Background/Objectives: Healthcare-associated infections (HAI) affect an estimated 4.3 million patients annually in EU/EEA hospitals; yet, reported prevalence rates vary nearly fivefold across member states, a degree of variation inconsistent with clinical or epidemiological differences alone. Romania exemplifies this paradox: it records one of the lowest reported HAI prevalence rates in Europe while sustaining one of the highest antimicrobial consumption levels on the continent. This study examines whether antimicrobial consumption data can serve as a cross-check on reported HAI prevalence across EU/EEA countries and discusses implications for European funding mechanisms. Methods: A cross-sectional ecological analysis was conducted using data from 26 EU/EEA countries. HAI prevalence was extracted from the ECDC Point Prevalence Survey 2022–2023; antimicrobial consumption indicators from the ESAC-Net Annual Epidemiological Report 2023. Pearson and Spearman correlations, multiple linear regression with Cook’s distance diagnostics, bootstrap resampling, and k-means cluster analysis were performed. Variance inflation factors were computed to assess multicollinearity; community sector AMC was excluded from the final regression model due to near-perfect collinearity with total AMC. Results: No antimicrobial consumption indicator was significantly associated with reported HAI prevalence (total AMC: r = 0.274, p = 0.175; broad-spectrum hospital proportion: r = 0.082, p = 0.692); bootstrap confidence intervals confirmed the instability of all estimates. Romania and Bulgaria were identified as influential outliers whose consumption profiles are substantially inconsistent with their reported infection rates, with model-based estimates of 7.3% and 7.0% respectively against reported values of 3.1% and 3.7%. Cluster analysis placed both countries in an isolated group with the highest antimicrobial consumption and broad-spectrum hospital antibiotic use in the sample alongside the lowest reported HAI prevalence, a configuration not replicated elsewhere in the EU/EEA. Conclusions: The absence of a significant aggregate association between antimicrobial consumption and reported HAI prevalence, combined with the systematic identification of Romania and Bulgaria as influential observations whose consumption profiles are inconsistent with their reported infection rates, raises the hypothesis of surveillance underreporting as a plausible explanation, though the ecological design does not permit causal inference and alternative explanations, including differences in antimicrobial stewardship maturity and prescribing culture, cannot be excluded. Antimicrobial consumption indicators, particularly the proportion of broad-spectrum antibiotics in hospital use, may serve as a proxy for HAI burden where direct surveillance is incomplete, and their integration into European surveillance frameworks is warranted. These findings have direct policy relevance for the allocation of resources under EU4Health, EU-JAMRAI 2, and national recovery and resilience programmes, and support investment in surveillance reform as a precondition for effective infection prevention programmes.

Background: Mucosal perforation during laparoscopic esocardiomyotomy is quite frequent, and its consequences cannot always be neglected. The purpose of the study is to investigate the risk factors for intraoperative mucosal perforation and its implications on the postoperative outcomes and the functional results three months postoperatively. Material and methods: We retrospectively identified the patients with laparoscopic esocardiomyotomy performed at Sf. Maria Hospital Bucharest, in the period between January 2017–January 2022 and collected the data (preoperative—clinic, manometric and imaging, intra-and postoperative). To identify the risk factors for mucosal perforations, we used logistic regression analysis. Results: We included 60 patients; intraoperative mucosal perforation occurred in 8.33% of patients. The risk factors were: the presence of tertiary contractions (OR = 14.00, 95%CI = [1.23, 158.84], p = 0.033206), the number of propagated waves ≤6 (OR = 14.50), 95%CI = [1.18, 153.33], p < 0.05), the length of esophageal myotomy (OR = 1.74, 95%CI = [1.04, 2.89] p < 0.05), the length of esocardiomyotomy (OR = 1.74, 95%CI = [1.04, 2.89] p < 0.05), and a protective factor—the intraoperative upper endoscopy (OR = 0.037, 95%CI = [0.003, 0.382] p < 0.05). Conclusions: Identifying risk factors for this adverse intraoperative event may decrease the incidence and make this surgery safer. Although mucosal perforation resulted in prolonged hospital stays, it did not lead to significant differences in functional outcomes.

Traditionally, the therapeutic approach to rectal cancer has involved neoadjuvant chemoradiotherapy followed by surgical resection, and, in some cases, adjuvant chemotherapy. This study aims to present current advances and ongoing controversies in the management of patients with locally advanced rectal cancer (LARC), with a particular focus on clarifying the role of total neoadjuvant therapy (TNT) in contemporary treatment strategies. Methods: We conducted a systematic literature review in Medline/PubMed using various keyword combinations, including “rectal cancer/neoplasia” and“therapy” or “neoadjuvant therapy” or “TNT”, and included articles published between 2015 and 2025. Results: The association of neoadjuvant radiochemotherapy with preoperative systemic chemotherapy has led to the current concept of total neoadjuvant therapy. The advantages of preoperative chemotherapy include better patient compliance, a decrease in the rate of local recurrence and distant metastases via the early destruction of infra-clinical micrometastases, and higher rates of pathological complete response. All of these have led to the inclusion of this strategy in treatment guidelines for patients with locally advanced rectal cancer. Conclusions: However, the selection of patients with advanced rectal tumors for optimal therapy requires comprehensive imaging assessments, molecular and genetic testing, and a multidisciplinary team to determine the most appropriate total neoadjuvant therapy approach.

Background: Artificial intelligence (AI) systems, including large language models, are increasingly used in clinical practice, whether consulted informally by clinicians or introduced by employers into decision workflows. It remains unclear how physicians attribute moral responsibility when a decision follows an AI recommendation and whether that attribution varies with the type of decision at stake. Methods: We conducted a cross-sectional, within-subject vignette survey of physicians in Romania. Each respondent rated the same three scenarios—urgent clinical, elective clinical, and administrative—in which a physician followed an AI recommendation under two extenuating institutional constraints. Five-point Likert items addressed the mitigation of blame by circumstances, physician responsibility despite the AI recommendation, and institutional co-responsibility. Analyses were non-parametric, with corrections for multiple testing. Results: Among 72 physicians from 17 specialties, respondents endorsed full personal responsibility in every scenario, including the administrative one, with no significant difference between scenarios. They rejected extenuating circumstances as mitigating in both clinical scenarios but were divided about them in the administrative scenario, which had the largest effect. Institutional co-responsibility was endorsed alongside personal responsibility rather than in place of it, and the two attributions were largely uncorrelated. No demographic association survived correction, although the study was not powered to detect small-effect sizes. Conclusions: Physicians treated AI as an instrument rather than a bearer of responsibility, which is unsurprising. The substantive findings lie elsewhere: personal responsibility was retained across all decision contexts, while what varied was the admissibility of institutional constraints as excuses and the emphasis placed on the institution’s share. Because respondents did not treat responsibility as a fixed quantity to be divided, the pattern is consistent with distributed-responsibility accounts rather than with a responsibility gap, though attitudinal data cannot adjudicate between normative accounts. The findings are exploratory and require confirmation in larger, more representative samples.

Psoriasis is a chronic inflammatory disease associated with multiple autoimmune conditions. This article reviews the relationship between psoriasis and autoimmune blistering dermatoses, vitiligo, alopecia areata, autoimmune thyroid disorders, systemic lupus erythematosus, and celiac disease, highlighting shared genetic susceptibility and overlapping immune pathways. The coexistence of these conditions may influence clinical presentations, prognosis, and treatment selection. In addition, various psoriasis therapies have been associated with the onset or exacerbation of concomitant autoimmune disorders. Therefore, recognizing these conditions is essential for individualized management and a multidisciplinary approach.