Neonatal infections remain a leading cause of morbidity and mortality worldwide, particularly among preterm and low-birth-weight infants and in low- and middle-income countries. This burden has intensified with the global increase in multidrug-resistant (MDR) bacteria, especially in neonatal intensive care units, where prolonged hospitalization, invasive interventions, and exposure to broad-spectrum antibiotics promote colonization, transmission, and invasive infection. In this narrative review, we explore the epidemiology and microbiological characteristics of MDR bacterial infections in newborns, alongside their associated risk factors, diagnostic challenges, treatment outcomes, and prevention strategies. Across different settings, Gram-negative pathogens, particularly Klebsiella pneumoniae, Escherichia coli, and Acinetobacter baumannii, account for a substantial proportion of severe neonatal infections, whereas methicillin-resistant Staphylococcus aureus remains important in selected units. The risk of MDR infection is driven by a complex interplay of factors, ranging from maternal and perinatal exposures to the inherent immunological vulnerability of newborns, hospital-based transmission, antibiotic selection pressure, and structural deficiencies in healthcare infrastructure. Diagnosis remains challenging because clinical presentations are nonspecific and culture-based methods are constrained by low blood volumes, prior antimicrobial exposure, and delayed turnaround times. Treatment is increasingly complicated due to resistance to standard empirical regimens, substantial regional variation in susceptibility profiles, and limited neonatal pharmacokinetic and safety data for reserve agents. Current evidence mainly supports surveillance-informed empirical therapy, susceptibility-guided treatment adjustment, antimicrobial stewardship, and strict infection prevention measures. Future progress will require neonatal-specific clinical trials, harmonized surveillance systems, stronger molecular epidemiology, and more equitable access to microbiological diagnostics and effective treatment.

Background: Wearable electrocardiography (ECG) devices such as smartwatches offer a novel means for detecting cardiac arrhythmias, particularly atrial fibrillation (AF), and ST-segment abnormalities. Their role in complementing or replacing traditional ECG methods is being increasingly investigated. Objective: To evaluate the diagnostic performance (sensitivity, specificity) of wearable ECG devices in detecting AF and ST-segment changes, compared to 12-lead ECG as the gold standard. Methods: A systematic search was performed in PubMed, Scopus, and additionally, the SpringerLink platform was consulted up to June 2025, targeting open-access, English-language clinical studies from the last five years. Inclusion criteria: adult population, use of a wearable ECG device, 12-lead ECG comparator, and diagnostic accuracy reporting. Out of 145 records, 5 studies met the inclusion criteria. The systematic review protocol was not prospectively registered in PROSPERO due to the limited number of available studies and the exploratory nature of the topic, which focused on the most recent clinical evaluations of wearable ECG devices. However, the review strictly adhered to the PRISMA 2020 guidelines for systematic reviews to ensure methodological transparency and reproducibility. Results: Five studies encompassing a total of 1133 participants were incorporated into the analysis. Devices evaluated included Apple Watch (Series 4–6), KardiaMobile 6L, FibriCheck, Preventicus, and HUAMI dynamic ECG. Sensitivity ranged from 83% to 100%, and specificity from 79% to 100%. Algorithm improvements and repeated measurements significantly reduced inconclusive recordings. Multichannel ECG methods using smartwatches showed high agreement with 12-lead ECG in ST-elevation myocardial infarction detection. Conclusions: Wearable ECG devices demonstrate high diagnostic performance for AF and ST-segment abnormalities, especially in supervised environments. However, inconclusive recordings and algorithm limitations remain barriers to widespread clinical use. Real-world validation and algorithm refinement are needed for broader adoption.

Background: Venous blood collection in pediatric patients is a critical procedure for diagnostic and monitoring purposes, yet it remains considerably more challenging than in adults. Factors such as small vein size, limited cooperation, and heightened sensitivity to pain contribute to technical difficulties and increased error rates. Objectives: This mini-review aims to provide a concise synthesis of current clinical practices and emerging technologies that support safer, more efficient venipuncture in children. Results: Key findings include the anatomical and procedural considerations relevant to pediatric venipuncture, age-specific recommendations for technique and positioning, as well as evidence-based strategies to reduce pain and anxiety. Common preanalytical errors, particularly hemolysis and insufficient sample volumes, are also addressed, along with their implications for clinical outcomes. Recent advances in medical digitalization, including the use of venous ultrasound, near-infrared projection, and transillumination, offer valuable support in overcoming procedural challenges. These technologies are not meant to replace human expertise but to complement it, improving vein visualization and increasing first-attempt success rates when integrated into a child-centered approach. Conclusions: Venous blood collection in pediatric patients requires a delicate balance between technical proficiency and human-centered care. Emphasis is placed on the importance of a child-centered approach, combining technical skill with empathy and clear communication. Enhancing the quality and safety of venous sampling in children requires not only training and standardization, but also a deeper understanding of the psychological dimensions involved in pediatric care.

Diabetes mellitus is a chronic metabolic disorder with significant systemic effects, including oral health. Recent studies indicate a distinct correlation between type 1 and type 2 diabetes, as well as gestational diabetes, and a heightened occurrence of dental caries. This relationship is attributed to various factors, including hyperglycemia, elevated HbA1c levels, diminished salivary flow, and alterations in the oral microbiota. This review seeks to analyze the existing literature regarding the relationship between diabetes mellitus and the incidence of dental caries, clarifying the fundamental pathophysiological mechanisms and proposed preventive strategies.

Background and Objectives: Topical diclofenac is recommended over oral non-steroidal anti-inflammatory drugs (NSAIDs) for osteoarthritis, particularly in older adults and those with comorbidities, on the assumption that low systemic absorption limits renal effects. Whether this presumed safety extends to patients already at increased risk of kidney injury has not been systematically evaluated. This review assessed the evidence on renal outcomes of topical diclofenac in adults. Materials and Methods: We conducted a systematic review (PROSPERO CRD420261393454) of studies reporting renal outcomes after topical diclofenac exposure. PubMed, Embase, Web of Science, and Scopus were searched from inception to 19 April 2026. Studies were stratified a priori into increased-renal-risk and general populations and synthesised separately, without pooling. Risk of bias was assessed with RoB 2, ROBINS-I, and JBI tools, certainty with GRADE, and synthesis followed the SWiM framework. Results: Eighteen studies, contributing data from more than 500,000 participants, were included; 14 underwent primary risk-of-bias appraisal (three at low, three at serious or high risk). In general populations, topical diclofenac produced little to no change in serum creatinine or creatinine clearance and smaller renal effects than oral diclofenac, providing high-certainty evidence of a favourable profile. In increased-renal-risk populations, one adjusted cohort reported higher acute kidney injury (AKI) risk among topical NSAID users, although exposure was predominantly to non-diclofenac agents; within the same cohort, topical NSAIDs carried lower risk than systemic NSAIDs. No study evaluated early renal injury biomarkers; certainty was moderate owing to indirectness. Conclusions: Relative to oral diclofenac, topical diclofenac shows a favourable renal safety profile, with high-certainty evidence in general populations. In adults at increased renal risk, moderate-certainty evidence derived from predominantly non-diclofenac exposure over short observation windows cannot exclude a modest excess of any-stage AKI; renal risk therefore appears reduced rather than absent. Diclofenac-specific studies in chronic kidney disease using sensitive biomarkers and longer follow-up are needed.

Background/Objectives: The Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT), and Reisberg Global Deterioration Scale (GDS) are used together in primary care. This study describes their score distributions across operational severity strata in a Romanian cohort. Methods: We conducted a cross-sectional descriptive study of a selected cohort of 326 adults aged ≥50 years with suspected cognitive impairment in three family medicine practices in Iași. One unblinded clinician administered all instruments and assigned the strata by integrated clinical assessment of functional status, MMSE performance, and Reisberg GDS staging, with approximate reference bands for both scales. Scores and their positions relative to these bands were summarised descriptively. Results: The strata comprised 53 participants with mild, 247 with moderate, and 26 with severe cognitive impairment; 39.3% of participants were illiterate or had ≤4 years of schooling. Cohort medians (ranges) were 15 (0–25) for the MMSE, 4 (0–10) for the CDT, and 5 (1–7) for the Reisberg GDS. In the mild and moderate strata, respectively, 30.2% and 30.0% of MMSE scores and 26.4% and 27.5% of Reisberg stages lay outside the approximate reference bands. Conclusions: Because MMSE and Reisberg information contributed to the classification, the assessor was not blinded, and the severe stratum was small, these descriptive results cannot establish diagnostic discrimination or comparative measurement performance.