboembolism risk, but their relationship with the severity and early course of acute pulmonary embolism (PE) is poorly characterized, and no validated Romanian-language instrument captures these domains in the acute PE setting. This protocol describes a prospective observational study with two distinct components: (i) a measurement component that develops and validates the Pulmonary Embolism Lifestyle and Nutrition Questionnaire (PE-LNQ), a composite patient-completed instrument, and (ii) a clinical component that analyzes the associations between lifestyle factors, routine clinical and laboratory data, and the severity and early outcomes of acute PE. Methods: Phase 1 comprises cross-cultural adaptation, content validation, piloting, and COSMIN-based psychometric evaluation. Its primary endpoints are test–retest reliability (ICC ≥ 0.70) and confirmation of ≥75% of a priori construct-validity hypotheses, including convergent validity against measured anthropometry and routine biomarkers. Phase 2 enrolls consecutive adults with CTPA-confirmed acute PE in a staged design (minimum 220 patients single-center; approximately 400 with a planned multicenter extension). The primary clinical endpoint is intermediate-/high-risk PE (vs. low risk) by sPESI/PESI, with the ordinal PESI class (I–V) as the key secondary endpoint. Severity data and a pre-specified panel of routine admission laboratory parameters are extracted from the medical record without study-specific sampling; patients are followed for in-hospital, 3-, and 6-month adverse events. The confirmatory analysis is multivariable logistic regression; ordinal, survival, incremental-value, and biomarker analyses are pre-specified as secondary or exploratory. Expected Results: The PE-LNQ is expected to show adequate reliability and validity, and less favorable lifestyle profiles to be associated with higher severity class and more early adverse events. Conclusions: This study will deliver a validated, freely reusable instrument and clarify the prognostic relevance of modifiable lifestyle factors, supporting their integration into risk assessment and secondary prevention.

Vulvovaginal candidiasis is caused predominantly by Candida albicans, but non-albicans species differ in antifungal susceptibility, and surveillance based on commercial susceptibility systems must be read against their analytical limitations. We retrospectively analyzed 2789 vaginal Candida isolates from 2789 unique patients recovered at Pelican Hospital, Oradea, Romania, between August 2018 and July 2026, tested with the Integral System YEASTS Plus colorimetric system and grouped into four two-year periods. Classifications for clotrimazole, econazole, miconazole, fluconazole and nystatin were analyzed as recorded, without conversion into EUCAST categories. C. albicans accounted for 84.6% of isolates, Nakaseomyces glabratus (Candida glabrata) for 8.4%, Pichia kudriavzevii (Candida krusei) for 3.8% and the C. parapsilosis complex for 2.8%, and the distribution of species assignments did not change across periods (p = 0.532). Phenotypes were strongly species dependent: P. kudriavzevii, which is intrinsically resistant to fluconazole, was never classified as fluconazole-susceptible (0/107); only 37.2% of C. parapsilosis complex isolates were classified as nystatin-susceptible; and 97.3% of C. albicans isolates were classified as fluconazole-susceptible, without temporal change. Directional trends surviving multiplicity correction were confined to C. albicans but reflected a synchronous final-period rise across pharmacologically distinct agents, while clotrimazole classifications fell and recovered simultaneously in all three non-albicans species during 2020–2022, unlike econazole. These structures, and the progressive enrichment of later periods with newly included patients inherent to the first-isolate design, are more consistent with analytical variation and cohort structure than with resistance evolution. Commercial colorimetric classifications should not be equated with reference MIC-based categories, and the species–drug signals identified require confirmation by reference methods.

Background/Objectives: Anastomotic leakage (AL) is among the most serious complications after colorectal resection with primary anastomosis. Emergency surgery has been identified as a procedural risk factor, but data from mid-volume, non-specialized centers in Central and Eastern Europe remain scarce. This study aimed to evaluate the association between emergency surgery and AL in a sample of unprotected colorectal anastomoses, while adjusting for selected clinical factors. Methods: We conducted a single-center retrospective observational study of consecutive adult patients undergoing left-sided or segmental colorectal resection with primary anastomosis and without protective diversion at a hospital in Gyula, Hungary, between January 2018 and December 2024, irrespective of whether the underlying indication was benign or malignant. Right colectomies, abdominoperineal resections, transanal total mesorectal excisions, Hartmann’s procedures, and diverted anastomoses were excluded. After further exclusion of patients with undocumented operative urgency, 268 patients were analyzed. AL was defined according to International Study Group of Rectal Cancer (ISREC) criteria (grade B or C). The association between emergency surgery and AL was assessed using univariable tests and an age-adjusted logistic regression model. Surgical approach was not included as a covariate because of its strong collinearity with operative urgency. Results: Of 268 patients, 61 (22.8%) underwent emergency surgery. AL occurred in 23 patients (8.6%). The leak rate was higher after emergency than elective surgery (19.7% vs. 5.3%; p = 0.001), although the confidence interval for the adjusted association was wide. Emergency surgery remained independently associated with AL after age-adjustment (adjusted odds ratio (OR) 4.35; 95% confidence interval (CI) 1.81–10.46; p = 0.001). No other variable was significantly associated with leakage. Conclusions: Emergency surgery was independently associated with an increased risk of AL in unprotected colorectal anastomoses. Operative urgency should be considered a relevant element of anastomotic risk stratification, warranting heightened vigilance and individualized protective strategies.

Peri-implantitis, a biofilm-driven inflammatory disease that causes progressive loss of the bone supporting dental implants, is common and difficult to treat: mechanical debridement cannot fully decontaminate the implant surface, and antibiotic adjuncts act non-selectively while promoting resistance. Antimicrobial peptides (AMPs) have emerged as a promising preventive strategy. As cationic, membrane-disrupting molecules they kill a broad spectrum of organisms with a low propensity to select for resistance, and as host-defense peptides they additionally modulate inflammation and promote epithelial and connective-tissue repair. This review examines AMP-functionalized titanium as a prospective strategy against peri-implantitis through a dermatological lens, drawing on the established roles of the cathelicidin LL-37 and the β-defensins in cutaneous and oral wound healing. We argue that the peri-implant transmucosal interface behaves as a healing epithelial barrier, so that a single class of host-defense peptides can address two goals usually pursued separately—suppressing the peri-implant biofilm and reinforcing the soft-tissue seal. Because peri-implant disease initiates at the transmucosal region, we give particular attention to the abutment or transmucosal collar as the primary sealing target, and we consider how the concept extends to zirconia and hybrid components. The evidence assembled here, however, is predominantly preclinical, derived from in vitro and animal studies, and does not yet demonstrate clinical prevention of peri-implantitis in patients. After surveying peri-implant epidemiology, microbiology, AMP biology, surface-engineering strategies, and the in vivo evidence, we appraise the translational barriers—stability, cytotoxicity, cost, regulation, and the absence of human trials—that remain. We conclude that biologically intelligent, multifunctional peptide coatings represent a rational direction for next-generation implant surfaces.