Stress urinary incontinence affects a large proportion of women in their lifetime. The objective of this review was to describe and compare the latest surgical trends in urinary incontinence and focus on the literature advantages, disadvantages, complications and efficacy of surgical procedures regarding this pathology. Using network meta-analysis, we have identified the most frequently used procedures (Burch surgery, midurethral sling and pubovaginal sling), and we have described and characterized them in terms of effectiveness and safety. Midurethral procedures remain the gold standard for surgical treatment of stress urinary incontinence, although the potential of serious complications following this procedure should be taken into consideration always. There is a clear need for a much more unified evaluation of possible complications and postoperative evolution. This process will help practitioners to adapt and individualize their strategy for each patient.

Pregnancy is a transformative stage in a woman’s life, marked by significant physical, emotional, and social changes. This study had three main objectives: (1) to assess the quality of life (QoL) of pregnant women in Romania, (2) to identify the sociodemographic, health, and obstetric factors influencing their QoL and (3) to examine the psychometric properties of the WHOQOL-BREF questionnaire within the Romanian context, determining its effectiveness in evaluating QoL during pregnancy. Methods: A cross-sectional analytical survey was conducted between January and July 2023 among pregnant women in Romania, targeting a geographically diverse sample from urban and rural areas. Eligible participants were Romanian citizens aged 18 or older. Data were collected through an online self-administered questionnaire using Google Forms, with informed consent obtained electronically. The survey included demographic, obstetric, and health-related variables alongside the WHOQOL-BREF tool, which evaluates QoL across four dimensions: Physical, Psychological, Social Relationships, and Environment. Statistical analysis involved confirmatory factor analysis, reliability testing (Cronbach’s α and McDonald’s ω), and comparisons using Welch’s t-tests and ANOVA. Results: A total of 1550 valid responses were analyzed. The WHOQOL-BREF demonstrated excellent internal consistency (Cronbach’s α > 0.9 across all dimensions). Women with higher education and stable employment reported significantly higher QoL scores in physical and psychological dimensions. No significant differences were found based on pregnancy trimester, previous births, or participation in prenatal classes, although trends suggested slight advantages for participants in prenatal education. Women delivering in private hospitals or non-hospital settings reported better psychological and physical QoL than those delivering in public hospitals. Support from partners and urban residency positively influenced perceived QoL. Conclusions: The WHOQOL-BREF is a reliable tool for assessing QoL in pregnant women in Romania. The study highlights the role of education, employment, and delivery location in influencing QoL, emphasizing the need for targeted support for vulnerable groups during pregnancy.

Background: Antifungal resistance among Candida species represents a growing clinical challenge, particularly in the context of increasing prevalence of non-albicans species. Methods: We conducted a retrospective analysis of 747 fungal isolates collected between 2021 and 2026, evaluating species distribution, antifungal susceptibility profiles, minimum inhibitory concentration (MIC) patterns, and temporal trends in resistance. Results: Non-albicans Candida species accounted for 67.5% of isolates, exceeding the proportion of Candida albicans. Fluconazole and flucytosine exhibited the highest resistance rates (16.1% and 17.4%, respectively), while amphotericin B showed the highest susceptibility rate (82.1%). MIC analysis revealed elevated MIC90 values for azoles in Candida glabrata and Candida krusei, consistent with reduced susceptibility. A significant association between antifungal agent and susceptibility profile was observed (χ² = 33.81, p < 0.001; Cramér’s V = 0.205). Temporal analysis demonstrated fluctuating resistance patterns rather than a consistent increase over time. Multidrug resistance was uncommon (2.5%), although non-susceptibility to multiple agents was more frequent (20.3%). Conclusions: The study highlights substantial variability in antifungal susceptibility across Candida species and antifungal agents, emphasizing the importance of continuous surveillance and species-specific treatment strategies.

Background: Congenital infections included in the TORCH complex remain an important cause of fetal and neonatal morbidity and mortality, being associated with miscarriage, intrauterine growth restriction, congenital malformations, neurological impairment, and long-term developmental sequelae. Prenatal serological screening may contribute to the early identification of maternal infections and facilitate preventive and therapeutic interventions. However, data regarding the utilization of TORCH screening and associated socio-demographic determinants in Romania remain limited. Objective: This study aimed to evaluate the self-reported uptake of prenatal serological testing for one or more infections included in the TORCH complex, particularly Toxoplasma gondii, rubella virus, cytomegalovirus (CMV), herpes simplex virus (HSV), and syphilis, and to identify socio-demographic, obstetrical, and prenatal care-related factors associated with TORCH testing among pregnant women in Romania. Materials and Methods: A cross-sectional observational study was conducted using an online self-administered questionnaire completed by 1301 pregnant women from Romania. Data collection was performed between August 2022 and March 2023 through digital platforms, including social media and pregnancy-related forums. The primary outcome was self-reported performance of serological testing for at least one TORCH-related infection during pregnancy. Associations between explanatory variables and TORCH testing were evaluated using chi-square tests and multivariable binary logistic regression models. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. Results: Overall, 75.6% of participants reported undergoing serological testing for at least one infection included in the TORCH complex during pregnancy, while 49.3% reported a complete TORCH panel. The most frequently reported investigations were for Toxoplasma gondii (92.8%) and rubella virus (89.9%), whereas HSV testing was less commonly reported (42.5%). Lower educational level was the strongest independent factor associated with reduced likelihood of TORCH testing (adjusted OR = 0.08; 95% CI: 0.03–0.19; p < 0.001) (adjusted OR—aOR). Unemployment status (aOR = 0.70; 95% CI: 0.50–0.99; p = 0.045) and multiparity (aOR = 0.62; 95% CI: 0.49–0.77; p < 0.001) were also associated with lower testing uptake. In contrast, participation in prenatal education programs was associated with increased likelihood of TORCH testing (aOR = 1.37; 95% CI: 1.04–1.80; p = 0.024). The number of prenatal consultations was not independently associated with testing uptake. Conclusions: The uptake of prenatal serological screening for congenital infections (assessed using an expanded Romanian panel that includes hepatitis B and HIV in addition to the classical TORCH agents) in Romania appears to be influenced predominantly by socio-educational and behavioral factors rather than by the quantitative utilization of prenatal care services alone. Given the online recruitment strategy and the predominantly urban and highly educated sample, the reported uptake rates may overestimate population-level coverage. Significant inequalities in access to preventive prenatal investigations were observed, particularly among women with lower educational and socio-economic status. Strengthening prenatal education programs and improving equitable access to standardized prenatal screening may contribute to optimizing congenital infection prevention and maternal–fetal health outcomes.

Objectives: Romania has one of the highest caesarean rates in the European Union, yet little is known about what shapes women’s preferred mode of birth there. This study examined how socio-demographic, obstetric and antenatal care characteristics relate to preferred mode of birth, with a focus on modifiable factors such as the information received during pregnancy, attendance of antenatal classes and access to midwifery care. Methods: A cross-sectional questionnaire study of 1301 pregnant women recruited online was conducted in Romania between January and July 2023. The association between each characteristic and preferred mode of birth was tested with Pearson’s chi-square test, and effect size was quantified with Cramér’s V. p-Values were adjusted for multiple comparisons with the Bonferroni method, and factors independently associated with preference were identified with multinomial logistic regression (reference category: vaginal birth). Results: One-third of the women preferred caesarean birth (33.4%), just under one-third preferred vaginal birth (29.9%), and 36.7% were undecided. Among parous women, preference was associated with the mode of a previous birth (V = 0.42); in the whole sample, the largest effect size was for the information the physician gave about the birth process (V = 0.36), followed by information about breastfeeding (V = 0.24), the number of antenatal consultations (V = 0.22) and information about early skin-to-skin contact (V = 0.21). Socio-demographic factors showed weaker associations. After Bonferroni adjustment, place of residence and perceived usefulness of access to a midwife were no longer significant. In the multivariable model (n = 1301), a previous caesarean (aOR 5.06), thorough physician information about birth (aOR 2.77) and age of 30 years or over were independently associated with preferring caesarean, whereas antenatal class attendance (aOR 0.35) and thorough information about breastfeeding (aOR 0.40) were associated with lower odds of preferring caesarean. Indecision clustered among women who had received little information and had fewer consultations. Conclusions: In this predominantly urban and highly educated online sample, preferred mode of birth was associated with previous mode of birth, with potentially modifiable antenatal care and information exposure and with some socio-demographic characteristics. Given the cross-sectional design, these associations are not causal, and whether midwife-led antenatal education and counselling support informed choice should be tested in longitudinal or interventional studies.

Background/Objectives: Multidrug-resistant tuberculosis (MDR-TB) remains a major public health challenge in the WHO European Region, which reports the highest global proportion of rifampicin-resistant and MDR-TB cases. Whole-genome sequencing (WGS) has emerged as a key tool for improving drug-resistance detection and supporting molecular surveillance. However, the level of genomic implementation across Central and Eastern Europe (CEE) remains insufficiently characterized. This scoping review aimed to evaluate the use of WGS for MDR-TB in CEE countries and to classify implementation maturity using a predefined framework (L0–L4). Methods: A structured search of PubMed/MEDLINE and Web of Science identified original studies published in English between 2015 and 2026 reporting genomic applications in MDR-TB across 13 predefined CEE countries. Data were extracted on sequencing approaches, resistance prediction, transmission analysis, monitoring of new or repurposed drugs, bioinformatic pipelines, and programmatic integration. Countries were categorized according to a five-level maturity model based on documented capacity, scope of application, and integration into national tuberculosis programs (NTPs). Results: Twenty-eight studies were included. WGS was used in 23/28 studies (82.1%), predominantly for genomic resistance prediction (25/28). Transmission analysis was reported in 19/28 studies, with heterogeneous single nucleotide polymorphism (SNP) thresholds and clustering methodologies. Monitoring of resistance to new or repurposed drugs was described in 8/28 studies. No country achieved Level L4 (formally integrated genomic surveillance). Four countries were classified as L3 and nine as L2, while no L0 or L1 settings were identified. Conclusions: Countries in Central and Eastern Europe demonstrate increasing operational use of WGS for MDR-TB, primarily driven by clinical resistance prediction. However, the lack of formal integration into national surveillance systems highlights a persistent gap between technological adoption and structured public health implementation. Strengthening programmatic integration and methodological standardization is essential for advancing genomic surveillance of MDR-TB in the region.