Vasile Goldiș Western University of Arad

Obesity and depression in childhood and adolescence represent major public health concerns, yet the nature and direction of their association remain incompletely understood. In the present study, we conducted a systematic review and stratified meta-analysis of epidemiological studies examining the relationship between obesity and depression in youth populations. A total of 945 records were identified through database searches, of which 18 studies met the inclusion criteria for the review. To ensure greater conceptual consistency, quantitative synthesis was restricted to studies examining categorical obesity (typically defined as body mass index (BMI) ≥ 95th percentile) and binary depression outcomes, which formed the longitudinal and cross-sectional meta-analytic cores, analyzed separately. Our longitudinal meta-analysis (k = 4; N = 5581) indicated that obesity was associated with an increased likelihood of subsequent depression (OR = 2.05, 95% CI: 1.40-2.99), whereas the cross-sectional meta-analysis (k = 6; N = 20,278) showed a weaker and non-significant association (OR = 1.40, 95% CI: 0.98-2.00) with moderate heterogeneity. Additional studies that could not be pooled due to differences in exposure or outcome definitions were integrated through narrative synthesis and showed mixed and generally less consistent patterns, broadly supporting the distinction between longitudinal and cross-sectional evidence. Overall, our findings suggest that obesity during childhood and adolescence is associated with an increased likelihood of subsequent depression, while concurrent associations appear more heterogeneous and more difficult to interpret. By distinguishing between study designs and prioritizing comparable effect estimates, this study provides a more transparent synthesis of the current evidence on the relationship between obesity and depression in youth.

Background: Gastric cancer (GC) remains a global health challenge, with high mortality rates often linked to late-stage diagnosis. Novel, non-invasive biomarkers are urgently needed to improve the detection and prognosis of this malignant pathology. This study aimed to evaluate the diagnostic and prognostic utility of serum Cluster of Differentiation 276 (CD276) and Dickkopf Related Protein 3 (DKK3) in patients with GC. Methods: In this case-control study, serum levels of CD276 and DKK3 were quantified in 40 GC patients and 40 age-matched healthy controls. The diagnostic performance of each marker and their combination was assessed using Receiver Operating Characteristic (ROC) curve analysis. Correlations between biomarker levels and clinicopathological features were evaluated using Spearman's correlation. The Kaplan-Meier method and the Cox Proportional Hazards Regression Model were used to assess survival. Results: Serum CD276 levels were found to be significantly elevated in GC patients compared to healthy controls (median 60.06 vs. 18.71 units, p < 0.001). Conversely, serum DKK3 levels were significantly suppressed in the GC group (median 92.47 vs. 121.02 units, p < 0.001). In ROC analysis, CD276 demonstrated excellent diagnostic accuracy as a standalone biomarker (AUC: 0.836). DKK3 showed independent diagnostic value (AUC: 0.792), but adding DKK3 to CD276 did not provide statistically significant incremental benefit (DeLong's p = 0.443). Survival analysis was underpowered due to limited events and short follow-up duration. Conclusions: In patients with predominantly locally advanced gastric cancer, CD276 can be a primary diagnostic marker, and the addition of DKK3 does not demonstrate a statistically significant improvement but may provide complementary information. Performance in early-stage disease requires validation in future studies. The opposing dysregulation of these markers, reflecting immune checkpoint activation (CD276) and tumor suppressor loss (DKK3), provides a robust and synergistic noninvasive signature. To assess the prognostic value of these two markers, studies involving a larger number of patients and a longer follow-up period are needed.

Background/Objectives: Psychiatric inpatient care varies substantially in its clinical goals, resource demands, and financial implications. Acute units focus on short-term crisis stabilization, whereas chronic units provide prolonged supervision for patients with persistent functional impairment. Limited evidence exists from Eastern Europe on how these differing service models impact both hospital costs and clinical outcomes such as early rehospitalization. This study aimed to compare the economic and operational performance of Acute versus Chronic Psychiatry and to identify predictors of 30-day readmission following acute psychiatric hospitalization. Methods: This retrospective observational study analyzed routinely collected data from a Romanian public hospital. All adult admissions to Acute and Chronic Psychiatry recorded between 1 January 2024 and 31 December 2024 were included. Standardized financial indicators were derived from administrative data, while clinical variables and readmission outcomes were extracted from electronic medical records. Between-group comparisons of economic and operational indicators were performed using t-tests. Multivariable logistic regression was used to determine independent predictors of 30-day readmission in Acute Psychiatry, reporting adjusted odds ratios (aOR) with 95% confidence intervals (CI). Model performance was evaluated with area under the curve (AUC), Hosmer-Lemeshow tests, and Nagelkerke R-2. Results: Acute Psychiatry demonstrated significantly higher mean cost per bed-day (798.76 vs. 373.75 lei; p < 0.001), but a lower mean cost per patient due to shorter hospitalization (10.17 vs. 53.32 days). A total of 188 acute patients (13.7%) were readmitted within 30 days. No early readmissions occurred in Chronic Psychiatry, consistent with its long-stay care model. Independent predictors of readmission included psychotic disorder diagnosis (aOR = 1.62, 95% CI: 1.18-2.23), multiple prior admissions (aOR = 1.35, 95% CI: 1.18-1.54), shorter length of stay (LOS) (aOR = 0.88 per 5-day increase, p = 0.006), and absence of a post-discharge plan (aOR = 0.54, 95% CI: 0.39-0.76). Model discrimination was acceptable (AUC = 0.74). Conclusions: Acute and chronic psychiatric services differ markedly in cost structures and care pathways. Early rehospitalization is a clinically relevant outcome within acute psychiatric care and is influenced by both patient-level and continuity-of-care factors. Enhancing discharge coordination, expanding continuity-of-care strategies, and optimizing resource allocation toward community-based support may reduce early rehospitalizations while improving hospital cost-efficiency.

Axial torsion with subsequent gangrene of Meckel’s diverticulum represents an exceptionally rare cause of small bowel obstruction, one of the rarest causes of small bowel obstruction. Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract, and it is often discovered incidentally during abdominal surgery, particularly in pediatric patients. Approximately 4% of individuals with Meckel’s diverticulum develop complications, including bleeding, obstruction, inflammation, intussusception, or perforation, with torsion being the rarest. Despite its rarity, symptomatic Meckel’s diverticulum poses serious diagnostic and therapeutic challenges due to its nonspecific clinical presentation, which may mimic other intra-abdominal pathologies. Consequently, preoperative diagnosis is difficult, and delayed management may lead to life-threatening complications. We report a case of axial gangrenous torsion of a giant Meckel’s diverticulum in a child without a history of previous abdominal surgery. In such cases, prompt decision-making for exploratory laparotomy or laparoscopy is crucial to achieving a favorable outcome. We report a case of axial torsion with gangrene of a giant Meckel’s diverticulum in a 7-year-old boy with no prior history of abdominal surgery. This case highlights the importance of early recognition and timely operative management in atypical presentations of acute abdomen in children.

Context: The increasing incidence of secondary caries and the failure of restorations have intensified research into dental restorative materials capable of actively interacting with the oral environment. In this context, antibacterial and bioregenerative nanomaterials have attracted growing scientific interest due to their potential to inhibit biofilm formation while simultaneously supporting mineral repair processes. Objective: This narrative review analyzes recent developments in nanostructured materials for restorative dentistry and oral health applications, with particular emphasis on antibacterial agents, bioactive systems, and emerging dual-function approaches that integrate multiple biological functions into restorative materials. Scope of the Review: The analyzed literature indicates that metallic nanoparticles, cationic monomers, and natural nanopolymers can reduce bacterial adhesion and metabolic activity under experimental conditions. In parallel, bioactive nanomaterials such as nanohydroxyapatite, bioactive glass, and calcium phosphate-based systems have demonstrated the ability to release remineralizing ions and to promote mineral deposition at the tooth–material interface. Dual-function hybrid materials aim to combine these antibacterial and bioregenerative effects within a single restorative system. Interpretative Perspective: Despite these advances, most available evidence derives from in vitro and preclinical studies, with significant heterogeneity across experimental models, evaluation methods, and outcome variables. This variability limits direct comparisons between studies and necessitates a cautious interpretation of claims regarding long-term antibacterial efficacy, functional tissue regeneration, and routine clinical applicability. Conclusions: Antibacterial and bioregenerative nanomaterials represent a relevant and continuously evolving research direction in restorative dentistry. Their successful clinical translation will depend on establishing standardized testing protocols, conducting comprehensive safety assessments, and generating clinically relevant evidence supporting long-term efficacy and biological compatibility. Their successful clinical translation will depend on establishing standardized testing protocols, conducting comprehensive safety assessments, and generating clinically relevant evidence supporting long-term efficacy and biological compatibility.