Background: Occupational stress and burnout in the medical field are common factors that can have a negative impact on the quality of clinical care. In the Romanian healthcare environment, there exists important financial difficulties contributing additionally to stress in this study, we aimed to investigate if resilience and emotional intelligence would prove to be protective factors against stress. Methods: In our cross-sectional study, we investigated 189 medical professionals, using convenience sampling, from July 2022 to September 2022 in two university centers. We applied a self-reported questionnaire that included socio-demographic characteristics and three scales that measured perceived stress (the Perceived Stress Scale), resilience to stress (the Connor–Davidson Resilience Scale), and emotional intelligence (the short-form Trait Emotional Intelligence Questionnaire). Results: Age was positively associated with resilience levels, meaning that resilience increases with age. While specialist physicians had the highest emotional intelligence score, nurses and other healthcare workers had the highest resilience scores. Perceived stress level was negatively correlated with resilience to stress and with emotional intelligence levels. Resilience to stress was positively correlated with emotional intelligence. Conclusions: The major strength of this study is the finding that resilience to stress mediated the association between perceived stress and emotional intelligence. Because resilience is negatively associated with burnout, resilience to stress and emotional intelligence are potential targets for training aimed at improving the working environment and reducing current levels of burnout in the Romanian Health System and beyond.

Background: Recently, vitamin D deficiency (VDD) has been described as a pandemic, affecting all groups of the population. Pregnant women and preterm infants are particularly vulnerable to vitamin D deficiency. Objectives: We aimed to evaluate the maternal and neonatal vitamin D status in relation with maternal vitamin D supplementations during pregnancy and to identify demographic, social, and healthcare risk factors for maternal VDD and vitamin D insufficiency in women delivering at ≤32 weeks of gestation. Methods: This prospective observational study was developed in the regional level III maternity unit of the Clinical County Emergency Hospital Sibiu. It included all admitted mothers who delivered at ≤32 weeks of gestation and their infants between 1 March 2022 and 28 February 2025. Infant deaths in the first 24 h of life, major congenital defects, chromosomal abnormalities, the admission of outborn infants without their mothers, or the transfer of the mother more than 48 h after birth were used as exclusion criteria. Maternal and neonatal data were collected from medical records. Data on maternal vitamin D supplementation were collected through interviews. Univariate and multivariate logistic regressions, linear regression, and predictive models were performed for data analysis. Results: A total of 146 mothers (median (IQR) age 30 (24–35) years) and their 164 preterm infants born at ≤32 weeks of gestation (median gestational age of 30 (27–31) weeks and birth weight of 1200 (900–1527) g) were included in this study. Only 43.15% of the mothers used multivitamins containing vitamin D during pregnancy, and 10.96% used specific vitamin D supplements. Vitamin D supplementation was used for a median of 4 (3–5) months at a median dose of 800 (250–1500) IU/day. Severe VDD (25(OH)D < 10 ng/mL), VDD (25(OH)D < 20 ng/mL), VDI (25(OH)D 20–29 ng/mL) were found in 19.86%, 55.48%, and 23.97% of the mothers and 16.46%, 58.53%, and 25.61% of their infants, respectively. A significant correlation was found between the maternal and neonatal status (r = 0.684, r² = 0.468, p < 0.001, B = 0.62). Both the maternal and neonatal vitamin D status were correlated with the vitamin D duration and dose used for supplementation during pregnancy. The logistic regression analysis showed that birth during a cold season and increased parity are independently associated with severe maternal VDD, while birth during the cold season and a lower educational status were independently associated with maternal VDD. Only an absent vitamin D supplementation (in the form of a multivitamin or specific vitamin D supplements) has been proven as an independent risk factor for VDI. Conclusions: Our findings revealed a worrisome prevalence of severe VDD, VDD, and VDI in mothers delivering very prematurely and in their infants. Additionally, less than half of the mothers in this study used vitamin D supplements during pregnancy despite the national recommendations. The professionals involved in advising pregnant women and policymakers should find solutions to improve the vitamin D status in these vulnerable groups of the population.

Borderline Personality Disorder (BPD) is a mental illness associated with a significant degree of distress and impairment because of the difficulties in effectively regulating emotions. BPD is frequently associated with Depressive Disorders, most commonly Major Depressive Disorder and Dysthymia. Here, we present a case report of an 18-year-old female patient hospitalized with a severe depressive episode and psychotic symptoms. A few months after discharge, the interpersonal difficulties, unstable self-image, fear of chronic abandonment, feeling of emptiness, paranoid ideation, helplessness, obsessive-compulsive elements, perfectionism, and social retreat led to the patient’s impaired functionality. The spectrum of signs and symptoms presented were characteristic of BPD. The specific presentation of mixed dependent/avoidant pattern of personality, with persistent feelings of guilt and shame, social anxiety, emotional attachments, obsessions, and feelings of inadequacy have further narrowed the diagnosis to discouraged BPD, as described by Theodore Millon. In our case, this particular subtype of personality disorder can be understood as BPN associated with social perfectionism. Both BPD and perfectionism, as a trait personality, were thought to exacerbate issues with self-conception and identity formation in this patient.

Introduction: Diabetes mellitus negatively influences oral health, significantly contributing to the worsening of odonto-periodontal pathology. Accurate diagnosis and monitoring of lesions are essential to prevent complications. CBCT (cone beam computed tomography) provides a detailed image of bone structures, being a valuable tool in this context. Materials and methods: Thisprospective observational comparative study included 120 patients with chronic periodontitis, divided into two equal groups: 60 with type 2 diabetes mellitus and 60 without systemic diseases. All were examined clinically and radiologically using high-resolution CBCT. Results: Diabetic patients presented a significantly higher mean bone loss (4.7 mm) compared to the non-diabetic patients (3.0 mm). Periodontal pockets >5 mm were more frequent in the diabetic group (75% vs. 50%). CBCT revealed vertical defects and extensive periapical lesions especially in patients with diabetes. Three-dimensional imaging allowed for detailed assessment and clear differentiation between the severity of cases. Conclusions: CBCT is essential in the early identification and evaluation of periodontal disease in diabetic patients. The use of this method significantly contributes to the correlation of clinical and imaging data, optimizing the diagnosis and treatment plan.

Background: The neutrophil-to-lymphocyte ratio (NLR) has been the focus of extensive research in recent years as an inexpensive inflammatory biomarker with prognostic value in oncology, but its relationship with tumor grade across solid malignancies remains uncertain. Methods: This systematic review evaluated original clinical studies reporting the association between peripheral blood NLR and histological tumor grade in solid tumors. PubMed and Web of Science were searched using Boolean strategies, and eligible full-text studies were synthesized qualitatively because of heterogeneity in tumor type, grading system, NLR threshold, and statistical reporting. Results: The qualitative synthesis included 13 retrospective primary studies comprising 5394 patients. Eight studies reported statistically significant associations between higher NLR and higher tumor grade or poorer differentiation, most consistently in bladder cancer and in single studies of prostate cancer, soft tissue sarcoma, renal cell carcinoma, pancreatic cancer, breast cancer, and colorectal cancer with synchronous liver metastases. Four studies reported no statistically significant grade-related association, mainly in heterogeneous breast cancer and ovarian cancer cohorts, whereas a small colorectal adenocarcinoma cohort study showed a non-significant positive trend. Conclusions: The available evidence suggests a possible relationship between systemic inflammation and tumor grade in selected malignancies, but the evidence remains preliminary, tumor-specific, retrospective, and vulnerable to confounding. NLR should not be interpreted as a surrogate for histological grade.

Most meta-analyses report less external apical root resorption (EARR) with clear aligners (CAs) than fixed appliances (FAs), but pooled differences are sub-millimetric and rest on few recurring studies. This scoping review (PRISMA-ScR) mapped how 2020–2026 evidence on CA–FA comparisons, treatment-related factors and imaging modalities was generated, and checked data consistency, without pooling. Its unregistered protocol (version 1.0) was reconstructed during manuscript preparation. PubMed, Scopus and Web of Science were searched; paired reviewers screened 1688 records and 263 full texts and included 176 reports (174 studies). Fifteen reports, including eight of 32 direct-comparison reports, were excluded because outcome data were not attributable to a distinct sample or not identifiable; in one, pooled by six syntheses, aligner values equal another study’s fixed-appliance values. Of 21 included comparisons, 17 had serious or high risk of bias, one accounted for clustering and three reported measurement error in millimetres; differences were 0.01–1.12 mm except in one. Fifteen of 17 studies not described as randomised reported less EARR with CAs; the only concealed-allocation trial of appliances alone found no difference. Two imaging comparisons disagreed on whether panoramic radiography under- or overestimates EARR. Differences should be judged against measurement error and design, and data consistency should be checked before pooling.