Background: The gut microbiome is increasingly recognized as a key player in metabolic health, influencing glucose and lipid metabolism through various mechanisms. However, the efficacy of gut microbiota-targeted interventions, such as probiotics, prebiotics, fecal microbiota transplantation (FMT), and diet-based treatments, remains unclear for specific metabolic outcomes. In this study, the aim was to evaluate the impact of these interventions on the glucose and lipid parameters in individuals with metabolic diseases such as diabetes mellitus (DM), obesity, and metabolic syndrome. Methods: This systematic review and meta-analysis included 41 randomized controlled trials that investigated the effects of gut microbiota-targeted treatments on metabolic parameters such as fasting glucose, glycated hemoglobin (HbA1c), homeostatic model assessment for insulin resistance (HOMA-IR), total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides. A comprehensive search was conducted using databases like PubMed, Google Scholar, and Scopus, focusing on interventions targeting the gut microbiota. A meta-analysis was performed using random-effects models, with effect sizes calculated for each outcome. Risk of bias was assessed using the Cochrane Risk of Bias tool. Results: Gut microbiota-targeted interventions significantly reduced fasting glucose, HbA1c, HOMA-IR, total cholesterol, LDL-C, and triglycerides, with moderate heterogeneity observed across studies. The interventions also led to modest increases in HDL-C levels. Probiotic and synbiotic interventions showed the most consistent benefits in improving both glucose and lipid profiles, while FMT yielded mixed results. Short-term interventions showed rapid microbial shifts but less pronounced metabolic improvements, whereas longer-term interventions had more substantial metabolic benefits. Conclusions: In this study, it is demonstrated that gut microbiota-targeted interventions can improve key metabolic outcomes, offering a potential therapeutic strategy for managing metabolic diseases. However, the effectiveness of these interventions varies depending on the type, duration, and population characteristics, highlighting the need for further long-term studies to assess the sustained effects of microbiota modulation on metabolic health.

Background: Chronic kidney disease (CKD) and renal failure remain critical global health challenges, with vascular access complications posing significant obstacles in hemodialysis management. Methods: This study investigates the early and late complications associated with vascular access procedures in a cohort of 1334 patients from Timiș County Emergency Clinical Hospital. Patients were categorized into early complications, occurring within 30 days postoperatively, and late complications, developing beyond this period. Demographic data, comorbidities, and lifestyle factors, including age, gender, body mass index (BMI), smoking status, hypertension, diabetes, and cardiovascular disease (CVD), were recorded and analyzed. Early complications included thrombosis, hemorrhage, edema, and non-maturation, while late complications involved thrombosis, aneurysmal dilation, venous hypertension, and infections. Results: Hemorrhage (32.3%) and thrombosis (30.8%) were the most prevalent early complications, influenced significantly by diabetes and hypertension. Non-maturation showed a strong association with diabetes and cardiovascular disease (odds ratio: 1.70). For late complications, thrombosis was most frequent, with hypertensive patients exhibiting increased risk (relative risk: 1.18). BMI was a significant factor in both early and late complications. Risk analysis using odds ratios and relative risks revealed distinct patterns of complication risks based on comorbidities and smoking status. Logistic regression modeling for thrombosis demonstrated moderate predictive accuracy (AUC: 0.64). Conclusions: These findings suggest that clinical interventions, such as stricter perioperative glycemic and blood pressure control, and personalized surgical strategies for patients with high BMI or comorbidities, could significantly reduce the incidence of vascular access complications and improve outcomes in this high-risk population.

Background and Objectives: As artificial intelligence (AI) and extended reality (XR) enter routine care, understanding patient acceptance is essential. We assessed attitudes toward AI/XR-enabled telemedicine among Romanian patients and examined correlates of acceptance. Methods: We analyzed 198 survey responses to a 20-item questionnaire. Ordinal items were encoded 1–4. The Acceptance Index measured trust in AI, perceived improvement in care, and willingness to choose AI-assisted visits (on a 1–4 scale). Results: Respondents were predominantly 31–50 years old (62.6%) and university educated (76.2%); 27.3% reported prior experience with AI/XR. Acceptance averaged 3.27 ± 0.59 (α = 0.780) and did not differ by age (p = 0.922). Prior users showed higher acceptance than non-users (3.47 ± 0.47 vs. 3.19 ± 0.59; p = 0.0011). Knowledge (ρ = 0.189, p = 0.048) and perceived accessibility (ρ = 0.229, p = 0.016) correlated with acceptance; privacy concern did not (ρ = 0.072, p = 0.455). Subgroups: Prior use was associated with higher acceptance across education levels, with a significant effect in secondary education (Holm-adjusted p = 0.029; Cliff’s δ = 0.56). Ordinal logistic model: higher willingness to pay (OR 6.81, 95% CI 3.39–13.66, p < 0.001) and greater perceived accessibility (OR 1.83, 95% CI 1.03–3.24, p = 0.040) independently predicted choosing AI-assisted visits. Conclusions: Patient acceptance of AI/XR-enabled telemedicine was moderate to high, strongest among prior users, and increased when access felt easy. Knowledge modestly supported acceptance; privacy concerns did not diminish it. Clear value propositions, streamlined access, and optional exposure pathways may enhance informed uptake.

Background and Objectives: Hip fractures are a leading cause of morbidity in the elderly, often resulting in declining physical function, psychological distress, and diminished quality of life (QoL). This study aimed to evaluate changes in QoL among hip fracture patients preoperatively and postoperatively, comparing diverse patient subgroups to identify factors influencing recovery. Methods: We conducted a prospective longitudinal observational study at Victor Babeș University of Medicine and Pharmacy Timișoara, recruiting 77 adult patients admitted for surgical management of hip fractures between March 2023 and March 2025. Standardized questionnaires, including the Short Form-36 (SF-36), World Health Organization Quality of Life (WHOQOL-BREF), Hospital Anxiety and Depression Scale (HADS), and Generalized Anxiety Disorder-7 (GAD-7), were administered preoperatively and at 3 months postoperatively. Demographic, clinical, and surgical variables were also recorded. Results: Participants’ mean age was 72.6 years (SD 8.1), with 57.1% female. Postoperative QoL scores (SF-36 Physical Function domain mean 52.7 ± 9.2) improved significantly compared to preoperative scores (44.8 ± 8.7, p = 0.012). WHOQOL-BREF physical and psychological domain scores similarly increased (p < 0.05). Anxiety and depression symptoms, as measured by HADS and GAD-7, decreased markedly postoperatively in most subgroups. Subgroup analyses revealed that patients undergoing total hip arthroplasty demonstrated more pronounced QoL improvements than those receiving partial hip replacement. Older patients (≥80 years) exhibited improvements but at a slower rate. Conclusions: Quality of life indicators show notable improvement following surgical treatment of hip fractures, underscoring the significance of timely orthopedic intervention and comprehensive perioperative care. Anxiety and depression levels also declined, highlighting the benefits of a structured follow-up. These findings may guide clinicians toward optimizing patient-centered recovery protocols and targeted interventions, particularly for older adults or those with high baseline anxiety and depression levels.

Background/Objectives: Early recovery after major head-and-neck reconstruction is not determined by flap survival alone. This exploratory study examined whether preoperative frailty-inflammatory phenotypes are associated with delayed swallowing recovery, persistent nutritional dependence, and poorer quality of life at 12 weeks. Methods: In a prospective single-center cohort study, 84 adults undergoing major head-and-neck oncologic reconstruction were assigned to three clinically defined phenotypes: low-risk (n = 28), intermediate (n = 29), and combined frailty-inflammatory (n = 27). Twelve-week outcomes included the Functional Oral Intake Scale (FOIS), MDADI, EORTC global health, PEG dependence, and a composite poor-recovery endpoint. Because of the small sample size, all estimates are reported to two significant figures, and every analysis is regarded as hypothesis-generating. Results: Compared with the low-risk group, the combined phenotype was older (63 ± 9 vs. 55 ± 9 years) and had a higher mFI-5 (3.2 ± 0.6 vs. 1.0 ± 0.7) and CRP/albumin ratio (2.2 ± 0.6 vs. 0.6 ± 0.2; all p < 0.001). At 12 weeks the combined phenotype showed greater weight loss (12 ± 2%), lower FOIS (3.2 ± 1.3), lower MDADI (51 ± 7), and PEG dependence in 52% (all p ≤ 0.002). A higher mFI-5 was associated with poor recovery (adjusted OR 2.1 per point; 95% CI 1.0–4.1; p = 0.04), an estimate whose confidence interval is wide and imprecise. Conclusions: In this small cohort a frailty-inflammatory framework was associated with clinically meaningful heterogeneity in early recovery. The findings are preliminary and require prospective, adequately powered, multicenter validation before any clinical use.

Background: Recovery after major head-and-neck reconstruction extends beyond flap survival and wound closure, involving swallowing, psychological adaptation, body image, and overall quality of life. Integrated multidimensional assessments remain limited in routine reconstructive outcomes research. Aim: The aim of this study was to characterize and compare six-month multidimensional recovery—clinical, functional, nutritional, psychological, and body-image outcomes—between microvascular free-flap and regional pedicled-flap reconstruction and to identify factors that stratify risk for persistent functional and psychosocial impairment. Methods: We conducted a single-center prospective cohort study at the “Victor Babeș” University of Medicine and Pharmacy, Timișoara, Romania, enrolling 87 adults undergoing major reconstructive surgery after ablative treatment of head-and-neck defects (52 microvascular free flaps; 35 regional pedicled flaps). Patients were assessed at baseline and 6 months using the SF-36, WHOQOL-BREF, Body Image Scale (BIS), HADS, PHQ-9, GAD-7, Functional Oral Intake Scale (FOIS), speech intelligibility, and PEG/tracheostomy dependence. Results: At 6 months, most SF-36 and WHOQOL-BREF domains improved with moderate effect sizes (d = 0.3–0.7; all p ≤ 0.009), and body image distress decreased significantly (ΔBIS −2.9 ± 4.6; p < 0.001), whereas social functioning showed no robust gain (p = 0.098; not surviving false-discovery-rate correction). Pedicled reconstruction was associated with higher PEG dependence (37.1% vs. 9.6%; p = 0.005) and worse FOIS (4.7 ± 1.4 vs. 5.6 ± 1.2; p = 0.003). Major complications were linked to blunted or worsening psychological trajectories and a threefold higher rate of clinically significant depression (HADS-D ≥ 11: 66.7% vs. 18.7%; p = 0.001). In a reduced four-predictor multivariable model, pedicled flap (aOR 4.6), adjuvant radiotherapy (aOR 2.8), major complication (aOR 3.3), and lower baseline FOIS (aOR 0.5 per point) were independently associated with PEG dependence (optimism-corrected AUC 0.79). Clustering identified three recovery phenotypes—functional/emotional responders, psychological/body-image responders, and global slow recovery—with significantly different PEG rates (5.9%, 21.4%, 40.0%; p = 0.006). Exploratory mediation analysis suggested that the association between reconstruction technique and mental quality-of-life recovery was partly statistically accounted for by swallowing and body-image improvement. Conclusions: Recovery after major head-and-neck reconstruction is multidimensional and heterogeneous. Baseline swallowing function, reconstruction technique, radiotherapy, and major complications jointly stratify risk for persistent functional and psychosocial impairment, supporting risk-adapted multidisciplinary rehabilitation and early psycho-oncologic screening.