Iuliana-Anamaria Trăilă

Background/Objectives: The optimal timing for orthodontic treatment in pediatric patients with malocclusion, particularly Class II discrepancies, remains a topic of ongoing clinical debate. Early treatment during the mixed dentition stage harnesses craniofacial growth potential, whereas later intervention may capitalize on pubertal growth for greater skeletal correction, especially for skeletal and airway improvements. This systematic review aimed to compare the outcomes of early versus late orthodontic treatment to assess their relative effectiveness. Methods: A systematic review was conducted in accordance with PRISMA guidelines, including randomized controlled trials and observational studies published between 2015 and 2025. Eleven studies comparing early and late treatment were analyzed, and the risk of bias was evaluated using standardized assessment tools. Results: Of the eleven studies, eight reported statistically significant improvements favoring early orthodontic intervention. Early treatment was associated with greater enhancement of maxillary and mandibular arch development, improved jaw relationships, and expanded airway dimensions. Studies utilizing headgear or other growth-modifying appliances also showed more favorable eruption patterns and alignment, underscoring the clinical relevance of early-phase management. Conclusions: Early orthodontic treatment can provide meaningful benefits in guiding skeletal growth, improving dental arch form, and enhancing treatment efficiency. These benefits were most consistently supported in skeletal and airway outcome domains. While late treatment may be suitable for some cases, personalized planning remains essential. Further large-scale, standardized longitudinal studies are needed to refine treatment-timing protocols in pediatric orthodontics.

Background and Objectives: Multiple primary malignancies involving endometrial carcinoma (EC) present complex diagnostic and management challenges. This study aimed to identify clinical, pathological, and demographic patterns among patients with EC and a second primary tumor and assess the role of comorbidities in tumor behavior. Materials and Methods: We retrospectively analyzed 35 women diagnosed with EC and a second malignancy between 2017 and 2024. We evaluated clinical variables, tumor characteristics, and comorbidities. Statistical analysis included chi-square tests, Mann–Whitney U tests, Kruskal–Wallis tests, Spearman correlations, and logistic regression. Multiple testing correction was applied using the Benjamini–Hochberg method. Results: Endometrioid EC was the most prevalent subtype (80%), most frequently associated with breast (28.5%) and colorectal cancers (11.4%). Obesity (45.7%), hypertension (62.9%), and diabetes (22.9%) were common. While univariate analysis suggested associations between comorbidities and tumor features (e.g., obesity and tumor type, ρ = 0.30, p = 0.08), no correlation remained significant after adjustment. Logistic regression identified age (OR = 0.88, CI: 0.79–0.98, p = 0.022) and obesity (OR = 0.11, CI: 0.01–0.83, p = 0.033) as independent predictors of non-endometrioid histology. Conclusions: These findings suggest that age and obesity may influence histological differentiation in EC with multiple primaries. This study suggest that age and obesity may play a role in the histological differentiation of EC in patients with multiple primary tumors. The small cohort size (n = 35) limits the statistical power and generalizability of the results; therefore, they should be regarded as exploratory and hypothesis-generating, warranting validation in larger prospective studies.

Background/Objectives: Psychotic disorders with childhood or adolescent onset pose major therapeutic challenges due to their complex etiology and variable treatment response. While pharmacogenetics and neuroimaging biomarkers have independently shown potential for guiding therapy, their combined utility remains underexplored. This study aimed to investigate whether integrating CYP2D6 pharmacogenetic profiles with structural neuroimaging findings can enhance personalized treatment and predict clinical outcomes in pediatric psychotic disorders. Methods: This prospective observational study included 63 children and adolescents (10–18 years) with DSM-5 diagnosed psychotic disorders. All patients underwent baseline MRI and standardized clinical assessments (PANSS, CGI, GAF). CYP2D6 genotyping was performed in 31 patients (49.2%), categorizing them as extensive (EMs) or intermediate metabolizers (IMs). Patients were treated with atypical antipsychotics and followed for 18 months. Outcomes included symptom severity, global functioning, and side-effect profiles. Results: EM patients demonstrated superior clinical improvement, as evidenced by a reduction in PANSS scores (from 118 to 40) and a corresponding increase in GAF scores (from 39 to 76), compared to the IM and non-tested groups. IM patients exhibited a higher prevalence of MRI abnormalities and slower response. Significant correlations emerged between CYP2D6 genotype, MRI findings, and treatment outcomes (p < 0.001). Combined biomarker profiles enhanced the prediction of therapeutic response and tolerability. Conclusions: Integrating CYP2D6 pharmacogenetic data with neuroimaging biomarkers provides valuable guidance for personalizing antipsychotic treatment in pediatric psychosis. This approach improves clinical outcomes and reduces adverse effects. Future research should further explore the integration of multimodal biomarkers in larger, longitudinal cohorts to optimize individualized psychiatric care for this vulnerable population.

The present study aimed to adapt and validate the Adult Hope Scale (AHS) for the Romanian population, addressing a gap in culturally appropriate instruments for measuring dispositional hope. Based on Snyder’s theoretical model, the AHS was translated, culturally adapted, and administered to 663 Romanian adults. Psychometric evaluation included internal consistency (Cronbach’s α = 0.84 for the eight positively worded items), test–retest reliability (ICC = 0.39 for the full scale), exploratory and confirmatory factor analyses, and assessments of convergent and discriminant validity. The two-factor model of the scale (agency and pathways) was confirmed, with significant item loadings and a strong correlation between the two latent factors (r = 0.717). Convergent validity was supported by moderate correlations with the Brief Resilience Scale (r = 0.36–0.45), while discriminant validity was indicated by low correlations with the Trait Anxiety Inventory (r = 0.18–0.20). Demographic analyses revealed higher hope levels in women and engineers, with significant differences by gender (p = 0.00018), education (p = 0.031), and profession (p = 0.008). Despite moderate temporal stability and one weakly performing item, the Romanian AHS demonstrates strong psychometric properties, making it a valid and reliable tool for assessing hope in research and clinical settings.