Human papillomavirus (HPV) is recognized as being related to a wide variety of known cancers: cervical, oropharyngeal, anal, vaginal, penile, and skin. For some of these cancers, rigorous algorithms for screening, therapeutical interventions, and follow-up procedures have been established. Vaccination using the nonvalent anti-HPV vaccine, which prevents infection regarding the most frequently involved high-risk HPV types (16, 18, 31, 33, 45, 52, and 58) and low-risk HPV types (6 and 11), has also extensively prevented, controlled, and even eradicated HPV infections. Still, even with all of these multidisciplinary interventions, the burden of HPV cancers is still high worldwide. The circulating DNA of HPV-induced cancers is thought to be an adequate biomarker for optimizing the control of these virus-related cancers. We analyzed the literature published in the last 5 years regarding ctDNA and four of the above-mentioned cancers. The most frequently used assay for ctDNA detection was the droplet digital PCR assay, used for the management of therapy in the late stages of cancer. ctDNA could not be used for early detection in any of the studied cancers. The OPSCCs were the most frequent cancers analyzed via ctDNA assays. Larger, properly designed cohort studies might establish the clinical utility of this biomarker.

Background: Intrauterine adhesions (IUAs) or Asherman syndrome (AS) represent pathological conditions that affect the endometrium and significantly influence female fertility through a variety of mechanisms. This study aims to identify risk factors, explore pathophysiological mechanisms, diagnostic approaches, and assess how medical background influence the development of these conditions. It also seeks to associate the severity of conditions with clinical outcomes, such as fertility, miscarriages, and menstrual cycle disorders, using American Fertility Society (AFS) scoring system. Materials and methods: This retrospective cohort study included 134 patients aged 18 to 45, who followed hysteroscopy between 2016 and 2024 at two hospitals in Iasi, focusing on those diagnosed with IUAs (102 patients) and AS (32 patients), based on hysteroscopic approach. The exclusions were based of factors like acute uterine bleeding, intrauterine device, obesity and other severe conditions. Results and discussions: Women over 35 years are more likely to develop these conditions due to prior gynaecological procedures which are often associated with fertility issues. Hysteroscopy is established as the gold standard for both diagnosis and treatment, intraoperative diagnosis representing 45.6 % of cases. Amenorrhea is a primary indicator in AS patients (OR = 26.19) and dysmenorrhea as a potential marker for IUAs (OR = 2.67). Patients with IUAs and primary infertility (82.9%) typically have an AFS score 1, corresponding to improved conception rates. Those with AS and primary infertility often present an AFS score 2 (54.5%); patients with AS and secondary infertility were linked to AFS score 3 (58.8%; p = 0.137). Although the incidence of miscarriages is comparable between the two groups, the timing differs: IUAs are predominantly associated with first trimester losses (64.9%), whereas AS is more commonly linked to second trimester miscarriages (45.5%; p = 0.001). Conclusions: The study highlights the necessity of a personalized approach in diagnosing and treating IUAs and AS, considering factors such as age, fertility index, and disease severity. The integration of hysteroscopic techniques with individualized treatment plans based on the patient’s unique medical profile is crucial for adequate management of IUAs and AS.

Introduction: Urinary tract infections (UTIs) caused by carbapenem-resistant pathogens are increasingly common and pose serious treatment challenges due to limited antibiotic options and high complication rates. Identifying patients at risk is essential for guiding empirical therapy and improving outcomes. The primary objective of this study was to identify risk factors associated with carbapenem-resistant (CR) UTIs by comparing them with carbapenem-susceptible (CS) UTIs. Secondary objectives included analyzing the types of microorganisms involved in both groups, their antibiotic susceptibility profiles, and the presence of carbapenemase enzymes among CR UTI cases. Method: We conducted a retrospective case-control study involving 127 hospitalized patients with UTIs caused by CR microorganisms and 91 patients with UTIs caused by multidrug-resistant (MDR) strains that retain susceptibility to carbapenems, admitted between 1 October 2023, and 31 March 2025. Results: In univariate analysis, CR UTI patients had significantly higher rates of neoplasia, neurological disorders, urosepsis at admission, septic shock, the presence of urinary catheters at diagnosis, permanent nephrostomy catheters, hospitalizations within the past 180 days, previous antibiotic exposure including carbapenems, and recent urological procedures. Multivariate analysis revealed four independent risk factors for CR UTIs: neoplasia (OR = 2.152; 95% CI: 1.044–4.436; p = 0.038), neurological disorders (OR = 7.427; 95% CI: 2.804–19.674; p < 0.0001), antibiotic use in the previous 180 days (OR = 2.792; 95% CI: 1.487–5.396; p = 0.001), and prior carbapenem treatment OR = 10.313; 95% CI: 1.277–83.248; p = 0.029). Most of the isolated organisms belonged to the Enterobacterales genus, with Klebsiella spp. and Pseudomonas aeruginosa being the most common pathogens in CR UTIs, accounting for over 90% of cases. Among patients tested for carbapenemase production, all but one tested positive for at least one carbapenemase. Conclusions: Neoplasia, neurological disorders, recent antibiotic therapy, and prior carbapenem use were significantly associated with increased risk of developing CR UTIs. Klebsiella spp. and Pseudomonas aeruginosa were the predominant causative organisms, with New Delhi metallo-β-lactamase (NDM) and Klebsiella pneumoniae carbapenemase (KPC) being the most frequently identified resistance mechanisms.

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.

Background: Pyelonephritis during pregnancy represents a significant maternal–fetal risk, particularly in the context of increasing multidrug-resistant (MDR) bacterial infections. This study aimed to characterize the microbiological profiles and antimicrobial resistance patterns of MDR pathogens causing pyelonephritis in pregnancy. Secondary objectives included the evaluation of patient characteristics, associated risk factors, and pregnancy outcomes. Methods: A retrospective comparative study was conducted including 171 pregnant patients hospitalized with acute pyelonephritis between 1 January 2017 and 30 April 2025. Thirty-four patients with MDR bacterial infections were compared with 137 patients with infections caused by pathogens with conserved antibiotic susceptibility (Non-MDR). Results: Patients with MDR pyelonephritis were significantly older than those with Non-MDR infections (mean age 27.76 vs. 25.30 years, p = 0.03). MDR infections were more frequently diagnosed in the third trimester of pregnancy (58.8% vs. 29.9%, p = 0.003) and affected multiparous women more often (44.1% vs. 19.7%, p = 0.006). No statistically significant differences were observed between groups regarding clinical presentation or laboratory parameters (p > 0.05). Prior antibiotic exposure was significantly more common in the MDR group (85.29% vs. 26.61%, p < 0.001), as was a history of urological procedures, including urinary catheterization (29.41% vs. 15.10%, p = 0.009). For multivariate analysis, two factors were predictive for pyelonephritis with MDR pathogens: previous antibiotic treatment—OR 20.37 (95% CI 2.19–189.88) and urological procedures—OR 13.23 (95% CI 2.24-78-22). Escherichia coli was the predominant pathogen in both groups but was isolated more frequently in the Non-MDR cohort (81.75% vs. 58.82%, p = 0.015), followed by Klebsiella pneumoniae, which appeared more frequently in the study group (23.53% vs. 10.22%, p = 0.011). MDR isolates demonstrated significantly higher resistance rates to all tested antibiotics (p < 0.05). Complete resistance to ampicillin was observed in the MDR group (100%), compared with 58.01% in the Non-MDR group, indicating markedly reduced efficacy of this agent. Adverse neonatal outcomes were more frequent in the MDR group, with higher rates of Apgar scores < 7 at admission (23.5% vs. 8.8%, p = 0.01) and increased neonatal intensive care unit admission (20.6% vs. 7.3%, p = 0.02). For multivariate analysis, pyelonephritis with MDR pathogens was predictive for Neonatal Intensive Care Unit (NICU) admission (OR 8.17, 95% CI 2.41–27.67). Conclusions: These findings highlight the need for the periodic revision of empirical antibiotic protocols and risk-adapted therapeutic strategies in pregnant patients in order to reduce maternal and fetal morbidity.

Background and Objectives: Hand hygiene remains one of the most important measures for preventing healthcare-associated infections, yet its implementation in routine clinical practice remains suboptimal. This study aimed to evaluate whether repeated hand hygiene retraining combined with adenosine triphosphate (ATP) bioluminescence feedback was associated with reduced ATP-assessed residual organic contamination on the hands of healthcare workers in a real-world hospital setting. Materials and Methods: We conducted a single-center before-and-after interventional study in 2025 at the County Emergency Hospital of Deva, Romania. Hand contamination was assessed using ATP bioluminescence testing, and results were categorized as low residual contamination (≤20 RLU), intermediate residual contamination (21–59 RLU), or high residual contamination (≥60 RLU). One ATP assessment was performed before and one after a repeated hand hygiene retraining program delivered during 2025. The primary outcomes were the change in mean ATP values and the change in ATP-defined contamination categories between baseline and post-intervention assessment. Results: Mean ATP values decreased from 842 ± 210 RLU before the intervention to 312 ± 118 RLU after the intervention, corresponding to a 62.9% relative reduction (p < 0.01). At baseline, 17.1% of participants were classified as having low residual contamination, 25.7% as intermediate residual contamination, and 57.1% as high residual contamination. After the intervention, these proportions changed to 62.9%, 22.9%, and 14.3%, respectively (p < 0.01). Improvement was observed across all professional categories. Physicians showed the highest post-intervention proportion of compliant results (85.0%), followed by nurses (61.1%) and auxiliary staff (35.7%). ATP values decreased significantly in all seven departments, with relative reductions ranging from 61.0% to 63.4%. Conclusions: Repeated hand hygiene retraining combined with ATP bioluminescence feedback was associated with a substantial reduction in ATP-assessed residual hand contamination among healthcare workers in this hospital setting. The intervention was followed by both a marked reduction in ATP values and a favorable shift in ATP-defined contamination categories across departments and professional groups. Because ATP is an indirect and device-dependent marker of residual organic material, these findings should be interpreted cautiously and primarily as evidence of improved ATP-assessed hand cleanliness within the study setting rather than as direct evidence of WHO-defined hand hygiene compliance or microbiological decontamination.