Background: Glycated hemoglobin (HbA1c) is widely used for the diagnosis and monitoring of diabetes mellitus. However, its potential role as a marker of metabolic stratification and early complication risk beyond diagnostic thresholds remains insufficiently explored. Prediabetes is often considered a transitional state, although growing evidence suggests the presence of early metabolic and microvascular alterations. Methods: In this cross-sectional observational study, adult subjects were stratified into three groups based on HbA1c levels: normoglycemic (HbA1c < 5.7%), prediabetic (HbA1c 5.7–6.4%), and diabetic (HbA1c ≥ 6.5%). Demographic data, metabolic parameters, cardiometabolic comorbidities, and diabetes-related complications were analyzed. Group differences were assessed using appropriate statistical tests. Cumulative complication burden was evaluated, and risk estimation was performed using univariate logistic regression models to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results: A total of 839 subjects were included in the analysis. HbA1c and fasting glucose levels increased progressively across groups (p < 0.001). Prediabetic individuals already exhibited a higher prevalence of peripheral neuropathy and retinopathy compared to normoglycemic subjects, while diabetic patients showed the highest overall complication burden. The cumulative number of complications increased significantly across HbA1c-based groups (p = 0.033). Risk estimation analyses revealed increased odds for presenting at least one complication and for peripheral neuropathy in diabetic subjects, with intermediate risk levels observed in the prediabetic group. Conclusions: HbA1c-based stratification captures meaningful differences in metabolic status, complication burden, and estimated risk across normoglycemic, prediabetic, and diabetic individuals. Prediabetes is associated with detectable microvascular involvement and higher complication risk. Given the cross-sectional design, these findings reflect associations rather than causal relationships. These findings highlight the potential clinical value of HbA1c for early risk assessment and targeted preventive strategies.

Background: Glycated hemoglobin (HbA1c) is widely used for the diagnosis and monitoring of diabetes mellitus; however, its interpretation is largely based on fixed diagnostic thresholds. This study moves beyond describing a glycemic continuum by translating the non-linear HbA1c–microvascular relationship into an individualized risk estimation framework. Methods: In this cross-sectional observational study, adult subjects from a real-world clinical cohort were analyzed using HbA1c as a continuous variable. Associations between HbA1c and metabolic parameters were assessed using correlation analysis. Linear regression was applied to evaluate the relationship between HbA1c and cumulative diabetes-related complication burden. Non-linear associations between HbA1c and the risk of presenting at least one complication were explored using restricted cubic spline logistic regression models. Additional risk estimation analyses focused on the HbA1c gray zone (5.5–6.4%). Results: HbA1c showed a strong continuous association with fasting plasma glucose (ρ = 0.73, p < 0.001) and was positively associated with cumulative complication burden (β = 0.016 per 1% increase in HbA1c, p = 0.009). Non-linear modeling revealed a progressive increase in complication risk beginning below the diagnostic threshold for diabetes, with an inflection of the risk curve within the HbA1c gray zone. Individuals within this interval exhibited a higher prevalence and increased odds of presenting at least one complication compared with lower HbA1c values, although some estimates did not reach statistical significance. Conclusions: HbA1c acts as a continuous and non-linear marker of metabolic stress, with potentially biologically meaningful increases in complication risk emerging below traditional diagnostic thresholds. We demonstrate a non-linear acceleration of microvascular risk within the 5.5–6.4% interval, rather than a simple linear gradient. These findings support the concept of a glycemic risk continuum and highlight the clinical relevance of the HbA1c sub-diagnostic interval for early risk stratification and preventive strategies.

Background: Scars are a natural consequence of the healing process, but with an impact on the psychological and social level for the individual, which can even lead to withdrawal and social stigmatization. We aimed to analyze the psychosocial impact determined by post-traumatic scars, using psychometric scales, to assess the effectiveness of the Mekereș’ Psychosocial Internalization Scale (MPIS), and to identify relevant predictors of traumatic and surgical scar internalization.Methods: Our cohort included 293 participants, 149 women and 144 men, aged 18–64 years who were screened for scar characteristics and completed a set of psychological scales. We compared the results obtained in two subgroups: 153 subjects with posttraumatic scars and 140 with surgical scars.Results: Relevant predictors for posttraumatic scar internalization (R² = 0.721) are adaptation time, age of the occurrence and subjective appraisal, while for the depression, and hopelessness relevant predictors are the subjective appraisal of the scars and the posttraumatic quality of life.Conclusion: The psychological and social reporting of the aftermath of trauma, that has been followed by scar-ring, is an indicator of how a person will react and could indicate the susceptibility to psycho-pathology.

(1) Background: Scars are the consequence of physiological inherent healing processes of post-traumatic and surgical lesions with a psychological impact. Post-traumatic scarring may induce emotional and behavioral changes through social stigma. In this study we analyze the internalization of scars and their impact on hopelessness, depression, or the perception of social support in subjects with post-traumatic scars compared to people with surgical scars. (2) Methods: to research this suggested model, we analyzed data collected from 110 participants 61 women and 49 men, aged between 18 and 64 years; 55 participants had post-traumatically and 55 surgically acquired scars. They all were examined to assess the characteristics of scars, were asked to complete four psycho-social scales, and the results were compared. (3) Results: our results indicate that people with post-traumatic scars are oriented toward the internalization of scars, depending on their shape and size. We argue that hopelessness, appreciation of scars, age, and how scars are produced are important predictors of internalization. (4) Conclusions: the patient’s attitude toward the appearance of a scar is an indicator of how he/she will react in the future and it could predict the vulnerability to hopelessness. Finally, we nuance the impact of objective bodily harm on the psychological and moral suffering.

This paper aimed to evaluate the effects of the COVID-19 pandemic on prescription rates and antibiotic resistance in a university hospital. A retrospective study was conducted on the medical records of patients admitted to the Bihor Emergency Clinical County Hospital in Romania in 2019 (pre-pandemic) and 2021 (during the pandemic period). We evaluated the antibiotic consumption index (ACI) and susceptibility rates. The overall percentage of antibiotic prescribing increased in 2021, while the total number of patients decreased. Genito-urinary, digestive, respiratory infections, heart diseases and wounds were the most common conditions for antibiotic prescriptions, but the number of them decreased in 2021. There was a decrease in the proportion of antibiotics from the Watch and Reserve class and an increase in the proportion of antibiotics from the Access class. Antibiotic use has been reduced despite an increase in the number of patients, with a high consumption in the Watch group in the ICU wards. By contrast, surgical wards had the highest rate of antibiotic prescriptions, but a decrease in the number of patients. The patients who were administered antibiotics were hospitalized for diagnoses other than COVID-19. Almost all prescribed antibiotics displayed decreasing sensitivity rates. The number of isolated ESKAPE pathogens, except for Staphylococcus aureus methicillin-resistant strains, were increased. Strategies to control antibiotic prescriptions and the spread of resistant pathogens should be improved.

Background: Diabetic kidney disease is a major complication of type 2 diabetes mellitus (T2DM) and a leading cause of chronic kidney disease (CKD) worldwide. While diabetes duration is often considered a marker of cumulative metabolic exposure, its independent contribution to renal decline beyond aging and hypertension remains incompletely defined. Methods: We conducted a cross-sectional study including 250 adults with T2DM. Diabetes duration was analyzed both as a continuous variable and across four predefined strata (0–4, 5–9, 10–14, and ≥15 years). The primary endpoint was estimated glomerular filtration rate (eGFR), analyzed as a continuous outcome. Functional CKD was defined as eGFR < 60 mL/min/1.73 m². Linear and logistic regression models were constructed in unadjusted and adjusted forms (age, sex, BMI, hypertension, HbA1c). A sensitivity analysis modeling duration per 5-year increase was performed. Results: Mean eGFR declined significantly across duration strata (82.45, 84.27, 78.72, and 61.57 mL/min/1.73 m², respectively; p < 0.001). The prevalence of functional CKD increased markedly in patients with ≥15 years of diabetes (54.2%) compared with shorter-duration groups (~15–18%; p < 0.001). In linear regression, each additional year of diabetes was associated with a 1.32 mL/min/1.73 m² decline in eGFR (p < 0.001), remaining significant after adjustment (β = −0.85; p < 0.001). In logistic regression, each additional year was associated with a 10.7% increase in adjusted odds of CKD (OR = 1.11; 95% CI 1.04–1.17; p < 0.001). Each 5-year increment conferred a 66% increase in adjusted CKD risk (OR = 1.66; 95% CI 1.25–2.21; p < 0.001). Patients with ≥15 years of diabetes had nearly fourfold higher adjusted odds of CKD compared with those with 0–4 years (OR = 3.90; 95% CI 1.42–10.75; p = 0.008). Conclusions: Diabetes duration is strongly and independently associated with declining kidney function. Prolonged disease exposure confers a substantial increase in CKD risk, even after adjustment for age, hypertension, and metabolic factors. These findings highlight the progressive nephrotoxic impact of cumulative hyperglycemic exposure and underscore the need for early and sustained nephroprotective strategies in T2DM.